Abstract:
BACKGROUND:The De Gramont regimen (or high-dose LV5FU2, HD-LV5FU2) is considered a standard treatment for metastatic colorectal cancer. The aim of the study was to evaluate the efficacy and the costs of three regimens as compared to HD-LV5FU2: raltitrexed (R), LV5FU2 with a lower dose of folinic acid (LD-LV5FU2), and weekly infusional 5FU (WI-FU). METHODS:An economic analysis was performed prospectively as part of a randomized trial comparing first-line chemotherapy regimens in 294 patients with unresectable metastatic colorectal cancer. The primary endpoint was event-free survival (EFS). Direct medical costs were computed from the health system viewpoint using 2001 unit costs. RESULTS:None of the three regimens improved EFS as compared to HD-LV5FU2. R was less effective and more toxic. The mean total cost per patient was euro 15,970 for HD-LV5FU2. The cost of R (10,687 euro) was lower than that of HD-LV5FU2 (p = 0.008). The cost of LD-LV5FU2 (14,888 euro) and of WI-FU (13,760 euro) was not significantly different from that of HD-LV5FU2. CONCLUSION:The lower efficacy and increased toxicity of R made it a clinically inferior regimen despite its easy administration and lower cost. The HD-LV5FU2 protocol remains a better treatment. LD-LV5FU2 appeared a good alternative regimen because it reduced costs without jeopardizing its efficacy. The WI-FU regimen did not show a significant difference in terms of efficacy, but suggested toxicity to be slightly increased.
journal_name
Oncologyjournal_title
Oncologyauthors
Borget I,Aupérin A,Pignon JP,Abbas M,Bouché O,Mousseau M,Raoul JL,Bedenne L,Cassan P,Clavero-Fabri MC,Stremsdoerfer N,Nasca S,Queuniet AM,Ducreux M,Fédération Francophone de Cancérologie Digestive.doi
10.1159/000100448subject
Has Abstractpub_date
2006-01-01 00:00:00pages
40-8issue
1-2eissn
0030-2414issn
1423-0232pii
000100448journal_volume
71pub_type
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