title: 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.
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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departement of Radiation Oncology, Centre Hospitalier de l'Université de Montréal (CHUM), Hôpital Notre-Dame, Montreal, Canada.
authors.forename: Vimal
authors.initials: V
authors.lastname: Krishnan
authors.forename: Guila
authors.initials: G
authors.lastname: Delouya
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Bahary
authors.forename: Sandra
authors.initials: S
authors.lastname: Larrivée
authors.forename: Daniel
authors.initials: D
authors.lastname: Taussky
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001918:Brachytherapy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment
chemical_list: D017430:Prostate-Specific Antigen
keywords: CAPRA; brachytherapy; external beam radiotherapy; predictive models; prostate cancer