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SCOT: a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer
Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland.
Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland.
Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland.
Southampton Univ Hosp NHS Fdn Trust, Southampton, Hants, England.
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2018 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 119, no 11, p. 1332-1338Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Short Course Oncology Therapy (SCOT) study is an international, multicentre, non-inferiority randomised controlled trial assessing the efficacy, toxicity, and cost-effectiveness of 3 months (3 M) versus the usually given 6 months (6 M) of adjuvant chemotherapy in colorectal cancer.

METHODS: In total, 6088 patients with fully resected high-risk stage II or stage III colorectal cancer were randomised and followed up for 3-8 years. The within-trial cost-effectiveness analysis from a UK health-care perspective is presented using the resource use data, quality of life (EQ-5D-3L), time on treatment (ToT), disease-free survival after treatment (DFS) and overall survival (OS) data. Quality-adjusted partitioned survival analysis and Kaplan-Meier Sample Average Estimator estimated QALYs and costs. Probabilistic sensitivity and subgroup analysis was undertaken.

RESULTS: The 3M arm is less costly (-4881; pound 95% CI: -6269; pound -3492) pound and entails (non-significant) QALY gains (0.08; 95% CI: -0.086; 0.230) due to a better significant quality of life. The net monetary benefit was significantly higher in 3M under a wide range of monetary values of a QALY. The subgroup analysis found similar results for patients in the CAPOX regimen. However, for the FOLFOX regimen, 3M had lower QALYs than 6M (not statistically significant).

CONCLUSIONS: Overall, 3M dominates 6M with no significant detrimental impact on QALYs. The results provide the economic case that a 3M treatment strategy should be considered a new standard of care.

Place, publisher, year, edition, pages
2018. Vol. 119, no 11, p. 1332-1338
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-372445DOI: 10.1038/s41416-018-0319-zISI: 000451634100004PubMedID: 30420616OAI: oai:DiVA.org:uu-372445DiVA, id: diva2:1275873
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved

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