Effect of adding prostate radiotherapy to ADT on (A) survival, (B) progression-free survival, (C) biochemical progression, and (D) failure-free survival in men with mHSPC. Each filled square denotes the HR for that trial comparison, with the horizontal lines showing the 95% confidence interval (CI). The size of the square is directly proportional to the amount of information contributed by a trial. The diamond represents a (fixed-effect) meta-analysis of the trial HRs, with the centre of this diamond indicating the HR and the extremities the 95% CI. ADT = androgen deprivation therapy; HR = hazard ratio; RT = radiotherapy.