title: Concurrent adjuvant radiochemotherapy versus standard chemotherapy followed by radiotherapy in operable breast cancer after breast conserving therapy: A meta-analysis.
abstract: BACKGROUND
  To compare the efficacy of concurrent and sequential administration of radiotherapy and chemotherapy on patients with operable breast cancer after breast.conserving surgery. (BCS).
  
  
  METHODS
  We searched MEDLINE (National Library of Medicine, Bethesda, Maryland) and EMBASE (Elsevier, Amsterdam, Netherlands) databases for eligible studies. Clinical outcomes (such as overall and locoregional recurrence-free survival, toxicity related complications) used as evaluation indexes of efficacy. Odds ratios (ORs) with 95% confidence intervals (CI) of each index was calculated and analyzed with the RevMan Version 5.2 software.
  
  
  RESULTS
  Three articles (two trials), which compared the clinical efficacy of concurrent and sequential administration of radiotherapy and chemotherapy for operable breast cancer patients, were eligible in this meta-analysis. There were significant differences between concurrent and sequential treatments in 5-year loco-regional recurrence free survival (OR: 0.39, 95% CI: 0.20-0.75, P = 0.005) and late skin toxicity of telangiectasia (OR: 2.00, 95% CI: 1.39-2.87, P = 0.0002). However, no significant difference was discovered in five-year overall survival (OR: 0.62, 95% CI: 0.35-1.11, P > 0.05), acute skin toxicity (OR: 1.73, 95% CI: 0.98-3.04, P > 0.05) and late skin toxicity of lymphedema (OR: 1.27, 95% CI: 0.88-1.83, P > 0.05).
  
  
  CONCLUSIONS
  Our study demonstrated that the concurrent administration of chemotherapy (anthracycline-based) and radiotherapy was superior to the sequential administration in locoregional recurrence-free survival for the operable node positive breast cancer patients. However, choose of treatment for operable breast cancer patients must be cautious due to high risk of lymphedema.
authors.forename: Ou
authors.initials: O
authors.lastname: Huang
authors.forename: Dandan
authors.initials: D
authors.lastname: Wu
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Yafen
authors.initials: Y
authors.lastname: Li
authors.forename: Weiguo
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Surgery, Ruijin Hospital, Medical School of Shanghai Jiaotong University, Shanghai, China.
authors.forename: Kunwei
authors.initials: K
authors.lastname: Shen
mesh_terms: D018943:Anthracyclines / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines