BACKGROUND: The Short Course Oncology Therapy (SCOT) study is an international, multicentre, non-inferiority randomised
controlled trial assessing the efficacy, toxicity, and cost-effectiveness of 3 months (3 M) versus the usually given 6 months (6 M) of
adjuvant chemotherapy in colorectal cancer.
METHODS: In total, 6088 patients with fully resected high-risk stage II or stage III colorectal cancer were randomised and followed
up for 3–8 years. The within-trial cost-effectiveness analysis from a UK health-care perspective is presented using the resource use
data, quality of life (EQ-5D-3L), time on treatment (ToT), disease-free survival after treatment (DFS) and overall survival (OS) data.
Quality-adjusted partitioned survival analysis and Kaplan–Meier Sample Average Estimator estimated QALYs and costs. Probabilistic
sensitivity and subgroup analysis was undertaken.
RESULTS: The 3M arm is less costly (-£4881; 95% CI: -£6269; -£3492) and entails (non-significant) QALY gains (0.08; 95% CI: −0.086;
0.230) due to a better significant quality of life. The net monetary benefit was significantly higher in 3M under a wide range of
monetary values of a QALY. The subgroup analysis found similar results for patients in the CAPOX regimen. However, for the
FOLFOX regimen, 3M had lower QALYs than 6M (not statistically significant).
CONCLUSIONS: Overall, 3M dominates 6M with no significant detrimental impact on QALYs. The results provide the economic
case that a 3M treatment strategy should be considered a new standard of care.
