The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-Analysis
Background. Intraoperative radiotherapy (IORT) is a novel promising technology that may replace external beam radiation therapy (EBRT) as boost for patients receiving breast-conserving surgery. To better evaluate the efficacy of IORT using low-kilovoltage (low-kV) X-rays as boost, we presented this...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi-Wiley
2023-01-01
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| Series: | The Breast Journal |
| Online Access: | http://dx.doi.org/10.1155/2023/9035266 |
| _version_ | 1797783592314601472 |
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| author | Yuanjian Fan Ruiwan Chen Ying Lu Ying Lin Yunjian Zhang Nan Shao Shenming Wang Dahong Nie Zhen Shan |
| author_facet | Yuanjian Fan Ruiwan Chen Ying Lu Ying Lin Yunjian Zhang Nan Shao Shenming Wang Dahong Nie Zhen Shan |
| author_sort | Yuanjian Fan |
| collection | DOAJ |
| description | Background. Intraoperative radiotherapy (IORT) is a novel promising technology that may replace external beam radiation therapy (EBRT) as boost for patients receiving breast-conserving surgery. To better evaluate the efficacy of IORT using low-kilovoltage (low-kV) X-rays as boost, we presented this meta-analysis according to the PRISMA checklist. Methods. Studies reported survival outcomes of intraoperative radiation using low-kilovoltage X-rays system (Intrabeam®, Carl Zeiss Meditec, Dublin, CA, USA) as boost were identified through electronic bibliographic database: PUBMED. The meta-analysis module in Stata (16.0) is used to pool the studies. A Poisson regression model is used to predict a 5-year local recurrence rate. Results. Twelve studies including 3006 cases were included in the final analysis, with a median follow-up of 55 months weighted by sample size. The pooled local recurrence rate is 0.39% per person-year (95% CI: 0.15%–0.71%), with a low degree of heterogeneity (I2 = 0%). The predicted 5-year local recurrence rate was 3.45%. No difference in pooled local recurrence rate was found between non-neoadjuvant patients studies and neoadjuvant patients studies (0.41% per person-year vs. 0.58% per person-year, P=0.580). Conclusions. This study shows that low-kV IORT is an effective method as boost in breast cancer patients, with a low pooled local recurrence rate and low predicted 5-year local recurrence rate. Besides, no difference in the local recurrence rate was found between non-neoadjuvant patients studies and neoadjuvant patients studies. Low-kV IORT boost may be a promising alternative to EBRT boost in the future, which is being tested in the ongoing TARGIT-B trial. |
| first_indexed | 2024-03-13T00:28:04Z |
| format | Article |
| id | doaj.art-667dcf12a9654a438827308ae62446b8 |
| institution | Directory Open Access Journal |
| issn | 1524-4741 |
| language | English |
| last_indexed | 2024-03-13T00:28:04Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi-Wiley |
| record_format | Article |
| series | The Breast Journal |
| spelling | doaj.art-667dcf12a9654a438827308ae62446b82023-07-11T00:00:02ZengHindawi-WileyThe Breast Journal1524-47412023-01-01202310.1155/2023/9035266The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-AnalysisYuanjian Fan0Ruiwan Chen1Ying Lu2Ying Lin3Yunjian Zhang4Nan Shao5Shenming Wang6Dahong Nie7Zhen Shan8Center of Vascular-Thyroid-Breast SurgeryDepartment of RadiologyDepartment of UltrasoundCenter of Vascular-Thyroid-Breast SurgeryCenter of Vascular-Thyroid-Breast SurgeryCenter of Vascular-Thyroid-Breast SurgeryCenter of Vascular-Thyroid-Breast SurgeryDepartment of RadiologyCenter of Vascular-Thyroid-Breast SurgeryBackground. Intraoperative radiotherapy (IORT) is a novel promising technology that may replace external beam radiation therapy (EBRT) as boost for patients receiving breast-conserving surgery. To better evaluate the efficacy of IORT using low-kilovoltage (low-kV) X-rays as boost, we presented this meta-analysis according to the PRISMA checklist. Methods. Studies reported survival outcomes of intraoperative radiation using low-kilovoltage X-rays system (Intrabeam®, Carl Zeiss Meditec, Dublin, CA, USA) as boost were identified through electronic bibliographic database: PUBMED. The meta-analysis module in Stata (16.0) is used to pool the studies. A Poisson regression model is used to predict a 5-year local recurrence rate. Results. Twelve studies including 3006 cases were included in the final analysis, with a median follow-up of 55 months weighted by sample size. The pooled local recurrence rate is 0.39% per person-year (95% CI: 0.15%–0.71%), with a low degree of heterogeneity (I2 = 0%). The predicted 5-year local recurrence rate was 3.45%. No difference in pooled local recurrence rate was found between non-neoadjuvant patients studies and neoadjuvant patients studies (0.41% per person-year vs. 0.58% per person-year, P=0.580). Conclusions. This study shows that low-kV IORT is an effective method as boost in breast cancer patients, with a low pooled local recurrence rate and low predicted 5-year local recurrence rate. Besides, no difference in the local recurrence rate was found between non-neoadjuvant patients studies and neoadjuvant patients studies. Low-kV IORT boost may be a promising alternative to EBRT boost in the future, which is being tested in the ongoing TARGIT-B trial.http://dx.doi.org/10.1155/2023/9035266 |
| spellingShingle | Yuanjian Fan Ruiwan Chen Ying Lu Ying Lin Yunjian Zhang Nan Shao Shenming Wang Dahong Nie Zhen Shan The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-Analysis The Breast Journal |
| title | The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-Analysis |
| title_full | The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr | The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-Analysis |
| title_short | The Efficacy of Low-Kilovoltage X-Rays Intraoperative Radiation as Boost for Breast Cancer: A Systematic Review and Meta-Analysis |
| title_sort | efficacy of low kilovoltage x rays intraoperative radiation as boost for breast cancer a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2023/9035266 |
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