The influence of gender, race, and marital status on survival in lung cancer patients: Analysis of radiation therapy oncology group trials

Objective: A meta-analysis was conducted to determine the influence of gender, race, and marital status on overall survival (OS) in Radiation Therapy Oncology Group nonoperative non-small cell lung cancer trials. Materials and Methods: Data from 1365 patients treated on nine prospective Radiation Therapy Oncology Group studies activated during the 1990s were analyzed. Impact of gender, marital status, and race was considered in the Cox proportional hazards models. Age, Karnofsky performance status, weight loss, stage, histology, location of primary tumor, biologic equivalent dose, deviation from protocol dose, and education level were adjusted in the model. A two-sided p value <0.05 was considered statistically significant. Results: Males had significantly higher mortality than females adjusted for other covariates (hazard ratio [HR] = 1.22, 95% confidence interval = 1.08-1.38). Race and marital status were not independently predictive for OS. Single females had significantly better OS than single males (HR = 0.72), and married males had lower OS than single females (HR = 1.36). Conclusions: These results suggest that although certain subgroups of gender, race, and/or marital status have better outcomes with respect to OS; gender seems to be the most significant factor influencing survival results among nonoperative non-small cell lung cancer patients.