ABSTRACT
CONTEXT: Hot flashes (HFs) and sexual dysfunction often affect breast cancer (BC) survivors and compromise their quality of life. Bupropion is an antidepressive medication used for smoking cessation and also has been previously studied for the treatment of sexual dysfunction. OBJECTIVES: We aimed to evaluate bupropion's efficacy in controlling HFs in BC survivors. METHODS: This was a randomized, double-blind, crossover, placebo-controlled pilot study that enrolled 55 BC survivors who reported more than seven HFs per week. Subjects were randomized to receive either bupropion 150mg twice daily for four weeks followed by one week of washout and four more weeks of placebo twice daily or vice versa. The primary end point was average daily HF activity (number of HFs and a score combining number and severity) reported while on bupropion or on placebo. Secondary end points were sexual dysfunction, depression, and quality of life evaluated with the Arizona Sexual Experience Scale, Beck Depression Inventory, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, respectively. RESULTS: Bupropion reduced HFs by 1.26 per day and the HF score by 6.31%, whereas placebo reduced HFs by 2.11 per day (P>0.05) and the HF score by 30.47% (P>0.05). There were no statistically significant differences between bupropion and placebo in the Arizona Sexual Experience Scale, Beck Depression Inventory, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. At the end of the study, 47% of the patients preferred bupropion, whereas 53% preferred placebo. There were no statistically significant differences in side effects between the study groups. CONCLUSION: Compared with placebo, bupropion did not control HFs in this group of BC survivors.
Subject(s)
Breast Neoplasms/complications , Breast Neoplasms/drug therapy , Bupropion/administration & dosage , Hot Flashes/complications , Hot Flashes/prevention & control , Sexual Dysfunction, Physiological/etiology , Sexual Dysfunction, Physiological/prevention & control , Adult , Aged , Antidepressive Agents, Second-Generation/administration & dosage , Cross-Over Studies , Dose-Response Relationship, Drug , Female , Humans , Middle Aged , Pilot Projects , Prospective Studies , Survivors , Treatment OutcomeABSTRACT
JUSTIFICATIVA E OBJETIVOS: Evidências apontam que cerca de metade dos pacientes com câncer apresentam altos níveis de estresse, condição que ainda permanece pouco diagnosticada e tratada. Este estudo piloto visou investigar a utilização do instrumento Termômetro de Estresse (TE) aplicando-o a pacientes idosos em vigência de tratamento quimioterápico, de forma a identificar possíveis fatores preditivos de estresse nessa população. MÉTODO: Foram selecionados aleatoriamente 40 pacientes com idade igual ou superior a 65 anos, portadores de neoplasia sólida ou hematológica, em tratamento quimioterápico nos serviços vinculados à Faculdade de Medicina do ABC. Estes responderam ao TE e a questionários para avaliação de qualidade de vida, atividades da vida diária, escala de sintomas relacionados à quimioterapia, escala de depressão geriátrica, mini-exame do estado mental e mini-avaliação nutricional. RESULTADOS: A pontuação média do TE foi de 4,20, sendo que 65% dos pacientes apresentaram alto nível de estresse (pontuação de corte maior ou igual a 4). Verificou-se a correlação do TE ao Questionário de Atividades Instrumentais de Lawton (p = 0,035), à Escala de Sintomas de Edmonton (p = 0,043) e à Escala de Depressão Geriátrica (p = 0,030). CONCLUSÃO: Pacientes idosos em tratamento quimioterápico sofrem de estresse, que pode estar relacionado à diminuição da capacidade de desenvolver atividades instrumentais da vida diária, aos próprios sintomas do regime quimioterápico e à manifestação de sintomas de depressão.
BACKGROUND AND OBJECTIVES: Up to half of all cancer patients experience clinically significant levels of stress and much of this stress goes unrecognized and untreated. This pilot study aimed to evaluate the Distress Thermometer (DT) in elderly patients undergoing chemotherapy in oncology services related to the School of Medicine of ABC and to identify possible predictors. METHOD: We randomly selected 40 patients aged over 65 years with hematologic or solid tumors undergoing chemotherapy treatment. They were asked to respond to the DT and questionnaires for assessing quality of life, activities of daily living, symptoms related to chemotherapy, geriatric depression scale, mini-mental state and mini-nutritional assessment. RESULTS : Regarding the DT, the average score was 4.20 and 26 patients (65% of total) had scores above 4 (the optimal DT cutoff score). In the correlation analysis, we obtained a correlation of TD to the questionnaires of Instrumental Activities of Daily Living (p= 0.035), Edmonton Symptom Assessment Scale (p =0.043) and Geriatric Depression Scale (p=0.030). CONCLUSION: Elderly patients undergoing chemotherapy suffer from stress that can be related to the decline in their ability to develop instrumental daily activities, to the symptoms related to the chemotherapy and to the development of depression symptoms.
