Meta-analysis of deep inspiration breath hold (DIBH) versus free breathing (FB) in postoperative radiotherapy for left-side breast cancer
Meta-analysis of deep inspiration breath hold (DIBH) versus free breathing (FB) in postoperative radiotherapy for left-side breast cancer
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DOI：
10.1007/s12282-019-01023-9
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发表时间：
2019-11-09
期刊：
影响因子：
4
通讯作者：
Long, Xin
中科院分区：
文献类型：
--
作者：
Lai, Junming;Hu, Shuang;Long, Xin
目的评价左乳腺癌术后放疗患者深吸气屏气（DIBH）与自由呼吸（FB）的差异，为临床实践提供参考。方法计算机检索PubMed、Science Direct、科克伦图书馆、Web of Science数据库中DIBH与FB在左侧乳腺癌术后放疗中的相关对照试验。关注的主要结果是心脏剂量、左前降支冠状动脉（LADCA）剂量、左肺剂量和靶区覆盖。我们计算了汇总标准化平均差（SMD）和95%置信区间（CI）。采用RevMan 5.3软件进行Meta分析。结果共纳入12个观察性研究的1019例患者，其中DIBH组576例，FB组443例。与FB组相比，DIBH组可更有效地降低心脏剂量、左前降支冠状动脉（LADCA）剂量和左肺剂量，差异有统计学意义（心脏剂量，SMD =-1.36，95%CI- 1.64相似-1.09，P < 0.01）。LADCA剂量，SMD =-1.45，95%CI- 1.62与- 1.27相似，P < 0.01。左肺剂量，SMD =-0.52，95% CI - 0.81与- 0.23相似，P < 0.01）。两组靶区覆盖率无显著差异（SMD = 0.03，95%CI- 0.11与0.18相似，P = 0.64）。结论在左侧乳腺癌术后放疗中实施DIBH可以减少心脏剂量、LADCA剂量和左肺剂量，而不影响靶区覆盖。
Objectives This meta-analysis evaluates the difference in deep inspiration breath hold (DIBH) versus free breathing (FB) for patients receiving postoperative radiotherapy for left breast cancer and provides a useful reference for clinical practice. Methods The relevant controlled trials of DIBH versus FB in postoperative radiotherapy for left-side breast cancer were retrieved from the databases of PubMed, Science Direct, Cochrane Library, and Web of Science databases. The principal outcome of interest was heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose and target coverage. We calculated summary standardized mean difference (SMD) and 95% confidence intervals (CI). The meta-analysis was performed using RevMan 5.3 software. Results The analysis included 1019 patients from 12 observational studies, of which 576 cases were in the DIBH group and 443 cases in the FB group. Compared with the FB group, the DIBH group can have lower heart dose, left anterior descending coronary artery (LADCA) dose, and left lung dose more effectively, and the difference was statistically significant (heart dose, SMD = - 1.36, 95% CI - 1.64 similar to - 1.09, P < 0.01. LADCA dose, SMD = - 1.45, 95% CI - 1.62 similar to - 1.27, P < 0.01. Left lung dose, SMD = - 0.52, 95% CI - 0.81 similar to - 0.23, P < 0.01). There was no significant difference in target coverage between the two groups (SMD = 0.03, 95% CI - 0.11 similar to 0.18, P = 0.64). Conclusion By this meta-analysis, we found that implementation of DIBH in postoperative radiotherapy for left-side breast cancer can reduce irradiation of heart dose, LADCA dose and left lung dose, without compromising target coverage.