Three linked nomograms for predicting biochemical failure in prostate cancer treated with radiotherapy plus androgen deprivation therapy

Nomograms were established to predict biochemical recurrence (BCR) after radiotherapy (RT) with a low weight of the characteristic variables of RT and androgen deprivation therapy (ADT). Our aim is to provide a new stratified tool for predicting BCR at 4 and 7 years in patients treated using RT with radical intent.

A retrospective, nonrandomized analysis was performed on 5044 prostate cancer (PCa) patients with median age 70 years, who received RT-with or without ADT-between November 1992 and May 2007 Median follow-up was 5 5 years BCR was defined as a rise in serum prostate-specific antigen (PSA) of 2 ng/ml over the post-treatment PSA nadir Univariate association between predictor variables and BCR was assessed by the log-rank test, and three linked nomograms were created for multivariate prognosis of BCR-free survival Each nomogram corresponds to a category of the Gleason score-either 6,7, or 8-10-and all of them were created from a single proportional hazards regression model stratified also by months of ADT (0, 1-6, 7-12, 13-24, 25-36, 36-60) The performance of this model was analyzed by calibration, discrimination, and clinical utility

Initial PSA, clinical stage, and RT dose were significant variables (p < 0 01) The model showed a good calibration The concordance probability was 0 779, improving those obtained with other nomograms (0 587, 0 571, 0 554) in the database Survival curves showed best clinical utility in a comparison with National Comprehensive Cancer Network (NCCN) risk groups

For each Gleason score category, the nomogram provides information on the benefit of adding ADT to a specific RT dose

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al] 2015 Jul 09 [Epub ahead of print]

Jose López-Torrecilla, Anna Boladeras, María Angeles Cabeza, Almudena Zapatero, Josep Jove, Luis M Esteban, Ivan Henriquez, Manuel Casaña, Carmen González-San Segundo, Antonio Gómez-Caamaño, Jose Luis Mengual, Asunción Hervás, Julia Luisa Muñoz, Gerardo Sanz

Servicio Oncología Radioterápica- ERESA, Hospital General Universitario, Avda Tres Cruces s/n, 46014, Valencia, Spain



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