Radiotherapy for Oligometastatic Prostate Cancer: Advancing Precision

This thesis investigates how radiotherapy for patients with oligometastatic recurrent prostate cancer, a form of relapse involving a limited number of metastases, can be further refined. The focus lies on enhancing the precision and effectiveness of metastasis, directed radiotherapy (MDRT), aiming to control the disease locally and postpone hormonal treatment.

The research is part of the nationwide ADOPT, study, conducted across ten hospitals in the Netherlands. This randomized trial evaluates whether adding short-term hormonal therapy to MDRT improves treatment outcomes. A total of 283 patients were enrolled.

The thesis presents key insights into patient selection, imaging interpretation, and technical delivery of radiotherapy. It highlights interobserver variation in the assessment of PSMA PET/CT, scans and introduces practical improvements such as simple immobilization techniques and evidence-based radiation margins.

Findings from this work have already influenced clinical practice. As such, the thesis contributes to the advancement of more targeted and patient-centered care for patients with recurrent prostate cancer.