Influence of chemoradiotherapy on nutritional status, functional capacity, quality of life and toxicity of treatment for patients with cervical cancer
Influência da quimiorradioterapia no estado nutricional, capacidade funcional, qualidade de vida e toxicidade do tratamento para pacientes com câncer cervical
Mariah Azevedo Aredes, Marcelly Ricci Garcez, Gabriela Villaça Chaves.
Abstract
Introduction: The adverse effects provoked by antineoplastic therapy may aggravate preexisting alterations of the nutritional status and can result in a larger chance of toxicity, bringing about other adverse consequences, such as a diminished response and tolerance of the treatment and reduction of quality of life (QoL). Objective: The objective of this study was to assess the influence of chemoradiotherapy on the nutritional status, functional capacity, and quality of life (QoL), associating these indicators with toxicity and interruption of oncologic treatment in women with cervical cancer. Methods: Prospective cohort study performed on 49 women, who underwent treatment between August 2015 and January 2016. For data collection, two appointments took place with the researcher in charge: the first one occurring the day before the first chemotherapy session (T0) and the other one after 35 days (T1). Nutritional status was measured by anthropometry and computed tomography (skeletal muscle index – SMI), functional capacity by handgrip strength (HGS) and Karnofsky Perfomace Status (KPS), and application of QoL questionnaire (EORTC QLQ-C30). Results: There was significant reduction in weight, BMI, HGS, KPS and QoL between T0 and T1. The interruption of chemotherapy was significantly associated with the variables of nutritional status assessed, in addition to a significant QoL reduction according to worsening nutritional status. Women that interrupted their treatment due to acute toxicity also had an SMI median significantly smaller in relation to those who concluded the treatment and 83% of these patients presented cachexia. Conclusion: Chemoradiotherapy treatment in patients with cervical cancer had changed negatively nutritional parameters, function capacity and QoL.
Keywords
Resumo
Introdução: Os efeitos adversos provocados pela terapia antineoplásica podem agravar alterações preexistentes do estado nutricional, que resultam em maior chance de toxicidade, além de outras consequências adversas, como diminuição da resposta e tolerância ao tratamento e redução da qualidade de vida (QV). Objetivo: O objetivo do estudo foi avaliar a influência da quimiorradioterapia sobre o estado nutricional, capacidade funcional e QV, associando esses indicadores à toxicidade e interrupção do tratamento oncológico em mulheres com câncer de colo uterino. Método: Foi realizado um estudo de coorte prospectivo com 49 mulheres submetidas ao tratamento quimiorradioterápico entre agosto de 2015 e janeiro de 2016. Para coleta de dados, foram realizadas duas consultas com o pesquisador responsável: a primeira ocorreu no dia anterior à primeira sessão de quimioterapia (T0) e a outra após 35 dias (T1). Em ambas as consultas, o estado nutricional foi avaliado por antropometria, a capacidade funcional pela força de preensão palmar (FPP) e pelo Karnofsky Performance Status (KPS) e foi aplicado um questionário específico para QV (EORTC QLQ-C30). Adicionalmente, foi utilizada a tomografia computadorizada para avaliação da massa magra (índice de músculo esquelético - IME) disponível no T0. Resultados: Houve redução significativa no peso, IMC, FPP, KPS e QV entre T0 e T1. A interrupção da quimioterapia foi significativamente associada às variáveis de estado nutricional, além de uma redução significativa da QV de acordo com a piora do estado nutricional. As mulheres que interromperam seu tratamento devido à toxicidade aguda também apresentavam mediana de IME significativamente menor em relação àquelas que concluíram o tratamento e 83% dessas pacientes apresentaram caquexia. Conclusão: O tratamento quimiorradioterápico em pacientes com câncer de colo uterino impactou negativamente nos parâmetros nutricionais, na capacidade funcional e na QV
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Referências
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Submetido em:
18/08/2017
Aceito em:
07/10/2017
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