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1.
Rev. Ateneo Argent. Odontol ; 64(1): 22-27, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1248381

ABSTRACT

La Asociación Americana de Cirugía Oral y Maxilofacial (American Association of Oral and Maxillofacial Surgeons [AAOMS]): define el concepto de osteonecrosis maxilar asociada a drogas antirresortivas (MRONJ) como: «área ósea necrótica expuesta al medio bucal con más de ocho semanas de permanencia, en presencia de tratamiento crónico con bifosfonatos en ausencia de radioterapia en cabeza y cuello¼. El objetivo de este artículo es asociar la enfermedad oncológica en relación con las drogas antirresortivas consumidas por pacientes, la prescripción de dichas drogas y el depósito de ellas en el organismo. Al mismo tiempo, la interacción médico-odontológico debe implementarse en favor de la salud de nuestros pacientes (AU)


American Association of Oral and Maxillofacial Surgeons AAOMS defined Medication Related of the Jaw (MRONJ) as «necrotic bone area exposed to the oral environment with more than eight weeks of permanence, in the presence of chronic treatment with BPs, in the absence of radiation therapy to the head and neck¼. The objective of this article is associate oncology antiresorptives treatments prescribed by physicians, their prescription and body accumulation in patients whose are treated with them. Interdisciplinary dental and physician clinical treatments must be implemented in patient favours (AU)


Subject(s)
Humans , Female , Diphosphonates/adverse effects , Bone Density Conservation Agents/adverse effects , Bisphosphonate-Associated Osteonecrosis of the Jaw , Radiotherapy/adverse effects , Breast Neoplasms/complications , Risk Factors , Diphosphonates/pharmacokinetics , Interprofessional Relations
2.
Rev. bras. cancerol ; 67(2): e-071133, 2021.
Article in Portuguese | LILACS | ID: biblio-1223054

ABSTRACT

Introdução: Diversos efeitos colaterais podem acometer a pele e seus anexos durante o tratamento oncológico de mulheres com câncer de mama, comprometendo a terapia. Objetivo: Identificar a ocorrência de alterações dermatológicas durante o tratamento oncológico de mulheres com câncer de mama. Método: Estudo documental e retrospectivo, de cunho quantitativo, com uso de dados secundários obtidos por meio de 190 prontuários clínicos (n=190) de um serviço privado de oncologia. Resultados: As participantes apresentaram média de idade de 53 anos (±11,2), com diagnóstico histopatológico de carcinoma ductal invasivo (85,8%). Todas foram submetidas à quimioterapia, 65,3% à mastectomia radical e 34,2% à radioterapia. As alterações dermatológicas identificadas e as ocorrências verificadas na amostra foram alopecia (94,2%), hiperpigmentação (48,4%), prurido (36,3%), eritema (6,8%), descamação (25,8%) e alterações ungueais (77,9%). Ao todo, foram identificadas 550 alterações dermatológicas, resultando em uma média de 2,9 (±1,3) por paciente. A radioterapia esteve associada a uma maior ocorrência de eritema (p<0,001) e mulheres expostas a taxanos apresentaram maior probabilidade de manifestar de alterações dermatológicas do que as não expostas (p<0,001), bem como fatores sociodemográficos não estiveram associados. Conclusão: A ocorrência de alterações dermatológicas identificadas nas participantes foi significativa, reforçando que essas manifestações podem ser frequentes em mulheres com câncer de mama durante o tratamento oncológico, requerendo medidas de prevenção e tratamento.


Introduction: Several side effects can affect the skin and its attachments during cancer treatment of women with breast cancer, compromising the therapy. Objective: To identify the occurrence of dermatological changes during cancer treatment of women with breast cancer. Method:Quantitative approach, documentary and retrospective study, using secondary data obtained from 190 clinical records (n=190) from a private oncology service. Results: The participants had a mean age of 53 years (±11.2), with histopathological diagnosis of invasive ductal carcinoma (85.8%). All participants were exposed to chemotherapy, 65.3% to radical mastectomy and 34.2% to radiotherapy. The dermatological alterations identified, and the occurrences verified in the sample were alopecia (94.2%), hyperpigmentation (48.4%), pruritus (36.3%), erythema (6.8%), desquamation (25.8%) and nail alterations (77.9%). In all, 550 dermatological alterations were identified, resulting in an average of 2.9 (±1.3) changes per patient. Radiotherapy was associated with a higher occurrence of erythema (p<0.001) and women exposed to taxanes were more likely to manifest dermatological alterations than those unexposed (p<0.001), sociodemographic factors were not associated. Conclusion: The occurrence of dermatological alterations identified in the participants was significant, reinforcing that these manifestations may be frequent in women with breast cancer during oncological treatment, requiring prevention and treatment actions.


Introducción: Varios efectos secundarios pueden afectar la piel y sus uniones durante el tratamiento del cáncer de mujeres con cáncer de mama, comprometiendo la terapia. Objetivo: Identificar la aparición de alteraciones dermatológicas durante el tratamiento del cáncer de mujeres con cáncer de mama. Método: Estudio documental y retrospectivo, de carácter cuantitativo, utilizando datos secundarios obtenidos de 190 registros clínicos (n=190) de un servicio oncológico privado. Resultados: Los participantes tenían una edad media de 53 años (±11,2), con diagnóstico histopatológico de carcinoma ductal invasivo (85,8%). Todas fueran sometidas a quimioterapia, el 65,3% a mastectomía radical y el 34,2% a radioterapia. Las alteraciones dermatológicas identificadas y las ocurrencias verificadas en la muestra fueron alopecia (94,2%), hiperpigmentación (48,4%), prurito (36,3%), eritema (6,8%), descamación (25,8%) y alteraciones en las uñas (77,9%). En total, se identificaron 550 alteraciones dermatológicas, lo que resultó en un promedio de 2,9 (±1,3) por paciente. En total, se identificaron 550 cambios dermatológicos, lo que resultó en un promedio de 2,9 (±1,3) alteraciones por paciente. La radioterapia se asoció con una mayor incidencia de eritema (p<0,001) y las mujeres expuestas a taxanos tienen más probabilidades de manifestar alteraciones dermatológicas que las no expuestas (p<0,001), además de que no se asociaron factores sociodemográficos. Conclusión: La ocurrencia de alteraciones dermatológicas identificadas en las participantes fue significativa, reforzando que estas manifestaciones pueden ser frecuentes en mujeres con cáncer de mama durante el tratamiento oncológico, requiriendo acciones de prevención y tratamiento.


Subject(s)
Radiotherapy/adverse effects , Skin Diseases , Breast Neoplasms/therapy , Antineoplastic Agents/adverse effects , Drug-Related Side Effects and Adverse Reactions/radiotherapy
3.
Femina ; 48(12): 747-752, 20201231. tab
Article in Portuguese | LILACS | ID: biblio-1141185

ABSTRACT

A qualidade de vida sexual é frequentemente afetada após tratamento oncológico em ginecologia. Reportamos a qualidade de vida sexual de pacientes em seguimento no serviço de Oncologia Ginecológica da Universidade Federal do Triângulo Mineiro, por meio da aplicação do questionário validado FSFI (Female Sexual Function Index), comparando pacientes diagnosticadas com câncer de colo uterino que receberam tratamento radioterápico com aquelas que foram submetidas a tratamento para câncer de colo uterino no qual não foi necessária a realização de radioterapia. Foi realizada análise estatística utilizando os testes D'Agostino-Pearson e o teste não paramétrico Mann-Whitney. Concluiu-se que a diminuição do desejo e da excitação foi mais frequente nas mulheres tratadas com radioterapia e que não houve diferença significativa entre as pacientes a respeito de lubrificação, orgasmo, satisfação e dispareunia.(AU)


Quality of sexual life is often affected after oncological treatment in gynecology. We report the quality of sexual life of patients in a follow-up at the Gynecological Oncology service of the Federal University of Triângulo Mineiro, through the application of a questionnaire validated in the Portuguese language. The purpose of this study was to compare cervical cancer patients diagnosed who received radiotherapy with those who have been submitted to treatment for cervical cancer in which it was not necessary to perform radiotherapy. Decreased desire and arousal were more frequent in women treated with radiotherapy. Statistical analysis was performed using the D'Agostino-Pearson tests and the non-parametric Mann-Whitney test. It was concluded that decreased desire and arousal were more frequent in women treated with radiotherapy, and that there was no significant difference between patients regarding lubrication, orgasm, satisfaction and dyspareunia.(AU)


Subject(s)
Humans , Female , Quality of Life , Radiotherapy/adverse effects , Uterine Cervical Neoplasms/physiopathology , Sexuality , Hysterectomy/adverse effects , Brazil/epidemiology , Uterine Cervical Neoplasms/radiotherapy , Surveys and Questionnaires , Data Interpretation, Statistical , Statistics, Nonparametric
4.
Rev. bras. ginecol. obstet ; 42(11): 759-768, Nov. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144181

ABSTRACT

Abstract Objective: To analyze the long-term effects of antineoplastic treatments on patient fertility. Selection of Studies: The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. Data Collection: The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. Data Synthesis: Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. Conclusion: Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.


Resumo Objetivo: Analisar os efeitos a longo prazo dos tratamentos antineoplásicos na fertilidade de pacientes. Fontes de dados: Os estudos foram selecionados através das bases de dados New PubMed, Scielo e Lilacs, junto com as referências utilizadas para a confecção do trabalho. Seleção dos estudos: Para a seleção dos estudos, foram utilizados artigos publicados entre os períodos de 01 de janeiro de 2015 a 06 de abril de 2020 nos idiomas inglês, português e espanhol. Como critérios de inclusão: estudos de coorte e estudos realizados in vitro. Como critérios de exclusão: artigos de revisão, relatos de caso, estudos que não abordavam a temática reprodução, estudos que não abordavam a temática câncer, artigos utilizando animais, artigos que abordavam preservação da fertilidade e artigos em duplicidade nas bases. Coleta de dados: Os dados coletados incluíram: idade do paciente ao início do tratamento, tipo de neoplasia, tipo de tratamento antineoplásico, quimioterápicos utilizados, dosagem da radioterapia, local da radioterapia, efeito dos agentes antineoplásicos na fertilidade e número de pacientes dentro do estudo. Síntese de dados: Trinta estudos foram avaliados. Os agentes quimioterápicos antineoplásicos e a radioterapia modulam níveis séricos hormonais de marcadores de fertilidade, reduzem a quantidade de células germinativas e estão correlacionados com um aumento da taxa de esterilidade. Os efeitos citados anteriormente ocorreram em pacientes com idade pré-púbere e pós-púbere. Conclusão: Os tratamentos antineoplásicos possuem efeitos citotóxicos em células germinativas, levando a modulação hormonal, e o status puberal não interfere diretamente na ação citotóxica das terapias.


Subject(s)
Humans , Female , Radiotherapy/adverse effects , Infertility, Female , Antineoplastic Agents/adverse effects , Fertility Preservation , Neoplasms/drug therapy , Neoplasms/radiotherapy
5.
An. Fac. Cienc. Méd. (Asunción) ; 53(2): 165-168, 20200800.
Article in Spanish | LILACS | ID: biblio-1119717

ABSTRACT

La enteritis por radiación o enteritis actínica es una complicación secundaria al uso de radioterapia para tratamiento de tumores pélvicos, que puede afectar con mayor frecuencia al intestino delgado (principalmente íleon) y al colon. La cirugía en pacientes con enteritis por radiación crónica debe reservarse ante la presencia de complicaciones, ya que está relacionada con una alta morbilidad y estancia hospitalaria prolongadas, así como posibilidad de re operación. Exponemos el caso de una paciente con oclusión intestinal secundaria a enteritis por radiación que desarrolló años después de la conclusión de su tratamiento por cáncer de cuello uterino, con el objetivo de que esta enfermedad sea sospechada en pacientes con antecedentes de radiación.


Radiation enteritis or actinic enteritis is a complication secondary to the use of radiotherapy to treat pelvic tumors, which can more frequently affect the small intestine (mainly ileum) and the colon. Surgery in patients with chronic radiation enteritis should be reserved in the presence of complications, since it is related to high morbidity and prolonged hospital stay, as well as the possibility of reoperation. We present the case of a patient with intestinal occlusion secondary to radiation enteritis who developed years after the conclusion of her treatment due to cervical cancer, with the objective that this disease has to be suspected in patients with history of radiation.


Subject(s)
Gastrointestinal Tract/radiation effects , Enteritis , Radiation , Radiotherapy/adverse effects
6.
Rev. bras. cancerol ; 66(1)20200129.
Article in Portuguese | LILACS | ID: biblio-1094999

ABSTRACT

Introdução: A qualidade de vida de pacientes oncológicos tem sido objeto de estudo em muitos trabalhos brasileiros. Contudo, apesar da alta prevalência de indivíduos submetidos à radioterapia, poucos estudos com ênfase nesse grupo de pacientes foram identificados. Objetivo: Avaliar a qualidade de vida e a prevalência de sintomas depressivos em pacientes com neoplasias malignas durante o tratamento radioterápico. Método: Estudo transversal quantitativo realizado com 153 pacientes oncológicos em vigência de tratamento radioterápico em um centro especializado em oncologia e radioterapia, localizado no Noroeste do Estado do Paraná. Os dados foram coletados entre março e setembro de 2018. O European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) e o Inventário de Depressão de Beck foram utilizados para avaliar a qualidade de vida e os sintomas depressivos, respectivamente. Resultados: Os domínios "qualidade de vida", "função cognitiva" e "função social" foram os que menos se mostraram prejudicados na amostra estudada, enquanto "insônia", "perda de apetite" e "dificuldades financeiras" destacaram-se entre os maiores preditores de baixa qualidade de vida. Ademais, contatou-se que 22% dos indivíduos avaliados apresentaram algum grau de transtorno de humor, sendo 11% diagnosticados com depressão. Conclusão: O declínio na qualidade de vida e a prevalência de sintomas depressivos em pacientes oncológicos, mesmo os em vigência de radioterapia, enaltecem a importância de intervenções precoces que visem a restabelecer a funcionalidade e o bem-estar.


Introduction: The quality of life of cancer patients has been studied in many Brazilian papers. However, despite the high prevalence of individuals undergoing radiotherapy, few studies with emphasis in this group of patients have been identified. Objective: To evaluate the quality of life and the prevalence of depressive symptoms in patients with malignant neoplasms undergoing radiotherapy treatment. Method: Quantitative cross-sectional study with 153 cancer patients undergoing radiotherapy treatment at an oncology and radiotherapy specialized center, located in the northwest of Paraná state. Data were collected between March and September 2018. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Beck Inventory were used to assess quality of life and depressive symptoms, respectively. Results: The domains "quality of life", "cognitive function" and "social function" were the least affected in the studied sample, while "insomnia", "loss of appetite" and "financial difficulties" stood out among the higher predictors of poor quality of life. In addition, it was found that 22% of the individuals evaluated had some degree of mood disorder, 11% being diagnosed with depression. Conclusion: The decline in quality of life and the prevalence of depressive symptoms in cancer patients, even those undergoing radiotherapy, emphasize the importance of early interventions aimed at restoring functionality and well-being.


Introducción: La calidad de vida de los pacientes con cáncer se ha estudiado en muchos estudios brasileños. Sin embargo, a pesar de la alta prevalencia de individuos sometidos a radioterapia, se han identificado pocos estudios con énfasis en este grupo de pacientes. Objetivo: Evaluar la calidad de vida y la prevalencia de síntomas depresivos en pacientes con neoplasias malignas sometidas a radioterapia. Método: Estudio transversal cuantitativo realizado con 153 pacientes con cáncer sometidos a tratamiento de radioterapia en un centro especializado en oncología y radioterapia, ubicado en el Noroeste del Estado de Paraná. Los datos se recopilaron entre marzo y septiembre de 2018. El European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) y el Inventario Beck se utilizaron para evaluar la calidad de vida y los síntomas depresivos, respectivamente. Resultados: Los dominios "calidad de vida", "función cognitiva" y "función social" fueron los menos afectados en la muestra estudiada, mientras que el "insomnio", la "pérdida de apetito" y las "dificultades financieras" se destacaron entre los dominios. predictores más altos de mala calidad de vida. Además, se encontró que el 22% de los individuos evaluados tenían algún grado de trastorno del estado de ánimo, y el 11% fue diagnosticado con depresión. Conclusión: La disminución de la calidad de vida y la prevalencia de síntomas depresivos en pacientes con cáncer, incluso en aquellos que reciben radioterapia, enfatizan la importancia de las intervenciones tempranas destinadas a restaurar la funcionalidad y el bienestar.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Quality of Life , Depression/epidemiology , Neoplasms/psychology , Neoplasms/radiotherapy , Radiotherapy/adverse effects , Brazil , Cross-Sectional Studies , Psycho-Oncology
8.
Article in Chinese | WPRIM | ID: wpr-879923

ABSTRACT

Radiation-induced lung injury (RILI), including acute radiation pneumonitis and chronic radiation-induced pulmonary fibrosis (RIPF), is a side effect of radiotherapy for lung cancer and esophageal cancer. Pulmonary macrophages, as a kind of natural immune cells maintaining lung homeostasis, play a key role in the whole pathological process of RILI. In the early stage of RILI, classically activated M1 macrophages secrete proinflammatory cytokines to induce inflammation and produce massive reactive oxygen species (ROS) through ROS-induced cascade to further impair lung tissue. In the later stage of RILI, alternatively activated M2 macrophages secrete profibrotic cytokines to promote the development of RIPF. The roles of macrophage in the pathogenesis of RILI and the related potential clinical applications are summarized in this review.


Subject(s)
Humans , Lung/radiation effects , Lung Injury/physiopathology , Macrophages/metabolism , Radiation Injuries , Radiation Pneumonitis/etiology , Radiotherapy/adverse effects
9.
Int. j. morphol ; 37(4): 1564-1571, Dec. 2019. tab
Article in Spanish | LILACS | ID: biblio-1040170

ABSTRACT

Las glándulas salivales humanas pueden ser gravemente lesionadas por la radioterapia utilizada contra neoplasias de cabeza y cuello, produciendo hiposialia y xerostomía, las cuales afectan la salud oral y sistémica, mermando la calidad de vida de la persona. Los tratamientos convencionales actuales están diseñados para disminuir los síntomas, sin actuar sobre los cambios fisiopatológicos que se dan a nivel glandular. Esta revisión intenta analizar aquellas terapias preventivas y/o curativas que están desarrollándose en el campo biomolecular y que tienen un futuro prometedor por sus características innovadoras: terapia génica, terapia con células madre y terapia con factores de crecimiento. Se evidencia un aporte adicional de la nanotecnología, la cual está mejorando las vías de aplicación de los tratamientos.


Human salivary glands can be seriously injured by the radiotherapy used against head and neck neoplasms, producing hyposialia and xerostomy, which affect oral and systemic health, diminishing the person's quality of life. Current conventional treatments are designed to reduce symptoms, without acting on the pathophysiological changes that occur at the glandular level. This review attempts to analyze those preventive and /or curative therapies that are developing in the biomolecular field and that have a promising future due to their innovative features: Gene therapy, stem cell therapy and growth factor therapy. An additional contribution of nanotechnology is evident, which is improving the routes of treatment application.


Subject(s)
Humans , Radiotherapy/adverse effects , Salivary Gland Diseases/prevention & control , Stem Cells/physiology , Genetic Therapy/methods , Intercellular Signaling Peptides and Proteins/therapeutic use , Radiation Injuries/prevention & control , Radiation-Protective Agents/therapeutic use , Salivary Gland Diseases/therapy , Salivary Glands/radiation effects , Xerostomia/prevention & control , Nanotechnology
10.
Rev. Assoc. Med. Bras. (1992) ; 65(6): 902-908, June 2019. tab, graf
Article in English | LILACS | ID: biblio-1012998

ABSTRACT

SUMMARY OBJECTIVE: To evaluate the epidemiological data and available treatments for fractures secondary to radiotherapy treatment. METHODS: Identification of publications on pathological skeletal fractures previously exposed to ionizing radiation. RESULTS: The incidence of fractures after irradiation varies from 1.2% to 25% with a consolidation rate of 33% to 75%, being more frequent in the ribs, pelvis, and femur. The time elapsed between irradiation and fracture occurs years after radiotherapy. Risk factors include age above 50 years, female gender, extensive periosteal detachment, circumferential irradiation, tumor size, and anterior thigh location. The etiology is still uncertain, but cellular disappearance, reduction of bone turnover and activity were observed hematopoietic as possible causes of failure of consolidation. CONCLUSION: There is no consensus in the literature on the factors related to the development of fractures, with radiation dose, previous tumor size and periosteal detachment being suggested as potential factors.


RESUMO OBJETIVO: Avaliar dados epidemiológicos e tratamentos disponíveis para fraturas secundárias ao tratamento radioterápico. MÉTODOS: Identificação de publicações sobre as fraturas patológicas ocorridas em esqueleto previamente exposto à radiação ionizante. RESULTADOS: A incidência de fraturas após irradiação varia de 1,2% a 25% com taxa de consolidação de 33% a 75%, sendo mais frequente em costelas, pelve e fêmur. O tempo decorrido entre a irradiação e a fratura ocorre anos após a radioterapia. Os fatores de risco incluem idade acima de 50 anos, sexo feminino, descolamento periosteal extenso, irradiação circunferencial, tamanho do tumor e localização anterior na coxa. A etiologia ainda é incerta, mas foram observados desaparecimento celular, redução do turnover ósseo e da atividade hematopoiética como possíveis causas da falha de consolidação. CONCLUSÃO: Não há consenso na literatura avaliada sobre os fatores relacionados ao desenvolvimento de fraturas, sendo a dose de radiação, o tamanho prévio do tumor e o descolamento periosteal sugeridos como fatores potenciais.


Subject(s)
Humans , Radiation Injuries/complications , Radiotherapy/adverse effects , Fractures, Bone/etiology , Risk Factors , Fractures, Bone/physiopathology
11.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 785-791, abr.-maio 2019.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-987479

ABSTRACT

Objective: The study's purpose has been to summarize the knowledge about primary studies that investigated radiotherapy experiences from the perspective of head and neck cancer patients. Methods: It is an integrative literature review. Results: The final sample consisted of 13 studies that were published from 1998 to 2015. Through the studies thematic analysis were identified four major themes, as follows: "physical consequences of radiotherapy", "psychological and emotional repercussions of radiotherapy", "lack of information about the treatment and posture of the health professional regarding the treatment adverse effects" and "support networks". Conclusion: The studies showed that the radiotherapy treatment had important negative repercussions in the patients' life regarding the reactions and readjustments, and also the roles played family wise, all due to the treatment. There was also an important knowledge gap on the subject, then demonstrating the need for new studies with a qualitative approach, aiming to better understand this experience, therefore, producing care improvement


Objetivo: Sintetizar o conhecimento de estudos primários que investigaram a experiência da radioterapia, na perspectiva do paciente com câncer de cabeça e pescoço. Método: Revisão integrativa da literatura. Resultados: Amostra final composta por 13 estudos publicados entre 1998 a 2015. Pela análise temática dos estudos foram identificados quatro temas maiores: "repercussões físicas da radioterapia", "repercussões psicológicas e emocionais da radioterapia", "falta de informação sobre o tratamento e a postura do profissional de saúde perante os efeitos adversos do tratamento" e "redes de apoio". Conclusão: Os estudos evidenciaram que o tratamento radioterápico trouxe repercussões negativas importantes na vida dos pacientes frente às reações e rearranjos na vida e nos papéis desempenhados dentro da família, decorrentes do tratamento. Verificou-se também uma lacuna importante de conhecimento sobre a temática, demonstrando a necessidade de novos estudos, com abordagem qualitativa, para melhor compreensão desta experiência, refletindo em aprimoramento da assistência


Objetivo: Sintetizar el conocimiento de estudios primarios que investigaron la experiencia de la radioterapia, en la perspectiva del paciente con cáncer de cabeza y cuello. Método: Revisión integrativa de la literatura. Resultados: La muestra final consistió en 13 estudios publicados entre 1998 y 2015. En el análisis temático de los estudios se identificaron cuatro temas más grandes: "repercusiones físicas de la radioterapia", "repercusiones psicológicas y emocionales de la radioterapia", "falta de información sobre el tratamiento y la la postura del profesional de la salud ante los efectos adversos del tratamiento y las redes de apoyo. Conclusión: Los estudios evidenciaron que el tratamiento radioterápico trajo repercusiones negativas importantes en la vida de los pacientes frente a las reacciones y reajustes en la vida y en los papeles desempeñados dentro de la familia, derivados del tratamiento. Se verificó también una laguna importante de conocimiento sobre la temática, demostrando la necesidad de nuevos estudios, con abordaje cualitativo, para una mejor comprensión de esta experiencia, reflejando en el perfeccionamiento de la asistencia


Subject(s)
Humans , Male , Female , Head and Neck Neoplasms/nursing , Head and Neck Neoplasms/psychology , Head and Neck Neoplasms/radiotherapy , Radiotherapy/adverse effects , Radiotherapy/nursing
12.
CoDAS ; 31(4): e20180176, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1019721

ABSTRACT

RESUMO Objetivo Analisar os efeitos da eletroestimulação sobre o fluxo salivar de pacientes com hipossalivação induzida por radioterapia em região de cabeça e pescoço. Estratégia de pesquisa Utilizaram-se as bases de dados Medline (via Pubmed), Cochrane Library, Scopus e Lilacs. Critérios de seleção Foram selecionados os ensaios clínicos que avaliaram objetivamente o fluxo salivar, publicados nos últimos 10 anos em português, inglês ou espanhol. Análise dos dados Para avaliação metodológica dos estudos, foi utilizada a escala PEDro. Resultados A estratégia de busca resultou em 21 publicações, sendo que 17 foram excluídas, selecionando-se assim 4 artigos. Os estudos incluídos contaram com um total de 212 participantes, sendo que todos demonstraram aumento do fluxo salivar, tanto por meio do método de eletroacupuntura quanto pela estimulação aplicada diretamente sobre as glândulas salivares. A pontuação obtida por meio da escala PEDro foi baixa, evidenciando qualidade metodológica baixa e com consideráveis riscos de viés. Conclusão os estudos incluídos demonstram o potencial clínico da TENS no aumento do fluxo salivar de pacientes com câncer de cabeça e pescoço tratados com RT.


ABSTRACT Purpose To analyze the effects of electrical stimulation on the salivary flow of head and neck cancer patients with radiotherapy-induced hyposalivation. Research strategies Searches were made in the Medline (via Pubmed), Cochrane Library, Scopus and Lilacs databases. Selection criteria Selection included clinical trials that evaluated salivary flow objectively, published in the last 10 years in either Portuguese, English or Spanish. Data analysis The PEDro scale was used for the methodological evaluation of the studies. Results The search strategy resulted in 21 publications, 17 of which were excluded, hence there were 4 articles left. The included studies had a total of 212 participants, all of whom had an increase in salivary flow, both through the electroacupuncture method and direct application on the salivary glands. The score obtained through the PEDRo scale was low, evidencing questionable methodological quality and risk of bias. Conclusion The included studies demonstrate the clinical potential of TENS to increase the salivary flow of head and neck cancer patients treated with RT.


Subject(s)
Humans , Radiotherapy/adverse effects , Xerostomia/therapy , Electric Stimulation , Xerostomia/etiology , Clinical Trials as Topic , Head and Neck Neoplasms/radiotherapy
13.
Rev. inf. cient ; 98(1): 44-52, 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1016477

ABSTRACT

Introducción: el cáncer de próstata es la primera causa de muerte por cáncer en los hombres cubanos y afecta la calidad de su vida sexual. Objetivo: caracterizar los resultados del uso del sildenafil para el manejo de la disfunción sexual eréctil en pacientes con cáncer de próstata tratados con hormonas o radioterapia. Método: se realizó un estudio observacional, ambispectivo y transversal, en el Servicio de Urología del Hospital "Dr. Agostinho Neto" de Guantánamo durante el periodo 2014-2018, que se aprobó por el comité de ética médica. El universo de estudio se conformó por 70 pacientes con diagnóstico de cáncer de próstata, tratados con hormonas o radioterapia, y que presentaron disfunción eréctil. En cada paciente se estudió la edad, tratamiento que se aplicó para el cáncer, tiempo de aparición de la disfunción luego de este, y la respuesta de la función eréctil del pene al uso de sildenafil. Resultados: el 37,2 por ciento de los pacientes tenían entre 70 y 79 años de edad y el 79,1 por ciento se trató con hormonas; la mayor proporción presentó disfunción eréctil de 1 a 2 años después del tratamiento (48,8 por ciento); el 81,4 por ciento respondió adecuadamente al tratamiento con sildenafil, lo que fue independiente del tratamiento del cáncer con hormonas o radioterapia. Conclusiones: los pacientes con cáncer de próstata tratados con hormonas y/o radioterapia se benefician de los efectos del sildenafil(AU)


Introduction: the prostate cancer is the first cause of death for cancer in the Cuban men and it affects the sexual quality of life. Objective: to characterize the results of the use of the sildenafil for the management of the erectile sexual dysfunction in patient with prostate cancer tried with hormones or radiotherapy. Method: was an observational, ambispective and traverse study, in the Service of Urology of the Hospital "Dr. Agostinho Neto" of Guantánamo during the period 2014-2018 that it was approved by the committee of medical ethics. The study universe conformed to for 70 patients with diagnostic of prostate cancer, treaties with hormones and/or radiotherapy, and that they presented erectile dysfunction. In each patient was studied the age, treatment that was applied for the cancer, time of appearance of the dysfunction after this, and the answer of the erectile function of the penis to the sildenafil use. Results: The 37.2 percent of the patients had between 70 and 79 years of age and 79.1 percent were talked with hormones. The biggest proportion presented erectile dysfunction 1 to 2 years after the treatment (48.8 percent). The 81.4 percent responded appropriately to the treatment with sildenafil, what was independent of the treatment of the cancer with hormones or radiotherapy. Conclusion: The patients with prostate cancer tried with hormones and/or radiotherapy benefitted with the use of the sildenafil(AU)


Introdução: em Cuba, o câncer de próstata é a principal causa de morte por câncer em homens. Objetivo: sistematizar as bases teóricas essenciais que sustentam a autopreparação do estudante de medicina e do clínico geral para sua participação na prevenção, diagnóstico precoce e manejo do paciente com câncer de próstata. Método: na Faculdade de Medicina de Guantánamo, entre setembro e dezembro de 2018; foi realizada uma busca nas bases de dados eletrônicas por meio do mecanismo de metabusca do Google Acadêmico. Resultados: elaborouse uma monografia sobre as atuais considerações sobre o câncer de próstata em nível de estudantes de medicina e clínico geral que continhaos seguintes núcleos de conhecimento: definição, fisiopatologia, etiologia, diagnóstico e tratamento. Conclusões: A expressão clínica desse tipo de câncer é diversa e ainda não tem biomarcadores precisos para o diagnóstico, o que torna inevitável permitindo que clínicos gerais para contribuir de forma eficaz na prevenção e no diagnóstico clínico precoce em termos de assegurar ao paciente um maior chance de cura e sobrevivencia(AU)


Subject(s)
Humans , Male , Radiotherapy/adverse effects , Treatment Outcome , Sildenafil Citrate/therapeutic use , Erectile Dysfunction/drug therapy , Prostatic Neoplasms , Cross-Sectional Studies , Observational Study
14.
J. appl. oral sci ; 27: e20180044, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-975876

ABSTRACT

Abstract Radiation-related caries are one the most undesired reactions manifested during or after head and neck radiotherapy. Fluoride application is an important strategy to reduce demineralization and enhance remineralizaton. Objective: To evaluate the effect of the topical application of fluoride during irradiation on dental enamel demineralization. Material and Methods: Thirty molars were randomly divided into three groups: Non-irradiated (NI), Irradiated (I), Irradiated with fluoride (IF). Each group was subdivided according to the presence or absence of pH-cycling (n=5). In the irradiated groups, the teeth received 70 Gy. The enamel's chemical composition was measured using Fourier Transform Infrared Spectrometry (organic matrix/mineral ratio - M/M and relative carbonate content - RCC). Vickers microhardness (VHN) and elastic modulus (E) were evaluated at three depths (surface, middle and deep enamel). Scanning electron microscopy (SEM) was used to assess the enamel's morphology. Results: The FTIR analysis (M/M and RCC) showed significant differences for irradiation, pH-cycling and the interaction between factors (p<0.001). Without pH-cycling, IF had the lowest organic matrix/mineral ratio and relative carbonate content. With pH-cycling, the organic matrix/mineral ratio increased and the relative carbonate content decreased, except for IF. VHN was influenced only by pH-cycling (p<0.001), which generated higher VHN values. ANOVA detected significant differences in E for irradiation (p<0.001), pH-cycling (p<0.001) and for the interaction between irradiation and pH-cycling (p<0.001). Increased E was found for group I without pH-cycling. With pH-cycling, groups I and IF were similar, and showed higher values than NI. The SEM images showed no morphological changes without pH-cycling. With pH-cycling, fluoride helped to maintain the outer enamel's morphology. Conclusions: Fluoride reduced mineral loss and maintained the outer morphology of irradiated and cycled enamel. However, it was not as effective in preserving the mechanical properties of enamel. Radiotherapy altered the enamel's elastic modulus and its chemical composition.


Subject(s)
Humans , Cariostatic Agents/pharmacology , Fluorides, Topical/pharmacology , Tooth Demineralization/prevention & control , Dental Enamel/drug effects , Radiotherapy/adverse effects , Reference Values , Surface Properties , Microscopy, Electron, Scanning , Cariostatic Agents/radiation effects , Cariostatic Agents/chemistry , Random Allocation , Fluorides, Topical/radiation effects , Fluorides, Topical/chemistry , Reproducibility of Results , Analysis of Variance , Tooth Demineralization/etiology , Spectroscopy, Fourier Transform Infrared , Dental Enamel/radiation effects , Elastic Modulus , Hardness Tests , Hydrogen-Ion Concentration
15.
Appl. cancer res ; 39: 1-5, 2019. ilus, tab
Article in English | LILACS, Inca | ID: biblio-997737

ABSTRACT

Purpose: We investigated the clinical outcome of sodium alginate treatment in radiation-induced pharyngeal mucositis (RIPM) after neck irradiation. Materials and methods: The study population included 32 patients (11 lung cancer, 10 breast cancer, 7 head and neck cancer, and 4 other primary lesions) who underwent neck external beam radiotherapy at the authors' institution between June 2006 and 2016. The patients received 5% sodium alginate solution orally for RIPM. Those who were followed up for less than 2 months or did not receive 5% sodium alginate were excluded from this retrospective study. RIPM was graded weekly as an acute toxicity according to the Common Terminology Criteria for Adverse Events (CTCAE), version 4. The administration of 10-15 ml of sodium alginate before each meal was continued until the radiotherapy was completed and after resolution of odynophagia. The efficacy of sodium alginate was assessed by two radiation oncologists as follows: Grade I, ineffective; grade II, moderately effective; grade III, very effective. When sodium alginate was ineffective, other analgesics, such as nonsteroidal antiinflammatory drugs (NSAIDS) or opioids, were added. Relationships between the presence/absence of additional analgesics and the radiation dose were investigated. Results: The median duration from the start of irradiation to sodium alginate administration was 15 days (range, 5­36 days). RIPM improved in 29/32 patients (grade: II, n = 22; III, n = 7). Three patients showed no improvement. No sodium alginate-related toxicities occurred. Additional analgesics were required in 5/32 patients. The radiation dose in these 5 patients was significantly higher than that in the sodium alginate-alone group (63.6 ± 7.8 Gy vs 48.3 ± 14.8Gy, P = 0.02). Patients who received > 50 Gy tended to require additional analgesics more frequently than those who received ≤50Gy (P = 0.10). Conclusions: The concurrent administration of sodium alginate and neck irradiation was feasible and tolerable without obvious toxicities. Under certain conditions sodium alginate could be a promising alternative to NSAIDs and opioids in RIPM. The results justify further prospective evaluations with detailed treatment protocols to clarify whether sodium alginate can improve RIPM (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Pharynx/radiation effects , Alginates/therapeutic use , Mucositis/drug therapy , Radiotherapy/adverse effects , Retrospective Studies , Treatment Outcome , Mucositis/etiology , Analgesics/therapeutic use , Neck/radiation effects
16.
Article in Portuguese | LILACS | ID: biblio-1026516

ABSTRACT

Introdução: A radioterapia é uma das modalidades terapêuticas de escolha para os tratamentos adjuvante e neoadjuvante, em pacientes com câncer de mama. Tal modalidade provoca reação de pele dolorosa conhecida como radiodermatite. Objetivo: Avaliar os fatores associados com o aparecimento de radiodermite após radioterapia e a sua associação com o maior grau de toxicidade nesses pacientes. Método: Estudo retrospectivo, com 117 pacientes com de câncer de mama submetidos à radioterapia conformacional 3D, entre 2016 a 2018, em doses variáveis. Dados pessoais foram coletados a partir de prontuário, e o grau de radiodermite estabelecido segundo os critérios do grupo de oncologia radioterápica. O total de 15 potenciais preditivos foram elencados e analisados por estatísticas univariada e multivariada. Resultados: A população do estudo apresentou uma média de 50 anos, 47% relataram alguma comorbidade, 59,83% realizaram cirurgia radical e 81,19% desenvolveram radiodermite. Observou-se, em análise multivariada, associação do desenvolvimento de radiodermite com maiores doses da radiação (p=0,011) e com uso de bólus diário (p=0,009). Conclusão: As principais variáveis que culminaram em maiores graus de radiodermite foram a dose da radiação e o uso de bólus diário. Categorizando os fatores preditivos, identificam-se o paciente com maior risco de lesões graves e a possibilidade da criação de protocolos mais eficazes na prevenção das radiodermatites.


Introduction: Radiotherapy is one of the therapeutic modalities chosen for adjuvant and neoadjuvant treatment in patients with breast cancer. This modality causes a painful skin reaction known as radiodermatitis. Objective:To evaluate the factors related with the appearance of radiodermatitis after radiotherapy and their relationship with the highest degree of toxicity in patients with breast cancer. Method: Retrospective study, with 117 patients with breast cancer submitted to 3D conformational radiotherapy between 2016 and 2018, at variable doses. Personal data were collected from medical records, and the degree of radiodermatitis established according to the criteria of the Radiation Oncology Group. The total of 15 predictive factors in potential were listed and later analyzed by univariate and multivariate statistics. Results: The study population presented an average of 50 years, 47% reported some comorbidities, 59.83% underwent radical surgery and 81.19% developed radiodermatitis. In a multivariate analysis, there was an association between development of radiodermatitis and higher doses of radiation (p=0.011) and daily bolus use (p=0.009). Conclusion:The main elements that culminated in higher degrees of radiodermatitis were the dose of radiation and the use of daily bolus. By categorizing the predictive factors, we can identify the patient with the highest risk of severe skin lesions and enables the creation of more effective protocols for the prevention of radiodermatitis.


Introducción: La radioterapia es una modalidad terapéutica para tratamiento adyuvante y neoadyuvante, en pacientes con cáncer de mama. Tal modalidad provoca reacción de piel dolorosa conocida como radiodermatitis. Objetivo: Evaluar factores conexos con la aparición de radiodermatitis tras la radioterapia y su asociación con el mayor grado de toxicidad. Método: Estudio retrospectivo, con 117 pacientes con cáncer de mama sometidos a la Radioterapia Conformacional 3D entre 2016 a 2018. Los datos personales fueron recolectados a partir de prontuario, así como el grado de radiodermatitis establecido según los criterios del grupo de oncología radioterápica. El total de 15 potencial predictivos fueron enumerados y posteriormente analizados por estadística univariana y multivariada. Resultados: La población del estudio presentó un promedio de 50 años, el 47% informó de algunas comorbilidades, el 59,83% se sometió a cirugía radical y el 81,19% desarrolló radiodermatitis. En un análisis multivariado, hubo una asociación entre el desarrollo de radiodermatitis y dosis más altas de radiación (p=0.011) y el uso diario de bolos (p=0.009). Conclusión: Las principales variables que culminaron en mayores grados de radiodermatitis fueron la dosis de radiación y el uso de bolos diarios. Al categorizar los factores predictivos, podemos identificar al paciente con el mayor riesgo de lesiones cutáneas graves y permitir la creación de protocolos más efectivos para la prevención de la radiodermatitis.


Subject(s)
Humans , Radiodermatitis/diagnosis , Radiotherapy/adverse effects , Breast Neoplasms/complications , Precipitating Factors , Retrospective Studies , Acute Toxicity
17.
Article in Portuguese | LILACS | ID: biblio-1047099

ABSTRACT

Introdução: A fadiga em mulheres com câncer de mama após a radioterapia é um dos efeitos colaterais mais debilitantes, sendo um sintoma subjetivo, multidimensional e multifatorial. Objetivo: Caracterizar a fadiga em pacientes com câncer de mama em radioterapia que realizam o tratamento no Serviço de Radioterapia de um hospital de referência em tratamento oncológico do Estado de Goiás. Método: Trata-se de um estudo longitudinal. A Escala de Fadiga de Piper - revisada foi utilizada para avaliação de fadiga no início (T1), meio (T2) e final (T3) da radioterapia. Resultados: A amostra foi composta por 89 mulheres. A prevalência de fadiga em T1 foi de 26,9%. Houve aumento significativo da fadiga ao longo da radioterapia, sendo que, em T3, 50,8% das mulheres apresentavam fadiga. Houve predomínio da fadiga moderada em T2 e T3, e o aumento mais significativo da intensidade da fadiga foi verificado do momento T1 para T2. A dimensão afetiva da fadiga apresentou escore mais alto comparado às dimensões sensorial/psicológica. Conclusão: A presença e a intensidade da fadiga durante a radioterapia aumentaram significativamente, predominando a fadiga moderada na última semana do tratamento. A magnitude da fadiga exibiu escores mais altos na dimensão afetiva nas avaliações. Portanto, atenção maior à fadiga durante a radioterapia precisa ser dada pelos profissionais de saúde.


Introduction: Fatigue in women with breast cancer after radiotherapy is one of the most debilitating side effects, being a subjective, multidimensional, multifactorial symptom. Objective: To characterize fatigue in patients with breast cancer in radiotherapy who undergo treatment in the radiotherapy service of a reference hospital in cancer treatment in the State of Goiás. Method: This is a longitudinal study. The Piper Fatigue Scale - revised was used to evaluate fatigue at the beginning (T1), middle (T2) and final (T3) of the radiotherapy. Results: The sample consisted of 89 women. The prevalence of T1 fatigue was 26.9%. There was a significant increase in fatigue during radiotherapy, and in T3, 50.8% of the women presented fatigue. There was a predominance of moderate fatigue in T2 and T3, and the most significant increase in fatigue intensity was verified from T1 to T2. The affective dimension of fatigue presented a higher score compared to the sensorial/psychological dimensions. Conclusion: The presence and intensity of fatigue during radiotherapy increased significantly, with moderate fatigue predominating in the last week of treatment. The magnitude of fatigue exhibited higher scores in the affective dimension of the evaluations. Therefore, health professionals must focus more attention to fatigue during radiotherapy.


Introducción: La fatiga en mujeres con cáncer de mama después de la radioterapia es uno de los efectos colaterales más debilitantes, siendo un síntoma subjetivo, multidimensional, multifactorial. Objetivo: caracterizar la fatiga en pacientes con cáncer de mama en radioterapia que realizan el tratamiento en el servicio de radioterapia de un hospital de referencia en tratamiento oncológico del Estado de Goiás. Método: Se trata de un estudio longitudinal. La Escala de Fatiga de Piper - revisada fue utilizada para evaluación de fatiga al inicio (T1), medio (T2) y final (T3) de la radioterapia. Resultados: La muestra fue compuesta por 89 mujeres. La prevalencia de fatiga en T1 fue de 26,9%. Se observó un aumento significativo de la fatiga a lo largo de la radioterapia siendo que, en T3, el 50,8% de las mujeres presentaban fatiga. Se observó un predominio de la fatiga moderada en T2 y T3, y el aumento más significativo de la intensidad de la fatiga fue verificado del momento T1 para T2. La dimensión afectiva de la fatiga presentó una puntuación más alta en comparación con las dimensiones sensorial/psicológica. Conclusión: La presencia e intensidad de la fatiga durante la radioterapia aumentó significativamente, predominando la fatiga moderada en la última semana del tratamiento. La magnitud de la fatiga exhibió escores más altos en la dimensión afectiva en las evaluaciones. Por lo tanto, los profesionales de la salud deben prestar mayor atención a la fatiga durante la radioterapia.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Breast Neoplasms/radiotherapy , Fatigue/etiology , Radiotherapy/adverse effects , Women , Longitudinal Studies
18.
Braz. j. otorhinolaryngol. (Impr.) ; 84(3): 344-350, May-June 2018. tab
Article in English | LILACS | ID: biblio-951827

ABSTRACT

Abstract Introduction: Internal lymphedema is one of the sequelae of head and neck cancer treatment that can lead to varying degrees of swallowing, speech, and respiration alterations. The Radiotherapy Edema Rating Scale, developed by Patterson et al., is a tool used to evaluate pharyngeal and laryngeal edema. Objective: To translate into Brazilian Portuguese, to culturally adapt and test this scale in patients undergoing treatment for head and neck cancer. Methods: The process followed the international guidelines and translation steps by two head and neck surgeons and back-translation performed independently by two North-American natives. The final version of the test was evaluated based on the assessment of 18 patients by two head and neck surgeons and two speech therapists using the scales in Brazilian Portuguese. Results: The translation and cultural adaptation were satisfactorily performed by the members of the committee in charge. Conclusion: The translation and adaptation into Brazilian Portuguese of the Radiotherapy Edema Rating Scale was successfully performed and showed to be easy to apply.


Resumo Introdução: O linfedema interno é uma das sequelas do tratamento para o câncer de cabeça e pescoço, pode levar a alterações de grau variado na deglutição, voz e respiração. A Escala do Edema da Radioterapia (Radiotherapy Edema Rating Scale), elaborada por Patterson et al., é uma ferramenta de avaliação do edema de faringe e laringe. Objetivo: Traduzir, para o português brasileiro, adaptar culturalmente e testar essa escala em pacientes submetidos ao tratamento para o câncer de cabeça e pescoço. Método: O processo seguiu as diretrizes internacionais e as etapas de tradução por dois cirurgiões de cabeça e pescoço e a retrotradução de forma independente por dois nativos norte-americanos. O teste da versão final para avaliação foi realizado a partir da avaliação de 18 pacientes por dois médicos cirurgiões de cabeça e pescoço e duas fonoaudiólogas por meio da aplicação das escalas em português. Resultados: A tradução e a adaptação cultural foram executadas satisfatoriamente pelos membros do comitê responsável. Conclusão: A tradução e adaptação da Escala do Edema da Radioterapia para o português foi bem-sucedida e de fácil aplicação.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Surveys and Questionnaires , Head and Neck Neoplasms/radiotherapy , Lymphedema/etiology , Radiotherapy/adverse effects , Translations , Brazil , Reproducibility of Results , Cultural Characteristics , Neck , Neoplasm Staging
19.
Rev. méd. Chile ; 146(1): 68-77, ene. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-902623

ABSTRACT

Recently, we have witnessed major improvements in cancer treatment. Early diagnosis and development of new therapies have reduced cancer-related mortality. However, these new therapies, along with greater patient survival, are associated with an increase in untoward effects, particularly in the cardiovascular system. Although cardiotoxicity induced by oncologic treatments affects predominantly the myocardium, it can also involve other structures of the cardiovascular system, becoming one of the main causes of morbidity and mortality in those who survive cancer. The main objective of cardio-oncology is to achieve the maximum benefits of oncologic treatments while minimizing their deleterious cardiovascular effects. It harbors the stratification of patients at risk of cardiotoxicity, the implementation of diagnostic tools (imaging techniques and biomarkers) for early diagnosis, preventive strategies and early treatment options for the complications. Herein, we discuss the basic knowledge for the implementation of cardio-oncology units and their role in the management of cancer patients, the diagnostic tools available to detect cardiotoxicity and the present therapeutic options.


Subject(s)
Humans , Radiotherapy/adverse effects , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Cardiotoxicity/etiology , Cardiotoxicity/prevention & control , Antineoplastic Agents/adverse effects , Biomarkers , Risk Factors , Program Development , Neoplasms/complications , Neoplasms/drug therapy , Antineoplastic Agents/classification
20.
CoDAS ; 30(3): e20170143, 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-952849

ABSTRACT

RESUMO Objetivo Verificar o efeito agudo da eletroestimulação sobre o fluxo salivar de pacientes com hipossalivação. Método Ensaio clínico não controlado que avaliou o efeito de uma única aplicação da Transcutaneous Electric Nerve Stimulation (TENS) sobre o fluxo salivar de 15 pacientes com hipossalivação induzida por radioterapia (RT), utilizada no tratamento de câncer de cabeça e pescoço. A média de idade dos pacientes foi de 56,8 ± 6,46 anos e o gênero masculino foi predominante (73%). A TENS foi programada com 50Hz de frequência, 250μs de largura de pulso e a intensidade foi ajustada ao longo dos 20 minutos conforme máxima tolerância. Os eletrodos foram fixados bilateralmente sobre a região das glândulas salivares. A avaliação do fluxo salivar foi realizada por meio de sialometria estimulada, antes e imediatamente após a aplicação da TENS. Resultados Em 80% dos casos, o tratamento oncológico incluiu quimioterapia. A RT foi aplicada em 80% dos casos na região e orofaringe, com intensidade média de 64,6 ± 7,27 Gy. Após a TENS, o fluxo salivar aumentou significativamente (p = 0,0051), passando de 0,05 (0,00; 0,40) mL/min para 0,10 (0,07;0,40) mL/min. A resposta à TENS foi diretamente correlacionada à intensidade da corrente elétrica tolerada (r = 0,553; p = 0,032) e à dose utilizada na RT (r = -0,514; p = 0,050). Conclusão A TENS aumentou significativamente o fluxo salivar de pacientes com hipossalivação induzida pela RT.


ABSTRACT Purpose To verify the acute effect of electrostimulation on the salivary flow of patients with hyposalivation. Methods Uncontrolled clinical trial evaluating 15 patients with hyposalivation induced by radiotherapy (RT) used for head and neck cancer treatment. Mean age of the patients was 56.8 ± 6.46 years. Males outnumbered females (73%). Transcutaneous Electrical Nerve Stimulation (TENS) was adjusted with 50Hz of frequency and 250μs of pulse width. Intensity was adjusted over a 20-minute period according to maximum tolerance. The electrodes were attached bilaterally on the region of the salivary glands. Evaluation of the salivary flow was performed through sialometry before and immediately after application of TENS. Results The most prevalent region for RT was the oropharynx (80.0% of cases). The mean dose used in RT was 64.6 ± 7.27 Gy. After TENS, salivary flow increased significantly (p = 0.0051) from 0.05 (0.00; 0.40) mL/min to 0.10 (0.07: 0.40) mL/min. The response to TENS was directly correlated with the intensity of the tolerated electric current (r = 0.553; p = 0.032) and the dose used in RT (r = -0.514; p = 0.050). Conclusion TENS was able to increase the salivary flow rate of patients with RT-induced hyposalivation.


Subject(s)
Humans , Male , Female , Salivary Glands/radiation effects , Xerostomia/therapy , Transcutaneous Electric Nerve Stimulation , Head and Neck Neoplasms/radiotherapy , Radiation Dosage , Radiotherapy/adverse effects , Saliva/metabolism , Salivation/radiation effects , Xerostomia/etiology , Radiotherapy, Intensity-Modulated , Middle Aged
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