Fast Five Quiz: Radiation Therapy for Metastatic and Advanced Prostate Cancer

Evelyn S. Marienberg, MD


November 08, 2022

With no overall survival benefit for its use in the metastatic setting, primary radiation therapy to the prostate is not recommended by most guidelines.

The HORRAD trial demonstrated no difference in overall survival with the addition of prostate-directed EBRT to ADT; however, prostate-specific antigen progression was longer in the group treated with EBRT and ADT. In addition, an arm of the STAMPEDE trial demonstrated no difference in overall survival or radiographic progression-free survival with the addition of radiation therapy to standard of care treatment for patients newly diagnosed with metastatic prostate cancer. However, a prespecified overall survival subgroup analysis of STAMPEDE using the low-volume criteria (eg, metastatic disease with three or fewer bone metastases and no visceral metastases) as defined in the CHAARTED trial showed a significant survival benefit of radiation therapy to the prostate for those with de novo low-burden metastatic disease. STAMPEDE and HORRAD demonstrated that this subgroup of patients with low-burden disease, or oligometastatic disease, benefited from prostate-directed radiation therapy.

Learn more about radiation treatment of metastatic prostate cancer.


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