Burdett S, et al. - Via a prospective framework, the researchers intended to review trials on promising therapies for metastatic hormone-sensitive prostate cancer (mHSPC), by adding prostate radiotherapy to androgen deprivation therapy (ADT) or ADT alone. One ongoing (PEACE-1) and two completed (HORRAD and STAMPEDE) eligible trials were identified. On the basis of randomization sequence generation, allocation concealment, completeness of outcome data, and selective outcome reporting, a low risk of bias was noted for both the trials. However, prostate radiotherapy could not clearly improve survival or progression-free survival in unselected men with mHSPC, a clear difference in the effect by the metastatic burden on survival, with an absolute improvement in 3-yr survival in men who had four or fewer bone metastases were observed. Hence, for men with mHSPC with a low metastatic burden prostate radiotherapy should be considered.