{
  "abstract": "Background/Aim: Prostate-directed radiotherapy (RT) improves outcomes in selected patients with metastatic castration-sensitive prostate cancer (mCSPC), particularly those with low metastatic burden. However, real-world information regarding its use after response to systemic therapy remains limited. This study describes the treatment characteristics, safety, and clinical course of selected patients with mCSPC who received prostate-directed RT.\n\nPatients and Methods: We retrospectively reviewed an institutional RT database containing 396 patients who initiated prostate-directed RT between April 2015 and March 2026. Thirteen patients had mCSPC at RT initiation and were included. Prostate-directed RT was considered after a marked prostate-specific antigen (PSA) decline and confirmation of no radiographic progression during first-line systemic therapy; no prespecified PSA threshold was used. Patient characteristics, RT details, RT-related adverse events, and clinical outcomes after RT completion were evaluated.\n\nResults: Eight patients had low-volume and five had high-volume disease. The median interval from initiation of first-line systemic therapy to RT was 8.4 months. The median PSA decline before RT was 99.9% (interquartile range=98.9-99.9%), and the median PSA level before RT was 0.028 ng/ml. All patients received intensity-modulated RT, and residual metastatic lesions were included in the RT target volume in six patients. All patients completed RT. No grade ≥2 acute genitourinary or gastrointestinal toxicity was observed, and no late RT-related toxicity occurred among the 11 patients evaluable for late toxicity. During follow-up (median, 39.6 months) after RT, four patients developed castration-resistant disease and four experienced radiographic progression. No post-RT local events or prostate cancer-specific deaths occurred; one patient died of an unrelated cause.\n\nConclusion: In this small, highly selected cohort of patients demonstrating favorable initial responses to systemic therapy, prostate-directed RT was feasible and well tolerated, with no grade ≥2 acute RT-related toxicity, no late toxicity among evaluable patients, and no local events. Comparative efficacy cannot be determined because of the retrospective design, small sample size, and absence of a non-RT control group.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan",
    "Department of Radiation Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "NOBUKI FURUBAYASHI"
    },
    {
      "affs": [
        1
      ],
      "name": "TAKAAKI NAKASHIMA"
    },
    {
      "affs": [
        1
      ],
      "name": "RYUJI UEHARA"
    },
    {
      "affs": [
        0
      ],
      "name": "TAKEHITO KOJIMA"
    },
    {
      "affs": [
        0
      ],
      "name": "YASUHIRO NAKANO"
    },
    {
      "affs": [
        0
      ],
      "name": "AKARI KATAOKA"
    },
    {
      "affs": [
        1
      ],
      "name": "MADOKA ABE"
    },
    {
      "affs": [
        0
      ],
      "name": "TAKAHITO NEGISHI"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1mhxrjssdqnaz.bib",
  "cited_by": 0,
  "doi": "10.21873/invivo.14520",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13724000/",
  "id": "1mhxrjssdqnaz",
  "issns": [
    "0258-851X",
    "1791-7549"
  ],
  "landing_url": "https://doi.org/10.21873/invivo.14520",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7224405424",
  "pdf_url": null,
  "pmcid": "PMC13724000",
  "pmid": "42957244",
  "published": "2026-10-29",
  "publisher": "International Institute of Anticancer Research",
  "ris": "https://research.draconitic.com/paper/1mhxrjssdqnaz.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:32Z",
      "native_id": "PMC13724000",
      "source": "pmc",
      "url": "https://doi.org/10.21873/invivo.14520"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Prostate Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Prostate-directed Radiotherapy in Selected Patients With Metastatic Castration-sensitive Prostate Cancer: A Real-world Case Series",
  "title_text": "Prostate-directed Radiotherapy in Selected Patients With Metastatic Castration-sensitive Prostate Cancer: A Real-world Case Series",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:43Z",
  "url": "https://research.draconitic.com/paper/1mhxrjssdqnaz",
  "venue": "In Vivo",
  "versions": []
}