Concord Cancer Centre, Sydney, Australia.
Australasian Gastro-Intestinal Trials Group, Australia.
JNCI Cancer Spectr. 2020 Nov 28;5(1). doi: 10.1093/jncics/pkaa107. eCollection 2021 Feb.
SCOT was an international, randomized phase 3 trial of 3 months vs 6 months of adjuvant chemotherapy with oxaliplatin and a fluoropyrimidine in patients with colorectal cancer. We sought patients' preferences for 3 months vs 6 months of adjuvant chemotherapy in the SCOT trial.
SCOT participants from Australia and New Zealand completed a validated questionnaire (at 3 and 18 months) to elicit the minimum survival benefits judged necessary to make an extra 3 months of adjuvant chemotherapy worthwhile, based on their experience. Standardized hypothetical scenarios used the following baseline survivals (with 3 months of chemotherapy): life expectancies (LE) of 5 years and 15 years and 5-year survival rates (5YS) of 65% and 85%.
Of the 160 participants, 82 were assigned 3 months adjuvant chemotherapy, and 78 were assigned 6 months. Adjuvant chemotherapy was FOLFOX in 121 (75.6%) and XELOX in 39 (24.4%). Preferences varied substantially and did not differ according to treatment group. The median survival benefits judged necessary to make the extra 3 months of chemotherapy worthwhile were an extra 3 years beyond a LE of 5 years; 3 years beyond a LE of 15 years; 15% beyond a 5YS of 65%; and 5% beyond a 5YS of 85%. Preferences were similar at 3 months and 18 months. Preferences were not predicted by participants' baseline characteristics.
Preferences varied substantially, and the benefits many required to warrant an extra 3 months of adjuvant chemotherapy were larger than the benefits of an extra 3 months of chemotherapy calculated in the International Duration Evaluation of Adjuvant Chemotherapy (IDEA) meta-analysis.
SCOT 是一项国际性、随机的 3 期临床试验，比较了奥沙利铂联合氟嘧啶类药物辅助化疗 3 个月与 6 个月治疗结直肠癌患者的疗效。本研究旨在评估 SCOT 试验中患者对 3 个月与 6 个月辅助化疗的偏好。
来自澳大利亚和新西兰的 SCOT 参与者完成了一份经过验证的问卷（在 3 个月和 18 个月时），根据他们的经验，确定了额外 3 个月辅助化疗获益所需的最小生存获益，以此来评估他们对 3 个月与 6 个月辅助化疗的偏好。使用以下基线生存数据（化疗 3 个月）的标准假设情景：预期寿命（LE）为 5 年和 15 年，5 年生存率（5YS）为 65%和 85%。
在 160 名参与者中，82 名被分配接受 3 个月的辅助化疗，78 名被分配接受 6 个月的辅助化疗。121 名（75.6%）接受 FOLFOX 化疗，39 名（24.4%）接受 XELOX 化疗。偏好差异很大，且与治疗组无关。判断额外 3 个月化疗获益所需的中位生存获益为：LE 超过 5 年的额外 3 年；LE 超过 15 年的额外 3 年；5YS 超过 65%的额外 15%；5YS 超过 85%的额外 5%。3 个月和 18 个月时的偏好相似。参与者的基线特征不能预测其偏好。
偏好差异很大，许多患者认为额外 3 个月的辅助化疗获益需要大于 IDEA 荟萃分析中额外 3 个月化疗获益。
