Evidence map›Paper›PMID 33445150›Full record

SynthesisBreast (Edinburgh, Scotland)2021

Loco-regional adjuvant radiation therapy in breast cancer patients with positive axillary lymph-nodes at diagnosis (CN2) undergoing preoperative chemotherapy and with complete pathological lymph-nodes response. Development of GRADE (Grades of recommendation, assessment, Development and Evaluation) recommendation by the Italian Association of radiation therapy and Clinical Oncology (AIRO).

Lorenza Marino, Valentina Lancellotta, Pierfrancesco Franco, Icro Meattini, Bruno Meduri, Marco Bernini, Alessandra Fabi, Renzo Corvò, Stefano M Magrini, Giovanni L Pappagallo and 2 more

Open access · goldAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Breast (Edinburgh, Scotland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
1.0field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
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  7. Radiotherapy in breast cancer patients achieving nodal pathologic complete response after neoadjuvant therapy: a scoping review.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 1 country.

Lorenza MarinoRadiotherapy Oncology Department, Humanitas-Istituto Clinico Catanese, Misterbianco (CT), Italy.
Valentina LancellottaFondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche Ed Ematologiche, Roma, Italy. Electronic address: valentina.lancellotta@policlinicogemelli.it.
Pierfrancesco FrancoDepartment of Oncology, Radiation Oncology, School of Medicine, University of Turin, Turin, Italy.
Icro MeattiniDepartment of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy; Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Bruno MeduriRadiation Oncology Unit, University Hospital of Modena, Modena, Italy.
Marco BerniniBreast Surgery Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.
Alessandra FabiOncology Unit 1, Regina Elena National Cancer Institute, Rome, Italy; La Sapienza University, Rome, Italy.
Renzo CorvòDepartment of Radiation Oncology, IRCCS Ospedale Policlinico San Martino and Department of Health Science, University of Genoa, Genoa, Italy.
Stefano M MagriniDepartment of Radiation Oncology, ASST Ospedali Civili and Brescia University, Brescia, Italy.
Giovanni L PappagalloMedical Oncology Unit, Azienda ULSS 3 Serenissima, Mirano-Dolo, Verona, Italy.
Stefano ArcangeliDepartment of Radiation Oncology, Policlinico S. Gerardo and University of Milan "Bicocca", Milan, Italy.
Rolando M D'AngelilloRadiotherapy, Dipartimento di Biomedicina e Prevenzione, Università Degli Studi di Roma Tor Vergata, Rome, Italy.
Azienda Ospedaliero-Universitaria Careggi · ITAgostino Gemelli University Polyclinic · ITFondazione Humanitas per la Ricerca · ITOspedale di Mirano · ITOspedale Policlinico San Martino · ITSapienza University of Rome · ITUniversity of Brescia · ITUniversity of Milano-Bicocca · ITUniversity of Rome Tor Vergata · ITUniversity of Turin · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo perform a meta-analysis to determine the effect of loco-regional radiation therapy (RT) compared to no loco-regional RT for operated patients in clinical stage cN2 breast cancer at diagnosis and ypN0 after preoperative chemotherapy (PST). MATERIAL AND

methodsEligible studies were identified through a systematic search of the medical literature performed independently by two researchers using a validated search strategy. An electronic search of Medline via PubMed and Embase (Breast cancer AND preoperative chemotherapy AND radiation therapy) was conducted with no language or publication status restrictions. The effect of loco-regional RT on overall (OS), disease free (DFS), loco-regional recurrence-free (LRRFS) survival and local recurrence was evaluated. An electronic search of Medline via PubMed and Embase (Toxicity AND radiation therapy breast cancer AND preoperative therapy; toxicity AND breast surgery AND preoperative chemotherapy) was conducted for outcomes of harm: major acute and late skin toxicity, lymphedema and cardiac events.

resultsOf 333 studies identified, 4 retrospective studies reporting on a total of 1107 patients were included in the meta-analysis. Six and 3 reported data of acute and late skin toxicity, while 2 studies provided information on cardiac events. Pooled results showed no difference in terms of hazard ratio for loco-regional RT versus no loco-regional RT [hazard ratio (HR) = 0.82, 95% confidence interval (CI) 0.63-1.68]. Loco-regional RT was associated with an OS benefit in the subgroup analysis: IIIB-C (loco-regional RT 79.3% vs no loco-regional RT 71.2%, p = 0.027) and T3-T4 (loco-regional RT 82.6% vs no loco-regional RT 76.6%, p = 0.025). No difference was shown in terms of 5-year DFS (loco-regional RT 91.2% vs no loco-regional RT 83%, p = 0.441) and LRRFS (loco-regional RT 98.1% vs no loco-regional RT 92.3%, p = 0.148). There was no significant difference between the groups in terms of acute and late skin toxicities, lymphedema and cardiac events.

conclusionsBecause of the limitations due to the small number of studies and heterogeneity in the analysis, the present study does not allow to draw any definitive conclusion, highlighting the need for well-controlled trials to determine the effect of loco-regional RT in patients with cN2 having a pathological complete response in the axillary nodes after preoperative chemotherapy.

Indexed as

Breast NeoplasmsChemotherapy, AdjuvantDisease-Free SurvivalFemaleHumansItalyMedical OncologyNeoplasm Recurrence, LocalRadiotherapy, AdjuvantRetrospective StudiesBreast cancerLoco-regional radiation therapyPreoperative chemotherapy

Identifiers

PMID33445150
PMCPMC7808946
OpenAlexW3119346784

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.