Department of Clinical and Biological Sciences, Clinical Pharmacology Service Franco Ghezzo, University of Turin, S. Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, TO, Italy.
Department of Public Health, University of Turin, Turin, Italy.
Eur J Clin Pharmacol. 2022 Jun;78(6):1029-1038. doi: 10.1007/s00228-022-03298-y. Epub 2022 Feb 22.
Given the biological differences between females and males, sex-specific evaluations should be carried out to obtain better cancer prevention, diagnosis, and treatment strategies. To this purpose, our aim was to evaluate sex differences for toxicity in a cohort of colorectal cancer (CRC) patients undergoing chemotherapy.
We performed a retrospective study in 329 CRC patients. Differences between males and females were tested performing the Mann-Whitney U test or the Fisher exact test. Multivariate logistic regression models were computed to evaluate the association between sex and risk of chemotherapy agent-related toxicity.
According association sex toxicity, significant differences were observed in the median number of episodes of nausea (p = 0.044), vomit (p = 0.007), heartburn (p = 0.022), thrombocytopenia (p = 0.005), mucositis (p = 0.024). Moreover, statistically significant differences between males and females were observed in the distribution of the highest toxicity grades of nausea (p = 0.024), heartburn (p = 0.016), and thrombocytopenia (p = 0.034). Females have an increased risk of vomit (p = 0.002), alopecia (p = 0.035), heartburn (p = 0.005), mucositis (p = 0.003), and lower risk for thrombocytopenia (p = 0.005).
According to the association of sex chemotherapy agent-related toxicities, females resulted on average at a significant increased risk of more common adverse events (constipation, dysgeusia, alopecia, heartburn, vomit, asthenia, nausea, pain events, and mucositis). Sex-tailored CRC chemotherapy treatment is necessary to obtain efficacy avoiding toxicity, based on patients' biological and genetic characteristics, a vision that would change CRC setting, a stable disease but still orphan of a real tailored approach.
鉴于女性和男性之间的生物学差异，应进行性别特异性评估，以获得更好的癌症预防、诊断和治疗策略。为此，我们旨在评估接受化疗的结直肠癌（CRC）患者队列中的毒性性别差异。
我们对 329 名 CRC 患者进行了回顾性研究。通过 Mann-Whitney U 检验或 Fisher 确切检验检验男性和女性之间的差异。计算多变量逻辑回归模型，以评估性别与化疗药物相关毒性风险之间的关联。
根据关联的性别毒性，观察到恶心（p = 0.044）、呕吐（p = 0.007）、烧心（p = 0.022）、血小板减少症（p = 0.005）、黏膜炎（p = 0.024）的发作次数中位数存在显著差异。此外，在恶心（p = 0.024）、烧心（p = 0.016）和血小板减少症（p = 0.034）的最高毒性等级分布方面，男性和女性之间存在统计学上的显著差异。女性呕吐（p = 0.002）、脱发（p = 0.035）、烧心（p = 0.005）、黏膜炎（p = 0.003）的风险增加，而血小板减少症（p = 0.005）的风险降低。
根据性别与化疗药物相关毒性的关联，女性平均面临更高的常见不良事件风险（便秘、味觉障碍、脱发、烧心、呕吐、乏力、恶心、疼痛事件和黏膜炎）。根据患者的生物学和遗传特征，需要进行基于性别的 CRC 化疗治疗，以获得疗效而避免毒性，这一愿景将改变 CRC 环境，使疾病稳定但仍缺乏真正的个体化治疗方法。
