Adjuvant RT linked to higher rate of locoregional complications in meta-analysis

  • Kanda MH & al.
  • J Surg Oncol
  • 26 Dec 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Compared with surgery alone, adjuvant radiotherapy (RT) plus surgery for breast cancer treatment is associated with higher rates of late locoregional complications, including lymphedema, capsular contracture, and lower mobility of upper limb.

Why this matters

  • The increased risk for late locoregional complications must be weighed against the benefits of RT, such as a decrease in locoregional recurrence and better survival.
  • This is the first meta-analysis of its kind.

Study design

  • A meta-analysis of 10 cohort studies (n>1700) comparing late complications (at 1-year postsurgery) of adjuvant RT+surgery vs surgery alone after the search of PubMed, EMBASE, and SCOPUS.
  • Funding: None disclosed.

Key results

  • Higher rates of lymphedema (RT+surgery vs surgery) in 1 of the 2 models:
    • Risk ratio (RR), 2.41 (95% CI, 0.97-5.97; random-effects model; borderline significance).
    • RR, 1.69 (95% CI, 1.36-2.1; fixed-effects model).
  • Higher rates of capsular contracture (RT+surgery vs surgery) in both models:
    • RR, 3.62 (95% CI, 1.79-7.31; random-effects model).
    • RR, 3.82 (95% CI, 2.53-5.79; fixed-effects model).
  • Higher rates of limited mobility in the upper limb (RT+surgery vs surgery) in both models:
    • RR, 3 (95% CI, 1.49-6.06; random-effects model).
    • RR, 2.88 (95% CI, 1.82-4.56; fixed-effects model).

Limitations

  • Observational design of original studies.
  • Small number of studies.