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

Hong Hwa Chen, William Tzu Liang Chen, Hsin Chung Lee, Jen Kou Lin, Chuan Yin Fang, Yenn Hwei Chou, Peng Chan Lin, Bo Wen Lin, Chi Chou Huang, Chung Hung Yeh, Hsi Hsien Hsu, Hung Chang Chen, Wen Chien Ting, Ming Chin Yang, Elise Chia Hui Tan

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)473-484
Number of pages12
JournalQuality of Life Research
Issue number2
Publication statusPublished - 2015 Feb

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health


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