Current role of salvage radiotherapy in oligometastatic prostate cancer at the time of recurrence

Abstract

To review the evidence for metastasis-directed therapy (MDT) in oligometastatic (OM) prostate cancer (PC) and future directions in this clinical setting. The indications for radiotherapy in PC have significantly increased over the last decade. The treatment of OM disease has been gaining popularity thanks to new molecular imaging techniques that allow more accurate identification of OM patients who may benefit from MDT. stereotactic body radiation therapy can offer potentially curative treatment with low toxicity rates. Although most published MDT studies focus on hormone-sensitive (HS) PC in the setting of recurrence, promising results have emerged in recent years even in patients with castration resistance. MDT has emerged as an effective treatment option for OM PC patients with favorable oncological outcomes and a low toxicity profile. Evidence suggests that MDT can be used to delay androgen deprivation therapy or in combination with systemic therapy to potentially improve efficacy outcomes. Molecular stratification is needed to determine who will benefit from treatment intensification with MDT þ/ systemic therapies.