Chest wall radiotherapy in SUPREMO: a quality-of-life perspective
Mené sur 1 691 patientes atteintes d'un cancer du sein à risque intermédiaire, cet essai randomisé international de phase III évalue l'efficacité, du point de vue de la qualité de vie à 5 ans, d'une radiothérapie de la paroi thoracique après mastectomie
The recently reported SUPREMO trial evaluated chest wall radiotherapy after mastectomy in patients with intermediate-risk breast cancer. Although chest wall radiotherapy did not improve overall survival, local recurrence was reduced (hazard ratio [HR] 0·45 [95%CI 0·20 to 0·99]), with an absolute benefit of just under 2%. With improving outcomes in modern breast cancer therapy, such incremental gains must be weighed against the burden of treatment-related toxicity. In this regard, Galina Velikova and colleagues are to be commended for their successful effort to include patient-reported quality of life (QOL) as a key component of the SUPREMO trial. 989 (80%) of 1233 patients in the UK had enrolled in the SUPREMO QOL substudy, reported in The Lancet Oncology, and questionnaire completion was high (620 [75%] of 832 patients) at 5 years of follow up. These results provide crucial context for shared decision making and add meaningfully to the scarce literature on QOL and chest wall radiotherapy. Strengths include comparison to a no radiotherapy group and the use of moderate hypofractionation in most patients, which reflects an important transition in fractionation of postmastectomy radiotherapy and enhances relevance to contemporary clinical practice.
The Lancet Oncology , commentaire, 2026