{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T03:06:42Z","timestamp":1787540802926,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,12,26]],"date-time":"2018-12-26T00:00:00Z","timestamp":1545782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) trial showed the survival benefit for prostate radiotherapy in newly diagnosed prostate cancer patients with a low metastatic burden. The result raises the next question whether additional radiotherapy to metastatic sites could improve the survival in those with a low metastatic burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated the efficacy and safety of prostate\u2010directed radiotherapy (PDRT) with or without metastasis\u2010directed radiotherapy (MDRT) in newly diagnosed oligometastatic patients who underwent combination of high\u2010dose\u2010rate prostate brachytherapy, external beam radiotherapy, and androgen deprivation therapy. Forty patients with bone metastasis and node positive prostate cancer were retrospectively analyzed. Of these, 22 (55%), 3 (7%), and 15 (38%) patients had N1M0, M1a, and M1b, respectively. Eighteen patients (45%) received MDRT to all metastatic sites. All patients initially underwent \u22676 months of androgen deprivation therapy. Oligometastatic disease was defined as presence of five or fewer metastatic lesions. Median follow\u2010up period was 62.5 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 40 patients, the 5\u2010year castration\u2010resistant prostate cancer (CRPC)\u2010free survival rate and cancer\u2010specific survival was 64.4% and 87.9%, respectively. Pre\u2010 or post\u2010treatment predictive value including prostate\u2010specific antigen (PSA) at diagnosis \u226520\u2009ng\/mL, Gleason grade group 5, positive biopsy core rate \u226551%, PSA nadir level of \u22650.02\u2009ng\/mL after the radiotherapy, and no MDRT were significantly associated with progression to CRPC. Patients with MDRT had significantly higher probability of achieving a PSA level of &lt;0.02\u2009ng\/mL than those without the therapy (88.8% vs 54.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.0354) and consequently had a better CRPC\u2010free survival than those without the therapy (HR 0.319, 95%CI: 0.116\u20100.877). Comparing PDRT alone, PDRT with MDRT did not significantly increase the incidences of genitourinary and gastrointestinal toxicities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This single\u2010institutional study revealed the feasibility of combining prostate brachytherapy and MDRT for newly diagnosed oligometastatic prostate cancer. This combined approach has potential to prolong CRPC\u2010free survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.23757","type":"journal-article","created":{"date-parts":[[2018,12,26]],"date-time":"2018-12-26T10:30:00Z","timestamp":1545820200000},"page":"506-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Long\u2010term outcomes of combining prostate brachytherapy and metastasis\u2010directed radiotherapy in newly diagnosed oligometastatic prostate cancer: A retrospective cohort study"],"prefix":"10.1002","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8962-2345","authenticated-orcid":false,"given":"Hideyasu","family":"Tsumura","sequence":"first","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromichi","family":"Ishiyama","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiation Oncology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken\u2010ichi","family":"Tabata","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akane","family":"Sekiguchi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiation Oncology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiation Oncology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takefumi","family":"Satoh","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kitano","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiation Oncology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatsugu","family":"Iwamura","sequence":"additional","affiliation":[{"name":"Department of Urology Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1213755"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000449"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.026500"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2017.06.002"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32486-3"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/PAS.0000000000000530","article-title":"Grading Committe. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system","volume":"40","author":"Epstein JI","year":"2016","journal-title":"Am J Surg Pathol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.4487"},{"key":"e_1_2_8_9_1","article-title":"Effect on survival of androgen deprivation therapy alone compared to androgen deprivation therapy combined with concurrent radiation therapy to the prostate in patients with primary bone metastatic prostate cancer in a prospective randomised clinical trial: data from the HORRAD Trial","author":"Boeve LMS","year":"2018","journal-title":"Eur Urol"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.23519"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.04.031"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2004.01.026"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12169"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0302-2838(02)00134-3"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410X.1997.33215.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.12.067"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2016.59686"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-252"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61389-X"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014618"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1207506"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.01.032"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.07.004"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.4853"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.23091"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.23196"},{"key":"e_1_2_8_27_1","first-page":"42","article-title":"Imaging approaches with advanced prostate cancer: techniques and timing","volume":"21","author":"Leung D","year":"2014","journal-title":"Can J Urol"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.23141"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpros.23757","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.23757","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pros.23757","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.23757","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T21:52:44Z","timestamp":1694728364000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.23757"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,26]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1002\/pros.23757"],"URL":"https:\/\/doi.org\/10.1002\/pros.23757","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,26]]},"assertion":[{"value":"2018-10-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}