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Trends in Primary- and Metastasis-Directed Radiotherapy Uptake and Survival in Metastatic Prostate Cancer
James O Suggitt1, Tej A Patel2, Miranda B Lam3,4
1Department of Radiation Oncology, Grossman School of Medicine, New York University, New York, NY 10016, USA.
Journal of Clinical Medicine
|May 4, 2026
Summary
Radiotherapy use increased modestly in men with metastatic prostate cancer after key trials. While primary-site radiotherapy showed survival benefits, metastasis-directed radiotherapy
Area of Science:
- Oncology
- Radiation Oncology
- Prostate Cancer Research
Background:
- Pivotal trials (STAMPEDE, STOMP) demonstrated survival benefits of radiotherapy for metastatic prostate cancer.
- Investigates radiotherapy utilization trends in response to these trials.
Purpose of the Study:
- To analyze radiotherapy utilization trends in men with metastatic prostate cancer.
- To assess the impact of pivotal trials on treatment patterns.
- To examine survival outcomes associated with different radiotherapy approaches.
Main Methods:
- Utilized data from the National Cancer Database.
- Analyzed treatment patterns before and after 2018.
- Examined comorbidity prevalence and survival outcomes using Cox proportional hazards models.
Main Results:
- Modest increases in primary- and metastasis-directed radiotherapy utilization were observed post-2018.
- Primary-directed radiotherapy was linked to improved survival overall but not in the post-2018 cohort.
- Metastasis-directed radiotherapy showed no significant survival benefit, but its non-receipt post-2018 was linked to increased mortality.
Conclusions:
- Clinical trials correlate with shifts in radiotherapy practices for metastatic prostate cancer.
- The survival benefit of radiotherapy to primary and metastatic sites requires further real-world investigation.
- Future research should explore patient populations and radiotherapy efficacy in metastatic disease.
