Analysis of the Cancer of the Prostate Risk Assessment to predict for biochemical failure after external beam radiotherapy or prostate seed brachytherapy - Abstract

OBJECTIVE: To analyze the value of the Cancer of the Prostate Risk Assessment (CAPRA) score to predict biochemical failure (bF) in patients with D'Amico low- or intermediate-risk prostate cancer treated with different radiation techniques.

METHODS: We analyzed 744 patients treated with either external beam radiotherapy (52.7%) or permanent-seed prostate brachytherapy (47.3%) without any androgen deprivation. External beam radiotherapy dose levels were extreme hypofractionation (45 Gy in 9 fractions) in 10%, 76-79.2 Gy (in 1.8-2.0 Gy per fraction) in 32.7%, and 70.2-74 Gy in 10%. All patients had a minimum of 36-month follow-up. Cox regression analysis was used for univariate and multivariate analysis to predict for bF, as per the Phoenix definition (prostate-specific antigen-nadir + 2 ng/mL).

RESULTS: Median follow-up for patients without bF was 56 months (range, 36-114 months). In univariate analysis, CAPRA score as a continuous variable was predictive of bF (hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.23-1.79; P < .001), and in multivariate analysis adjusted for treatment type, the HR was 1.39 (95% CI, 1.14-1.71; P = .002). D'Amico intermediate-risk vs low-risk patients had an HR for bF of 1.93 (95% CI, 1.07-3.47; P = .029) in univariate analysis, but the difference was not statistically significant anymore after adjustment for treatment type, (P = .206). The area under the curve of the CAPRA score as a continuous variable at 3 and 5 years was 0.66 and 0.62, respectively (P = .005 for both years).

CONCLUSION: The CAPRA score is predictive of bF. Each 1-point rise increased the risk of bF by 39%, which is comparable to surgical series.

Written by:
Delouya G, Krishnan V, Bahary JP, Larrivée S, Taussky D.   Are you the author?
Department of Radiation Oncology, Hôpital Notre-Dame, Center Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada; University of Montreal Hospital Research Centre, Montreal, Canada.  

Reference: Urology. 2014 Sep;84(3):629-33.
doi: 10.1016/j.urology.2014.05.032

PubMed Abstract
PMID: 25168545 Prostate Cancer Section


Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.