Preditores para Não Adesão e Não Persistência à Terapia Hormonal Adjuvante em Mulheres com Câncer de Mama: Revisão Sistemática da Literatura
DOI:
https://doi.org/10.32635/2176-9745.RBC.2025v71n4.5090Palavras-chave:
Neoplasias da Mama/terapia, Cooperação e Adesão ao Tratamento, Tamoxifeno, Inibidores de AromataseResumo
Introdução: A terapia hormonal adjuvante em mulheres com câncer de mama receptor hormonal positivo reduz a recorrência da doença e a mortalidade. No entanto, muitos estudos sugerem que o tratamento para o câncer de mama com terapia endócrina é comprometido pela não adesão e não persistência. Objetivo: Identificar os preditores de não adesão e/ou não persistência que prejudicam os bons resultados do tratamento com terapia endócrina em pacientes com câncer de mama. Método: Revisão sistemática da literatura realizada por meio do MEDLINE/PubMed, Embase e Scopus. Os estudos elegíveis para esta revisão foram selecionados por meio do aplicativo Rayyan QCRI, analisados e classificados segundo a hierarquia dos níveis de evidência Grading of Recommendations Assessment, Development and Evaluations (GRADE) e a confiabilidade entre os examinadores (coeficiente Kappa). O trabalho foi protocolado no International Prospective Register of Systematic Reviews (PROSPERO) e publicado sob n.º CRD42021212788. Resultados: Foram identificados preditores em 21 artigos, com metodologia quantitativa. Esses preditores foram agrupados em sete categorias da seguinte forma: reações adversas, tipo de medicamento, tempo de tratamento, fatores psicológicos, localização geográfica, polifarmácia/comorbidades, aspectos relacionados ao acompanhamento da equipe multiprofissional, considerados responsáveis por não adesão e/ou não persistência à terapia endócrina. Conclusão: Os preditores reações adversas, o uso do tamoxifeno e o longo tempo de tratamento estiveram associados à não adesão e à não persistência à terapia endócrina do câncer de mama.
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