DataSheet_1_Comparison of the Oncological Efficacy Between Intraoperative Radiotherapy With Whole-Breast Irradiation for Early Breast Cancer: A Meta-Analysis.docx

BackgroundIntraoperative radiotherapy (IORT) and whole-breast irradiation (WBI) are both effective radiotherapeutic interventions for early breast cancer patients undergoing breast-conserving surgery; however, an issue on whether which one can entail the better prognosis is still controversial. Our study aimed to investigate the 5-year oncological efficacy of the IORT cohort and the WBI cohort, respectively, and compare the oncological efficacy between the cohorts.
Materials and MethodsWe conducted a computerized retrieval to identify English published articles between 2000 and 2021 in the PubMed, the Web of Science, the Cochrane Library, and APA PsycInfo databases. Screening, data extraction, and quality assessment were performed in duplicate.
ResultsA total of 38 studies were eligible, with 30,225 analyzed participants. A non-comparative binary meta-analysis was performed to calculate the weighted average 5-year local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) in the two cohorts, respectively. The LRFS, DMFS, and OS (without restriction on the 5-year outcomes) between the two cohorts were further investigated by a comparative binary meta-analysis. The weighted average 5-year LRFS, DMFS, and OS in the IORT cohort were 96.3, 96.6, and 94.1%, respectively, and in the WBI cohort were 98.0, 94.9, and 94.9%, respectively. Our pooled results indicated that the LRFS in the IORT cohort was significantly lower than that in the WBI cohort (pooled odds ratio [OR] = 2.36; 95% confidential interval [CI], 1.66–3.36). Nevertheless, the comparisons of DMFS (pooled OR = 1.00; 95% CI, 0.76–1.31), and OS (pooled OR = 0.95; 95% CI, 0.79–1.14) between the IORT cohort with the WBI cohort were both not statistically significant.
ConclusionsDespite the drastically high 5-year oncological efficacy in both cohorts, the LRFS in the IORT cohort is significantly poorer than that in the WBI cohort, and DMFS and OS do not differ between cohorts.

背景：术中放疗（Intraoperative radiotherapy, IORT）与全乳放疗（Whole-breast irradiation, WBI）均为接受保乳手术的早期乳腺癌患者的有效放射治疗干预手段，但二者何者可带来更优预后仍存在争议。本研究旨在分别探究术中放疗队列与全乳放疗队列的5年肿瘤学疗效，并比较两队列间的肿瘤学疗效差异。

材料与方法：本研究通过计算机检索，筛选2000年至2021年间发表于PubMed、Web of Science、Cochrane图书馆及APA PsycInfo数据库的英文文献。文献筛选、数据提取及质量评估均由两名研究者独立重复完成。

结果：最终共纳入38项符合标准的研究，涉及30225名分析对象。本研究首先开展非比较性二分类Meta分析，分别计算两个队列的加权平均5年局部复发无进展生存期（local recurrence-free survival, LRFS）、远处转移无进展生存期（distant metastasis-free survival, DMFS）及总生存期（overall survival, OS）。随后通过比较性二分类Meta分析，进一步对比两个队列的LRFS、DMFS及OS（不对5年结局设置限制）。术中放疗队列的加权平均5年LRFS、DMFS及OS分别为96.3%、96.6%及94.1%，全乳放疗队列则分别为98.0%、94.9%及94.9%。合并分析结果显示，术中放疗队列的LRFS显著低于全乳放疗队列（合并比值比[odds ratio, OR]=2.36；95%置信区间[confidence interval, CI]=1.66~3.36）。不过，术中放疗队列与全乳放疗队列的DMFS（合并OR=1.00；95%CI=0.76~1.31）及OS（合并OR=0.95；95%CI=0.79~1.14）的对比均无统计学显著性差异。

结论：尽管两个队列的5年肿瘤学疗效均处于较高水平，但术中放疗队列的LRFS显著劣于全乳放疗队列，而DMFS与OS在两队列间无显著差异。