{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:43:48Z","timestamp":1783039428867,"version":"3.54.6"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"ASTRO-PCF Career Development Award to End Prostate Cancer"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metastasis-directed radiotherapy (MDT) is the mainstay in management of oligometastatic prostate cancer (PCa), and PSMA-PET is currently the most sensitive imaging modality for localizing PCa metastases. The efficacy of MDT guided by PSMA-PET imaging with and without androgen deprivation therapy (ADT) \u00b1 androgen-receptor pathway inhibitor (ARPI) has not yet been well characterized. We sought to evaluate the efficacy of PSMA PET-guided MDT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a single-institutional retrospective study of patients diagnosed with metastatic PCa by PSMA-PET imaging who were treated with MDT. Survival analyses were performed using the Kaplan-Meier method with Cox proportional hazards testing for significance. Cumulative incidence analyses were performed with Gray\u2019s testing for significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred and ninety-four metastatic lesions from 101 patients identified by PSMA PET were irradiated with MDT. Forty-seven of the 79 (59%) patients with hormone-sensitive PCa (HSPC) received ADT \u00b1 ARPI along with MDT. Four of 194 lesions (2.1%) demonstrated radiographic progression after MDT, with a median follow-up of 22.4\u2009months. Two-year cumulative incidence of progression from HSPC to CRPC was 11% in patients who received ADT \u00b1 ARPI and 35% in those who did not (P\u2009=\u2009.027). Median biochemical progression free survival of patients with CRPC, HSPC treated without ADT or ARPI, and HSPC treated with ADT \u00b1 ARPI was 5.4, 7.6, and 43.9\u2009months, respectively (P\u2009&amp;lt;\u2009.0001). No Grade 3-5 adverse effects were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MDT guided by PSMA-PET imaging is well-tolerated and delays biochemical progression in patients with CRPC and HSPC, with a greater effect observed in patients also receiving ADT \u00b1 ARPI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jncics\/pkaf096","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T11:45:09Z","timestamp":1759578309000},"source":"Crossref","is-referenced-by-count":2,"title":["Utility of metastasis-directed radiotherapy with and without hormonal therapy in management of oligometastatic prostate cancer"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-670X","authenticated-orcid":false,"given":"William S","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]},{"name":"Department of Urology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abuzar Moradi","family":"Tuchayi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6826-959X","authenticated-orcid":false,"given":"Ali","family":"Sabbagh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8670-6595","authenticated-orcid":false,"given":"Inkyu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6273-5788","authenticated-orcid":false,"given":"Evan","family":"Porter","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Ashraf-Ganjouei","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8077-4975","authenticated-orcid":false,"given":"Yun Rose","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, City of Hope Comprehensive Cancer Center , Duarte, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Witztum","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhejit","family":"Rajagopal","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6841-968X","authenticated-orcid":false,"given":"Steven N","family":"Seyedin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2684-5258","authenticated-orcid":false,"given":"Roxanna","family":"Juarez","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1086-4334","authenticated-orcid":false,"given":"Peter R","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-4037","authenticated-orcid":false,"given":"Felix Y","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, San Francisco , San Francisco, CA,","place":["United States"]},{"name":"Department of Urology, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J","family":"Small","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco , San Francisco, CA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-5823","authenticated-orcid":false,"given":"Thomas 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