Narrative review of local prostate and metastasis-directed radiotherapy in the treatment of metastatic prostate cancer

Abstract

The role of local treatment in patients with de novo metastatic prostate cancer is controversial. In population-based retrospective studies, metastatic prostate cancer patients who received local treatment with prostate radiotherapy showed a better prognosis than those who did not. In addition, several prospective randomized studies demonstrated that prostate radiotherapy achieves a survival benefit for patients with oligo-metastasis. Moreover, the efficacy of metastasis-directed radiotherapy was evaluated, revealing a potential benefit for patients with oligo-metastasis. Importantly, these radiotherapies may reduce the occurrence of symptomatic local events. In this review, the rationale, efficacy and future perspectives for local prostate and metastasis-directed radiotherapy in the treatment of metastatic prostate cancer were described and summarized.

Progress in Oligometastatic Prostate Cancer: Emerging Imaging Innovations and Therapeutic Approaches

“…While the European Society for Radiotherapy and Oncology and the European Organisation for Research and Treatment of Cancer have recently introduced a classification system for oligometastases, categorizing them as de novo, repeat, or induced oligometastases [24], clinical practice simplifies the categorization of oligometastatic PCa into three distinct disease scales: de novo oligometastatic PCa, oligorecurrent PCa, and oligoprogressive PCa (Table 1) [9,10,12,23,25]. Castration-sensitive PCa (CSPC) with synchronous oligometastasis at the initial diagnosis is characterized as de novo, with synchronous oligometastasis remaining untreated in both metastatic and primary tumors.…”

“…Patients with metastatic PCa typically receive systemic therapy, such as androgen deprivation therapy (ADT), in conjunction with androgen-receptor-axis-targeted therapies (ARATs) and/or chemotherapy, contingent upon the extent of the metastatic tumor burden [11,12]. In recent years, there has been a burgeoning demand for personalized treatment approaches for metastatic PCa.…”