{"doi":"10.1016/j.adro.2020.06.018","title":"Clinical Outcomes of Combined Prostate- and Metastasis-Directed Radiation Therapy for the Treatment of De Novo Oligometastatic Prostate Cancer","abstract":"The Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) trial reported overall survival benefits for prostate-directed radiation therapy (PDRT) in low-burden metastatic prostate cancer. Oligometastasisdirected radiation therapy (ORT) improves androgen deprivation therapy (ADT)efree and progression-free survivals. Comprehensive PDRT ORT to all detectable metastases may offer benefit for de novo oligometastatic prostate cancer (DNOPC) and is under prospective study; given few available benchmarks, we reviewed our institutional experience. Methods and Materials: Forty-seven patients with DNOPC with predominantly M1b disease received neoadjuvant, concurrent, and adjuvant ADT plus PDRT ORT to 1 to 6 oligometastases. Gross pelvic (N1) nodes were not considered oligometastases unless focally targeted without broader nodal coverage. Outcomes were analyzed from radiation therapy (RT) start using Kaplan-Meier, competing risks, and Cox regression. Median follow-up was 27 (95% confidence interval, 16-42) months. Results: At 1-and 2-years post-RT, cumulative incidence of distant metastatic progression (DMP) was 21% and 32%, whereas overall survival was 90% and 87%, respectively. Neuroendocrine/intraductal histology, prostate-specific antigen (PSA) < 20, and detectable PSA after PDRT ORT were associated with increased DMP risk; number and location of oligometastases were not. Local failure was rare, with 3 prostate recurrences and progression of 10 treated oligometastases during follow-up. After neoadjuvant ADT, 9 (19%) patients had undetectable PSA (<0.05 ng/mL), which increased to 32 (68%) after PDRT ORT. Overall 2-year incidence of biochemical recurrence (BCR) and development of castrate resistance were 23% and 36%, respectively. Undetectable PSA post-RT was associated with lower risk of BCR (hazard ratio, 0.19; P Z .004) and DMP (hazard ratio, 0.26; P Z .025). Overall, 23 (49%)","journal":"Advances in Radiation Oncology","year":2020,"id":78760,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9613,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":410589,"name":"Melissa Varghese","orcid":null,"position":1,"is_corresponding":false},{"id":283450,"name":"Debra A. Goldman","orcid":null,"position":2,"is_corresponding":false},{"id":281409,"name":"Zhigang Zhang","orcid":"0000-0002-1556-7945","position":3,"is_corresponding":false},{"id":377113,"name":"Richard M. Gewanter","orcid":"0000-0002-4397-7394","position":4,"is_corresponding":false},{"id":409511,"name":"Ariel E. Marciscano","orcid":"0000-0001-8838-2127","position":5,"is_corresponding":false},{"id":409512,"name":"Borys Mychalczak","orcid":"0000-0003-4346-3374","position":6,"is_corresponding":false},{"id":409513,"name":"Daniel Gorovets","orcid":"0000-0003-0529-0812","position":7,"is_corresponding":false},{"id":409514,"name":"Marisa Kollmeier","orcid":"0000-0003-4342-7066","position":8,"is_corresponding":false},{"id":255799,"name":"Sean M. McBride","orcid":"0000-0002-9676-1669","position":9,"is_corresponding":false},{"id":343935,"name":"Michael J. Zeléfsky","orcid":"0000-0002-6090-6424","position":10,"is_corresponding":false},{"id":363895,"name":"Brandon S. Imber","orcid":"0000-0002-1281-5915","position":0,"is_corresponding":true}],"reference_count":54,"raw_metadata":null,"created_at":"2026-07-18T21:50:09.793321Z","pmid":"33305082","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}