{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:13:21Z","timestamp":1790712801740,"version":"4.1.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"1186","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Treatment options for metastatic hormone-sensitive prostate cancer (mHSPC) have expanded, with evidence supporting prostate radiotherapy in low-volume disease. However, evidence for consolidative radiotherapy to residual sites in patients rendered oligometastatic after systemic therapy is lacking. Advanced imaging with WB-MRI and PSMA PET\/CT enables more accurate assessment of tumor burden and response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This feasibility study assessed response to initial systemic treatment with an ARPI or docetaxel in 29 patients with polymetastatic (&amp;gt;5 metastases) HSPC. PSA and WB-MRI response using MET-RADS-P criteria were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 20\/29 (69.0.%) of patients were down-risked to oligometastatic disease (\u22645 sites) after a median of 5.5 (IQR 5-5.8) months, identified on WB-MRI. Median PSA was 0.2\u2009ng\/mL (IQR 0.1-0.7) in down-risked patients vs 1.5\u2009ng\/mL (IQR 1.1-84) in those not down-risked. Residual intraprostatic disease was seen in 55% (11\/20) of down-risked patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most patients were down-risked on WB-MRI, supporting the existence of an induced oligometastatic state and providing rationale for the STAR TRAP randomized trial (ISRCTN16448082), which will assess the role of consolidative radiotherapy in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>WB-MRI correlates with PSA response and shows potential as an imaging biomarker in mHSPC in this small feasibility study.<\/jats:p>\n                  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