title: Health-related quality of life and cost comparison of adjuvant capecitabine versus 5-fluorouracil/leucovorin in stage III colorectal cancer patients.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Hong-Hwa
authors.initials: HH
authors.lastname: Chen
authors.forename: William Tzu-Liang
authors.initials: WT
authors.lastname: Chen
authors.forename: Hsin-Chung
authors.initials: HC
authors.lastname: Lee
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.forename: Chuan-Yin
authors.initials: CY
authors.lastname: Fang
authors.forename: Yenn-Hwei
authors.initials: YH
authors.lastname: Chou
authors.forename: Peng-Chan
authors.initials: PC
authors.lastname: Lin
authors.forename: Bo-Wen
authors.initials: BW
authors.lastname: Lin
authors.forename: Chi-Chou
authors.initials: CC
authors.lastname: Huang
authors.forename: Chung-Hung
authors.initials: CH
authors.lastname: Yeh
authors.forename: Hsi-Hsien
authors.initials: HH
authors.lastname: Hsu
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Chen
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ting
authors.forename: Ming-Chin
authors.initials: MC
authors.lastname: Yang
authors.forename: Elise Chia-Hui
authors.initials: EC
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000191:economics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics* / Q000627:therapeutic use; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003362:Cost-Benefit Analysis; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use; D006304:Health Status; D006801:Humans; D002955:Leucovorin / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil
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