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Research Letter
December 5, 2019

Association of Sex With Toxic Effects, Treatment Adherence, and Oncologic Outcomes in the CAO/ARO/AIO-94 and CAO/ARO/AIO-04 Phase 3 Randomized Clinical Trials of Rectal Cancer

Author Affiliations
  • 1Department of Radiotherapy and Oncology, University of Frankfurt, Frankfurt, Germany
  • 2Frankfurt Cancer Institute, Frankfurt, Germany
  • 3Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
  • 4Department of Medical Oncology, University Hospital Mannheim, Heidelberg University, Heidelberg, Germany
  • 5Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany
  • 6German Cancer Research Center (DKFZ), Heidelberg, German Cancer Consortium (DKTK), Partner Site Frankfurt am Main, Frankfurt, Germany
JAMA Oncol. 2020;6(2):294-296. doi:10.1001/jamaoncol.2019.5102

Interest has been increasing regarding the association of sex with toxic effects of treatment and clinical outcome in patients with cancer.1 The risk of toxic effects from chemotherapy is greater in women than in men, as shown in lung and colon cancer, sarcoma, Hodgkin lymphoma, and glioblastoma, which can be explained by different pharmacokinetics and pharmacodynamics.1 Few studies have demonstrated better clinical outcome in women with melanoma, lymphoma, glioblastoma, sarcoma, lung cancer, gastric cancer, and anal cancer compared with men,1 but large confirmatory analyses are lacking. Intriguingly, despite the large number of phase 3 multimodal randomized clinical trials published to date for rectal cancer, the association of sex with treatment-related factors and clinical outcome remains largely unexplored for this disease site.

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    1 Comment for this article
    Why would you use the word "Sex"?
    Mark Tulchinsky |
    I would like to make a point that using the word "sex" in the article and, especially, in the title is unnecessarily ambiguous. The word can be used as a noun or a verb. As a noun, it has at least 4 rather different meanings. It is my suggestion to the authors and the Editors - use the word "gender" instead (unless your ulterior motive is to provide material for punning on the article's title). Respectfully, Dr. T