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Sex differences in fluorouracil-induced stomatitis
J A Sloan1, C L Loprinzi, P J Novotny
1Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. jsloan@mayo.edu
Summary
Women experienced more frequent and severe stomatitis from fluorouracil (5-FU) chemotherapy than men. This meta-analysis highlights sex-based differences in 5-FU toxicity, including stomatitis and leukopenia.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Fluorouracil (5-FU) is a cornerstone chemotherapy agent.
- Stomatitis is a common and dose-limiting toxicity of 5-FU chemotherapy.
- Previous studies have suggested potential sex-based differences in chemotherapy-induced toxicities.
Purpose of the Study:
- To investigate the association between sex and the incidence and severity of stomatitis in patients receiving their first fluorouracil (5-FU)-based chemotherapy.
- To analyze data from multiple North Central Cancer Treatment Group (NCCTG) trials.
Main Methods:
- Meta-analysis of six NCCTG trials involving 731 patients (402 men, 329 women).
- Comparison of stomatitis incidence and severity rates between sexes using binomial testing and t tests.
- Logistic regression and weighted analyses were used for cross-validation.
Main Results:
- Women reported stomatitis more frequently (63% vs. 52%, P=.002) and with greater severity than men.
- Women reported higher average stomatitis scores (0.4 points higher on a 0-4 scale, P<.00001).
- Women also had a higher incidence of leukopenia (grade >/= 1 and grade 3+).
Conclusions:
- Women are more likely to experience 5-FU-induced stomatitis compared to men.
- The underlying biological mechanisms driving these sex-based differences in stomatitis remain unclear.