title: Does gender influence outcomes from a multidisciplinary intervention for quality of life designed for patients with advanced cancer?
abstract: OBJECTIVE
  Cancer treatment can profoundly impact the patient's quality of life (QOL). It has been well documented that there are gender differences in the symptoms associated with cancer treatment. This study explores the impact of gender on QOL for patients with newly diagnosed advanced cancer.
  
  
  METHODS
  A randomized, controlled clinical trial in patients receiving radiotherapy for advanced cancer demonstrated maintenance of QOL with a six session multidisciplinary structured intervention compared to controls. This current study reports the gender differences in that trial. Outcome measures included the functional assessment of cancer therapy-general (FACT-G), linear analog self-assessment (LASA), and profile of mood states (POMS) at baseline and weeks 4, 27, and 52. Kruskal-Wallis was used to compare QOL scores.
  
  
  RESULTS
  One hundred thirty-one patients (45 women and 86 men, mean age 58.7) participated in the clinical trial. At week 4 postintervention, women in the intervention group had statistically significant improvement in their FACT-G score, FACT-G physical well-being subscale, LASA fatigue, POMS total score, POMS fatigue-inertia subscale, and POMS confusion-bewilderment subscale (p < 0.05). Men receiving the intervention had a smaller decrease in FACT-G score compared to controls (p = 0.048) and also worsened on the LASA financial (p = 0.02). At week 27, the only gender difference was that intervention group men had more POMS anger-hostility (p = 0.009). By week 52, there were no statistically significant gender differences in any of the QOL measures.
  
  
  CONCLUSIONS
  Gender-based differences appear to play a role in the early, but not late, response to a multidisciplinary intervention to improve QOL for patients with advanced cancer, suggesting that early interventions can be tailored for each gender.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. lapid.maria@mayo.edu
authors.forename: Maria I
authors.initials: MI
authors.lastname: Lapid
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Atherton
authors.forename: Simon
authors.initials: S
authors.lastname: Kung
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Cheville
authors.forename: Molly
authors.initials: M
authors.lastname: McNiven
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Rummans
mesh_terms: D000339:Affect; D000786:Anger; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology* / Q000532:radiotherapy*; D010348:Patient Care Team; D011584:Psychology; D011788:Quality of Life / Q000523:psychology*; D011878:Radiotherapy / Q000523:psychology*; D012647:Self-Assessment; D012727:Sex Characteristics; D012737:Sex Factors; D016896:Treatment Outcome