The C ancer of the P rostate R isk A ssessment ( CAPRA ) score predicts biochemical recurrence in intermediate‐risk prostate cancer treated with external beam radiotherapy ( EBRT ) dose escalation or low‐dose rate ( LDR ) brachytherapy

Objective To study the prognostic value of the U niversity of C alifornia, S an F rancisco C ancer of the P rostate R isk A ssessment ( 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 G leason 7 including 244 EBRT patients (70.2–79.2  G y) 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 P hoenix 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  G y ( 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.