10-year data show hypofractionated postmastectomy radiotherapy remains effective

A randomised phase 3 trial (CHN HYPOPMRT) compared hypofractionated (43.5 Gy in 15 fractions) with conventional fractionated (50 Gy in 25 fractions) postmastectomy radiotherapy in women with high-risk breast cancer who underwent modified radical mastectomy with axillary dissection. At a median follow-up of 11.5 years, 10-year cumulative locoregional recurrence was 10.3% with conventional fractionation versus 12.0% with hypofractionation (hazard ratio 1.19, 95% CI 0.79-1.82), and rates of grade 3 adverse events such as ischaemic heart disease and lymphoedema were similar between groups, with no grade 4-5 events, brachial plexopathy, or treatment-related deaths reported. The investigators state these findings support hypofractionated radiotherapy as a more time-efficient option with durable locoregional control and no increase in severe late adverse events compared with conventional fractionation.

Most relevant for: Women with high-risk breast cancer undergoing postmastectomy radiotherapy, including regional nodal irradiation after modified radical mastectomy and axillary dissection.

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