RESUMO
OBJETIVO: Avaliar a taxa de resposta patológica completa atingida pelas pacientes com diagnóstico de câncer de mama localmente avançado submetidas à quimioterapia neoadjuvante baseada no esquema doxorrubicina/ciclofosfamida seguido de paclitaxel. MÉTODOS: Coorte retrospectiva de pacientes admitidas no Hospital de Câncer de Barretos com câncer de mama localmente avançado entre 2006 e 2008 submetidas ao protocolo de doxorrubicina/ciclofosfamida seguido de paclitaxel (4 ciclos de doxorrubicina 60mg/m² e ciclofosfamida 600mg/m² a cada 21 dias; 4 ciclos de paclitaxel 175mg/m² a cada 21 dias). As seguintes variáveis foram avaliadas: idade, menopausa, performance status, estadiamento clínico inicial, dados antropométricos, quimioterapia (dose - duração), perfil de toxicidade, estadiamento clínico pós-tratamento, cirurgia, resposta patológica completa, sobrevida livre de doença e características anatomopatológicas (tipo e grau histológico, perfil hormonal e comprometimento linfonodal). A análise estatística foi realizada considerando-se o nível de significância de 5%. RESULTADOS: Das 434 pacientes avaliadas, 136 foram excluídas por erro no estadiamento ou por terem recebido outro tipo de quimioterapia. A mediana de idade foi 50 anos, todas com performance status 0-1. A mediana do tamanho clínico inicial do tumor foi 65mm e a mediana do tamanho clínico final do tumor foi 22mm. Apresentaram resposta patológica completa 51 (17,1%) pacientes. Aquelas que apresentavam perfil hormonal negativo ou que eram triplo-negativas (Her-2 e perfil hormonal negativos) tiveram impacto favorável na resposta patológica completa. CONCLUSÃO: Quimioterapia neoadjuvante com doxorrubicina/ciclofosfamida seguidas de paclitaxel ofereceu taxa de resposta patológica completa na população estudada de acordo com a literatura. Pacientes triplo-negativas tiveram maior chance de atingir essa resposta.
OBJECTIVE: To evaluate the complete pathologic response attained by patients diagnosed with locally advanced breast cancer submitted to neoadjuvant chemotherapy based on the doxorubicin/cyclophosphamide regimen followed by paclitaxel. METHODS: A retrospective cohort of patients with locally advanced breast cancer, admitted to the Hospital de Câncer de Barretos between 2006 and 2008 submitted to the doxorubicin/cyclophosphamide protocol followed by paclitaxel (4 cycles of doxorubicin 60mg/m² and cyclophosphamide 600mg/m² every 21 days; 4 cycles of paclitaxel 175mg/m² every 21 days). The following variables were assessed: age, menopause, performance status, initial clinical staging, anthropometric data, chemotherapy (dose - duration), toxicity profile, post-treatment staging, surgery, pathologic complete response rate, disease-free survival, and pathological characteristics (type and histological degree, hormonal profile and lymph node involvement). Statistical analysis was performed using a 5% level of significance. RESULTS: Of the 434 patients evaluated, 136 were excluded due to error in staging or because they had received another type of chemotherapy. Median age was 50 years, all with performance status 0-1. Median initial clinical size of tumor was 65mm and the median final clinical size of the tumor was 22mm. Fifty-one (17.1%) patients experienced a pathologic complete response. Those with a negative hormonal profile or who were triple-negative (negative Her-2 and hormonal profile) experienced a favorable impact on the pathologic complete response. CONCLUSION: Neoadjuvant chemotherapy with doxorubicin/cyclophosphamide followed by paclitaxel provided a pathologic complete response in the population studied in accordance with that observed in the literature. Triple-negative patients had a greater chance of attaining this response.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Antineoplásicos Alquilantes/administração & dosagem , Antineoplásicos Fitogênicos/administração & dosagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Estudos de Coortes , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Terapia Neoadjuvante , Estadiamento de Neoplasias , Paclitaxel/administração & dosagem , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Trata-se de uma revisão integrativa, com o objetivo de identificar as evidências disponíveis acerca do conhecimento sobre a qualidade de vida de idosos com mobilidade física prejudicada, entre 2001 e 2011. Os dados foram coletados nas bases de dados LILACS, MEDLINE e COCHRANE. Após leitura analítica das obras, foram selecionados 16 artigos para a análise em duas categorias temáticas: qualidade de vida e satisfação pessoal, e qualidade de vida e capacidade funcional. As limitações da mobilidade, dor e bem-estar emocional nos idosos podem ser atribuídas às condições crônicas, afetando negativamente a qualidade de vida deles; e também, os idosos que relatam uma piora na qualidade de vida, são os que apresentam maior grau de dependência, influenciando na participação social e bem-estar. Sugere-se a atuação do enfermeiro em pesquisas de intervenções, que possibilitem melhorar a qualidade de vida do idoso com mobilidade física prejudicada.
This is an integrative review, which aimed at identifying the available evidence about the knowledge on the quality of life of the elderly with impaired physical mobility between 2001 and 2011. Data collection happened in the LILACS, MEDLINE and COCHRANEdatabases. After analytical reading of works, we selected 16 articles for analysis in two thematic categories: quality of life and personal satisfaction, and quality of life and functional capacity. The mobilitylimitations, pain and emotional well-being in the elderly can be attributed to chronic conditions, negatively affecting the quality of life; and the elderly who report a decreased quality of life, are those with a higher degree of dependence, influencing social participation and well-being. We suggest the nurses performance in research on interventions that allow improving the quality of life of the elderly with impaired physical mobility.
Se trata de una revisión integradora, con objetivo de identificar evidencias disponibles acerca del conocimiento sobre calidad de vida de ancianos con movilidad física perjudicada, entre 2001 y 2011. Los datos fueron recolectados en las bases de datos LILACS, MEDLINE y Cochrane. Después de lectura analítica de las obras, se seleccionaron 16 artículos para análisis en dos categorías temáticas: calidad de vida y satisfacción personal, y calidad de vida y capacidad funcional. Limitaciones de la movilidad, dolor y bienestar emocional de ancianos pueden ser atribuidas a enfermedades crónicas, que afectan negativamente la calidad de vida de ellos; y también, los ancianos que reportan baja calidad de vida, son los que tienen mayor grado de dependencia, influyendo en la participación social y bienestar. Se sugiere la actuación del enfermero en investigaciones de intervenciones que permitan mejorar la calidad de vida de ancianos con movilidad física perjudicada.
Assuntos
Humanos , Idoso , Idoso , Limitação da Mobilidade , Qualidade de VidaRESUMO
OBJECTIVE: To evaluate the complete pathologic response attained by patients diagnosed with locally advanced breast cancer submitted to neoadjuvant chemotherapy based on the doxorubicin/cyclophosphamide regimen followed by paclitaxel. METHODS: A retrospective cohort of patients with locally advanced breast cancer, admitted to the Hospital de Câncer de Barretos between 2006 and 2008 submitted to the doxorubicin/cyclophosphamide protocol followed by paclitaxel (4 cycles of doxorubicin 60mg/m² and cyclophosphamide 600mg/m² every 21 days; 4 cycles of paclitaxel 175mg/m² every 21 days). The following variables were assessed: age, menopause, performance status, initial clinical staging, anthropometric data, chemotherapy (dose - duration), toxicity profile, post-treatment staging, surgery, pathologic complete response rate, disease-free survival, and pathological characteristics (type and histological degree, hormonal profile and lymph node involvement). Statistical analysis was performed using a 5% level of significance. RESULTS: Of the 434 patients evaluated, 136 were excluded due to error in staging or because they had received another type of chemotherapy. Median age was 50 years, all with performance status 0-1. Median initial clinical size of tumor was 65mm and the median final clinical size of the tumor was 22mm. Fifty-one (17.1%) patients experienced a pathologic complete response. Those with a negative hormonal profile or who were triple-negative (negative Her-2 and hormonal profile) experienced a favorable impact on the pathologic complete response. CONCLUSION: Neoadjuvant chemotherapy with doxorubicin/cyclophosphamide followed by paclitaxel provided a pathologic complete response in the population studied in accordance with that observed in the literature. Triple-negative patients had a greater chance of attaining this response.