OBJECTIVE: To study the prognostic value of the University of California, San Francisco Cancer of the Prostate Risk Assessment (CAPRA) score to predict biochemical failure (bF) after various doses of external beam radiotherapy (EBRT) and/or permanent seed prostate brachytherapy (PB).
MATERIAL AND METHODS: We retrospectively analyzed 345 patients with a PSA 10 - 20 ng/ml and/or Gleason 7 including 244 EBRT patients (70.2 - 80 Gy) and 101 patients treated with PB. Minimum follow up was 3 years. No patient received primary androgen deprivation therapy (ADT). Biochemical failure (bF) was defined according to Phoenix definition. Cox regression analysis was used to estimate the differences between CAPRA groups.
RESULTS: Overall bF was 13% (45/345). The CAPRA score as a continuous variable was statistically significant in multivariate analysis for predicting bF (HR: 1.37, 95%CI 1.10-1.72, p=0.006). There was a trend for lower bF rate in patients treated with brachytherapy when compared to those treated by EBRT ≤ 74 Gy (HR: 0.234, 95%CI 0.05-1.03, p=0.055) in multivariate analysis. In the subgroup of patients with a CAPRA of 3 - 5, CAPRA remained predictive of bF as a continuous variable (HR: 1.51, 95%CI 1.01-2.27, 0.047) in multivariate analysis.
CONCLUSION: The CAPRA score is useful to predict biochemical recurrence in patients treated for intermediate-risk prostate cancer with EBRT or PB. It could help in treatment decisions and can be completed by incorporating Cell Cycle Progression scores.
Written by:
Krishnan V, Delouya G, Bahary JP, Larrivée S, Taussky D. Are you the author?
Departement of Radiation Oncology, Centre hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada.
Reference: BJU Int. 2013 Nov 26. Epub ahead of print.
doi: 10.1111/bju.12587
PubMed Abstract
PMID: 24274784
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