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Table 1 Baseline characteristics and dose fraction of 3871 patients in 25 studies with breast cancer after mastectomy

From: Comparing hypofractionated to conventional fractionated radiotherapy in postmastectomy breast cancer: a meta-analysis and systematic review

Study (year published)Sample sizeAge (years)Clinical stageInterventions (Gy/fractions)OutcomesNOSThe type of RT techniqueRT area and prescriptive method usedBolusBreast reconstruction
HFRTCFRTHFRTCFRT
Wang (2019) [12]40140924~74II~III43.5/1550/25OS, DFS, LRR, Toxicities92DRT, 3DCRT, or IMRTCW: a single appositional field with 6–9 MeV electron beam, depending on CW thickness
SPC: anteroposterior field using a 6 MV photon, combined 6 MV photon, and 9–15 MeV electron or a 10~12 MeV electron beam
5 mm bolus to CWNone
Abhilash (2016) [14]303025~67II~III39/1350/25LRR, Toxicities62DRTCW: bilateral tangent pair fields
SPC: a direct anterior field
Cobalt 60 teletherapy machine with gamma energy 1.25 MeV
NRNone
Bi (2011) [15]514928~64II~III43.5/1550/25OS, LRR, Toxicities62DRTCW: a 6~12 MeV electron beam
SPC: 12 MeV electron and 6 MV X-ray beams mixed
5 mm bolus to CWNone
Bedi (2018) [16]303039~61II~III42.5/1650/25Toxicities53DCRTCW: two tangential fields using 6 MV X-ray beam
SPC: a direct anterior field with 6 MV photon beam
Universal bolus to CWNone
Das (2018) [17]555348/50 aI~III42.56/1650/25DFS, LRR, DM, Toxicities62DRTCW: medial and lateral tangential fields
SPC: anteroposterior field
Cobalt 60 teletherapy machine
NRNone
Eldeeb (2012) [18]664125~67I~III45/17、40/1550/25LRR, Toxicities72DRTCW: two tangential fields
SPC and Axillary: an anterior field
6 MV photon linear accelerator or Cobalt 60 machine
NRNone
El-Sayed (2012) [19]1598430~69II~III42.5/16、39/1350/25OS, DFS, LRR, Toxicities72DRTCW: medial and lateral tangential fields using 6 MV photon beam
SPC: anteroposterior field using 6 MV photon beam
NRNone
Elsayed (2014) [20]252233~70II~III42.72/1650/25OS, DFS, Toxicities82DRTCW and Axillary: two tangential fields using 6 MV photon beam
SPC: a direct anterior field using 6 MV photon beam
NRNone
Fatma (2018) [21]505031~68II~III40/1550/25DFS, LRR, Toxicities73DCRTCW: two tangential fields using 6 MV or 15 MV photon beam
SPC: an anterior field using 6 MV or 15 MV photon beam
NRNone
He (2016) [22]486325~57I~II40/1550/25Toxicities63DCRTCW and SPC: 6 MV photon beamNRNone
Huang (2013) [23]707025~65II~III43.5/1548.5/22LRR6NRRT area: CW and SPCNRNone
Jin (2013) [24]16413623~75NR45/1550/25OS, DM, LRR, Toxicities6NRRT area: CW, SPC, Axillary, Axillary dome or internal mammary lymph node region if necessaryNRNone
Kalita (2018) [25]252527~70II~III40/1550/25Toxicities52DRT,CW: two parallel opposed tangential fields
SPC and Axillary: a separate direct anterior field
All fields using 6 MV photon beam
NRNone
Kouloulias (2016) [26]873033~78II~III48.3/21、42.56/1650/25Toxicities73DCRTCW and SPC using 6 MV photon beamNRNone
Kumbhaj (2013) [27]464531~70I~III40/1750/25DFS, LRR, DM, Toxicities62DRT,CW: tangent pair technique by using Cobalt 60 machine;
SPC: NR
NRNone
Pinitpatcharalert (2011) [28]1486744~56I~III42.72/1650/25OS, DFS, Toxicities82DRTCW: medial and lateral tangential chest wall fields
SPC: anteroposterior ipsilateral supraclavicular field
Axillary boost: clinical N2 disease, inadequate node excision (less than 10 nodes), or perinodal invasion
CW and SPC field were treated with cobalt 60
5 mm bolus to CWNone
Purohit (2016) [29]252518~65II~III40/1550/25Toxicities62DRTCW: medial tangential and lateral tangential fields
SPC: anteroposterior field
two field technique by using Cobalt 60 energy source
NRNone
Rastogi (2018) [30]505021~79II~III42.72/1650/25DFS, LRR, DM73DCRTCW and SPC: single beam energy, or a combination of both 6 and 15 MV photon beam was used depending on patients’ anatomy None
Wang (2010) [31]313032~71NR41.6/1350/25OS, Toxicities52DRTCW and SPC: 12 MeV electron and 6 MV X-ray beams mixed, two parallel opposed tangential fieldsNRNone
Wu (2003) [32]17714926~74I~III45/1550/25OS, LRR82DRT,SPC, Axillary and Axillary dome: 8 MV X-ray, and the 20 Gy SPC was added with 1.5 cm bolus
Internal mammary: 14 MeV electron beam or mixed with 8 MV X-ray;
CW: tangent to 8 MV X-ray or 6–8 MeV electron beam
1.5 cm bolus to SPCNone
Wu (2014) [33]535331~68II~IV b42/1550/25NR63DCRTRT area: CW and SPCNRNone
Yu (2011) [34]17517121~76II~III45/1550/25NR72DRTSPC and Axillary: 4 MV X-ray by single anterior field, and the 20 Gy of total dose was added with 5 mm bolus
CW and internal mammary: 8 MV X-ray two parallel opposed tangential fields
all beams supplemented by 100–200 KV X-ray
5 mm bolus to SPC and AxillaryNR
Zhang (2015) [35]363024~68II~III43.5/1550/25Toxicities53DCRTIrradiation target area: CW and SPCNRNone
Zhao (2014) [36]414418~70II~III42.56/1650/25LRR, DM, Toxicities63DCRTCW and SPC: two parallel opposed tangential fields by using 6 MV X-ray beamNRNone
Zhao (2016) [37]373537~59II~III42.56/1650/25OS, LRR, DM, Toxicities73DCRTRT area: CW, SPC and Axillary, excluding the Internal mammary
6 MV X-ray beam
5 mm bolus to CWNone
  1. OS overall survival, LRR locoregional recurrence, DFS disease-free survival, DM distant metastasis, HFRT hypofractionated radiotherapy, CFRT conventional fractionated radiotherapy, RT radiotherapy, NOS Newcastle-Ottawa Scale, 2DRT two-dimensional radiotherapy, 3DCRT three-dimensional conformal radiotherapy, IMRT intensity-modulated radiotherapy, NR not reported, CW chest wall, SPC supraclavicular
  2. aMean age in HFRT group and CFRT group
  3. bOnly one stage IV case in the HFRT group