Table 1 Baseline characteristics and dose fraction of 3871 patients in 25 studies with breast cancer after mastectomy
Study (year published) | Sample size | Age (years) | Clinical stage | Interventions (Gy/fractions) | Outcomes | NOS | The type of RT technique | RT area and prescriptive method used | Bolus | Breast reconstruction | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
HFRT | CFRT | HFRT | CFRT | |||||||||
Wang (2019) [12] | 401 | 409 | 24~74 | II~III | 43.5/15 | 50/25 | OS, DFS, LRR, Toxicities | 9 | 2DRT, 3DCRT, or IMRT | CW: 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 CW | None |
Abhilash (2016) [14] | 30 | 30 | 25~67 | II~III | 39/13 | 50/25 | LRR, Toxicities | 6 | 2DRT | CW: bilateral tangent pair fields SPC: a direct anterior field Cobalt 60 teletherapy machine with gamma energy 1.25 MeV | NR | None |
Bi (2011) [15] | 51 | 49 | 28~64 | II~III | 43.5/15 | 50/25 | OS, LRR, Toxicities | 6 | 2DRT | CW: a 6~12 MeV electron beam SPC: 12 MeV electron and 6 MV X-ray beams mixed | 5 mm bolus to CW | None |
Bedi (2018) [16] | 30 | 30 | 39~61 | II~III | 42.5/16 | 50/25 | Toxicities | 5 | 3DCRT | CW: two tangential fields using 6 MV X-ray beam SPC: a direct anterior field with 6 MV photon beam | Universal bolus to CW | None |
Das (2018) [17] | 55 | 53 | 48/50 a | I~III | 42.56/16 | 50/25 | DFS, LRR, DM, Toxicities | 6 | 2DRT | CW: medial and lateral tangential fields SPC: anteroposterior field Cobalt 60 teletherapy machine | NR | None |
Eldeeb (2012) [18] | 66 | 41 | 25~67 | I~III | 45/17、40/15 | 50/25 | LRR, Toxicities | 7 | 2DRT | CW: two tangential fields SPC and Axillary: an anterior field 6 MV photon linear accelerator or Cobalt 60 machine | NR | None |
El-Sayed (2012) [19] | 159 | 84 | 30~69 | II~III | 42.5/16、39/13 | 50/25 | OS, DFS, LRR, Toxicities | 7 | 2DRT | CW: medial and lateral tangential fields using 6 MV photon beam SPC: anteroposterior field using 6 MV photon beam | NR | None |
Elsayed (2014) [20] | 25 | 22 | 33~70 | II~III | 42.72/16 | 50/25 | OS, DFS, Toxicities | 8 | 2DRT | CW and Axillary: two tangential fields using 6 MV photon beam SPC: a direct anterior field using 6 MV photon beam | NR | None |
Fatma (2018) [21] | 50 | 50 | 31~68 | II~III | 40/15 | 50/25 | DFS, LRR, Toxicities | 7 | 3DCRT | CW: two tangential fields using 6 MV or 15 MV photon beam SPC: an anterior field using 6 MV or 15 MV photon beam | NR | None |
He (2016) [22] | 48 | 63 | 25~57 | I~II | 40/15 | 50/25 | Toxicities | 6 | 3DCRT | CW and SPC: 6 MV photon beam | NR | None |
Huang (2013) [23] | 70 | 70 | 25~65 | II~III | 43.5/15 | 48.5/22 | LRR | 6 | NR | RT area: CW and SPC | NR | None |
Jin (2013) [24] | 164 | 136 | 23~75 | NR | 45/15 | 50/25 | OS, DM, LRR, Toxicities | 6 | NR | RT area: CW, SPC, Axillary, Axillary dome or internal mammary lymph node region if necessary | NR | None |
Kalita (2018) [25] | 25 | 25 | 27~70 | II~III | 40/15 | 50/25 | Toxicities | 5 | 2DRT, | CW: two parallel opposed tangential fields SPC and Axillary: a separate direct anterior field All fields using 6 MV photon beam | NR | None |
Kouloulias (2016) [26] | 87 | 30 | 33~78 | II~III | 48.3/21、42.56/16 | 50/25 | Toxicities | 7 | 3DCRT | CW and SPC using 6 MV photon beam | NR | None |
Kumbhaj (2013) [27] | 46 | 45 | 31~70 | I~III | 40/17 | 50/25 | DFS, LRR, DM, Toxicities | 6 | 2DRT, | CW: tangent pair technique by using Cobalt 60 machine; SPC: NR | NR | None |
Pinitpatcharalert (2011) [28] | 148 | 67 | 44~56 | I~III | 42.72/16 | 50/25 | OS, DFS, Toxicities | 8 | 2DRT | CW: 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 CW | None |
Purohit (2016) [29] | 25 | 25 | 18~65 | II~III | 40/15 | 50/25 | Toxicities | 6 | 2DRT | CW: medial tangential and lateral tangential fields SPC: anteroposterior field two field technique by using Cobalt 60 energy source | NR | None |
Rastogi (2018) [30] | 50 | 50 | 21~79 | II~III | 42.72/16 | 50/25 | DFS, LRR, DM | 7 | 3DCRT | CW 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] | 31 | 30 | 32~71 | NR | 41.6/13 | 50/25 | OS, Toxicities | 5 | 2DRT | CW and SPC: 12 MeV electron and 6 MV X-ray beams mixed, two parallel opposed tangential fields | NR | None |
Wu (2003) [32] | 177 | 149 | 26~74 | I~III | 45/15 | 50/25 | OS, LRR | 8 | 2DRT, | 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 SPC | None |
Wu (2014) [33] | 53 | 53 | 31~68 | II~IV b | 42/15 | 50/25 | NR | 6 | 3DCRT | RT area: CW and SPC | NR | None |
Yu (2011) [34] | 175 | 171 | 21~76 | II~III | 45/15 | 50/25 | NR | 7 | 2DRT | SPC 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 Axillary | NR |
Zhang (2015) [35] | 36 | 30 | 24~68 | II~III | 43.5/15 | 50/25 | Toxicities | 5 | 3DCRT | Irradiation target area: CW and SPC | NR | None |
Zhao (2014) [36] | 41 | 44 | 18~70 | II~III | 42.56/16 | 50/25 | LRR, DM, Toxicities | 6 | 3DCRT | CW and SPC: two parallel opposed tangential fields by using 6 MV X-ray beam | NR | None |
Zhao (2016) [37] | 37 | 35 | 37~59 | II~III | 42.56/16 | 50/25 | OS, LRR, DM, Toxicities | 7 | 3DCRT | RT area: CW, SPC and Axillary, excluding the Internal mammary 6 MV X-ray beam | 5 mm bolus to CW | None |