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. 2022 Mar 23;14(7):1613.
doi: 10.3390/cancers14071613.

The Prognostic Value of PI-RADS Score in CyberKnife Ultra-Hypofractionated Radiotherapy for Localized Prostate Cancer

Marcin Miszczyk  1 , Justyna Rembak-Szynkiewicz  2 , Łukasz Magrowski  1 , Konrad Stawiski  3 , Agnieszka Namysł-Kaletka  4 , Aleksandra Napieralska  4 , Małgorzata Kraszkiewicz  4 , Grzegorz Woźniak  4 , Małgorzata Stąpór-Fudzińska  4 , Grzegorz Głowacki  4 , Benjamin Pradere  4 , Ekaterina Laukhtina  5   6 , Paweł Rajwa  5   7 , Wojciech Majewski  4
Affiliations

The Prognostic Value of PI-RADS Score in CyberKnife Ultra-Hypofractionated Radiotherapy for Localized Prostate Cancer

Marcin Miszczyk et al. Cancers (Basel). .

Abstract

Prostate Imaging-Reporting and Data System (PI-RADS) has been widely implemented as a diagnostic tool for significant prostate cancer (PCa); less is known about its prognostic value, especially in the setting of primary radiotherapy. We aimed to analyze the association between PI-RADS v. 2.1 classification and risk of metastases, based on a group of 152 patients treated with ultra-hypofractionated stereotactic CyberKnife radiotherapy for localized low or intermediate risk-group prostate cancer. We found that all distant failures (n = 5) occurred in patients diagnosed with a PI-RADS score of 5, and axial measurements of the target lesion were associated with the risk of developing metastases (p < 0.001). The best risk stratification model (based on a combination of greatest dimension, the product of multiplication of PI-RADS target lesion axial measurements, and age) achieved a c-index of 0.903 (bootstrap-validated bias-corrected 95% CI: 0.848−0.901). This creates a hypothesis that PI-RADS 5 and the size of the target lesion are important prognostic factors in early-stage PCa patients and should be considered as an adverse prognostic measure for patients undergoing early treatment such as radiation or focal therapy.

Keywords: Pi-Rads; metastasis-free survival; prognosis; prostate cancer; radiotherapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The probability of metastases-free survival over the course of follow-up depending on the PI-RADS score, in patients treated with ultra-hypofractionated CyberKnife radiosurgery for the primary treatment of a low or intermediate risk-group localized prostate cancer. All the events were experienced in patients with a PI-RADS score of 5.
Figure 2
Figure 2
Best stratification conditional tree models. Panel A shows the probability of developing metastases over the course of follow-up depending on the product of multiplication of the PI-RADS target lesion axial measurements, in patients treated with ultra-hypofractionated CyberKnife radiosurgery for the primary treatment of a low or intermediate risk-group localized prostate cancer. Panel B provides a decision tree constructed based on the best feature subset.
See this image and copyright information in PMC

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