ABSTRACT
PURPOSE: Paullinia cupana (guaraná) is an Amazonian plant that has been previously shown to be effective in treating chemotherapy-related fatigue (CRF) in patients with breast cancer. We aimed to evaluate the efficacy of a purified dry extract of P. cupana (PC-18) in patients with various solid tumors treated with chemotherapy. METHODS: We included 40 patients with solid tumors who showed increases in their Brief Fatigue Inventory (BFI) questionnaire scores after 1 week of systemic chemotherapy. PC-18 was administered at 37.5 mg by mouth two times per day (PO bid), starting after 1 week of chemotherapy, for 3 weeks (induction phase). Patients who had an improvement in or stabilization of their BFI scores were randomized to receive either PC-18 at the same dose or placebo for the following 3 weeks (maintenance phase). RESULTS: After PC-18 treatment, the BFI fatigue scores improved or stabilized in 36 out of the 40 patients (mean BFI score difference = 2.503; 95% confidence interval: 1.716-3.375, p = .0002). Three weeks after randomization (16 patients on PC-18 and 17 on placebo), we observed no significant differences in the BFI, Functional Assessment of Chronic Illness Therapy, Hospital Anxiety and Depression Scale, and Pittsburgh Sleep Quality Index scores between patients randomized to PC-18 versus placebo. CONCLUSIONS: We conclude that the PC-18 extract may be effective for the treatment of CRF in patients with a variety of solid tumors. A conditioning effect, which was observed in patients who had a beneficial effect of PC-18 on CRF, may explain the better than expected fatigue scores of the placebo-treated patients.
Subject(s)
Antineoplastic Agents/adverse effects , Fatigue/drug therapy , Neoplasms , Paullinia , Phytotherapy , Plant Extracts/therapeutic use , Adult , Aged , Fatigue/chemically induced , Female , Humans , Male , Middle Aged , Neoplasms/drug therapy , Plant Extracts/pharmacology , Quality of Life , Surveys and QuestionnairesABSTRACT
Objetivos: Analisar as características dos pacientes que frequentam os serviços de Oncologia da FMABC e comparar com as estatísticas acionais e da região. Métodos: Trata-se de um levantamento epidemiológico conduzido de 14/9/2010 a 18/5/2011 nos ambulatórios de oncologia de dois hospitais públicos da região do grande ABC, que tabulou de forma sistemática as características clínicas dos pacientes atendidos. Resultados: Do total de 2.366 pacientes avaliados, 60% eram oriundos do Hospital Mário Covas, 63% eram mulheres, com idade média de 60,25 (12-105) anos. Os tumores mais prevalentes foram: mama (31,6%), colorretal (14,8%), próstata (11,2%), linfoma não Hodgkin (6%) e estômago (3,9%). Do total de pacientes (excetuando-se linfoma não Hodgkin), 15,3% apresentaram metástase no momento da sua inclusão. Conclusões: Em comparação com os dados do INCA para o Brasil e região Sudeste de 2010, nosso serviço apresenta significativamente mais casos de câncer de mama (31,5% FMABC versus 13% Brasil e 13,6% Sudeste) e menor número de casos de câncer de pulmão (2,5% FMABC versus 7,36% Brasil e 6,7% Sudeste). Volumes diferentes de cirurgias oncológicas nos diversos serviços de referência de nossa instituição, assim como maior intensidade de medidas preventivas para câncer de mama podem explicar parte das diferenças observadas. Não podemos excluir, todavia, fatores epidemiológicos específicos regionais para explicar a alta prevalência de câncer de mama na região do ABC.
