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Prostate cancer · De novo metastatic HSPC · prostate RT

STAMPEDE Arm H

Does prostate RT improve outcomes in newly diagnosed metastatic disease, particularly low-burden disease?

Phase III RCT; n=2,061. Standard care (ADT ± docetaxel) vs standard care+prostate RT.

Arms / design

Phase III RCT; n=2,061. Standard care (ADT ± docetaxel) vs standard care+prostate RT.

Outcome visualization · source-reported data

3-year OS in low-burden subgroup

Low-burden OS HR 0.68 (95% CI 0.52–0.90); overall-population OS HR 0.92

SOC + prostate RT
81%
SOC alone
73%

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

Key result

Benefit was concentrated in low metastatic burden; do not extrapolate to high-burden disease.

Interpretation and limitations

https://pubmed.ncbi.nlm.nih.gov/30355464/

Primary source

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Current-practice context · reviewed 14 October 2026

Prostate radiotherapy improves overall survival in de novo metastatic hormone-sensitive prostate cancer with low metastatic burden, not in the overall unselected metastatic population. The result supports adding prostate RT to systemic therapy for appropriate low-burden patients; it does not support replacing systemic intensification or treating all metastatic patients with prostate RT. Apply contemporary imaging, burden definitions and current guideline criteria.

STAMPEDE Arm H primary report ↗ · Current guideline guidance ↗