[Treatment of the primary tumour in oligometastatic prostate cancer]

In the treatment of metastatic prostate cancer, significant improvements have recently been made. In addition to androgen deprivation, various options are available, such as anti-androgen receptor therapies with abiraterone and enzalutamide and taxane-based chemotherapy. It is still being discussed whether oligometastatic patients should only be treated systemically, or whether they benefit from additional local therapy for the primary tumour. Until mid-2018, there was no evidence-based recommendation to perform local prostate irradiation in newly diagnosed prostate cancer with distant metastases. At best, this could be indicated as an individual decision based on data from retrospective series. Accordingly, there were no recommendations in the guidelines. The data from the STAMPEDE study and the HORRAD study were published in 2018 /19 and clearly demonstrate the indication for local irradiation of the primary tumour in oligometastatic prostate cancer with less than 4 bone metastases. The following overview summarises the data from these two studies, evaluates them and finally gives a recommendation for the use of local prostate radiation therapy in the oligometastatic situation.