title: Patients' and clinicians' preferences for adjuvant chemotherapy in endometrial cancer: an ANZGOG substudy of the PORTEC-3 intergroup randomised trial.
abstract: BACKGROUND
  To determine the minimum survival benefits that patients, and their clinicians, judged sufficient to make adjuvant chemotherapy (ACT) worthwhile, in addition to pelvic radiotherapy, for women with high risk and advanced stage endometrial cancer.
  
  
  METHODS
  Eighty-three participants in the PORTEC-3 trial completed a time trade-off questionnaire before and after adjuvant therapy; 44 of their clinicians completed it once only. The questionnaire used four hypothetical scenarios including baseline survival times without ACT of 5 and 8 years, and baseline survival rates at 5 years without ACT of 50 and 65%.
  
  
  RESULTS
  Over 50% of patients judged an extra 1 year of survival time or an extra 5% in survival rate sufficient to make ACT worthwhile. Over 50% of clinicians judged an extra 1 year of survival time, or an extra 10% in survival rate, sufficient to make ACT worthwhile. Compared with patients, clinicians required similar survival time benefits (medians both 1 year, P=0.4), but larger survival rate benefits (medians 8.5% vs 5%, P=0.03), and clinicians' preferences varied less (IQR 0.5-1.5 years vs 0.4-2 years, P=0.0007; 5-10% vs 1-13%, P=0.004). Patients' preferences changed over time for the survival rate scenarios depending on whether they had ACT or not (change in median benefit - 3 months vs 2.5 months respectively, P=0.028). There were no strong predictors of patients' or clinicians' preferences.
  
  
  CONCLUSIONS
  Patients and clinicians judged moderate survival benefits sufficient to make ACT worthwhile after pelvic radiotherapy for endometrial cancer. These benefits are larger than those judged sufficient by patients with breast or colon cancers, but similar to those judged sufficient by patients with lung or ovarian cancers.
authors.affiliation: Concord Cancer Centre, Hospital Road, Concord, NSW 2139, Australia.
authors.forename: Prunella
authors.initials: P
authors.lastname: Blinman
authors.affiliation: Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, VIC 8006, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Mileshkin
authors.affiliation: Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, VIC 8006, Australia.
authors.forename: Pearly
authors.initials: P
authors.lastname: Khaw
authors.affiliation: Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Goss
authors.affiliation: Wellington Hospital, Riddiford St, Newtown, Wellington 6021, New Zealand.
authors.forename: Carol
authors.initials: C
authors.lastname: Johnson
authors.affiliation: Calvary Mater Newcastle, Edith St & Platt St, Waratah, NSW 2298, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Capp
authors.affiliation: Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand.
authors.forename: Susan
authors.initials: S
authors.lastname: Brooks
authors.affiliation: Westmead Hospital, Hawkesbury Road & Darcy Road, Westmead, NSW 2145, Australia.
authors.forename: Gerard
authors.initials: G
authors.lastname: Wain
authors.affiliation: NHMRC Clinical Trials Centre, Lifehouse Building, 119-143 Missenden Road, Camperdown, NSW 2050, Australia.
authors.forename: Ilka
authors.initials: I
authors.lastname: Kolodziej
authors.affiliation: NHMRC Clinical Trials Centre, Lifehouse Building, 119-143 Missenden Road, Camperdown, NSW 2050, Australia.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Veillard
authors.affiliation: NHMRC Clinical Trials Centre, Lifehouse Building, 119-143 Missenden Road, Camperdown, NSW 2050, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: O'Connell
authors.affiliation: Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
authors.forename: Carien L
authors.initials: CL
authors.lastname: Creutzberg
authors.affiliation: Concord Cancer Centre, Hospital Road, Concord, NSW 2139, Australia.|NHMRC Clinical Trials Centre, Lifehouse Building, 119-143 Missenden Road, Camperdown, NSW 2050, Australia.|University of Sydney, NSW 2006, Australia.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Stockler
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy; D006282:Health Personnel / Q000523:psychology; D057240:Patient Preference / Q000523:psychology; D017060:Patient Satisfaction; D011878:Radiotherapy / Q000379:methods; D011795:Surveys and Questionnaires; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents