Three-week post-mastectomy radiotherapy held up at ten years in high-risk breast cancer

The edition in brief

CHN HYPOPMRT randomised 820 women with high-risk breast cancer after mastectomy and axillary dissection, 94% stage III, to chest wall and supraclavicular radiotherapy of 50 Gy in 25 fractions or 43.5 Gy in 15 fractions. At a median of 11.5 years, locoregional recurrence was 10.3% with conventional and 12.0% with hypofractionated treatment (HR 1.19, CI 0.79–1.82). Grade 3 late effects were rare and similar, with no brachial plexopathy. The 10-year analysis was not a formal non-inferiority test, but it supports three-week schedules after mastectomy, which matters where patients travel far for radiotherapy. An analysis of GLOBOCAN 2024 estimated that 2.3 million new cancers, 12% of the total, were attributable to infection, led by H. pylori and HPV (each about 750,000) and hepatitis B. Most of these are preventable with vaccination, screening and treatment. A meta-analysis of 92 studies in hepatocellular carcinoma found sarcopenia on CT or MRI was associated with higher mortality across curative, locoregional and systemic treatment (pooled HR 1.85, I² 0%). A small exploratory study found plasma phosphorylated neurofilament-heavy chain did not track oxaliplatin neuropathy. The pearl covers assessing muscle mass from a staging scan.