Three weeks of postmastectomy radiotherapy held up against five at ten years

The edition in brief

CHN HYPOPMRT randomised 820 women with high-risk breast cancer, 94% stage III, after mastectomy and axillary dissection to 43.5 Gy in 15 fractions or 50 Gy in 25 fractions to the chest wall and supraclavicular region. At a median 11.5 years, ten-year locoregional recurrence was 12.0% with hypofractionation and 10.3% with conventional fractionation (HR 1.19, 95% CI 0.79–1.82), with no difference in severe late effects and no brachial plexopathy. A Lancet Oncology analysis estimates that 2.3 million cancers in 2024, 12% of the total, were attributable to infections, led by H pylori and HPV (about 750,000 each). A meta-analysis of three trials (685 patients) of first-line zanidatamab combinations in HER2-positive gastro-oesophageal adenocarcinoma found a pooled response rate of 70% and median progression-free survival of 12.6 months, with grade 3 or worse treatment-related events in 65%. In 34 studies of gastrointestinal cancer, cachexia was associated with more postoperative complications (OR 1.38) and two extra hospital days; certainty was very low.