Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Management of Oligometastatic Prostate Cancer with Radiotherapy

Key clinical point: Metastasis directed therapy (MDT) can be effective across a wide range of oligometastatic prostate cancer (OPCa) subtypes, however, with differential efficacy.

Major finding: Of 150 patients with toxicity data, 35% experienced acute grade 1 toxicity, 5% had grade 2, and none had grade 3 toxicity. 9% had late toxicities.

Study details: The Kaplan-Meier method and multivariable Cox regression analysis was performed on 156 OPCa patients and 354 metastatic lesions with median follow-up of 24.6 months.


Deek MP, et al. Int J Radiat Oncol Biol Phys. 2019 Aug 13. doi: 10.1016/j.ijrobp.2019.08.008.


The notion that oligometastatic disease is unique from early stage and widely metastatic disease is gaining traction amongst several solid tumor types, including prostate cancer. Optimizing use of treatment modalities to avoid excess toxicity while increasing patient benefit has been at the center of new clinical trials. The possibilities for study design are numerous, and resources are limited. Thus, studies such as that reported by Deek et al. provide the foundation on which to design larger and potentially practice-changing studies. Several large, phase III trials designed to evaluate this approach in prostate cancer are needed before such approaches become standard. —Mark A. Klein, MD