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Prostate cancer · Oligorecurrent bone-metastatic HSPC · SABR ± radium-223

RAVENS

Does radium-223 added to SABR delay progression in recurrent bone-metastatic HSPC?

Randomized phase II; n=64; at least one bone metastasis. SABR vs SABR+6 cycles radium-223.

Trial design

Randomized phase II; n=64; at least one bone metastasis. SABR vs SABR+6 cycles radium-223.

Outcome visualization · source-reported data

Median PFS

Adjusted HR 1.42 (95% CI 0.79–2.56); p=0.24

SABR alone
11.8 months SABR
SABR + Ra-223
10.5 months + Ra-223

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

Key result

No PFS improvement with added radium-223; grade 3 treatment-related events were 6% vs 17%.

Interpretation and limitations

https://pubmed.ncbi.nlm.nih.gov/40334149/

Primary source

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Current-practice context · reviewed 14 October 2026

RAVENS did not show a PFS improvement from adding six cycles of radium-223 to SABR in recurrent bone-metastatic hormone-sensitive prostate cancer. Radium-223 should not be added routinely to MDT in this setting; its established role is different and generally concerns selected symptomatic bone-predominant mCRPC without visceral metastases. MDT/systemic choices should follow current prostate-cancer guidance.

Current guideline guidance ↗