The current standard for the management of locally advanced and early stage metastatic prostate cancer relies on a backbone of androgen deprivation therapy (ADT) combined with radiotherapy (RT), a regimen that at a glance appears relatively straightforward. The emergence of newer diagnostic, genomic and imaging modalities have allowed for better disease risk-stratification and opened avenues for the development of more patient-centered treatment strategies. This review aims to highlight the central role of RT as part of a multi-modal approach and discuss established and emerging data for the management of locally advanced disease, biochemical recurrence, and oligometastatic disease, as well as the use of immunotherapies and radio-isotopes. This review will also briefly discuss ongoing clinical trials that provide new insights into the paradigm shift in the management of locally advanced prostate cancer.

中文翻译：

---

早期转移性前列腺癌的管理：评估局部治疗和放射治疗，有或没有免疫调节。

目前治疗局部晚期和早期转移性前列腺癌的标准依赖于雄激素剥夺疗法 (ADT) 与放射疗法 (RT) 相结合的主干，这一方案乍一看似乎相对简单。更新的诊断、基因组和影像学模式的出现使得疾病风险分层更好，并为开发更多以患者为中心的治疗策略开辟了道路。本综述旨在强调 RT 作为多模式方法的一部分的核心作用，并讨论用于管理局部晚期疾病、生化复发和寡转移性疾病以及免疫疗法和放射性同位素的使用的已建立和新出现的数据.