Introduction: Primary site locoregional treatment (LRT) of metastatic breast cancer has been performed and evaluated with the aim to improve survival, prevent complications, and alleviate local symptoms. As some studies fail to show a survival benefit, the quality of life is important to consider when deciding on LRT. The aim of this study was to evaluate and quantify the impact of LRT on the quality of life of patients with de novo metastatic breast cancer (dnMBC) through a systematic review of the literature and a meta-analysis. Methods: Multiple databases were searched on May 2024 with the following keywords: (i) dnMBC; (ii) LRT, including surgery +/− radiotherapy; and (iii) QOL. Results: Six studies were included in the qualitative synthesis and four in meta-analysis (481 women,n= 251 in the LRT andn= 230 in the control groups). There was a significant QOL decrease in the LRT group at 18 months (standardized mean difference [SMD] = −0.63; 95% confidence interval [CI] −0.98–−0.26;p< 0.001, low heterogeneity I2= 33%) and after 30 months (SMD −0.82; 95%CI −1.58–−0.06;p= 0.034, high heterogeneity I2= 93%), while no statistically significant difference was observed at short term (6 months,p= 0.333). Conclusions: This study shows that there is lacking evidence regarding the QOL benefits after LRT in this population, and even a numerical deterioration in global QOL several months after the treatment. Future and ongoing research may provide additional insights into this question on dnMBC and specifics subgroups.
引言：对转移性乳腺癌进行原发灶局部区域治疗（LRT）旨在改善生存、预防并发症及缓解局部症状，相关实践与评估已有开展。鉴于部分研究未能证实其生存获益，在决定是否实施LRT时，生活质量成为重要考量因素。本研究旨在通过系统文献综述和荟萃分析，评估并量化LRT对初诊转移性乳腺癌（dnMBC）患者生活质量的影响。方法：于2024年5月检索多个数据库，关键词包括：（1）dnMBC；（2）LRT（含手术±放疗）；（3）生活质量。结果：共纳入6项研究进行定性综合，其中4项（涉及481例女性患者，LRT组251例，对照组230例）进入荟萃分析。结果显示LRT组在18个月时出现显著生活质量下降（标准化均数差[SMD] = -0.63；95%置信区间[CI] -0.98至-0.26；p < 0.001，异质性较低I²=33%），在30个月后亦出现下降（SMD -0.82；95%CI -1.58至-0.06；p=0.034，异质性较高I²=93%），而短期（6个月）未观察到统计学显著差异（p=0.333）。结论：本研究表明，目前缺乏证据支持LRT能为该人群带来生活质量获益，甚至在治疗数月后观察到整体生活质量的数值下降。未来及正在进行的研究可能为dnMBC及其特定亚组的这一问题提供更多见解。
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