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

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.

Patients with colorectal cancer: relationship between demographic and disease characteristics and acceptance of disability.

AIM: This article is a report of a study conducted to examine acceptance of disability among patients with colorectal cancer and its relationships to other disease-related factors. BACKGROUND: Colorectal cancer had become the third leading cause of cancer death worldwide. Recently, the topic of acceptance of disability in patients with chronic disease, especially cancer, has attracted enormous attention because the higher acceptance, the better coping with disease and the better quality of life after therapy. METHOD: A cross-sectional study was carried out with 110 patients with colorectal cancer recruited from a medical centre in northern Taiwan in 2008. Data were collected using the Acceptance of Disability Scale. Descriptive statistics, Pearson correlations and multiple linear regression analysis were used for analysis. FINDINGS: Participants reported moderate levels of acceptance of disability. The regression model showed that those with shorter disease duration, stoma, lower educational level (below 9th grade), or in Duke C1 stage or above reported lower levels of acceptance, and these variables accounted for 25% of the total variance. CONCLUSION: The results suggest that acceptance of disability (i) is a useful construct to examine in future studies on psychosocial adaptation to cancer, and (ii) can be integrated into a clinical intervention programme of providing holistic care to patients with colorectal cancer.