Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Sep 18:11:e15949.
doi: 10.7717/peerj.15949. eCollection 2023.

Comparative efficacy of intraoperative radiotherapy and external boost irradiation in early-stage breast cancer: a systematic review and meta-analysis

Jiaxin Liu #  1 , Xiaowei Shi #  1 , Zhenbo Niu  2 , Cheng Qian  2
Affiliations
Meta-Analysis

Comparative efficacy of intraoperative radiotherapy and external boost irradiation in early-stage breast cancer: a systematic review and meta-analysis

Jiaxin Liu et al. PeerJ. .

Abstract

External boost radiotherapy (EBRT) and intraoperative radiotherapy (IORT) are shown to be effective in patients with early-stage breast cancer. However, the difference between IORT and EBRT for patients' prognosis remains to be elucidated. The purpose of this meta-analysis is to investigate differences in local recurrence (LR), distant metastases, disease free survival (DFS), and overall survival (OS) between these two therapies. We searched the Cochrane Library, PubMed, Web of Science and Embase, from inception to Jan 10th, 2022. We used The Cochrane risk-of-bias assessment tool to assess the risk of bias of the included studies, and the STATA15.0 tool was used for the meta-analyses. Eight studies were ultimately included. Meta-analysis demonstrated that there was an inconsistent finding in the long-term risk of LR between the two radiotherapies, and there was no significant difference in short-term risk of LR, the metastasis rate, DFS, and OS IORT would be more convenient, less time-consuming, less costly, and more effective at reducing side effects and toxicity. However, these benefits must be balanced against the potential for increased risk of LR in the long term.

Keywords: Breast cancer; External irradiation therapy; Intraoperative radiation therapy; Meta-analysis; RCT.

PubMed Disclaimer

Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Flow diagram of the study selection process.
Figure 2
Figure 2. (A–C) Analysis of local recurrence.
Figure 3
Figure 3. (A–C) Analysis of distant metastasis.
Figure 4
Figure 4. (A–C) Analysis of the disease-free survival.
Figure 5
Figure 5. (A–C) Analysis of the overall survival.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Beddok A, Lahaye C, Calugaru V, De Marzi L, Fouillade C, Salvador S, Fontbonne JM, Favaudon V, Thariat J. A comprehensive analysis of the relationship between dose rate and biological effects in preclinical and clinical studies, from brachytherapy to flattening filter free radiation therapy and flash irradiation. International Journal of Radiation Oncology, Biology, Physics. 2022;113(5):985–995. doi: 10.1016/j.ijrobp.2022.02.009. - DOI - PubMed
    1. Ciabattoni A, Gregucci F, Fastner G, Cavuto S, Spera A, Drago S, Ziegler I, Mirri MA, Consorti R, Sedlmayer F. IOERT versus external beam electrons for boost radiotherapy in stage I/II breast cancer: 10-year results of a phase III randomized study. Breast Cancer Research. 2021;23(1):46. doi: 10.1186/s13058-021-01424-9. - DOI - PMC - PubMed
    1. Fertsch S, Munder B, Hagouan M, Schulz T, Thamm O, Stambera P, Abu-Ghazaleh A, Schaberick J, Andree C. Immediate-DElayed AutoLogous (IDEAL) breast reconstruction with the DIEP flap. Chirurgia. 2017;112(4):387–393. doi: 10.21614/chirurgia.112.4.387. - DOI - PubMed
    1. Hashemi S, Javadi S, Akbari ME, Mirzaei HR, Mahdavi SR. Outcomes of radical and boost dose of intraoperative radiotherapy with electron and low KV X-ray based on Islamic Republic intraoperative radiotherapy (IRIORT) consensus and the external beam radiotherapy in pure ductal carcinoma in situ (DCIS) in breast cancer patients. International Journal of Cancer Management. 2020;13(8):e105639. doi: 10.5812/ijcm.105639. - DOI
    1. Hashemi S, Javadi S, Akbari ME, Mirzaei H, Mahdavi SR. Comparison of IORT (Radical and Boost Dose) and EBRT in terms of disease-free survival and overall survival according to demographic, pathologic, and biological factors in patients with breast cancer. International Journal of Surgical Oncology. 2021;2021:2476527. - PMC - PubMed