Should capecitabine replace 5-fluorouracil in the first-line treatment of metastatic colorectal cancer?

BACKGROUND: A phase-III trial showed the non-inferiority of oral capecitabine plus oxaliplatin (XELOX) vs 5-fluorouracil/leucovorin plus oxaliplatin (FOLFOX-6) in terms of efficacy in first-line treatment of metastatic colorectal cancer.A secondary objective was to compare the quality of life (QoL) and health-care satisfaction of patients.METHODS: Patients were randomised to receive XELOX (n ¼ 156) or FOLFOX-6 (n ¼ 150) for 6 months.Quality of life and satisfaction were assessed by the Quality of Life Questionnaire-C30 (QLQ-C30) and Functional Assessment of Chronic Illness Therapy Chemotherapy Convenience and Satisfaction Questionnaire (FACIT-CCSQ), respectively.Patients completed questionnaires at baseline, at Cycle3 (C3) and Cycle (C6) (XELOX) or at C4 and C8 visits (FOLFOX-6) and at their final visit.RESULTS: A total of 245 and 225 patients were assessed using QLQ-C30 and FACIT-CCSQ, respectively.The completion rates were 480%.Global QoL scores did not differ significantly between groups during the study.According to FACIT-CCSQ, XELOX seemed more convenient (C3/C4, Po0.001; C6/C8, P ¼ 0.009) and satisfactory to patients (C6/C8, P ¼ 0.003) than FOLFOX-6.At the final visit, XELOX patients spent fewer days on hospital visits (3.3 vs 5.3 days, P ¼ 0.045) and lost fewer hours of work/daily activities (10.2 vs 37.1 h lost, P ¼ 0.007).CONCLUSION: XELOX has a similar QoL profile, but seemed to be more convenient in terms of administration at certain time points and reduced time lost for work or other activities compared with FOLFOX-6.