Metastasis Directed Therapy and/or Systemic Therapy in Hormone-naive Oligometastatic Prostate Cancer Patient: an Emerging Dilemma.

Author(s) :

Francesco Cuccia1 and Filippo Alongi1,2

1 Advanced Radiation Oncology Department – Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy

2 University of Brescia, Brescia, Italy

Corresponding author: Francesco Cuccia, Email:

Published: Journal of Medical and Radiation Oncology 1 (2021) 139-144, , , - DOI: 10.53011/JMRO.2021.01.13

Open Access

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March 22, 2021 0 Comments


The hormone-naive oligometastatic prostate cancer is a challenging setting for the radiation oncology community, as it represents a sort of transition scenario potentially suitable for two different approaches: a local ablative treatment alone vs a metastasis-directed treatment with the addition of hormone therapy. The choice to add androgen deprivation therapy in the oligorecurrent hormone-sensitive patient is a matter of debate, given the detrimental impact on the quality of life and the number of adverse events. To date, there is no clear agreement on the optimal management of this subset of patients. As some authors highlight the attractiveness of a local approach alone, as well tolerated, easily repeatable and with very limited costs, on the other hand, other authors focus the need to cover the micrometastatic disease, often not detectable, even with the newly available imaging modalities. In this commentary, we briefly summarize the literature data in support of both therapeutic strategies.

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