| Background:The standard treatment for borderline and malignant phyllodes tumors is wide local excision with either breast conservation surgery or mastectomy. Because of the high risk of LR (local recurrence) after surgical intervention alone, the addition of adjuvant radiotherapy has been studied by others; however, conclusions were inconsistent, needed further analysis and evaluation.Objective:The aim of this study was to investigate the impact of adjuvant RT (radiotherapy) on borderline and malignant phyllodes through systematic review and meta-analysis.Methods:We systematically searched PubMed and Web of Science to identify appropriate studies that assessed the impact of postoperative radiotherapy on borderline and malignant phyllodes tumors from the inception of this technique through May,2014. Selection of literatures was done according to the inclusion and exclusion criteria, and the relevant data were extracted from each study to perform a systematic review and meta-analysis.Results:Our searches identified 8 studies among 332 citations. In the meta-analysis, patients who received radiotherapy had a lower relative risk of local recurrence (HR 0.43; 95% CI 0.23-0.64). The absolute risk difference was 10.1% (95% CI 4.9-17.6), corresponding with a number needed to treat of 10.The pooled hazard ratio of LR in BCS (breast-conserving surgery) group proved a lower relative risk of local recurrence in patients with radiotherapy (HR 0.31; 95% CI-0.10-0.72). However, the combined hazard ratio for LR in TM (total mastectomy) group was 0.68(95% CI-0.29-1.64). No differences were observed for overall survival or disease-free survival.Conclusions:Our analysis suggests that postoperative radiotherapy on borderline and malignant phyllodes tumor will decrease the local recurrence rate for patients with breast-conserving surgery. However, adjuvant radiotherapy had no effect on OS (overall survival) or DFS (disease-free survival). |
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