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Introduction: Brazil is a developing and an Upper Middle Income, categorized by the World Bank. Therefore, it is a country that needs a special vision for children with oncological diseases who require Pediatric Palliative Care. This study aimed to understand the specificities of services that provide oncology services in comparison to those that do not provide oncological care. Methods: This is a descriptive, cross-sectional, and online survey study. A questionnaire was created by a multidisciplinary group of leaders from the Brazilian Pediatric Palliative Care Network and then the survey was distributed using a snowball strategy. Results: Of the 90 services that answered the questionnaire, 40 (44.4%) attended oncologic patients. The Southeast represented most of the services (57.57%), followed by the Northeast, with 18.89% (17 services), the South with 12.22% (11 services), and the Center West with 8.89% (8 services). No differences were observed in access to opioid prescriptions between the services. It was observed that those services that attended oncologic patients had a tendency to dedicate more time to Pediatric Palliative Care. Discussion: The distribution of services that cover oncology and those that do not, are similar in the different regions of Brazil. In Brazil, there are difficulties in accessing opioids in pediatrics: access to opioid prescriptions without differences revealed that even pediatric oncologists might have difficulty with this prescription, and this should improve. It is concluded that education in Pediatric Palliative Care is the key to improvements in the area.

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RESUMO Estudo retrospectivo, observacional, transversal que analisou os encaminhamentos de 120 pacientes oncológicos para uma equipe de Cuidados Paliativos (CP) em hospital público de referência em oncologia no norte do Paraná, em fevereiro de 2020. Os dados foram coletados nos prontuários e analisados com base no suporte teórico da bioética. Observou-se que expressiva maioria dos pacientes 82,5% chegou ao hospital com doença avançada e 59,7% foram encaminhados para CP em menos de seis meses após a entrada no serviço. Parte importante dos pacientes chegou sem possibilidade de terapia específica oncológica, sendo, por isso, rapidamente encaminhados aos CP. Esses e outros achados da pesquisa sustentam uma discussão entre cuidados paliativos, atenção primária à saúde e diagnóstico oncológico tardio. O artigo conclui que, no contexto dos CP, as mortes relacionadas ao diagnóstico oncológico tardio, antecedidas de sofrimentos evitáveis e decorrentes de falhas estruturais em políticas públicas de saúde, expressam uma problemática forma de mistanásia.

ABSTRACT This retrospective study analyzed the referrals of 120 cancer patients to a Palliative Care (PC) team in a public oncology referral hospital in northern in northern Paraná, in February 2020. It was observed that the vast majority of patients (82.5%) arrived at the hospital with advanced disease, while 59.7% were referred to PC in less than six months after entering the service. An important part of the patients arrived with no possibility of specific oncological therapy, and were therefore quickly referred to PC. These and other research data support a discussion between palliative care, primary health care and late cancer diagnosis. The article concludes that, in the context of PC, deaths related to late cancer diagnosis, preceded by avoidable suffering due to structural failures in public health policies, are characterized as a problematic form of mysthanasia.

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OBJECTIVES: [51Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI). METHODS: 1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [51Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods. RESULTS: Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m2. ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m2 for all methods, except for SS methods in subgroups BMI > 40 kg/m2; GFR > 105 or < 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR < 45. CONCLUSION: 46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.

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Acute megakaryoblastic leukemia (M7 AML) is a rare subtype of acute myeloid leukemia in adults, the incidence of which is higher in children aged 1 to 3 years, especially in patients with Down Syndrome; and in the age group between 60 and 70 years old, with an adverse prognosis. We report the case of a 28-year-old male patient, with a history of non-seminoma germ cell tumour of the testis, diagnosed with M7 AML. Nine months after performing an orchiectomy to remove the testicular tumour, the patient developed dyspnea, dry cough and asthenia, associated with the presence of erythematous-purple lesions on the skin, ascites and pleural effusion. The myelogram demonstrated medullary hypocellularity, with the presence of 53% of blastic, pleomorphic and bulky cells, with positivity for the markers CD34, CD31 and CD117 in immature cells in immunohistochemistry. Despite undergoing cycles of chemotherapy with cisplatin and a BEP regimen (Bleomycin, Etoposide and Cisplatin), the patient presented with chest tomography with the presence of pulmonary nodules and magnetic resonance imaging of the skull and neuraxial with infiltration of the bone marrow in the spine and cranial vault, resulting in with neurological impairment and died. In view of the case presented, we observed agreement with previous reports of the adverse prognosis of M7 AML in young adults and we questioned its relationship with germ cell tumour. (AU)

A leucemia megacarioblástica aguda (LMA M7) é um subtipo raro em adultos de leucemia mielóide aguda, cuja incidência é maior em crianças de 1 a 3 anos, especialmente em pacientes portadores de Síndrome de Down; e na faixa etária entre 60 e 70 anos, com um prognóstico adverso. Relatamos o caso de um paciente, do sexo masculino, 28 anos, com histórico de tumor germinativo não seminoma de testículo, diagnosticado com LMA M7. Nove meses após a realização de uma orquiectomia para a retirada do tumor testicular, o paciente apresentou quadro de dispneia, tosse seca e astenia, associado a presença de lesões eritemato-arroxeadas na pele, ascite e derrame pleural. O mielograma demonstrou hipocelularidade medular, com presença de 53% de células blásticas, pleomórficas e volumosas, com a positividade para os marcadores CD34, CD31 e CD117 em células imaturas na imunohistoquímica. Apesar da realização de ciclos de quimioterapia com cisplatina e esquema BEP (Bleomicina, Etoposídeo e Cisplatina), o paciente apresentou Tomografia de tórax com presença de nódulos pulmonares e ressonância magnética de crânio e neuroeixo com infiltração da medula óssea em coluna vertebral e calota craniana, intercorrendo com comprometimento neurológico e foi a óbito. Diante do caso apresentado observamos a concordância com relatos prévios do prognóstico adverso da LMA M7 em jovens adultos e indagamos a sua relação com o tumor de células germinativas. (AU)

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BACKGROUND: The Spanish Society of Medical Oncology (SEOM) has provided open-access guidelines for cancer since 2014. However, no independent assessment of their quality has been conducted to date. This study aimed to critically evaluate the quality of SEOM guidelines on cancer treatment. METHODS: Appraisal of Guidelines for Research and Evaluation II (AGREE II) and AGREE-REX tool was used to evaluate the qualities of the guidelines. RESULTS: We assessed 33 guidelines, with 84.8% rated as "high quality". The highest median standardized scores (96.3) were observed in the domain "clarity of presentation", whereas "applicability" was distinctively low (31.4), with only one guideline scoring above 60%. SEOM guidelines did not include the views and preferences of the target population, nor did specify updating methods. CONCLUSIONS: Although developed with acceptable methodological rigor, SEOM guidelines could be improved in the future, particularly in terms of clinical applicability and patient perspectives.

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PURPOSE: The American College of Surgeons Standard 4.8 requires an institution to implement a survivorship program to become a Commission on Cancer (CoC)-accredited cancer center. The online information offered by these cancer centers can help educate patients and their caregivers about available services. We assessed the content of survivorship program websites of CoC-accredited cancer centers in the United States. METHODS: Of the 1245 CoC-accredited centers for adults, we sampled 325 institutions (26%) based proportionately on the 2019 new cancer cases by state. Website pages of the institutions' survivorship programs were assessed for information and services offered using the COC Standard 4.8. We included programs for adult survivors of adult- and childhood-onset cancers. RESULTS: 54.5% of the cancer centers did not have a survivorship program website. Of the 189 included programs, most were aimed at adult survivors in general, rather than those with specific cancer types. On average, five essential CoC-recommended services were described, most commonly nutrition, care plans, and psychology services. The least mentioned services were genetic counseling, fertility, and smoking cessation. Most programs described services offered to patients who had completed treatment, while 7.4% of described services for those with metastatic disease. CONCLUSION: More than half of CoC-accredited programs did have information about cancer survivorship programs on their websites and when included, had variable and limited description of services. IMPLICATIONS FOR CANCER SURVIVORS: Our study provides an overview of online cancer survivorship services and offers a methodology that may be used by cancer centers to review, expand, and improve the information described on their websites.

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ABSTRACT Objective: To analyze the validity evidence of the Brazilian version of the Cancer Behavior Inventory - Brief Version. Method: Methodological study, conducted between November and December 2021, with 140 patients undergoing hospital cancer treatment in João Pessoa, Paraíba, Brazil. Psychometric analyses were performed in the adapted version, using exploratory factor analysis and correlation with correlated constructs. Results: A two-factor and 10-item model was evidenced. The cumulative variance explained about 61% the shared variance of the items. Satisfactory values were observed for the factors in the analyses of composite reliability (0.89 and 0.91, respectively), internal consistency (0.86 and 0.91, respectively) and ORION (0.89 and 0.85, respectively). The expected correlations of self-efficacy with quality of life (convergent) and with anxiety and depression (divergent) were evident. Conclusion: The Brazilian version of the instrument showed evidence of validity, being considered reliable to assess the self-efficacy of patients undergoing cancer treatment.

RESUMEN Objetivo: Analizar las evidencias de validez de la versión brasileña del Cancer Behavior Inventory - Brief Version. Método: Estudio metodológico, realizado entre noviembre y diciembre de 2021, con 140 pacientes en tratamiento oncológico hospitalario en João Pessoa, Paraíba, Brasil. Se realizaron análisis psicométricos en la versión adaptada, mediante análisis factorial exploratorio y correlación con constructos correlacionados. Resultados: Se evidenció un modelo de 2 factores y 10 ítems. La varianza acumulada explicó alrededor del 61% de la varianza compartida de los ítems. Se observaron valores satisfactorios para los factores en el análisis de confiabilidad compuesta (0,89 y 0,91, respectivamente), consistencia interna (0,86 y 0,91, respectivamente) y ORION (0,89 y 0,85, respectivamente). Se evidenciaron las correlaciones esperadas de la autoeficacia con la calidad de vida (convergente) y con la ansiedad y la depresión (divergente). Conclusión: La versión brasileña del instrumento mostró evidencias de validez, siendo considerado confiable para evaluar la autoeficacia de pacientes en tratamiento oncológico.

RESUMO Objetivo: Analisar as evidências de validade da versão brasileira do Cancer Behavior Inventory - Brief Version. Método: Estudo metodológico, realizado entre os meses de novembro e dezembro de 2021, com 140 pacientes em tratamento oncológico hospitalar em João Pessoa, Paraíba, Brasil. Foram realizadas análises psicométricas na versão adaptada, mediante a análise fatorial exploratória e correlação com constructos correlacionados. Resultados: Evidenciou-se um modelo de 2 fatores e 10 itens. A variância acumulada explicou cerca de 61% da variância compartilhada dos itens. Foram observados valores satisfatórios para os fatores nas análises de confiabilidade composta (0,89 e 0,91, respectivamente), consistência interna (0,86 e 0,91, respectivamente) e ORION (0,89 e 0,85, respectivamente). Evidenciaram-se as correlações esperadas da autoeficácia com a qualidade de vida (convergente) e com a ansiedade e depressão (divergente). Conclusão: A versão brasileira do instrumento mostrou evidências de validade, sendo considerada como confiável para avaliar a autoeficácia dos pacientes em tratamento oncológico.

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ABSTRACT Objectives: to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients' perception of the information received. Methods: a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey - Short Form 34 were used. Analysis occurred using Cronbach's alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis. Results: 128 respondents participated. Cronbach's alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information. Conclusions: validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.

RESUMEN Objetivos: validar psicométricamente el instrumento European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 e identificar los dominios que influyen en la percepción del paciente sobre la información recibida. Métodos: metodología transversal con pacientes con cáncer en una institución hospitalaria filantrópica brasileña. Se utilizaron instrumentos sociodemográficos y clínicos, EORTC QLQ-C30, EORTC QLQ-INFO25 y Supportive Care Needs Survey - Short Form 34. El análisis se realizó mediante coeficientes alfa de Cronbach, correlación intraclase, prueba-reprueba y análisis factorial exploratorio. Resultados: participaron 128 encuestados. El coeficiente alfa de Cronbach fue de 0,85. La prueba-reprueba obtuvo p-valor=0,21. En el análisis factorial se excluyó un ítem. La satisfacción con la información recibida fue del 74%, con tres áreas con promedios inferiores al 70%. En las preguntas abiertas hubo mayor deseo de información. Conclusiones: se obtuvo evidencia de validación con confiabilidad, consistencia y estabilidad del instrumento. Los encuestados expresaron satisfacción con la información recibida.

RESUMO Objetivos: validar psicometricamente o instrumento da European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 e identificar os domínios que influenciam na percepção do paciente sobre as informações recebidas. Métodos: metodológico, transversal, com pacientes com câncer em instituição hospitalar filantrópica brasileira. Utilizaram-se instrumentos sociodemográficos e clínicos, EORTC QLQ-C30, EORTC QLQ-INFO25 e Supportive Care Needs Survey - Short Form 34. Análise ocorreu utilizando coeficientes alfa de Cronbach, correlação intraclasse, teste-reteste e análise fatorial exploratória. Resultados: participaram 128 respondentes. O coeficiente alfa de Cronbach foi de 0,85. O teste-reteste obteve p-valor=0,21. Na análise fatorial, foi excluído um item. A satisfação da informação recebida foi de 74%, com três domínios com médias inferiores a 70%. Nas questões abertas, evidenciou-se maior desejo por informações. Conclusões: evidências de validação foram obtidas com confiabilidade, consistência e estabilidade do instrumento. Os respondentes demonstraram satisfação com as informações recebidas.

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Abstract Objectives: [51Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI). Methods: 1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [51Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods. Results: Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m2. ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m2 for all methods, except for SS methods in subgroups BMI > 40 kg/m2; GFR > 105 or < 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR < 45. Conclusion: 46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.

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ABSTRACT Objectives: to analyze the completeness of variables from Hospital-Based Cancer Registries of cases of prostate neoplasm in the Oncology Care Network of a Brazilian state between 2000 and 2020. Methods: an ecological time series study, based on secondary data on prostate cancer Hospital-Based Cancer Registries prostate. Data incompleteness was classified as excellent (<5%), good (between 5%-10%), fair (10%-20%), poor (20%-50%) and very poor (>50%), according to the percentage of lack of information. Results: there were 13,519 cases of prostate cancer in the Hospital-Based Cancer Registries analyzed. The variables "family history of cancer" (p<0.001), "alcoholism" (p<0.001), "smoking" (p<0.001), "TNM staging" (p<0.001) had a decreasing trend, while "clinical start of treatment" (p<0.001), "origin" (p=0.008) and "occupation" (p<0.001) indicated an increasing trend. Conclusions: most Hospital-Based Cancer Registries variables showed excellent completeness, but important variables had high percentages of incompleteness, such as TNM and clinical staging, in addition to alcoholism and smoking.

RESUMEN Objetivos: analizar la completitud de las variables del Registro Hospitalario de Cáncer de casos de neoplasias de próstata en la Red de Atención Oncológica de un estado brasileño entre 2000 y 2020. Métodos: estudio de series de tiempo ecológicas, a partir de datos secundarios sobre el cáncer de próstata Registro Hospitalario de Cáncer próstata. La información incompleta se clasificó como excelente (<5%), buena (entre 5%-10%), regular (10%-20%), mala (20%-50%) y muy mala (>50%), según el porcentaje de falta de información. Resultados: hubo 13.519 casos de cáncer de próstata en los Registro Hospitalario de Cáncer analizados. Las variables "antecedentes familiares de cáncer" (p<0,001), "alcoholismo" (p<0,001), "tabaquismo" (p<0,001), "estadificación TNM" (p<0,001) tuvieron una tendencia decreciente, mientras que "inicio clínico" de tratamiento" (p<0,001), "origen" (p=0,008) y "ocupación" (p<0,001) indicaron una tendencia creciente. Conclusiones: la mayoría de las variables Registro Hospitalario de Cáncer mostraron una excelente completitud, pero variables importantes tuvieron altos porcentajes de incompletitud, como el TNM y el estadiaje clínico, además del alcoholismo y el tabaquismo.

RESUMO Objetivos: analisar a completude das variáveis dos Registros Hospitalares de Câncer dos casos de neoplasia prostática da Rede de Atenção Oncológica de um estado brasileiro entre 2000 e 2020. Métodos: estudo ecológico de séries temporais, baseados em dados secundários de câncer de próstata dos Registros Hospitalares de Câncer. A incompletude dos dados foi classificada como excelente (<5%), boa (entre 5%-10%), regular (10%-20%), ruim (20%-50%) e muito ruim (>50%), de acordo com o percentual de ausência de informação. Resultados: foram analisados 13.519 casos de câncer próstata. As variáveis "histórico familiar de câncer" (p<0,001), "alcoolismo" (p<0,001), "tabagismo" (p<0,001), "estadiamento TNM" (p<0,001) tiveram tendência de decréscimo, enquanto que "clínica do início do tratamento" (p<0,001), "procedência" (p=0,008) e "ocupação" (p<0,001) indicaram tendência crescente. Conclusões: a maioria das variáveis dos Registros Hospitalares de Câncer apresentou completude excelente, porém importantes variáveis tiveram altos percentuais de incompletude, como estadiamento TNM e clínico, além de alcoolismo e tabagismo.

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RESUMO Objetivo: descrever a percepção de enfermeiros sobre o cuidado ao paciente com câncer na Atenção Primária à Saúde. Método: estudo qualitativo, desenvolvido em 26 Centros de Saúde da Família de um município do Oeste catarinense - Brasil, entre setembro e outubro de 2022. Participaram 33 enfermeiros, que responderam um questionário on-line. O texto foi interpretado com base nos preceitos conceituais da cultura organizacional da teoria administrativa de Chiavenatto. Questões objetivas foram analisadas pela frequência das respostas; para as dissertativas, utilizou-se o Discurso do Sujeito Coletivo. Resultados: os enfermeiros percebem-se despreparados e identificam ausência de protocolos e fluxos organizacionais. Considerações finais: na Atenção Primária à Saúde há a crença consolidada no cotidiano laboral e que se torna integrante da cultura organizacional dos serviços de saúde, que o paciente com câncer deve seguir para o cuidado especializado. Nota-se desconhecimento das políticas de saúde, o que implica o profissional na atenção ao paciente com câncer.

ABSTRACT Objective: To describe nurses' perceptions of cancer patient care in Primary Health Care. Method: A qualitative study was conducted in 26 Family Health Centers in a municipality in western Santa Catarina - Brazil, between September and October 2022. A total of 33 nurses took part and completed an online questionnaire. The text was interpreted based on the conceptual precepts of organizational culture from Chiavenatto's administrative theory. The frequency of responses analyzed objective questions; the Collective Subject Discourse was used for the essay questions. Results: Nurses perceive themselves as unprepared and identify a lack of protocols and organizational flows. Final considerations: In primary Health Care, there is a belief consolidated in everyday work and becomes part of the organizational culture of health services, that cancer patients should go on to specialist care. There is a lack of knowledge of health policies, which implicates professionals in caring for cancer patients.

RESUMEN Objetivo: describir las percepciones de los enfermeros sobre la atención al paciente oncológico en Atención Primaria. Método: estudio cualitativo realizado en 26 Centros de Salud de la Familia de un municipio del oeste de Santa Catarina - Brasil, entre septiembre y octubre de 2022. Participaron 33 enfermeros que cumplimentaron un cuestionario en línea. El texto se interpretó basándose en los preceptos conceptuales de la cultura organizativa de la teoría administrativa de Chiavenatto. Las preguntas objetivas se analizaron por la frecuencia de las respuestas; para las preguntas de ensayo, se utilizó el discurso del sujeto colectivo. Resultados: los enfermeros no se sienten preparados e identifican una falta de protocolos y flujos organizativos. Consideraciones finales: en Atención Primaria existe la creencia, consolidada en el trabajo diario y que se ha convertido en parte integrante de la cultura organizativa de los servicios sanitarios, de que los pacientes con cáncer deben pasar a la atención especializada. Existe un desconocimiento de las políticas sanitarias, que implica a los profesionales en la atención a los pacientes con cáncer.

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Objetivo: levantar produções científicas sobre os impactos da comunicação de más notícias na assistência de enfermagem domiciliar a pacientes oncológicos sob cuidados paliativos exclusivos. Método: revisão integrativa da literatura, realizada nas bases de dados BVS, Scielo e Medline. Os dados foram analisados utilizando o Software IRAMUTEQ e a Classificação Hierárquica Descendente. Resultados: as classes identificadas incluem a importância da assistência domiciliar no cuidado paliativo exclusivo (Classes 3 e 4), os desafios e sucessos da enfermagem nesse contexto (Classes 1 e 6), e a comunicação e envolvimento da família para decisões no cuidado paliativo (Classes 2 e 5). Destaca-se a importância da colaboração entre equipe de enfermagem, outros profissionais e familiares para a eficácia dos cuidados. Considerações finais: uma comunicação eficaz, o engajamento da equipe e a humanização são essenciais para melhorar a qualidade de vida desde o diagnóstico do cuidado paliativo até o fim da vida.

Objective: to gather scientific literature on the impacts of delivering bad news in home nursing care for oncology patients under exclusive palliative care. Method: an integrative literature review was conducted using the databases BVS, Scielo, and Medline. Data were analyzed using the IRAMUTEQ software and Descending Hierarchical Classification. Results: identified classes included the importance of home care in exclusive palliative care (Classes 3 and 4), challenges and successes of nursing in this context (Classes 1 and 6), and communication and family involvement in palliative care decisions (Classes 2 and 5). The importance of collaboration among nursing staff, other professionals, and family members for care effectiveness was emphasized. Conclusion: effective communication, team engagement, and humanization are essential to improve the quality of life from palliative care diagnosis to end-of-life.

Objetivo: recopilar literatura científica sobre los impactos de comunicar malas noticias en la atención domiciliaria de enfermería a pacientes oncológicos bajo cuidados paliativos. Método: se realizó una revisión integrativa de literatura utilizando las bases de datos BVS, Scielo y Medline. Los datos fueron analizados con IRAMUTEQ y la Clasificación Jerárquica Descendente. Resultados: las clases identificadas incluyen la importancia de la atención domiciliaria en cuidados paliativos (Clases 3 y 4), desafíos y éxitos de enfermería en este contexto (Clases 1 y 6), y comunicación y participación de la familia en decisiones de cuidados paliativos (Clases 2 y 5). Se destaca la importancia de la colaboración entre el personal de enfermería, otros profesionales y familiares para la eficacia de los cuidados. Conclusiones: una comunicación efectiva, el compromiso del equipo y la humanización son esenciales para mejorar la calidad de vida desde el diagnóstico de cuidados paliativos hasta el final de la vida.se caracterizaron por tener baja capacidad funcional.

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Esta pesquisa transversal, descritiva e observacional objetivou avaliar a saúde bucal dos participantes infantojuvenis diagnosticados com leucemia, assistidos pela odontologia. Foram incluídas todas as crianças e adolescentes de 3 a 18 anos matriculadas no centro de referência hematológico e diagnosticados com leucemia, atendidos pela instituição, entre junho/2022 e janeiro/2023. Foram coletados os dados sociodemográfcos, médicos, odontológicos e laboratoriais, seguidos de uma avaliação clínica odontológica e registro fotográfco. Para avaliação da prevalência de cárie utilizou-se o índice de dentes cariados, perdidos, obturados, por dente e o índice de dentes decíduos cariados, indicado a extração e obturado. A avaliação das manifestações orais fo irealizada conforme protocolo da Organização Mundial de Saúde. Compuseram a pesquisa 25 participantes, 14 masculinos e 11 femininos, a média deidade foi de 10,12 anos (d.p. = 4,8).A leucemia linfoide aguda foi a mais prevalente (80%), a maioria dos participantes apresentou índice de cárie zero (60%), as manifestações orais foram diagnosticadas em 60% deles, sendo as mais frequentes: alteração de paladar (24%), mucosite (16%) e xerostomia (12%). Os participantes também apresentaram alta incidência de manifestações orais, condição de higiene bucal insatisfatória, porém baixo índice de cárie. Outrossim, observa-se a importância de os cirurgiões dentistas conhecerem as manifestações orais mais encontradas em crianças com leucemia, a necessidade da higiene bucal de qualidade, bem como a condição de saúde bucal total, buscando garantir que a boca não seja uma fonte de infecção que prejudique a condição de saúde geral e o tratamento oncológico.

This study aimed to evaluate the oral health of child and adolescent participants diagnosed with leukemia, assisted by dentistry. The research was configured a cross-sectional, descriptive and observational. All. All children and adolescents enrolled in the hematological reference center, aged 3 to 18 years, diagnosed with leukemia, treated by the institution, between June 2022 and January 2023 were included. Sociodemographic, medical, dental and laboratory data were collected; followed by a clinical dental evaluation and photographic recording. To assess the prevalence of caries, the index of decayed, missing,filled teeth per tooth and the index of decayed primary teeth, indicated for extraction and filling, were used. The evaluation of oral manifestations was carried out according to the World Health Organization protocol.The research included 25 participants, 14 male and 11 female and the average age was 10.12 years (SD = 4.8). Acute lymphoblastic leukemia was the most prevalent (80%). Regarding the caries index, the majority of participants had zero (60%) and oral side effects were diagnosed in 60% of them, the most frequent being:change in taste (24%), mucositis (16%) and xerostomia (12%). Participants also had a high incidence of oral manifestations, unsatisfactory oral hygiene, but a low rate of caries. Furthermore, it is important for dental surgeons to know the ora manifestations most commonly found in children with leukemia, the need for quality oral hygiene, as well as the oral health condition as a whole, seeking to ensure that the mouth is not a source of infection, which harms the general health condition and cancer treatment.

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Introducción: Los tumores malignos son afecciones prevalentes que exigen un diagnóstico temprano para un tratamiento oportuno. La confección de una galería de imágenes como medio de enseñanza con la tecnología digital constituye una herramienta de aprendizaje de incuestionable valor en la especialidad de oncología. Objetivo: Confeccionar una galería de imágenes digitales de tumores malignos como medio de enseñanza alternativo para la docencia de residentes y profesionales de enfermería. Métodos: Se realizó una innovación tecnológica en el Hospital Oncológico Docente Provincial Conrado Benítez García de Santiago de Cuba, durante el bimestre enero-febrero del 2023. El objeto de estudio y el campo de acción fueron los recursos del aprendizaje y las imágenes digitalizadas sobre tumores malignos, respectivamente. Se combinaron los métodos de investigación teóricos (sistematización, vivencial y analítico sintético) y empíricos (análisis documental y encuesta en forma de cuestionario a informantes clave). Resultados: Como medio de enseñanza alternativo para la docencia médica y de enfermería, manualmente se confeccionó una galería digital con 164 imágenes de tumores malignos que incluían casi todas las localizaciones. Los expertos en informática, especialistas, residentes y enfermeras valoraron de muy adecuado el producto informático, basado en la cientificidad y la didáctica tecnológica para la formación académica integral. Conclusiones: La galería de imágenes digitales constituye una herramienta didáctica, motivacional, atractiva e interesante para el aprendizaje de las neoplasias malignas; es un recurso ilustrativo y utilitario para la docencia médica y del profesional de enfermería.

Introduction: Malignancies are prevalent affections that demand an early diagnosis for an opportune treatment. The making of an images gallery as teaching means with digital technology constitutes a learning tool of unquestionable value in the oncology specialty. Objective: To make a gallery of malignancies digital images as alternative teaching means for the residents and nursing professionals. Methods: A technological innovation was carried out in Conrado Benítez García Provincial Teaching Oncological Hospital in Santiago de Cuba, during the January-February two-month period, 2023. The study object and action field were the learning resources and the digital images on malignancies, respectively. The theoretical investigation methods (systematizing, experiential and analytic synthetic) and empiric (documental analysis and interviews in questionnaire form to key informants) were combined. Results: As alternative teaching means for medical and nursing teaching, a digital gallery was manually made with 164 malignancies images that included almost all the localizations. Computer science experts, specialists, residents and nurses valued as very appropriate the computer product, based on the scientificity and the technological didactics for the integral academic training. Conclusions: The gallery of digital images constitutes a didactic, motivational, attractive and interesting tool for learning of malignancies; it is an illustrative and utilitarian resource for medical and nursing professional teaching.

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OBJETIVO: Descrever a trajetória para a implementação de um Programa de Navegação para pacientes oncológicos. MÉTODO: Estudo descritivo, tipo relato de experiência realizado em um Centro de Oncologia do Sul do Brasil. RESULTADOS: O processo de implementação da navegação ocorreu em quatro etapas: a primeira iniciou com implementação da navegação para pacientes privados com câncer de cabeça e pescoço; a segunda envolveu o piloto do programa de navegação de pacientes com câncer de mama para entender as principais barreiras enfrentadas pelas pacientes; a terceira etapa, foi elaborar e aprovar a Política do Programa de Navegação Institucional. Na última, o Programa de Navegação da linha de cuidado da mama foi implementado para pacientes com indicação de neoadjuvância. Obteve-se redução de 70% na mediana de tempo de indicação e primeira consulta oncológica, de 28,6% no tempo entre sintoma e diagnóstico, 26,0% no tempo entre diagnóstico e início de tratamento. CONCLUSÃO: A implementação de um Programa de Navegação para pacientes com câncer exige dedicação e comprometimento institucional onde se evidencia um melhor cuidado oncológico, tendo o enfermeiro como protagonista da gestão e efetivação do processo.

OBJECTIVE: To describe the process of implementing a Navigation Program for cancer patients. METHOD: Descriptive study, type of experience report carried out in an Oncology Center in Southern Brazil. RESULTS: The process of implementing navigation took place in four stages: the first began with the implementation of navigation for private patients with head and neck cancer; the second involved piloting the navigation program for breast cancer patients to understand the main barriers faced by patients; the third stage, was to draw up and approve the Institutional Navigation Program Policy. In the last stage, the Breast Care Navigation Program was implemented for patients with neoadjuvant indications. A 70% reduction was achieved in the median time between indication and first oncology consultation, 28.6% between symptom and diagnosis, and 26.0% between diagnosis and start of treatment. CONCLUSION: Implementing a Navigation Program for cancer patients requires dedication and institutional commitment, leading to better cancer care, with nurses playing a leading role in managing and implementing this process.

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Resumo Um homem de 65 anos com histórico de carcinoma de língua procurou o pronto-socorro com contrações insensíveis estando em casa. Ele estava em terapia com 5-fluorouracil (5-FU) na época. O paciente foi desfibrilado e intubado porque a fibrilação ventricular (FV) se desenvolveu durante o monitoramento no pronto-socorro. A ecocardiografia mostrou que a fração de ejeção do ventrículo esquerdo (FEVE) era de 70% e a espessura do septo interventricular era de 15 mm. A angiografia coronária não revelou qualquer estenose crítica. A ressonância magnética cardíaca (RMC) não mostrou anormalidade de perfusão, fibrose ou cicatriz sugestiva de envolvimento cardíaco. Foi sugerido que a arritmia do paciente estava relacionada principalmente à cardiotoxicidade induzida pelo 5-FU. O fato de as causas secundárias terem sido proeminentes em nosso caso, de nenhuma patologia cardíaca óbvia que pudesse causar arritmia ter sido encontrada no exame detalhado e de a arritmia não ter recorrido durante a internação hospitalar, que durou até 15 dias, nos levou a acreditar que esse paciente poderia receber alta sem um cardioversor-desfibrilador implantável. Nosso caso foi apresentado para contribuir com a literatura.

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Avaliar a eficácia do TEGUM® versus produto já utilizado na instituição na prevenção de radiodermites. Método: Estudo prospectivo, quantitativo, do tipo descritivo-exploratório em um hospital oncológico. O projeto foi aprovado pelo Comitê de Ética em Pesquisa com o CAAE: 24278319.8.0000.0099. Resultados: Dos 88 pacientes, 96,6% tinham câncer de mama. Em média os pacientes passaram por 25 aplicações de radioterapia, sendo 92% tratados em acelerador linear e 8% em cobalto. Dos 88 pacientes, tivemos 51,1% no Braço 1 (produto à base de Aloe Vera) e 48,9% no Braço 2 (Tegum®), e após levantamento a prevenção de radiodermite foi efetiva em 70,5% dos pacientes em ambos os braços. Conclusão: Concluímos que é necessária a prevenção, visando a redução das radiodermites nos pacientes submetidos a radioterapia. Além de mais estudos que possam definir melhor essa reação, melhorando a qualidade de vida durante e após o término do tratamento oncológico.(AU)

TTo evaluate the effectiveness of TEGUM® versus the product already used in the institution in preventing radiodermatitis. Method: Prospective, quantitative, descriptive-exploratory study in an oncology hospital. The project was approved by the Research Ethics Committee with CAAE: 24278319.8.0000.0099. Results: Of the 88 patients, 96.6% had breast cancer. On average, patients underwent 25 radiotherapy applications, with 92% treated with linear accelerator and 8% with cobalt. Of the 88 patients, we had 51.1% in Arm 1 (Aloe Vera-based product) and 48.9% in Arm 2 (Tegum®), and after survey the prevention of radiodermatitis was effective in 70.5% of patients in both arms. Conclusion: We conclude that prevention is necessary, aiming to reduce radiodermatitis in patients undergoing radiotherapy. In addition to more studies that can better define this reaction, improving quality of life during and after the end of cancer treatment.(AU)

Evaluar la efectividad de TEGUM® versus el producto ya utilizado en la institución para prevenir la radiodermatitis. Método: Estudio prospectivo, cuantitativo, descriptivo-exploratorio en un hospital de oncología. El proyecto fue aprobado por el Comité de Ética en Investigación con CAAE: 24278319.8.0000.0099. Resultados: De las 88 pacientes, el 96,6% presentó cáncer de mama. En promedio, los pacientes se sometieron a 25 aplicaciones de radioterapia, de las cuales el 92% fueron tratados con acelerador lineal y el 8% con cobalto. De los 88 pacientes, teníamos el 51,1 % en el grupo 1 (producto a base de aloe vera) y el 48,9 % en el grupo 2 (Tegum®), y después de la encuesta, la prevención de la radiodermatitis fue efectiva en el 70,5 % de los pacientes en ambos grupos. Conclusión: Concluimos que la prevención es necesaria, teniendo como objetivo reducir la radiodermatitis en pacientes sometidos a radioterapia. Además de más estudios que puedan definir mejor esta reacción, mejorando la calidad de vida durante y después de finalizar el tratamiento contra el cáncer.(AU)

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To improve pediatric hematology and oncology outcomes, there is a recognized potential for partnerships between low- and high-resource institutions within health care systems. The SickKids Caribbean Initiative is a partnership between health care professionals at the Hospital for Sick Children in Toronto, Canada, and seven Caribbean institutions across six countries (Bahamas, Barbados, Jamaica, Saint Lucia, Saint Vincent and the Grenadines, and Trinidad and Tobago). The primary aim of the SickKids Caribbean Initiative has been to improve the outcomes and the quality of life of children in the Caribbean aged <18 years who have cancer and blood disorders. This article describes five key activities undertaken within the SickKids Caribbean Initiative, including providing education and training, assisting with case consultations and diagnostic services, developing local oncology databases, engaging in advocacy and ensuring stakeholder engagement, and coordinating administration and project management.

Las colaboraciones de instituciones de recursos bajos y altos dentro de los sistemas de atención de salud tienen un potencial reconocido para mejorar las respuestas a los tratamientos hematológicos y oncológicos pediátricos. La iniciativa SickKids para el Caribe es una asociación entre profesionales de la salud del Hospital for Sick Children de Toronto (Canadá) y siete instituciones de seis países del Caribe (Bahamas, Barbados, Jamaica, Santa Lucía, San Vicente y las Granadinas y Trinidad y Tabago). El objetivo principal de la iniciativa SickKids para el Caribe ha sido mejorar la respuesta a los tratamientos y la calidad de vida de los menores de 18 años del Caribe con cáncer o trastornos hematológicos. En este artículo se describen cinco actividades clave emprendidas en el marco de la iniciativa SickKids para el Caribe, consistentes en impartir formación y capacitación, prestar asistencia en materia de consultas de pacientes y servicios de diagnóstico, crear bases de datos locales en el área de la oncología, participar en actividades de promoción y garantizar la participación de las partes interesadas, y coordinar la administración y gestión de proyectos.

Há um potencial reconhecido para parcerias entre instituições com poucos e muitos recursos dentro dos sistemas de saúde para melhorar os resultados de hematologia e oncologia pediátricas. A iniciativa SickKids no Caribe é uma parceria entre profissionais de saúde do Hospital for Sick Children em Toronto, Canadá, e sete instituições em seis países do Caribe (Bahamas, Barbados, Jamaica, Santa Lúcia, São Vicente e Granadinas e Trinidad e Tobago). O objetivo principal da iniciativa SickKids no Caribe tem sido melhorar os desfechos e a qualidade de vida das crianças caribenhas com menos de 18 anos que têm câncer e doenças hematológicas. Este artigo descreve cinco atividades principais realizadas no âmbito da iniciativa SickKids no Caribe: oferecimento de educação e capacitação; assistência em consultas de casos e serviços diagnósticos; desenvolvimento de bancos de dados locais em oncologia; promoção da causa, assegurando o envolvimento das partes interessadas; e coordenação da administração e da gestão de projetos.

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Radiation oncology (RO) plays a crucial role in cancer care; cancer patients often undergo their initial diagnostic study by general physicians. However, studies have shown that most physicians are uncomfortable referring cancer patients to radiation therapy (RT). To assess the knowledge of RO among non-oncology physicians, we sent invitations to complete an online survey that required the responders to self-rate their understanding of RT and objective assessment. The survey was targeted at hospitalists and primary care physicians. Forty physicians responded to the survey, and 89.7% practiced primarily as hospitalists, with 67% being Internal Medicine graduates. Fifty percent of physicians have referred patients to RO before, although more than 90% have not done additional CME (continuing medical education) in Oncology. More than 50% of recent graduates (one to five years post-residency) self-rated themselves as "not knowledgeable" when it comes referral process to RO as well as general knowledge regarding RT. Factors, such as "type of cancer," "patients' wishes," and "life expectancy," are most cited as factors influencing the decision for a referral.

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Introduction: Cancer treatment is increasingly aggressive. The aim was to estimate who died due to cancer, to report use of chemotherapy (CT) in the last 3 months of life, and to describe clinical-epidemiological characteristics of these patients. Methods: We included a consecutive sample of deceased during 2017, affiliated to Hospital Italiano de Buenos Aires. Through manual review of medical helath records, they were classified according to the cause of death (cancer or other cause), validating diagnosis and baseline stage, performance status (PS). Prevalences with 95% CI are reported and descriptive statistics were used. Results: A total of 2293 adults died, 59% women with a median age of 84 years old. There were a total of 736 deaths from cancer, representing 32% (95%CI 30-34). This last subgroup were 54% women, with a median age of 75 years, and only one patient had advance directives. Regarding the place of death, 80% were hospitalized (65% general ward and 15% intensive care units). The most frequent tumors were: lung, colorectal-gastric, hematological, and breast. A total of 390 patients received CT at the end of life (53%; 95%CI 49-57), 53% being women and with a mean age of 68 years. Regarding the underlying oncological disease: 81% had a solid tumor, 75% advanced stage, and mostly with poor/regular ability to perform daily activities (25% PS3 and 32% PS4, respectively). Conclusion: There is a high frequency of CT at the end of life and deaths continue to be mainly in-hospital.

Introducción: El tratamiento oncológico es cada vez más agresivo. El objetivo de este trabajo fue estimar las personas fallecidas por causa oncológica, reportar la frecuencia de uso de quimioterapia (QT) en los últimos 3 meses de vida, y describir las características clínicas-epidemiológicas de estos pacientes. Métodos: Se incluyó una muestra consecutiva de fallecidos durante el 2017, afiliados a prepaga del Hospital Italiano de Buenos Aires. Mediante revisión de historias clínicas, se los clasificó según la causa de muerte (oncológico u otra causa), validando diagnóstico y estadio de base, performance status (PS). Se reportan prevalencias con IC95% y se utilizó estadística descriptiva. Resultados: Fallecieron 2293 personas, 59% mujeres con mediana de 84 años. Hubo un total de 736 fallecidos por cáncer, representando el 32% (IC95% 30-34). Este último subgrupo presentó una mediana de 75 años, 54% eran mujeres y sólo una paciente tenía directivas anticipadas. En cuanto al lugar de fallecimiento, 80% ocurrió hospitalizado (65% sala general y 15% unidad cerrada). Los tumores más frecuentes fueron: pulmón, colorrectal-gástrico, hematológico, y mama. Un total de 390 pacientes recibieron QT al final de la vida (53%; IC95% 49-57), siendo 53% mujeres y con promedio de 68 años. En cuanto a la enfermedad oncológica de base: 81% tenían tumor sólido, 75% estadío avanzado, y mayoritariamente con mala/regular capacidad para realizar actividades cotidianas (25% PS3 y 32% PS4 respectivamente). Conclusión: Existe una frecuencia preocupante del uso de QT en el fin de vida y los fallecimientos siguen siendo principalmente intrahospitalarios.

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