HORRAD
HORRAD found no overall survival benefit from irradiating the prostate in men presenting with bone metastases, though a possible gain in those with few metastases fed into STAMPEDE's later positive finding.
Overview
HORRAD randomised 432 men with newly diagnosed prostate cancer and bone metastases to androgen deprivation therapy with or without external beam radiotherapy to the prostate. Median overall survival was 45 months with radiotherapy and 43 months without (hazard ratio 0.90, not significant); time to PSA progression improved and a subgroup with fewer than five metastases suggested benefit (Boeve and colleagues, European Urology 2019). STAMPEDE arm H later confirmed a survival gain from prostate radiotherapy in low-volume metastatic disease.
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