Influence of gender on treatment outcome and toxicity in small cell lung cancer (SCLC)

Abstract

7041 Background: Female gender has been shown consistently to be a favourable prognostic factor in SCLC. Studies have shown that women with other tumor types experience greater treatment toxicity, but there have been few studies of gender related toxicity in SCLC. Methods: This was a gender-based retrospective analysis of 4 SCLC trials, which were conducted by the NCIC CTG between 1981 and 1996. All 1006 patients (648 male, 358 female) received similar chemotherapy consisting of cyclophosphamide/ doxorubicin/vincristine and etoposide/ cisplatin . Toxicities examined included myelosuppression, stomatitis, vomiting and infection. Other endpoints included number of dose reductions required, number of omitted cycles, response rates and overall survival. Toxicities between the genders were compared using chi-square test in univariate analyses and logistic regression adjusting for age, BSA, performance status, LDH and individual trial in multivariate analyses. Results: Women experienced significantly more toxicity in both univariate and multivariate analyses (see Table). However, toxic death rates were similar for men and women (1.5% vs 1.1%, p=0.58). Despite increased toxicity, 76% of females vs 73.4% of males received all 6 treatment cycles (p=0.38), but 52% of females vs 43.4% of males had treatment delayed for ≥ 2 weeks (p=0.022). The ORR was 80.3% for females and 66.9% for males (p<0.0001) and the median survival was 1.31 years for females and 0.91 for males (p<0.0001) Conclusions: Women clearly experience more chemotherapy related toxicity in the treatment of SCLC, but this does not result in more toxic deaths or omitted treatment cycles, nor does it compromise outcome. No significant financial relationships to disclose.