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.
脑肿瘤相关不良事件（AEs）中存在明显的性别差异，但脑转移（BrMs）特异性不良事件的性别差异尚未得到充分研究。在脑转移病例中，肺癌脑转移占主导地位，占比超过半数。本研究利用SEER-Medicare数据库，探讨了66岁及以上肺癌脑转移患者不良事件的性别差异。通过多变量逻辑回归模型，在调整人口学因素和合并症后，按组织学亚型、治疗方案、年龄及诊断年份进行分层分析，对原发性肺癌脑转移患者的不良事件进行了评估。为反映治疗模式的转变，诊断年份以2013年为界进行分组。结果显示不良事件存在细微的性别特异性差异：2013年后确诊小细胞癌、鳞状细胞癌或其他非小细胞癌脑转移的女性患者，其头痛发生率高于男性；而2013年后确诊腺癌的男性患者更易发生脑疝。在76岁及以上小细胞癌脑转移患者中，女性比同龄男性面临更高的视力障碍风险，其他年龄组则未见显著差异。接受治疗的男性腺癌患者出血性卒中风险更高。本研究揭示了老年肺癌脑转移患者不良事件存在性别特异性差异，且差异程度因组织学亚型、年龄、诊断年份及治疗方案而异。
肿瘤(癌症)患者之家