The Cancer of the Prostate Risk Assessment (CAPRA) score predicts biochemical recurrence in intermediate-risk prostate cancer treated with external beam radiotherapy (EBRT) dose escalation or low-dose rate (LDR) brachytherapy

Authors

  • Vimal Krishnan,

    1. Departement of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada
    Search for more papers by this author
  • Guila Delouya,

    1. Departement of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada
    2. CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada
    Search for more papers by this author
  • Jean-Paul Bahary,

    1. Departement of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada
    2. CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada
    Search for more papers by this author
  • Sandra Larrivée,

    1. CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada
    Search for more papers by this author
  • Daniel Taussky

    Corresponding author
    1. Departement of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada
    2. CRCHUM-Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Canada
    • Correspondence: Daniel Taussky, Centre hospitalier de l'Université de Montréal – Hôpital Notre-Dame, Department of Radiation Oncology, 1560 Sherbrooke St. E. Montreal, Quebec, Canada H2L 4M1.

      e-mail: daniel.taussky.chum@ssss.gouv.qc.ca

    Search for more papers by this author

Abstract

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 low-dose rate (LDR) prostate brachytherapy (PB).

Patients and Methods

We retrospectively analysed 345 patients with intermediate-risk prostate cancer, with PSA levels of 10–20 ng/mL and/or Gleason 7 including 244 EBRT patients (70.2–79.2 Gy) and 101 patients treated with LDR PB. The minimum follow-up was 3 years. No patient received primary androgen-deprivation therapy. bF was defined according to the Phoenix definition. Cox regression analysis was used to estimate the differences between CAPRA groups.

Results

The overall bF rate was 13% (45/345). The CAPRA score, as a continuous variable, was statistically significant in multivariate analysis for predicting bF (hazard ratio [HR] 1.37, 95% confidence interval [CI] 1.10–1.72, P = 0.006). There was a trend for a lower bF rate in patients treated with LDR PB when compared with 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 score of 3–5, CAPRA remained predictive of bF as a continuous variable (HR 1.51, 95% CI 1.01–2.27, P = 0.047) in multivariate analysis.

Conclusion

The CAPRA score is useful for predicting biochemical recurrence in patients treated for intermediate-risk prostate cancer with EBRT or LDR PB. It could help in treatment decisions.

Ancillary