Estudo prospetivo sobre complicações neurológicas do cancro da mama e dos seus tratamentos: atualização três anos após o diagnóstico

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Estudo prospetivo sobre complicações neurológicas do cancro da mama e dos seus tratamentos: atualização três anos após o diagnóstico

Terça, 02.08.2016

Mais de 40% das doentes apresentaram pelo menos uma complicação neurológica três anos após o diagnóstico de cancro da mama; a dor neuropática (DN) permaneceu a principal responsável pela carga global destas complicações. Ter sido submetida a esvaziamento ganglionar axilar e a quimioterapia associou-se à prevalência de DN um e três anos após o diagnóstico de cancro, respetivamente. O tratamento com esquemas de quimioterapia que incluíam taxanos associou-se à prevalência de neuropatia periférica induzida pela quimioterapia.

 

Autores e afiliações:

Filipa Fontes a, Susana Pereira a,b, José Manuel Castro-Lopes c,d, Nuno Lunet a,e

a ISPUP – EPIUnit, University of Porto, Porto, Portugal

b Portuguese Institute of Oncology of Porto, Porto, Portugal

c Department of Experimental Biology, Faculty of Medicine, University of Porto, Porto, Portugal

d Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal

e Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Porto, Portugal

 

Abstract:

Objectives: To quantify the prevalence of neurological complications among breast cancer patients at one and three years after diagnosis, and to identify factors associated with neuropathic pain (NP) and chemotherapy-induced peripheral neuropathy (CIPN).

Material and methods: Prospective cohort study including 475 patients with newly diagnosed breast cancer, recruited among those proposed for surgical treatment (Portuguese Institute of Oncology, Porto). Patients underwent a neurological evaluation and had their cognitive function assesses with the Montreal Cognitive Assessment, before treatment and at one and three years after enrolment. We estimated the prevalence of each neurological complication, and odds ratios (OR), adjusted for socio-demographic and clinical characteristics, to identify factors associated with NP and CIPN.

Results: More than half of the patients [54.7%, 95% confidence interval (95%CI): 50.2-59.2] presented at least one neurological complication, at one and at three years after cancer diagnosis. Between the first and the third year of follow-up, there was an increase in the prevalence of NP (from 21.1% to 23.6%), cognitive impairment (from 7.2% to 8.2%), cerebrovascular disease (from 0.6% to 1.5%) and brain metastasis (from 0.0% to 0.6%). The prevalence of CIPN decreased from 14.1% to 12.6%. Axillary lymph node dissection was associated with NP at one year (OR = 2.75, 95%CI: 1.34-5.63) and chemotherapy with NP at three years (OR = 2.10, 95%CI: 1.20-3.67). Taxane-based chemotherapy was strongly associated with prevalence of CIPN at one and three years.

Conclusion: Neurological complications are frequent even three years after cancer diagnosis and NP remained the major contributor to the burden of these conditions among survivors.

 

Revista: The Breast

 

Link: http://www.thebreastonline.com/article/S0960-9776(16)30087-X/fulltext