The effect of post mastectomy radiation therapy on breast reconstruction with and without acellular dermal matrix: a systematic review and meta-analysis protocol

Abstract

Background The widespread implementation of acellular dermal matrix (ADM) has broadened the reconstructive repertoire for alloplastic breast reconstruction. ADM’s role in the context of postoperative radiation therapy remains unclear. The present review will evaluate whether ADM reduces complication rates in patients undergoing post-mastectomy radiation therapy (PMRT). Methods A healthcare librarian assisted in performing a search strategy of electronic databases MEDLINE (via Ovid), EMBASE, and CENTRAL. A combination of the keywords and Medical Subject Headings (MESH) to describe the various commercially available ADMs and terms for radiation therapy will be used. The search strategy will identify patients undergoing postoperative radiation following implant-based breast reconstruction and compare outcomes between those with and without ADM. Extracted data will include patient demographics, intraoperative data, and postoperative complications. Data on patient satisfaction and resource utilization will also be extracted if available. The references of selected works will be reviewed for additional studies meeting study criteria. Only peer-reviewed papers written in English will be included. The study data will be assessed for risk of bias and heterogeneity. Providing that sufficient studies can be identified, a meta-analysis will be performed. This review has been registered with PROSPERO (CRD42017056495). Conclusions To date, the short- and long-term performance of ADM in the context of postoperative radiation remains unclear. The objective of the present review will be to critically evaluate the literature with the intention of improving postoperative outcomes in the context of mastectomy and radiation. Electronic supplementary material The online version of this article (10.1186/s13643-019-0958-z) contains supplementary material, which is available to authorized users.

Mapping evidence on management of cervical cancer in sub-Saharan Africa: scoping review protocol

“…Citation tracking will be done using the Reference Manager Software in Endnote version X7. Data analysis and tabulation of the findings will be done using Review Manager (RevMan) [ 48 ]. The narrative synthesis approach [ 49 ] will help summarise and identify the patterns across studies using tabulations, clustering, textual descriptions, conceptual triangulation (concept mapping) and thematic analysis.…”

Complications From Postmastectomy Radiation Therapy in Patients Undergoing Immediate Breast Reconstruction: A Population-Based Study

“… 25 Novel emerging approaches, such as prepectoral implant-based reconstruction, where the implant is wrapped in acellular dermal matrix and placed in the subcutaneous pocket to help avoid pectoral capsular contracture, may emerge as options for minimizing radiation-related complications from immediate implant-based reconstruction given the lower reported rate of capsular contracture 26 ; however, there is currently limited experience with this approach and more research is needed. 27 Other novel adaptations to treatment include the delivery of postmastectomy radiation to the anterior aspect of the reconstruction, excluding the implant or tissue expander, such that radiation dosage is not delivered to the deep chest wall where recurrences are exceedingly rare, 28 thus avoiding circumferential full coverage of the reconstructive volume by the proscribed dose and resultant capsular contracture.…”

Mapping Evidence on Management of Cervical Cancer in Sub-Saharan Africa: Scoping Review Protocol

“…Citation tracking will be done using Reference Manager Software in Endnote version X7. Data analysis and tabulation of the findings will be done using Review Manager (RevMan) (29). The narrative synthesis approach (30) will help summarise and identify patterns across studies using tabulations, clustering, textual descriptions, conceptual triangulation (concept mapping) and thematic analysis.…”