Three Versus 6 Months of Adjuvant Oxaliplatin‑Fluoropyrimidine Chemotherapy for Colorectal Cancer: Final Results of SCOT—An International, Randomized, Phase III, Noninferiority Trial
The SCOT trial demonstrates that 3 months of adjuvant chemotherapy with CAPOX is noninferior to 6 months of treatment for overall survival in most colorectal cancer patients, whereas 3 months of FOLFOX does not achieve noninferiority.
The SCOT study, a Phase III international randomized noninferiority trial, compared 3‑month versus 6‑month adjuvant oxaliplatin‑fluoropyrimidine chemotherapy (CAPOX or FOLFOX) in 6,088 high‑risk stage II/III colorectal cancer patients. With a median follow‑up of 113 months, 5‑year overall survival was 82.4% in both groups (hazard ratio 0.96, 95% CI 0.86‑1.07), confirming noninferiority of 3‑month treatment for overall survival. Subgroup analysis revealed noninferiority for CAPOX but not for FOLFOX, and similar analysis in rectal cancer patients showed noninferiority for CAPOX and not for FOLFOX.
These findings support shorter adjuvant chemotherapy courses, reducing cumulative oxaliplatin‑induced neuropathy, limiting treatment burden, and preserving quality of life without compromising survival for most colorectal cancer patients.
Evidence level: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.
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