乳房切除术后放射治疗是高危患者辅助治疗的重要组成部分。然而，对重建乳房进行放射可能会导致各种并发症。最近，多个国家采用了大分割（HF）方案。在这里，我们的目的是通过对现有文献的荟萃分析和系统回顾来评估 HF 方案对植入重建乳房的影响。在 PubMed、Cochrane 图书馆和 EMBASE 数据库中系统检索了截至 2023 年 8 月发布的记录。关键词包括大分割放射治疗、乳房切除术和乳房重建。选择了在假体重建后使用 HF 和传统分割 (CF) 的研究。由于结果中事件的罕见性，Mantel-Haenszel 的比值比是使用固定效应模型计算的，以比较 HF 和 CF 组之间的并发症发生率。为了进行高异质性分析，使用了随机效应模型。纳入了 7 篇文章，共 924 例种植体重建，其中 506 例 (54.8%) 接受了 HF。 HF 患者平均接受 43.8 Gy，而 CF 患者平均接受 51.2 Gy。平均随访时间为 10.6 至 35 个月。荟萃分析中纳入了七项研究。心衰组发生包膜挛缩（OR 0.25，95% CI 0.11-0.55）、重大翻修手术（OR 0.19，95% CI 0.05-0.80）和伤口裂开（OR 0.24，95% CI 0.07-0.78）的风险显着降低）与CF组相比。其他并发症的风险没有统计学意义。这项研究表明，在种植体重建患者中，HF 方案的并发症少于 CF 方案。这些发现表明，高频 PMRT 在种植体重建的乳腺癌患者中的应用是合理的。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Post-mastectomy radiation therapy is an important component of adjuvant therapy for high-risk patients. However, radiation to reconstructed breasts can cause various complications. Recently, hypofractionated (HF) protocols have been adopted in several countries. Here, we aimed to assess the impact of HF protocols on implant-reconstructed breasts through a meta-analysis and systematic review of the currently available literature.Records published until August 2023 were systematically searched in PubMed, Cochrane Library, and EMBASE databases. Keywords included hypofractionation radiotherapy, mastectomy, and breast reconstruction. Studies that utilized HF and conventional fractionation (CF) after prosthetic reconstruction were selected. Due to the rarity of events in outcomes, Mantel-Haenszel's odds ratios were calculated using a fixed-effect model to compare the complication rates between HF and CF groups. For analysis with high heterogeneity, a random effect model was used.Seven articles with 924 implant reconstructions, in which 506 (54.8 %) underwent HF were included. HF patients received 43.8 Gy on average, while CF patients received 51.2 Gy. Mean follow-up ranged from 10.6 to 35 months. Seven studies were included in the meta-analysis. HF groups had a significantly lower risk of capsular contracture (OR 0.25, 95 % CI 0.11-0.55), major revision surgery (OR 0.19, 95 % CI 0.05-0.80), and wound dehiscence (OR 0.24, 95 % CI 0.07-0.78) compared to CF groups. The risks of other complications were not statistically significant.This study indicates that HF protocols are associated with fewer complications than CF protocols in implant-reconstructed patients. These findings suggest that the application of HF PMRT in implant-reconstructed patients with breast cancer is plausible.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.