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目的:比较乳腺癌改良根治术后容积调强弧形治疗(VMAT)与调强放疗(IMRT)对计划靶区(PTV)和危及器官(OAR)的剂量学差异，为临床提供循证学依据。方法:根据纳入和排除标准，计算机检索PubMed、Cochrane Library、FMRS、中国知网、万方数据库及维普全文期刊数据库，筛选所有乳腺癌改良根治术后VMAT与IMRT剂量学比较的文献纳入研究。检索时间从建库至2020年3月。应用Stata14.0软件进行n Meta分析。n 结果:13项研究的281例纳入n Meta分析。与IMRT计划相比，VMAT计划明显提高PTV剂量(Dn 95%，n P<0.001)，明显改善PTV剂量均匀性(n P0.05)。IMRT计划较VMAT计划降低心脏Vn 5Gy (n P＝0.001)，但对心脏Vn 5Gy纳入文献进行敏感性分析，显示结果稳定性较差。VMAT计划比IMRT计划明显减少治疗时间(n P<0.001)和机器跳数(n P<0.001)。n 结论:乳腺癌改良根治术后放疗中VMAT比IMRT在靶区剂量覆盖、均匀性和适形性，对患侧肺和健侧肺保护，以及治疗效率方面均更具剂量学优势。“,”Objective:To compare the dosimetric differences between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) on planning target volume (PTV) and organ-at-risk (OAR) for breast cancer after modified radical mastectomy, aiming to provide evidence-based reference for clinical practice.Methods:According to strict inclusion and exclusion criteria, literature search was performed in PubMed, Cochrane Library, FMRS, CNKI, Wanfang Data and VIP full text databases from the inception of databases up to March 2020. The controlled clinical trials of dosimetric comparison between VMAT and IMRT for breast cancer following modified radical mastectomy were selected. The meta-analysis was performed using Stata14 software.Results:The meta-analysis included 281 patients from 13 observational studies. Compared with IMRT, VMAT significantly increased the PTV dose coverage Dn 95%(n P<0.001) and significantly improved the PTV homogeneity index (HI,n P0.05). Compared with VMAT, IMRT reduced the cardiac Vn 5Gy (n P=0.001). However, sensitivity analysis of included literature on cardiac Vn 5Gy showed that the P value was reversed, indicating that the stability of the results was poor. VMAT significantly shortened the delivery time (n P<0.001) and the number of monitor units (n P<0.001) compared to IMRT.n Conclusion:Compared with IMRT, VMAT can achieves superior target dose coverage, HI and CI, better protection for the ipsilateral and contralateral lung, fewer monitor units and shorter delivery time.