In randomized i-STOP, adding SBRT to intermittent ADT reduced 3-year biochemical progression from 60% to 21% in PSMA PET-only oligometastatic prostate cancer. ADT re-initiation was also numerically less frequent, but not significantly.
In the randomized COMPPARE proton cohort, 60 Gy(RBE) in 20 fractions was noninferior to 78 Gy(RBE) in 39 fractions for 3-year bowel function, with similar grade 2+ GI toxicity and biochemical control.
Long-term NRG/RTOG 0815 shows that adding 6 months of ADT to dose-escalated RT reduces biochemical failure, metastases, and prostate cancer mortality, but still does not significantly improve overall survival.
In phase III GETUG P05, brachytherapy boost did not improve 5-year biochemical control over dose-escalated EBRT to 80 Gy in intermediate-risk prostate cancer and increased mild-to-moderate urinary toxicity.
In INTREPID, replacing 6 months of ADT with darolutamide during RT preserved erectile function but failed the prespecified noninferiority endpoint for early PSA suppression. Longer-term oncologic outcomes remain pending
After proton reirradiation for recurrent pediatric ependymoma, 5-year survival was 64% with one grade 3 radiation injury and no grade 4+ toxicity.
In recurrent IDH-wildtype glioblastoma LMD, comprehensive RT and systemic therapy were independently associated with longer survival.
In randomized phase II I-SABR, four doses of nivolumab added to SABR improved 6-year OS to 69% vs 55% and EFS to 55% vs 32%. The long-term signal is compelling, but OS was a secondary endpoint in a relatively small phase II trial.
In phase III MAVERICK, MRI surveillance without PCI improved cognitive failure-free survival, reduced cognitive failure and toxicity, and preserved current OS, despite more brain metastases. Final OS noninferiority analysis is still pending.
Randomized long-term data link low-dose RT for early knee osteoarthritis with durable symptom relief, less structural progression, lower disability, and fewer knee replacements in KL2 disease, supporting a potential disease-modifying effect.
In AEWS1221, SBRT produced a 2% 3-year local recurrence rate in treated bone metastases. Comprehensive metastasis-directed therapy was also associated with substantially better EFS and OS, although the survival comparison was not randomized.
A prospective phase II study found that 4 Gy response-adapted RT relieved pain in most patients with symptomatic myeloma bone lesions, while only 24% required a second course and no grade 3+ treatment-related toxicity occurred.
Five-year NRG-GU003 results support shorter postprostatectomy RT with preserved patient-reported urinary and bowel outcomes and similar biochemical control, but reveal more physician-reported grade 3 GU toxicity with hypofractionation.
In SPPORT, PAM50 Luminal B tumors derived substantially greater benefit from ADT-based intensification, supporting molecular subtyping as a potential tool for personalizing salvage radiotherapy.
In 607 predominantly high-risk patients, 15 Gy HDR boost plus EBRT produced durable six-year disease control with low severe late toxicity.