{"entity":{"id":"paper-stampede-plos-med-2022-update","kind":"paper","name":"Radiotherapy to the prostate for men with metastatic prostate cancer in the UK and Switzerland: Long-term results from the STAMPEDE randomised controlled trial","aka":[],"tldr":"Later report from the STAMPEDE trial registered as NCT00268476, in PLOS Medicine (2022); its title describes an updated or longer-term analysis.","summary":"Background: STAMPEDE has previously reported that radiotherapy (RT) to the prostate improved overall survival (OS) for patients with newly diagnosed prostate cancer with low metastatic burden, but not those with high-burden disease. In this final analysis, we report long-term findings on the primary outcome measure of OS and on the secondary outcome measures of symptomatic local events, RT toxicity events, and quality of life (QoL).\n\nMethods and findings: Patients were randomised at secondary care sites in the United Kingdom and Switzerland between January 2013 and September 2016, with 1:1 stratified allocation: 1,029 to standard of care (SOC) and 1,032 to SOC+RT. No masking of the treatment allocation was employed. A total of 1,939 had metastatic burden classifiable, with 42% low burden and 58% high burden, balanced by treatment allocation. Intention-to-treat (ITT) analyses used Cox regression and flexible parametric models (FPMs), adjusted for stratification factors age, nodal involvement, the World Health Organization (WHO) performance status, regular aspirin or nonsteroidal anti-inflammatory drug (NSAID) use, and planned docetaxel use. QoL in the first 2 years on trial was assessed using prospectively collected patient responses to QLQ-30 questionnaire. Patients were followed for a median of 61.3 months. Prostate RT improved OS in patients with low, but not high, metastatic burden (respectively: 202 deaths in SOC versus 156 in SOC+RT, hazard ratio (HR) = 0·64, 95% CI 0.52, 0.79, p < 0.001; 375 SOC versus 386 SOC+RT, HR = 1.11, 95% CI 0.96, 1.28, p = 0·164; interaction p < 0.001). No evidence of difference in time to symptomatic local events was found. There was no evidence of difference in Global QoL or QLQ-30 Summary Score. Long-term urinary toxicity of grade 3 or worse was reported for 10 SOC and 10 SOC+RT; long-term bowel toxicity of grade 3 or worse was reported for 15 and 11, respectively.\n\nConclusions: Prostate RT improves OS, without detriment in QoL, in men with low-burden, newly diagnosed, metastatic prostate cancer, indicating that it should be recommended as a SOC.\n\nTrial registration: ClinicalTrials.gov NCT00268476, ISRCTN.com ISRCTN78818544.\n\nIndexed on Europe PMC as PubMed record 35671327 (DOI 10.1371/journal.pmed.1003998). Its abstract cites the registry id NCT00268476, which is how it was matched to this trial; no figure has been checked by an editor.","asOf":"2026-09-22","links":[{"label":"PLoS Med 2022","url":"https://doi.org/10.1371/journal.pmed.1003998"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/35671327/"},{"label":"Europe PMC","url":"https://europepmc.org/article/MED/35671327"},{"label":"ClinicalTrials.gov NCT00268476","url":"https://clinicaltrials.gov/study/NCT00268476"}],"tags":["europepmc-ingest"],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["stampede"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["plos-medicine"],"dependsOn":[],"notes":[],"journal":"PLOS Medicine","year":2022,"doi":"10.1371/journal.pmed.1003998","pmid":"35671327","authors":"Parker CC, James ND, Brawley CD, et al.","paperType":"rct","findings":[],"whatItMeans":"A second publication from the STAMPEDE trial, later than the first and described in its title as an update or longer-term analysis. Read it with the primary publication linked from the trial page; the record was linked automatically and its figures have not been checked by hand.","caveats":["Matched to the trial by the registry id cited in the Europe PMC record; the summary reproduces the record's abstract and no figure has been verified against the full paper.","Chosen as a later report by words in its title (updated, long-term, final, overall survival or a year count), not by reading the paper."]},"route":"/key-papers/paper-stampede-plos-med-2022-update/","neighbours":{"trial":[{"id":"stampede","kind":"trial","name":"STAMPEDE","route":"/trials/stampede/"}],"journal":[{"id":"plos-medicine","kind":"journal","name":"PLOS Medicine","route":"/journals/plos-medicine/"}]}}