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Qualidade de vida da pessoa com cancro da próstata metastático resistente à castração
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Introdução: A avaliação da qualidade de vida (QdV) nos doentes com cancro tem vindo a ser reconhecida como um importante objetivo complementar da terapêutica oncológica. O cancro da próstata metastático resistente à castração (CPMRC), tem sido um desafio em termos terapêuticos pois não existem tratamentos curativos para este estado avançado da doença. Têm sido várias as opções de tratamentos alternativos desenvolvidas com o objetivo de aumentar a sobrevivência das pessoas com esta doença. Objetivo: Avaliar a variação da QdV da pessoa com CPMRC desde o início do tratamento sistémico de primeira linha até aos primeiros três meses de tratamento. Material e Métodos: Doentes com diagnóstico de CPMRC que iniciaram tratamento sistémico de primeira linha com docetaxel, enzalutamida, acetato de abiraterona e cabazitaxel no Centro Clínico Champalimaud (CCC), de julho 2019 a março de 2020. Foi aplicado o questionário da European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 antes do tratamento (M0), quinze dias depois (M1), um mês (M2) e três meses (M3) depois do início do tratamento sistémico. Resultados: 26 doentes completaram o preenchimento dos questionários nos quatro momentos propostos, com uma mediana de idades de 73,5 anos (de 59 a 89 anos). O tratamento mais utilizado foi acetato de abiraterona (n=20; 76,9%), seguido de enzalutamida (n=5; 19,2%) e docetaxel (n=1; 3,8%). Nenhum doente iniciou tratamento com cabazitaxel. Não houve diferenças estatisticamente significativas (p> 0,05) nos parâmetros avaliados ao longo dos três meses de avaliação. No entanto, foram mantidos scores elevados de funcionalidade e estado de saúde global/QdV ao longo do tempo, com permanência de baixos scores de sintomas para o tratamento com enzalutamida e acetato de abiraterona. Conclusões: Os doentes com CPMRC apresentam uma perceção positiva da sua QdV ao longo dos três primeiros meses de tratamento sistémico de primeira linha. A amostra total do estudo foi limitada para poder tirar conclusões comparando estatisticamente os fármacos de primeira linha utilizados.
Background: The quality of life (QoL) assessment in cancer patients has been recognized as an important outcome of cancer therapy. Metastatic castration-resistant prostate cancer (MCRPC) treatment has been a huge therapeutic challenge because there are no curative treatments for this advanced disease. There have been several alternative treatment options developed with the aim of increasing the survival of people with this disease. Objective: To evaluate the quality of life evolution in patients with CPMRC at different times during the first-line treatment. Material and Methods: Patients diagnosed with MCRPC who started first-line treatment with docetaxel, enzalutamide, abiraterone and cabazitaxel at the Champalimaud Clinical Center (CCC), between July of 2019 and March of 2020 were included in the study. The QLQ-C30 European Organization for Research and Treatment of Cancer (EORTC) questionnaire was applied before the first-line treatment (M0) and fifteen days (M1), one month (M2) and three months (M3) after starting first line treatment. Results: 26 patients completed all questionnaires at the four determined times, with a median age of 73,5 years (from 59 to 89 years). The most used treatment was abiraterone (n=20; 76,9%), followed by enzalutamide (n=5; 19.2%) and docetaxel (n=1; 3.8%). No patient started treatment with cabazitaxel. The results do not report statistically significant differences (p> 0.05) in the parameters evaluated over the three months of evaluation. However, high scores on functionality and overall health status/QoL were maintained over time, with low symptom scores associated to treatment with enzalutamide and abiraterone acetate. Conclusions: Patients with MCRPC present a positive perception of their QoL over three months of treatment. The sample was limited in order to be able to draw conclusions comparing statistically the first line drugs used.
Background: The quality of life (QoL) assessment in cancer patients has been recognized as an important outcome of cancer therapy. Metastatic castration-resistant prostate cancer (MCRPC) treatment has been a huge therapeutic challenge because there are no curative treatments for this advanced disease. There have been several alternative treatment options developed with the aim of increasing the survival of people with this disease. Objective: To evaluate the quality of life evolution in patients with CPMRC at different times during the first-line treatment. Material and Methods: Patients diagnosed with MCRPC who started first-line treatment with docetaxel, enzalutamide, abiraterone and cabazitaxel at the Champalimaud Clinical Center (CCC), between July of 2019 and March of 2020 were included in the study. The QLQ-C30 European Organization for Research and Treatment of Cancer (EORTC) questionnaire was applied before the first-line treatment (M0) and fifteen days (M1), one month (M2) and three months (M3) after starting first line treatment. Results: 26 patients completed all questionnaires at the four determined times, with a median age of 73,5 years (from 59 to 89 years). The most used treatment was abiraterone (n=20; 76,9%), followed by enzalutamide (n=5; 19.2%) and docetaxel (n=1; 3.8%). No patient started treatment with cabazitaxel. The results do not report statistically significant differences (p> 0.05) in the parameters evaluated over the three months of evaluation. However, high scores on functionality and overall health status/QoL were maintained over time, with low symptom scores associated to treatment with enzalutamide and abiraterone acetate. Conclusions: Patients with MCRPC present a positive perception of their QoL over three months of treatment. The sample was limited in order to be able to draw conclusions comparing statistically the first line drugs used.
Descrição
Tese de mestrado, Cuidados Paliativos, Universidade de Lisboa, Faculdade de Medicina, 2021
Palavras-chave
Cancro da próstata metastático Cancro da próstata resistente à castração Qualidade de vida Teses de mestrado - 2021