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目的评价术后放疗对伴有1~3个淋巴结转移的乳腺癌根治术患者的局部控制率和远期生存率的影响。方法通过对PubMed数据库、EBM Reviews-Cochrane中心注册的对照试验、Embase数据库、ICTRP平台、中国生物医学文献数据库(CBM)、中国知识资源总库(CNKI)、中文科技期刊数据库(VIP)和中国肿瘤数据库进行检索数据库进行检索,检索日期截止至2015年12月31日,纳入所有关于伴1~3个淋巴结转移的乳腺癌患者的术后放疗的随机对照试验。使用Revman5.3软件进行meta分析。结果共纳入4个随机对照试验,1 254例患者。4个试验质量好。对于随访10~20年的结果进行分析。结果显示:局部复发率的风险比(hazard ratio,HR)值为0.23,95%置信区间(95%CI)为(0.15,0.37),P<0.000 01,存在异质性(P=0.09,I~2=59%)。总生存率的HR值为0.82,95%CI为(0.71,0.93),P=0.002,无异质性(P=0.65,I~2=0%)。无远处转移生存率的HR值为0.71,95%CI为(0.56,0.90),P=0.005,无异质性(P=0.63,I~2=0%)。无病生存率的HR值为0.74,95%CI为(0.66,0.85),P<0.000 01,无异质性(P=0.49,I~2=0%)。结论术后放疗可以降低1~3个淋巴结转移乳腺癌患者的局部复发率,提高远期生存率。
Objective To evaluate the effect of postoperative radiotherapy on the local control rate and long-term survival rate of patients with breast cancer with one to three lymph node metastases. Methods According to the PubMed database, EBM Reviews-Cochrane Central Register of Controlled Trials, Embase database, ICTRP platform, CBM, CNKI, VIP and Chinese tumor The database was searched by a search database and searched by December 31, 2015. All randomized controlled trials of postoperative radiotherapy for breast cancer patients with 1 to 3 lymph node metastases were included. Use Revman 5.3 software for meta-analysis. Results A total of 4 randomized controlled trials were included, with 1 254 patients. 4 tests of good quality. Follow-up of 10 to 20 years of the results were analyzed. The results showed that the hazard ratio (HR) of local recurrence rate was 0.23, 95% confidence interval (95% CI) was (0.15,0.37), P <0.000 01, and there was heterogeneity (P = 0.09, ~ 2 = 59%). The overall survival rate of HR was 0.82, 95% CI was (0.71,0.93), P = 0.002, no heterogeneity (P = 0.65, I ~ 2 = 0%). No distant metastasis survival rate of HR 0.71, 95% CI (0.56,0.90), P = 0.005, no heterogeneity (P = 0.63, I ~ 2 = 0%). The HR of disease-free survival was 0.74, and the 95% CI was (0.66, 0.85), P <0.000 01, with no heterogeneity (P = 0.49, I ~ 2 = 0%). Conclusion Postoperative radiotherapy can reduce the local recurrence rate of 1 ~ 3 lymph node metastatic breast cancer patients and improve the long-term survival rate.