Avaliação do Perfil Clínico de Pacientes com Tumores Ginecológicos em Tratamento Antineoplásico

Autores

  • Ana Paula do Nascimento Antonio National Cancer Institute José Alencar Gomes da Silva (INCA). Cancer Hospital II (HCII). Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0003-0049-8868
  • Thiago Ribeiro Nery Fundação Getúlio Vargas (FGV). Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0002-1228-2864
  • Liliana Rosa Alves Manaças National Cancer Institute José Alencar Gomes da Silva (INCA). Cancer Hospital II (HCII). Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0002-6918-0391
  • Priscila Helena Marietto Figueira National Cancer Institute José Alencar Gomes da Silva (INCA). Cancer Hospital II (HCII). Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0001-5516-2961

DOI:

https://doi.org/10.32635/2176-9745.RBC.2022v68n1.1879

Palavras-chave:

neoplasias dos genitais femininos, efeitos colaterais e reações adversas relacionados a medicamentos, antineoplásicos, suspensão de tratamento

Resumo

Introdução: A avaliação das causas de interrupção do plano terapêutico antineoplásico permite a elaboração de estratégias que aumentem a adesão e os desfechos positivos do tratamento. Objetivo: Traçar o perfil clínico das pacientes com tumores ginecológicos, em tratamento antineoplásico intravenoso, identificando o risco de interrupção do plano terapêutico. Método: Estudo retrospectivo e quantitativo (2011-2018), incluindo pacientes maiores de 18 anos, com tumores ginecológicos em tratamento antineoplásico. O banco de dados foi construído a partir das planilhas de controle de antineoplásicos da Central de Quimioterapia. As variáveis coletadas foram ano de tratamento, idade, tipo de tumor, finalidade do tratamento, protocolo, medicamento, dose, início e término do tratamento e interrupção do tratamento. Resultados: Avaliaram-se 6.496 pacientes ao longo de oito anos. Cinquenta e dois por cento das pacientes apresentavam câncer cervical. Quase 48% (47,6%) apresentaram uma finalidade de tratamento paliativo para seus tumores. Aproximadamente 23% (22,6%) interromperam o tratamento antineoplásico. Para fins adjuvantes, curativos e paliativos, a faixa etária de 18 a 30 anos apresentou a maior interrupção, respectivamente 33%, 36% e 41%. O protocolo paclitaxel/carboplatina foi o mais prescrito com percentual significativo de interrupção. Conclusão: Os achados sugerem que exista uma associação entre a suspensão do tratamento e a idade dos pacientes e a finalidade terapêutica.

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Referências

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

Publicado

2021-12-23

Como Citar

1.
Antonio AP do N, Nery TR, Manaças LRA, Figueira PHM. Avaliação do Perfil Clínico de Pacientes com Tumores Ginecológicos em Tratamento Antineoplásico. Rev. Bras. Cancerol. [Internet]. 23º de dezembro de 2021 [citado 25º de novembro de 2024];68(1):e-011879. Disponível em: https://rbc.inca.gov.br/index.php/revista/article/view/1879

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