Prostate cancer · De novo metastatic HSPC · prostate RT

HORRAD

Does prostate RT added to ADT improve OS in newly diagnosed bone-metastatic prostate cancer?

Phase III RCT; n=432. ADT+prostate EBRT vs ADT alone.

Arms / design

Phase III RCT; n=432. ADT+prostate EBRT vs ADT alone.

Outcome visualization · source-reported data

Median OS

HR 0.90 (95% CI 0.70–1.14); p=0.4

ADT + prostate RT

45 mo

ADT alone

43 mo

Visualization reflects reported outcomes; it does not itself generate an NNT or establish an overall-survival benefit.

Key result

Most participants had >5 bone metastases; no statistically significant OS difference. PSA progression time was 15 vs 12 months.

Interpretation and limitations

https://pubmed.ncbi.nlm.nih.gov/30266309/

Primary source

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Current-practice context · reviewed 14 October 2026

HORRAD did not show an overall-survival benefit from prostate radiotherapy in an unselected population with newly diagnosed bone-metastatic prostate cancer, most of whom had extensive bone disease. The combined STAMPEDE evidence supports prostate RT for selected men with low metastatic burden; apply contemporary burden definitions and systemic intensification, and do not use HORRAD alone to deny RT to appropriate low-volume patients.