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    The strength of female sex as a prognostic factor in small-cell lung cancer: a pooled analysis of chemotherapy trials from the Manchester Lung Group and Medical Research Council Clinical Trials Unit.

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    Authors
    Wheatley-Price, P
    Ma, C
    Ashcroft, Linda
    Nankivell, M
    Stephens, R J
    White, Shane C
    Lorigan, Paul C
    Thatcher, Nick
    Blackhall, Fiona H
    Shepherd, F A
    Affiliation
    Department of Medical Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario. paulwp@doctors.org.uk
    Issue Date
    2010-02
    
    Metadata
    Show full item record
    Abstract
    BACKGROUND: Previous studies reported that women survive longer than men, but experience greater toxicity, when treated for small-cell lung cancer (SCLC). METHODS: Individual patient data from six randomized phase II/III chemotherapy trials, from the Manchester Lung Group and UK Medical Research Council, were pooled for analysis. End points included overall survival, response rate, toxicity, dose intensity (DI) and transfusion rates. RESULTS: Of 1707 patients analyzed, 44% were women. At baseline, women had poorer performance status (PS) (57% versus 67% Eastern Cooperative Oncology Group PS 0-1/Karnofsky PS 80-100, P = 0.0004) and more were of normal weight or underweight (57% versus 48%, P = 0.003), but fewer were anemic (25% versus 62%, P < 0.0001). Response rates between women and men were similar (77% versus 76%, P = 0.64). In univariate [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.76-0.96, P = 0.006] and multivariate (HR 0.88, 95% CI 0.79-0.99, P = 0.04) analyses, female sex predicted for longer survival. Women experienced more grade 3/4 emesis (18% versus 9%, P < 0.0001) and grade 3/4 mucositis (13% versus 8%, P = 0.005) than men. There were no differences in DI, infections, transfusions or treatment-related deaths. CONCLUSION: Data from >1700 patients in randomized SCLC chemotherapy trials confirm that women survive modestly longer than men but may experience greater toxicity.
    Citation
    The strength of female sex as a prognostic factor in small-cell lung cancer: a pooled analysis of chemotherapy trials from the Manchester Lung Group and Medical Research Council Clinical Trials Unit. 2010, 21 (2):232-7 Ann Oncol
    Journal
    Annals of Oncology
    URI
    http://hdl.handle.net/10541/107553
    DOI
    10.1093/annonc/mdp300
    PubMed ID
    19675093
    Type
    Article
    Language
    en
    ISSN
    1569-8041
    ae974a485f413a2113503eed53cd6c53
    10.1093/annonc/mdp300
    Scopus Count
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    All Christie Publications

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