The Role Of Postmastectomy Radiation Therapy In Patients With Breast Implants Reconstruction:A Meta-analysis

Objective:At present,there is still a lot of controversy about whether patients who need postoperative radiotherapy can safely perform breast implant reconstruction surgery and the choice of surgical methods.This study uses meta-analysis to evaluate radiotherapy through a comprehensive analysis of related clinical studies The impact on breast implant reconstruction surgery and the differences between the two implant reconstruction methods,in order to obtain a more clear choice of treatment direction.Methods:By retrieving databases such as CNKI,VIP databases,Wanfang data,PubMed,and Embase,the meta-analysis was performed on the documents that met the inclusion criteria.The review manager 5.3 statistical software was used to analyze the reconstruction failure rate,satisfaction of patients,primary complications,and secondary complications.Results:A total of 15 studies were included,with a total of 10,845 people.The meta-analysis results:1.Radiotherapy increased the failure rate of implant reconstruction surgery(OR:3.76;95% CI: 2.82-5.02;P <0.00001).There was no statistical difference in the failure rate of one-step implant reconstruction surgery with radiotherapy(OR: 3.98;95%).CI: 0.65-24.33;P = 0.14),radiotherapy can increase the failure rate of two-step implant reconstruction surgery(OR: 5.80;95% CI: 3.56-9.46;P <0.00001).The failure rate of implant surgery was lower than that of two-step implant reconstruction(OR: 0.34;95% CI: 0.13-0.93;P = 0.04).2.Radiotherapy reduced satisfaction with implant reconstruction surgery(OR:0.2;95% CI: 0.15-0.27;P <0.00001),and radiotherapy can reduce satisfaction with one-step implant reconstruction surgery(OR: 0.36;95% CI: 0.16-0.81;P = 0.01),radiotherapy can reduce satisfaction with two-step implant reconstruction surgery(OR: 0.17;95% CI: 0.13-0.24;P <0.00001),after one-step implant surgery Patients who underwent radiotherapy were more satisfied than patients who underwent postoperative radiotherapy with two-step implants(OR: 5.66;95% CI: 2.92-10.94;P<0.00001).3.Radiotherapy increased the incidence of primary complications in implant reconstruction surgery(OR: 3.40;95% CI: 2.36-4.89;P <0.00001).Radiotherapy can increase the incidence of primary complications in patients undergoing one-step implant reconstruction surgery(OR: 4.34;95% CI: 2.09-9.03;P <0.0001),radiotherapy can increase the incidence of primary complications in patients undergoing two-step implant reconstruction surgery(OR: 2.47;95% CI: 1.56-3.91;P= 0.0001),The incidence of primary complications was lower in the one-step method than in the two-step method [odds ratio(OR: 0.59;95% CI: 0.45-0.76;P <0.0001).4.There were no significant differences in secondary complications between the groups(P> 0.05).Conclusion:PMRT does increase the incidence of complications after implant reconstruction,including the incidence of reconstruction failure and primary complications,and can reduce the overall satisfaction of patients with reconstructed breasts,especially in the two-step method.Compared with the two-step method,the one-step method,has a lower reconstruction failure rate? primary complication rate,and a higher patient satisfaction rate.