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Strahlenther Onkol. 2015 Oct;191(10):792-800. doi: 10.1007/s00066-015-0866-7. Epub 2015 Jul 9.

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

Author information

1
Servicio Oncología Radioterápica- ERESA, Hospital General Universitario, Avda. Tres Cruces s/n, 46014, Valencia, Spain. jltorrecilla@eresa.com.
2
S.Oncología Radioterápica, Institut Catala d'Oncologia, Hospitalet, Spain.
3
S.Oncología Radioterápica, Hospital Universitario Doce de Octubre, Madrid, Spain.
4
S.Oncología Radioterápica, Hospital Universitario de la Princesa, Madrid, Spain.
5
S.Oncología Radioterápica, Institut Catala d'Oncologia, Badalona, Spain.
6
Escuela Universitaria Politécnica de La Almunia, Universidad de Zaragoza, Zaragoza, Spain.
7
S.Oncología Radioterápica, Hospital Universitari Sant Joan de Reus, Reus, Spain.
8
S.Oncología Radioterápica, Fundación Instituto Valenciano de Oncología, Valencia, Spain.
9
S.Oncología Radioterápica, Hospital Universitario Gregorio Marañon, Madrid, Spain.
10
S.Oncología Radioterápica, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.
11
S.Oncología Radioterápica, Hospital Universitario Ramón y Cajal, Madrid, Spain.
12
S.Oncología Radioterápica, Hospital Infanta Cristina, Badajoz, Spain.
13
Departamento de Métodos Estadísticos, Universidad de Zaragoza, Zaragoza, Spain.

Abstract

BACKGROUND:

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.

MATERIALS AND METHODS:

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.

RESULTS:

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.

CONCLUSION:

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

KEYWORDS:

Adjuvant therapy; Gleason score; Prostate-specific antigen; Radiation dose; Survival

PMID:
26156249
DOI:
10.1007/s00066-015-0866-7
[Indexed for MEDLINE]
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