Evaluation of the Clinical Profile of Patients with Gynecological Tumors undergoing Antineoplastic Treatment
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n1.1879Keywords:
genital neoplasms, female, drug-related side effects and adverse reactions, antineoplastic agents, withholding treatmentAbstract
Introduction: The evaluation of the causes of interruption of the antineoplastic therapeutic plan allows the development of strategies that increase adherence and positive treatment outcomes. Objective: Outline the clinical profile of the patients with gynecological tumors under intravenous antineoplastic treatment, identifying the risk of interrupting the therapeutic plan. Method: Retrospective and quantitative study (2011-2018), including patients older than 18 years old, with gynecological tumors undergoing antineoplastic treatment. The database was built from the spreadsheets of antineoplastic drug handling at the Chemotherapy Center. The variables collected were: year of treatment, age, type of tumor, purpose of treatment, protocol, medication, dose, start and end of treatment, and treatment interruption. Results: 6,496 patients over 8 years were evaluated. Fifty two percent of the patients presented cervical cancer. Almost forty eight percent (47.6%) showed a palliative treatment purpose for their tumors. Approximately, twenty three percent (22.6%) interrupted the antineoplastic treatment. For adjuvant, curative, and palliative purposes the age range 18-30 presented the highest interruption, respectively 33%, 36% and 41%. The paclitaxel/carboplatin protocol was the most prescribed with a significant percentage of interruption. Conclusion: The findings suggest that there is an association between treatment discontinuation and patients’ age and therapeutic purpose.
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Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34. doi: https://doi.org/10.3322/caac.21551 DOI: https://doi.org/10.3322/caac.21551
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi: https://doi.org/10.3322/caac.21492 DOI: https://doi.org/10.3322/caac.21492
Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2019.
Pimenta JM, Maluf FC, Calabrich A, et al. Cérvice. In: Buzaid AC, Maluf FC, Lima CMR. organizadores. Manual de oncologia clínica do Brasil. São Paulo: Dendrix; 2015. p. 342-59.
National Comprehensive Cancer Network. Plymouth Meeting, PA: NCCN; c2021. NCCN Guidelines: uterine neoplasms; Version: 1.2019.
National Comprehensive Cancer Network. Plymouth Meeting, PA: NCCN; c2021. NCCN Guidelines: cervical cancer. Version: 3.2019.
National Comprehensive Cancer Network. Plymouth Meeting, PA: NCCN; c2021. NCCN Guidelines: vulvar cancer. Version: 2.2019.
National Comprehensive Cancer Network. Plymouth Meeting, PA: NCCN; c2021. NCCN Guidelines: ovarian cancer. Version: 2.2018.
Bertolazzi LG, Lanza MVC, Bitencourt EC, et al. Incidência e caracterização de reações adversas imediatas à infusão de quimioterápicos em hospital sentinela. Arq Ciênc Saúde. 2015;22(3):84. doi: https://doi.org/10.17696/2318-3691.22.3.2015.107 DOI: https://doi.org/10.17696/2318-3691.22.3.2015.107
Laskey RA, Poniewierski MS, Lopez MA, et al. Predictors of severe and febrile neutropenia during primary chemotherapy for ovarian cancer. Gynecol Oncol. 2012;125(3):625-30. doi: https://doi.org/10.1016/j.ygyno.2012.03.015 DOI: https://doi.org/10.1016/j.ygyno.2012.03.015
Taha A, Vinograd I, Sakhnini A, et al. The association between infections and chemotherapy interruptions among cancer patients: prospective cohort study. J Infect. 2015;70(3):223-9. doi: https://doi.org/10.1016/j.jinf.2014.10.008 DOI: https://doi.org/10.1016/j.jinf.2014.10.008
Adjogatse D, Thanopoulou E, Okines A, et al. Febrile neutropaenia and chemotherapy discontinuation in women aged 70 years or older receiving adjuvant chemotherapy for early breast cancer. Clin Oncol (R Coll Radiol). 2014;26(11):692-6. doi: https://doi.org/10.1016/j.clon.2014.05.002 DOI: https://doi.org/10.1016/j.clon.2014.05.002
Won HS, Sun DS, Choi JY, et al. Factors associated with treatment interruption in elderly patients with cancer. Korean J Intern Med. 2019;34(1):156-64. doi: https://doi.org/10.3904/kjim.2016.318 DOI: https://doi.org/10.3904/kjim.2016.318
Woopen H, Richter R, Ismaeel F, et al. The influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and overall survival in ovarian cancer. Gynecol Oncol. 2016;140(3):554-8. doi: https://doi.org/10.1016/j.ygyno.2016.01.012 DOI: https://doi.org/10.1016/j.ygyno.2016.01.012
Wildes TM, Ruwe AP, Fournier C, et al. Geriatric assessment is associated with completion of chemotherapy, toxicity, and survival in older adults with cancer. J Geriatr Oncol. 2013;4(3):227-34. doi: https://doi.org/10.1016/j.jgo.2013.02.002 DOI: https://doi.org/10.1016/j.jgo.2013.02.002
Aaldriks AA, Maartense E, Nortier HJWR, et al. Prognostic factors for the feasibility of chemotherapy and the Geriatric Prognostic Index (GPI) as risk profile for mortality before chemotherapy in the elderly. Acta Oncol. 2016;55(1):15-23. doi: https://doi.org/10.3109/0284186X.2015.1068446 DOI: https://doi.org/10.3109/0284186X.2015.1068446
Kalsi T, Babic-Illman G, Fields P, et al. The impact of low-grade toxicity in older people with cancer undergoing chemotherapy. Br J Cancer. 2014;111(12):2224-8. doi: https://doi.org/10.1038/bjc.2014.496 DOI: https://doi.org/10.1038/bjc.2014.496
Extermann M, Boler I, Reich RR, et al. Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer. 2012;118(13):3377- 86. doi: https://doi.org/10.1002/cncr.26646 DOI: https://doi.org/10.1002/cncr.26646
Cortez AJ, Tudrej P, Kujawa KA, et al. Advances in ovarian cancer therapy. Cancer Chemother Pharmacol. 2018;81(1):17-38. doi: https://doi.org/10.1007/s00280-017-3501-8 DOI: https://doi.org/10.1007/s00280-017-3501-8
Renna Junior NL, Azevedo e Silva G. Tendências temporais e fatores associados ao diagnóstico em estágio avançado de câncer do colo uterino: análise dos dados dos registros hospitalares de câncer no Brasil, 2000-2012. Epidemiol Serv Saúde. 2018;27(2):e2017285. doi: https://doi.org/10.5123/S1679-49742018000200003 DOI: https://doi.org/10.5123/S1679-49742018000200003
Carvalho PG, O´Dwer G, Rodrigues NCP. Trajetórias assistenciais de mulheres entre diagnóstico e início de tratamento do câncer de colo uterino. Saúde Debate. 2018;42(118):687-701. doi: https://doi.org/10.1590/0103-1104201811812 DOI: https://doi.org/10.1590/0103-1104201811812
Feliu J, Heredia-Soto V, Gironés R, et al. Can we avoid the toxicity of chemotherapy in elderly cancer patients? Crit Rev Oncol Hematol. 2018;131:16-23. doi: https://doi.org/10.1016/j.critrevonc.2018.08.008 DOI: https://doi.org/10.1016/j.critrevonc.2018.08.008
van Abbema DL, van den Akker M, Janssen-Heijnen ML, et al. Patient- and tumor-related predictors of chemotherapy intolerance in older patients with cancer: a systematic review. J Geriatr Oncol. 2019;10(1):31-41. doi: https://doi.org/10.1016/j.jgo.2018.04.001 DOI: https://doi.org/10.1016/j.jgo.2018.04.001
Webster EM, Burke WM, Ware HM, et al. Patient reported outcomes in evaluation of chemotherapy toxicity in women with gynecologic malignancies: a pilot study. Gynecol Oncol. 2018;150(3):487-93. doi: https://doi.org/10.1016/j.ygyno.2018.07.008 DOI: https://doi.org/10.1016/j.ygyno.2018.07.008
Li H, Wu X, Cheng X. Advances in diagnosis and treatment of metastatic cervical cancer. J Gynecol Oncol. 2016;27(4):e43. doi: https://doi.org/10.3802/jgo.2016.27.e43 DOI: https://doi.org/10.3802/jgo.2016.27.e43
Krusun S, Pesee M, Supakalin N, et al. Treatment interruption during concurrent chemoradiotherapy of uterine cervical cancer; analysis of factors and outcomes. Asian Pac J Cancer Prev. 2014;15(14):5653-7. doi: https://doi.org/10.7314/apjcp.2014.15.14.5653 DOI: https://doi.org/10.7314/APJCP.2014.15.14.5653
Jang TK, Kim DY, Lee SW, et al. Trends in treatment during the last stages of life in end-stage gynecologic cancer patients who received active palliative chemotherapy: a comparative analysis of 10-year data in a single institution. BMC Palliat Care. 2018;17(1):99. doi: https://doi.org/10.1186/s12904-018-0348-7 DOI: https://doi.org/10.1186/s12904-018-0348-7
Muralikrishnan S, Hatzis C, Katz A, et al. Chemotherapy for elderly ovarian cancer patients. Gynecol Obstet (Sunnyvale). 2016;6(8):397. doi: https://doi.org/10.4172/2161-0932.1000397 DOI: https://doi.org/10.4172/2161-0932.1000397
Chambers LM, Son J, Radeva M, et al. Evaluation of non-completion of intraperitoneal chemotherapy in patients with advanced epithelial ovarian cancer. J Gynecol Oncol. 2019;30(6):e93. doi: https://doi.org/10.3802/jgo.2019.30.e93 DOI: https://doi.org/10.3802/jgo.2019.30.e93
Falandry C, Weber B, Savoye AM, et al. Development of a geriatric vulnerability score in elderly patients with advanced ovarian cancer treated with first-line carboplatin: a GINECO prospective trial. Ann Oncol. 2013;24(11):2808-13. doi: https://doi.org/10.1093/annonc/mdt360 DOI: https://doi.org/10.1093/annonc/mdt360
Khouri OR, Frey MK, Musa F, et al. Neoadjuvant chemotherapy in patients with advanced endometrial cancer. Cancer Chemother Pharmacol. 2019;84(2):281- 5. doi: https://doi.org/10.1007/s00280-019-03838-x DOI: https://doi.org/10.1007/s00280-019-03838-x
de Boer SM, Powell ME, Mileshkin L, et al. Toxicity and quality of life after adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2016;17(8):1114-26. doi: https://doi.org/10.1016/S1470-2045(16)30120-6 DOI: https://doi.org/10.1016/S1470-2045(16)30120-6
Hurria A, Togawa K, Mohile SG, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter Study. J Clin Oncol. 2011;29(25):3457-65. doi: https://doi.org/10.1200/JCO.2011.34.7625 DOI: https://doi.org/10.1200/JCO.2011.34.7625
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