Determinantes da Perda de Peso e da Redução da Força Muscular em Pacientes com Câncer do Trato Gastrointestinal Submetidos à Quimioterapia
DOI:
https://doi.org/10.32635/2176-9745.RBC.2026v72n1.5465Palavras-chave:
Estado Nutricional/efeitos dos fármacos, Redução de Peso/efeitos dos fármacos, Força Muscular/efeitos dos fármacos, Neoplasias Gastrointestinais/tratamento farmacológico, Terapia Neoadjuvante/efeitos adversosResumo
Introdução: Tumores do trato gastrointestinal estão associados à alta prevalência de desnutrição, com perda de peso e redução da força muscular associados a pior prognóstico. Objetivo: Avaliar determinantes da perda de peso e da força muscular em pacientes com tumores gastrointestinais submetidos à quimioterapia. Método: Estudo de coorte prospectivo e observacional com pacientes submetidos à quimioterapia neoadjuvante ou exclusiva, com avaliações antes e após o término do tratamento. A avaliação subjetiva global produzida pelo paciente (ASG-PPP), o peso corporal e a força de preensão manual (FPM) foram mensurados. Resultados: Dos 51 pacientes, 53% apresentavam tumor colorretal, 53% estadiamento III, 76% desnutrição ou suspeita de desnutrição e 84% submetidos à quimioterapia neoadjuvante, com mediana de 101 dias entre a consulta pré-tratamento e a consulta próxima ao término da quimioterapia (intervalo interquartil 58–158 dias). Houve redução significativa de peso e FPM em homens e redução do escore da ASG-PPP em ambos os sexos. A localização tumoral e o intervalo entre consultas foram associados à variação de peso. Pacientes com tumor colorretal e de canal anal apresentaram quase 3 vezes mais chance de manutenção/ganho de peso comparado aos tumores de esôfago e estômago. O sexo e a duração do tratamento foram determinantes da FPM. O sexo feminino apresentou 2,3 vezes mais chance de manutenção/ganho de FPM comparado ao sexo masculino. Conclusão: Destaca-se a importância do acompanhamento nutricional e da avaliação dos fatores relacionados à perda de peso e à força muscular para a identificação precoce de pacientes em risco nutricional.
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