SCOT : a comparison of cost-effectiveness from a large randomised phase III trial of two durations of adjuvant Oxaliplatin combination chemotherapy for colorectal cancer
Robles-Zurita, José (University of Glasgow. Institute of Health and Wellbeing)
Boyd, Kathleen A. (University of Glasgow. Institute of Health and Wellbeing)
Briggs, Andrew H. (University of Glasgow. Institute of Health and Wellbeing)
Iveson, Timothy (University Hospital Southampton NHS Foundation Trust (Regne Unit))
Kerr, Rachel S. (University of Oxford. Department of Oncology)
Saunders, Mark P. (The Christie Hospital)
Cassidy, Jim (University of Glasgow. Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences)
Hollander, Niels Henrik (Zealand University Hospital)
Tabernero, Josep (Universitat Autònoma de Barcelona. Departament de Medicina)
Segelov, Eva (Australasian Gastro-Intestinal Trials Group (AGITG) and Monash University and Monash Health)
Glimelius, Bengt (University of Uppsala)
Harkin, Andrea (University of Glasgow. Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences)
Allan, Karen (University of Glasgow. Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences)
McQueen, John (University of Glasgow. Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences)
Pearson, Sarah (University of Oxford. Department of Oncology, OCTO)
Waterston, Ashita (Beatson West of Scotland Cancer Centre (Glasgow, Regne Unit))
Medley, Louise (Royal United Hospital)
Wilson, Charles (Addenbrookes Hospital (Cambridge, Regne Unit))
Ellis, Richard (Royal Cornwall Hospitals NHS Trust)
Essapen, Sharadah (St Luke's Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust)
Dhadda, Amandeep S. (Castle Hill Hospital)
Hughes, Rob (Mount Vernon Cancer Centre)
Falk, Stephen (Bristol Cancer Institute, Bristol, UK)
Raouf, Sherif (Barking Havering and Redbridge University Hospital NHS Trust, Barking, UK)
Rees, Charlotte (University Hospital Southampton NHS Foundation Trust (Regne Unit))
Olesen, Rene K. (Zealand University Hospital)
Propper, David (Barts Cancer Institute (BCI))
Bridgewater, John (University College London)
Azzabi, Ashraf (Newcastle upon Tyne Hospitals NHS Foundation Trust)
Farrugia, David (Gloucestershire Oncology Centre, Cheltenham General Hospital)
Webb, Andrew (Brighton And Sussex University Hospitals NHS Trust (Brighton, Regne Unit))
Cunningham, David (Royal Marsden (funded by NIHR BRC at the Royal Marsden))
Hickish, Tamas (Poole Hospital/Bournemouth University)
Weaver, Andrew (Churchill Hospital, Oxford University Hospitals Foundation Trust)
Gollins, Simon (North Wales Cancer Treatment Centre, Rhyl, UK)
Wasan, Harpreet S.. (Hammersmith Hospital (Londres))
Paul, James (University of Glasgow. Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences)

Data:	2018
Resum:	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. 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. The 3 M arm is less costly (-£4881; 95% CI: -£6269; -£3492) 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 3 M 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, 3 M had lower QALYs than 6 M (not statistically significant). Overall, 3 M dominates 6 M with no significant detrimental impact on QALYs. The results provide the economic case that a 3 M treatment strategy should be considered a new standard of care.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; Versió publicada
Matèria:	Health care economics ; Economics ; Chemotherapy
Publicat a:	British journal of cancer, Vol. 119 (november 2018) , p. 1332-1338, ISSN 1532-1827

DOI: 10.1038/s41416-018-0319-z
PMID: 30420616

7 p, 434.6 KB

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