Avaliação de neurotoxicidade clínica e alterações bioquímicas em saliva de pacientes em uso de oxaliplatina

• Autor(a) principal: Martins, Jefferson Silva [UNIFESP]
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7656613; https://repositorio.unifesp.br/handle/11600/59372
• topic: Saliva; Oxaliplatin; Toxicity; Biochemistry; Cancer; Peripheral Neurotoxicity Induced By Oxaliplatin; Saliva; Oxaliplatina; Toxicidade; Bioquímica; Câncer; Neurotoxicidade Periférica Induzida Por Oxaliplatina

Introduction: Oxaliplatin is one of main drugs used in the treatment of gastrointestinal cancers. Peripheral neuropathy is the greatest adverse reaction, which, depending on its degree, may limit the patient’s quality of life. Objectives: To evaluate the incidence of clinical neurotoxicity due to the chemotherapy and electrolyte dosage in saliva of patients with gastrointestinal cancer submitted to oxaliplatin. Methods: We included cancer patients using oxaliplatin from UNIFESP’s oncology center and volunteers without cancer who never used oxaliplatin. The oxaliplatin toxicity assessment questionnaire (QATIO) adapted from the Common Terminology Criteria for Adverse Events toxicity questionnaire was applied. The saliva was collected by the method of voluntary spitting in a universal collector for 5 minutes. After collection, the saliva samples were stored at -80° C. The dosages of sodium, potassium, chlorum, magnesium, phosphorus and calcium were determined. Statistical analysis: Exploratory data analysis included mean, median, standard deviation and variation for continuous variables and number and proportion for categorical variables. Comparison of continuous variables between independent groups was performed by the Mann-Whitney test, and categorical variables using Pearson's chi-square test or Fisher's exact test, when appropriate. Comparison of electrolytes over time was performed by the Friedman test. All tests were two-tailed and values of P <0.05 were considered significant. Results: We included 17 cancer patients and 46 controls. The cumulative oxaliplatin dose range was 77 mg / m² to 2906 mg / m². In the cancer group, questionnaires and saliva collection were performed 1-4 times, totalizing 43 QATIOs and the same number of saliva samples was collected. Through the application of QATIO it was possible to identify neuropathy in cancer patients, as well as the simplification of the questionnaire from 13 to 7 questions to be used by health professionals. Increased oxaliplatin neurotoxicity corresponded to increased exposure to oxaliplatin. Conclusion: In this study, it was possible to analyze the peripheral neuropathy associated with the use of oxaliplatin through the application of QATIO. We obtained 7 from a total of 13 questions with statistical significance in relation to the control. Therefore, we suggest the application of QATIO in the determination of oxaliplatin induced peripheral neuropathy.