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Health-related quality of life and cost comparison of adjuvant capecitabine versus 5-fluorouracil/leucovorin in stage III colorectal cancer patients

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Abstract

Purpose

The purpose of this study was to compare health-related quality of life (HRQoL) and costs associated with 2 adjuvant chemotherapy regimens [capecitabine-based therapy versus 5-fluorouracil/leucovorin (5-FU/LV)-based therapy] in stage III colorectal cancer patients.

Methods

We conducted a prospective, open-label, observational, multicenter study from July 2008 to July 2011. The European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires was used to assess HRQoL before, during, and after treatment. The direct and indirect costs of adjuvant treatment were estimated from a specially prepared questionnaire, the National Health Insurance Research Database, and other published sources. We used propensity scoring to match samples between groups and performed multivariate analyses to adjust for differences in patient demographics and clinical characteristics.

Results

A total of 497 patients were enrolled, and 356 completed the surveys. Following propensity score matching, 239 patients were included in the analysis (122 in the capecitabine-based group, 117 in the 5-FU/LV-based group). Global HRQoL scores did not differ significantly between the two groups. However, compared to patients in the 5-FU/LV-based group, patients in the capecitabine-based group had less nausea and vomiting (mid-term, P = 0.024; final, P = 0.013), appetite loss (mid-term, P < 0.0001; final, P = 0.001), and fewer side effects from chemotherapy (mid-term, P = 0.017). In addition, the monthly cost of capecitabine-based therapy was lower than those of 5-FU/LV-based therapy [NT$31,895.46 (US$1063.18) vs. NT$79,159.24 (US$2638.64) per patient].

Conclusions

Capecitabine is a reasonable alternative and cost-effective treatment option under current conditions for patients with stage III colorectal cancer.

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Acknowledgments

This study was supported by funding from Roche Products Ltd. However, the work and opinions presented in this manuscript are solely those of the authors.

Conflict of interest

The authors declare no conflict of interest.

Ethical Standards

The study protocol was approved by the ethics committee of each hospital, and all participants provided written informed consent.

Author information

Authors and Affiliations

  1. Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hong-Hwa Chen

  2. Department of Surgery, China Medical University Hospital, Taichung, Taiwan

    William Tzu-Liang Chen

  3. Department of Surgery, Cathay General Hospital, Taipei, Taiwan

    Hsin-Chung Lee

  4. Section of Colon and Rectal Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

    Jen-Kou Lin

  5. Division of Colon and Rectal Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan

    Chuan-Yin Fang

  6. Division of Colorectal Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

    Yenn-Hwei Chou

  7. Department of Internal Medicine, Division of Hematology and Oncology, National Cheng-Kung University Medical Institute and Hospital, Tainan, Taiwan

    Peng-Chan Lin

  8. Division of Colon and Rectal Surgery, Department of Surgery, National Cheng-Kung University Medical Institute and Hospital, Tainan, Taiwan

    Bo-Wen Lin

  9. Division of Colon and Rectal Surgery, Chuang Shan Medical University Hospital, Taichung, Taiwan

    Chi-Chou Huang & Wen-Chien Ting

  10. Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan

    Chung-Hung Yeh

  11. Department of Colorectal Surgery, Mackay Memorial Hospital, Taipei, Taiwan

    Hsi-Hsien Hsu

  12. Department of Colorectal Surgery, Changhua Christian Hospital, Changhua, Taiwan

    Hung-Chang Chen

  13. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan

    Ming-Chin Yang & Elise Chia-Hui Tan

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  1. Hong-Hwa Chen
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Correspondence to Ming-Chin Yang.

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Chen, HH., Chen, W.TL., Lee, HC. et al. Health-related quality of life and cost comparison of adjuvant capecitabine versus 5-fluorouracil/leucovorin in stage III colorectal cancer patients. Qual Life Res 24, 473–484 (2015). https://doi.org/10.1007/s11136-014-0773-x

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