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Top Line : Is bone metastasis burden really predictive of the survival benefit of prostate radiation in men with M1 disease? The Study : In 2018, the STAMPEDE trial's comparison showed no overall improvement in survival with the addition of prostate radiation to ADT for men with metastatic prostate cancer. However, among the subset of men with “low burden” metastatic disease, 3-year overall survival was significantly improved from 73 → 81%. Low burden M1 disease was defined as < 4 bone mets and no visceral mets on standard imaging. But is the 1-3 bone met definition kinda arbitrary like the old 1-3 brain mets rule for SRS? This exploratory analysis of STAMPEDE sought to specifically determine 1) if the number of bone mets on bone scan is a clinically relevant predictor of the benefit of prostate radiation in men with M1 disease and 2) if a higher threshold of mets exists that still benefits from radiation. They found that, indeed, bone met count as a continuous variable was inv

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