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Do you offer RT both to the prostate and synchronous oligometastases in de novo oligometastatic prostate cancer?
If a patient presents with de novo oligometastatic (i.e., meeting STAMPEDE low met burden criteria) prostate cancer with no prior history of primary treatment to the prostate, will you routinely offer primary radiation to the prostate via STAMPEDE (55/20 fractions) AND concurrent SBRT to all synchronous oligometastatic sites via ORIOLE?
Answer from: Radiation Oncologist at Academic Institution
We do not yet have good evidence to tell us whether or when we should offer metastasis-directed therapy (MDT) for de novo oligometastatic prostate cancer. ORIOLE (like STOMP) was conducted in the recurrent setting. Those trials showed that MDT could delay progression and possibly allow a delay in th...
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Answer from: Radiation Oncologist at Community Practice
Offer a man a lifetime of ADT or upfront radiotherapy and intermittent ADT, and I think most patients would pursue the latter. The EXTEND phase 2 trial of metastasis directed therapy may offer a way to treat all sites of metastatic disease (maximum 5) combined with limited duration ADT. And limited ...
Answer from: Radiation Oncologist at Academic Institution
Yes, depending on the number of mets.