Dmukauskas Mantas, Cioffi Gino, Waite Kristin A, Mammoser Aaron G, Sloan Andrew E, Ma Patrick C, Barnholtz-Sloan Jill S
Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
Neuroscience Service Line and Piedmont Brain Tumor Center, Piedmont Health, Atlanta, GA 30309, USA.
Cancers (Basel). 2024 Aug 28;16(17):2986. doi: 10.3390/cancers16172986.
Sex differences are evident in adverse events (AEs) related to brain tumors, yet sex differences in AEs specific to brain metastases (BrMs) are underexplored. Lung cancer BrMs dominate among BrM, comprising over half of cases. This study examined sex differences in AEs associated with lung cancer BrMs in individuals aged 66 or older using the SEER-Medicare dataset. Multivariable logistic regression, adjusted for demographic factors and comorbidities, stratified by histological subtype, treatment, age, and year of diagnosis were used to analyze AEs among those with BrMs from primary lung tumors. Year of diagnosis was grouped into prior/post-2013, to account for shifts in treatment paradigms. The results showed nuanced sex-specific AEs. Females diagnosed post-2013 with small-cell, squamous-cell, or other non-small-cell carcinoma BrMs had a higher headache likelihood than males. Males with adenocarcinoma post-2013 were more likely to experience brain herniation. Females aged 76 and older with small-cell BrM exhibited increased vision difficulty risk compared to males of the same age, with no significant difference in other age groups. Males treated for adenocarcinoma faced heightened hemorrhagic stroke risk. This study reveals sex-specific disparities in AEs among older individuals with lung cancer BrMs, varying by histological subtype, age, diagnosis year, and treatment.
与脑肿瘤相关的不良事件（AE）中存在明显的性别差异，但脑转移瘤（BrM）特有的不良事件中的性别差异尚未得到充分研究。在脑转移瘤中，肺癌脑转移瘤占主导地位，占病例的一半以上。本研究使用SEER - 医疗保险数据集，调查了66岁及以上个体中与肺癌脑转移瘤相关的不良事件中的性别差异。采用多变量逻辑回归分析，对人口统计学因素和合并症进行调整，按组织学亚型、治疗、年龄和诊断年份分层，以分析原发性肺癌脑转移瘤患者的不良事件。诊断年份分为2013年之前/之后，以考虑治疗模式的变化。结果显示了细微的性别特异性不良事件。2013年后被诊断为小细胞、鳞状细胞或其他非小细胞癌脑转移瘤的女性比男性更容易出现头痛。2013年后患有腺癌的男性更有可能发生脑疝。与同龄男性相比，76岁及以上患有小细胞脑转移瘤的女性出现视力障碍的风险增加，其他年龄组无显著差异。接受腺癌治疗的男性面临更高的出血性中风风险。这项研究揭示了老年肺癌脑转移瘤患者不良事件中存在性别特异性差异，这些差异因组织学亚型、年龄、诊断年份和治疗而异。
