Predictores de la No Adherencia y la No Persistencia de la Terapia Hormonal Adyuvante en Mujeres con Cáncer de Mama: Revisión Sistemática de la Literatura
DOI:
https://doi.org/10.32635/2176-9745.RBC.2025v71n4.5090Palabras clave:
Neoplasias de la Mama/terapia, Cumplimiento y Adherencia al Tratamiento, Tamoxifeno, Inhibidores de la AromatasaResumen
Introducción: La terapia hormonal adyuvante reduce la recurrencia de la enfermedad y la mortalidad en mujeres con cáncer de mama con receptores hormonales positivos. Sin embargo, muchos estudios sugieren que el tratamiento del cáncer de mama con terapia endocrina se ve comprometido por no adherencia y no persistencia. Objetivo: Identificar los predictores de baja adherencia y/o no persistencia que perjudican los buenos resultados del tratamiento con endocrinoterapia en pacientes con cáncer de mama. Método: Revisión Sistemática de la Literatura realizada en MEDLINE/PubMed, Embase y Scopus. Los estudios elegibles para esta revisión se seleccionaron mediante la aplicación Rayyan QCRI, se analizaron y clasificaron de acuerdo con la jerarquía de niveles de evidencia Grading of Recommendations Assessment, Development and Evaluations (GRADE), y se calculó la confiabilidad entre evaluadores (coeficiente Kappa). La obra fue archivada en el Registro Prospectivo Internacional de Revisiones Sistemáticas (PROSPERO) y publicada con el número CRD42021212788. Resultados: Se identificaron predictores en 21 artículos con metodología cuantitativa. Estos predictores se agruparon en siete categorías de la siguiente manera: reacciones adversas, tipos de medicamentos, duración del tratamiento, factores psicológicos, ubicación geográfica, polifarmacia/comorbilidades y aspectos relacionados con el seguimiento por el equipo multidisciplinario, considerados responsables de la no adherencia y/o no persistencia a la terapia endocrina. Conclusión: Los predictores de reacciones adversas, el uso de tamoxifeno y la duración prolongada del tratamiento se asociaron con la falta de adherencia y la falta de persistencia a la terapia hormonal para el cáncer de mama.
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