Avaliação da Cardiotoxicidade induzida por Quimioterapia em pacientes com Câncer de Mama
Evaluation of Chemotherapy-induced Cardiotoxicity in Breast Cancer patients
Igor Luiz Argani; Camila Arruda; Jean Schoueri; Mirella Scaff; Fernando Kaufman; Juliana Canonaco; João Vitor Teixeira; Claudia Sette; Daniel Cubero; Auro del Giglio
Resumo
Objetivo: Avaliar a alteração da função cardíaca em pacientes com câncer de mama tratadas com quimioterapia. Métodos: Estudo observacional retrospectivo com coleta de dados em prontuário no Hospital Mário Covas (Santo André – Brasil). Avaliou-se a fração de ejeção obtida pelo ecocardiograma (ECO) antes do tratamento quimioterápico, em comparação com o ECO ao final do tratamento. Resultados: Foram incluídas 234 pacientes com câncer de mama submetidas a QT, das quais 100 realizaram ao menos um ECO e 33, pelo menos dois exames. Desse total, apenas 18 puderam ser analisados, pois apresentavam ECO feito corretamente, i.e., antes e depois do tratamento quimioterápico. Analisando esses ECOs, observou-se diferença da fração de ejeção média de 5% (IC95% 2,9-7,6; p=0,0001). Conclusão: A alta prevalência e o expressivo aumento da sobrevida de pacientes com câncer de mama indicam a necessidade de acompanhamento adequado dos efeitos a longo prazo da QT. A análise dos ECO feitos adequadamente nos pacientes com câncer de mama nesse estudo demonstrou significante queda da fração de ejeção, confirmando os efeitos cardiotóxicos da QT. Apesar disso, apenas uma fração pouco expressiva dos pacientes apresentou acompanhamento adequado.
Palavras-chave
Abstract
Objective: Evaluate the alteration of cardiac function in breast cancer patients treated with chemotherapy. Methods: Retrospective observational study with data collection in medical records at Hospital Mário Covas (Santo André - Brazil). The ejection fraction obtained by the echocardiogram (ECO) before the chemotherapy treatment was evaluated, in comparison with the ECO at the end of the treatment. Results: 234 breast cancer patients undergoing chemotherapy were included, of whom 100 performed at least one ECO and 33 at least two exams. Of this total, only 18 could be analyzed, since they had ECO done correctly, i.e., before and after the chemotherapy treatment. Analyzing these ECOs, we observed a difference of the mean ejection fraction of 5% (95% CI 2.9-7.6, p = 0.0001). Conclusion: The high prevalence and significant increase in survival of breast cancer patients indicate the need for adequate follow-up of the long-term effects of QT. The analysis of echocardiogram performed adequately in patients with breast cancer in this study demonstrated a significant decrease in ejection fraction, confirming the cardiotoxic effects of chemotherapy. Despite this, only a small fraction of the patients presented adequate follow-up
Keywords
Referências
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