Estado nutricional, biomarcadores inflamatórios e qualidade de vida de mulheres com câncer de mama recebendo quimioterapia ambulatorial

• Autor(a) principal: Marcarini, Julia Anhoque Cavalcanti
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/17212
• topic: Nutrição; Estado nutricional; Neoplasias da mama; Quimioterapia; Fatores de risco; Oncologia; subject.br-rjbn

Introduction: Introduction: Patients with breast cancer undergoing chemotherapy treatment present losses in their nutritional status, which may be mainly associated with weight gain. Another characteristic of cancer is the presence of systemic inflammation, related both to the tumor development process and as a consequence of chemotherapy. All of these factors greatly impact patients’ quality of life. Objective: To evaluate the nutritional status and inflammatory biomarkers of women with non-metastatic breast cancer receiving outpatient chemotherapy and identify their association with sociodemographic, clinical and quality of life variables. Methodology: Prospective longitudinal study conducted at Hospital Santa Rita de Cássia - reference in cancer treatment in the state of Espírito Santo. Patients who meet the following eligibility criteria will be included: a) women aged over 18 years; b) with an anatomopathological diagnosis of breast cancer in stage I, II or III; and c) patients (only new cases) undergoing outpatient chemotherapy. Exclusion criteria include: a) patients with a previous history of cancer treatment (chemotherapy, radiotherapy); b) patients in exclusive palliative care. The instruments for data collection include: 1) Socio-demographic and clinical characterization form based on the tumor form from the Hospital-based Cancer Registry (HCR); 2) Nutritional Risk Screening (NRS-2002); 3) Dietary assessment; 4) Anthropometric assessment; 5) The EQ-5D-3L, to assess quality of life. Blood count analysis will be performed in the 1st and 3rd cycle of chemotherapy to assess inflammatory aspects (Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio), as well as collection of Creactive protein (CRP) samples. All analyzes will be performed using the statistical software R (version 4.2.2) and the software RStudio (version 2023.03.1), with a significance level (alpha) set at 5%. Results: There was a predominance of overweight patients, with an increase in the 3rd cycle of CT. About 6.67% and 10% of patients were at nutritional risk in the 1st and 3rd cycle of CT, respectively. Anxiety/depression was more frequent in the 1st cycle of CT, with a significant association with nutritional risk (p=0.002). Age at the 3rd cycle of CT and pain/discomfort at the 1st cycle of CT also showed significant associations with nutritional risk (p=0.049 and p=0.043, respectively). In addition, the CRP was elevated in the first cycle of chemotherapy, remaining the same in the third cycle of treatment. The NLR and PLR presented averages below the recommendation, but increased throughout the chemotherapy treatment. Variables such as self-reported color, waist circumference, Body Mass Index, tricipital skinfold thickness and arm perimeter area showed an association with CRP. NLR was associated with marital status, staging, TNM, diabetes and corrected arm muscle area. Conclusion: This research emphasizes the complex interaction between nutritional status, neuropsychological symptoms, sociodemographic as well as inflammatory characteristics in patients with non-metastatic breast cancer during chemotherapy treatment, highlighting the need for personalized interventions to qualify care in Oncology.