title: Accelerated partial irradiation for breast cancer: systematic review and meta-analysis of 8653 women in eight randomized trials.
abstract: OBJECTIVE
  Accelerated partial breast irradiation (APBI) is the strategy that allows adjuvant treatment delivery in a shorter period of time in smaller volumes. This study was undertaken to assess the effectiveness and outcomes of APBI in breast cancer compared with whole-breast irradiation (WBI).
  
  
  METHODS
  Systematic review and meta-analysis of randomized controlled trials of WBI versus APBI. Two authors independently selected and assessed the studies regarding eligibility criteria.
  
  
  RESULTS
  Eight studies were selected. A total of 8653 patients were randomly assigned for WBI versus APBI. Six studies reported local recurrence outcomes. Two studies were matched in 5 years and only one study for different time of follow-up. Meta-analysis of two trials assessing 1407 participants showed significant difference in the WBI versus APBI group regarding the 5-year local recurrence rate (HR=4.54, 95% CI: 1.78-11.61, p=0.002). Significant difference in favor of WBI for different follow-up times was also found. No differences in nodal recurrence, systemic recurrence, overall survival and mortality rates were observed.
  
  
  CONCLUSIONS
  APBI is associated with higher local recurrence compared to WBI without compromising other clinical outcomes.
authors.affiliation: Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil; Department of Radiation Oncology, Instituto do Câncer de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, Brazil. Electronic address: gnmarta@uol.com.br.
authors.forename: Gustavo Nader
authors.initials: GN
authors.lastname: Marta
authors.affiliation: Brazilian Cochrane Center and Discipline of Emergency Medicine and Evidence-Based Medicine, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP-EPM), Brazil. Electronic address: crisrufa@terra.com.br.
authors.forename: Cristiane Rufino
authors.initials: CR
authors.lastname: Macedo
authors.affiliation: Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil; Department of Radiation Oncology, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. Electronic address: heloisa.carvalho@hc.fm.usp.br.
authors.forename: Heloisa de Andrade
authors.initials: Hde A
authors.lastname: Carvalho
authors.affiliation: Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil. Electronic address: samir.hanna@hsl.org.br.
authors.forename: Samir Abdallah
authors.initials: SA
authors.lastname: Hanna
authors.affiliation: Department of Radiation Oncology, Hospital Sírio-Libanês, Brazil. Electronic address: jluis@hsl.org.br.
authors.forename: João Luis Fernandes
authors.initials: JL
authors.lastname: da Silva
authors.affiliation: Brazilian Cochrane Center and Discipline of Emergency Medicine and Evidence-Based Medicine, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP-EPM), Brazil. Electronic address: rachelriera@hotmail.com.
authors.forename: Rachel
authors.initials: R
authors.lastname: Riera
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental / Q000379:methods / Q000401:mortality; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Accelerated partial breast irradiation; Breast cancer; Breast-conserving therapy; Whole-breast irradiation