Abstract
Goals of Work. To examine if gender differences exist in patient-rated symptoms following whole brain radiotherapy for treatment of brain metastases.
Patients and Methods. Patients with brain metastases treated with palliative whole brain radiotherapy were asked to rate their symptoms using the Edmonton Symptom Assessment Scale (ESAS) before, and 1, 2, 4, 8 and 12 weeks following treatment. The mean difference of each ESAS symptom at follow up was compared with the baseline value. Mean differences with a p value < 0.01 were considered statistically significant.
Main Results. From January 1999 to January 2002 one hundred and seventy patients (102 female and 68 male) were accrued. The median age for males was 67 years (range 40–82) and 64 years for females (range 33–84). At baseline, there were no significant gender differences in age, symptomatology and Karnofsky Performance score. Following treatment, there was a statistically significant deterioration from the baseline for females in the following ESAS domains: at week 1 in fatigue (1.5) and drowsiness (1.6); week 8 in appetite (3.8) and sense of well being (2.0); and week 12 in fatigue (2.4), nausea (2.5), depression (2.9), drowsiness (2.8), appetite (4.2), and sense of well being (2.8). Males showed deterioration only at week 12 in drowsiness (3.0).
Conclusions. Based on the responding patients' evaluated symptoms, significantly more deterioration was seen in women when compared to men following whole brain radiotherapy. Our result showing a gender difference should be considered only as a hypothesis-generating finding. This needs tobe confirmed in larger studies.