Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Neuroscience Service Line and Piedmont Brain Tumor Center, Piedmont Health, Atlanta, GA, USA.
J Neurooncol. 2024 May;168(1):111-123. doi: 10.1007/s11060-024-04652-z. Epub 2024 Apr 2.
Glioblastoma (GB) is the most common primary malignant brain tumor with the highest incidence occurring in older adults with a median age at diagnosis of 64 years old. While treatment often improves survival it brings toxicities and adverse events (AE). Here we identify sex differences in treatment patterns and AE in individuals ≥ 66 years at diagnosis with GB.
Using the SEER-Medicare dataset sex differences in adverse events were assessed using multivariable logistic regression performed to calculate the male/female odds ratio (M/F OR) and 95% confidence intervals [95% CI] of experiencing an AE adjusted for demographic variables and Elixhauser comorbidity score.
Males with GB were more likely to receive standard of care (SOC; Surgery with concurrent radio-chemotherapy) [20%] compared to females [17%], whereas females were more likely to receive no treatment [26%] compared to males [21%]. Females with GB receiving SOC were more likely to develop gastrointestinal disorders (M/F OR = 0.76; 95% CI,0.64-0.91, p = 0.002) or blood and lymphatic system disorders (M/F OR = 0.79; 95% CI,0.66-0.95, p = 0.012). Males with GB receiving SOC were more likely to develop cardiac disorders (M/F OR = 1.21; 95% CI,1.02-1.44, p = 0.029) and renal disorders (M/F OR = 1.65; 95% CI,1.37-2.01, p < 0.001).
Sex differences for individuals, 66 years and older, diagnosed with GB exist in treatment received and adverse events developed across different treatment modalities.
胶质母细胞瘤(GB)是最常见的原发性恶性脑肿瘤,发病率最高的人群为年龄在 64 岁及以上的老年人。虽然治疗通常可以提高生存率,但也会带来毒性和不良反应(AE)。在这里,我们确定了诊断为 GB 的年龄≥66 岁的个体在治疗模式和 AE 方面的性别差异。
使用 SEER-Medicare 数据集,使用多变量逻辑回归评估 AE 中的性别差异,以计算经历 AE 的男性/女性比值(M/F OR)和 95%置信区间 [95%CI],并根据人口统计学变量和 Elixhauser 合并症评分进行调整。
与女性(20%)相比,男性更有可能接受标准治疗(SOC;手术联合放化疗)[20%],而女性更有可能不接受治疗[26%],而男性[21%]。接受 SOC 的女性更容易出现胃肠道疾病(M/F OR=0.76;95%CI,0.64-0.91,p=0.002)或血液和淋巴系统疾病(M/F OR=0.79;95%CI,0.66-0.95,p=0.012)。接受 SOC 的男性更容易出现心脏疾病(M/F OR=1.21;95%CI,1.02-1.44,p=0.029)和肾脏疾病(M/F OR=1.65;95%CI,1.37-2.01,p<0.001)。
年龄在 66 岁及以上的诊断为 GB 的个体在不同治疗模式下接受的治疗和发生的不良反应存在性别差异。