| Objectice To Analyze the change trend of the incidence and mortality of breast cancer in Chinese women from 2005 to 2013 by Joinpoint regression model,a comprehensive analysis of the efficacy and safety of intensity modulated radiotherapy and conventional radiotherapy for female breast cancer was carried out by Meta-analysis,and to explore whether there is a difference in the severity of acute radiation dermatitis and acute myelosuppression between intensive-modulated radiotherapy and conventional radiotherapy in postoperative female breast cancer patients.In order to provide references for the implement of the prophylaxis and treatment of breast cancer in China,to provide scientific basis for rational utilization of radiotherapy technology with breast cancer.Then we can prevent the occurrence of breast cancer,improve the therapeutic effect and the quality of life of breast cancer.Methods(1)The full records of the incidence and mortality of female breast cancer from2005 to 2013 were extracted from Chinese Cancer Registry Annual Report,the annual age-adjusted incidence and mortality,age-specific incidence and mortality was calculated and then applied the Joinpoint regression model to analyze the change trend of the incidence and mortality of breast cancer in Chinese women(2)The published literatures about the efficacy and safety of intensity-modulated radiotherapy and conventional radiotherapy after breast cancer surgery were searched in the databases of CNKI,WANFANG,VIP,Medline,Web of Science and the Cochrane Library from the inception to December,2018.The Meta analysis was performed using Stata 12.0after literature screening,data extraction and literature quality evaluation.The heterogeneity of the included studies was tested by Cochrane's Q test and I~2,the stability of the Meta-analysis was tested by sensitivity analysis and the publication bias was tested by Begg rank correlation test and Egger linear regression test.(3)Retrospective analysis was performed on 329 patients with breast cancer.SPSS 18.0was used to analyze the severity of acute radioactive dermatitis in postoperative intensity-modulated radiotherapy and conventional radiotherapy.(4)Retrospective analysis was performed on 504 patients with breast cancer.SPSS 18.0was used to analyze the severity of acute myelosuppression in postoperative intensive-modulated radiotherapy and conventional radiotherapy.Results(1)The incidence levels of breast cancer among urban women in China was higher than that in rural from 2005 to 2013,the change trend of urban incidence was stable(t=-0.2,P>0.050),the rural incidence showed an increasing trend(t=7.8,P<0.001).the peaks of urban and rural incidence were in the age group of 50 and the age group of 45 respectively.The mortality of breast cancer among urban women in China was higher than that in rural from 2005 to 2013,the change trend of urban mortality was stable(t=0.8,P>0.05),and the rising trend of rural mortality was obvious(t=3.3,P<0.001).The mortality of urban women began to rise after the age of 30,accelerating to rise after the age of 75,the mortality of rural women began to rise after the age of 30,the change tended to be stable at the age of 55~69,and began to rise after the age of 70 again.(2)A total of 18 articles involving 3161 patients were included in the meta-analysis,including 7 randomized controlled studies and 11 cohort studies.The results showed that the 2-year local control rate[RR=1.09,95%CI(1.01,1.18),Z=2.09,P=0.037<0.05]and2-year tumor-free survival rate[RR=1.08,95%CI(1.01,1.16),Z=2.13,P=0.033<0.05]in the breast cancer postoperative intensity-modulated radiotherapy group were higher than those in the control group,and the difference was statistically significant.The incidence of acute radiation dermatitis in the intensity-modulated radiotherapy group after breast cancer surgery was lower than that in the conventional radiotherapy group,and the difference was statistically significant[RR=0.62,95%ci(0.52,0.72),Z=5.81,P<0.01].(3)There was a statistically significant difference in the severity of acute radioactive dermatitis between intensity-modulated radiotherapy and conventional radiotherapy for 329breast cancer patients after surgery(Z=-3.156,P=0.002).(4)There was a statistically significant difference in the severity of acute myelosuppression between intensity-modulated radiotherapy and conventional radiotherapy for 504 breast cancer patients after surgery(Z=-2.787,P=0.005).Conclusions(1)The incidence and mortality of breast cancer among urban women in China were all higher than that in rural from 2005 to 2013,the rising trend of the incidence and mortality of breast cancer among rural women was obvious,so the prophylaxis and treatment measures of breast cancer should be actively formulated and perfected.(2)To some extent,compared with postoperative conventional radiotherapy,imrt can improve the treatment effect of female breast cancer and reduce the risk of acute radiation dermatitis.(3)Breast cancer patients were treated with intensity-modulated radiotherapy and conventional radiotherapy,the severity of acute radiation dermatitis and acute myelosuppression were different.Therefore,radiotherapy technology should be selected reasonably and scientifically in clinical practice to reduce the severity of side effects of postoperative radiotherapy for breast cancer,so as to ensure the smooth progress of radiotherapy for breast cancer,improve the treatment effect and improve the quality of life. |
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