Evidence map›Paper›PMID 36375981›Full record

Trial reportBMJ open2022

Economic evaluation of FLOT and ECF/ECX perioperative chemotherapy in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma.

Hanqing Zeng, Chunjiang Wang, Li-Ying Song, Su-Jie Jia, Xiaohui Zeng, Qiao Liu

Registry-linked trialOpen access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01216644 (A Randomized Multicenter Phase II/III Study Comparing 5-FU, Leucovorin, Oxaliplatin and Docetaxel), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01216644 phase2 / phase3completednot on this map

A Randomized Multicenter Phase II/III Study Comparing 5-FU, Leucovorin, Oxaliplatin and Docetaxel (FLOT) Versus Epirubicin, Cisplatin and 5-FU (ECF) in Patients With Locally Advanced Resectable Adenocarcinoma of the Esophagogastreal Junction or the Stomach

TypeinterventionalSponsorKrankenhaus NordwestRan2010 to 2019Enrolled716ConditionsGastric CancerArms5-Fluorouracil, Leucovorin, Oxaliplatin, Docetaxel, Epirubicin
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Perioperative immunotherapy in gastric cancer in the spotlight.World journal of clinical oncology · 2025
    Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Hanqing ZengDepartment of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.ORCID 0000-0001-5521-5461
Chunjiang WangDepartment of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Li-Ying SongDepartment of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Su-Jie JiaDepartment of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Xiaohui ZengDepartment of Nuclear Medcine/PET Image Center, Second Xiangya Hospital, Changsha, Hunan, China.ORCID 0000-0001-6050-4137
Qiao LiuDepartment of Pharmacy, Second Xiangya Hospital, Changsha, Hunan, China liuqiao6767@csu.edu.cn.
Central South University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe perioperative chemotherapy with fluorouracil, leucovorin, oxaliplatin plus docetaxel (FLOT) was recommended by the Chinese Society of Clinical Oncology Guidelines for gastric cancer (2018 edition) for patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (class IIA). However, the economic impact of FLOT chemotherapy in China remains unclear. The analysis aimed to compare the cost-effectiveness of FLOT versus epirubicin, cisplatin plus fluorouracil or capecitabine (ECF/ECX) in patients with locally advanced resectable tumours.

designWe developed a Markov model to compare the healthcare and economic outcomes of FLOT and ECF/ECX in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma. Costs were estimated from the perspective of Chinese healthcare system. Clinical and utility inputs were derived from the FLOT4 phase II/III clinical trial and published literature. Sensitivity analyses were employed to assess the robustness of our result. The annual discount rate for costs and health outcomes was set at 5%. OUTCOME MEASURES: The primary outcome of incremental cost-effectiveness ratios (ICERs) was calculated as the cost per quality-adjusted life years (QALYs).

resultsThe base-case analysis found that compared with ECF/ECX, the use of FLOT chemotherapy was associated with an additional 1.08 QALYs, resulting in an ICER of US$851/QALY. One-way sensitivity analysis results suggested that the HR of overall survival and progression-free survival had the greatest impact on the ICER. Probabilistic sensitivity analysis demonstrated that FLOT was more likely to be cost-effective compared with ECF/ECX at a willingness-to-pay threshold of US$31 513/QALY.

conclusionsFor patients with locally advanced resectable tumours, the FLOT chemotherapy is a cost-effective treatment option compared with ECF/ECX in China. TRIAL REGISTRATION NUMBER: NCT01216644.

Indexed as

AdenocarcinomaEsophageal NeoplasmsStomach NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsCisplatinCost-Benefit AnalysisDocetaxelFluorouracilHumansLeucovorinOxaliplatinCisplatinDocetaxelFluorouracilLeucovorinOxaliplatingastroenterologygastrointestinal tumourshealth economics

Identifiers

PMID36375981
PMCPMC9664295
OpenAlexW4308981361

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.