CLINICAL PROTOCOLS ADOPTED BY NURSES IN THE EXTRAVASATION OF ANTINEOPLASTIC DRUGS: AN INTEGRATIVE REVIEW / PROTOCOLOS CLÍNICOS ADOPTADOS POR ENFERMERÍA EN LA EXTRAVASACIÓN DE FÁRMACOS ANTINEOPLÁSICOS: UNA REVISIÓN INTEGRADORA / PROTOCOLOS CLÍNICOS ADOTADOS PELOS ENFERMEIROS NO EXTRAVASAMENTO DE ANTINEOPLÁSICOS: UMA REVISÃO INTEGRATIVA

Objective: To identify the patient safety measures and clinical protocols adopted by nurses in the case of antineoplastic extravasation. Methodology: The research approach was based on an integrative literature review that used the PICo strategy to structure the research question. Bibliographic surveys were carried out using the MEDLINE, Lilacs, BDENF, SciELO and PubMed databases using the following terms according to DeCS: "Clinical Protocols", " Extravasation of Therapeutic and Diagnostic Materials", "Oncology Nursing", "Patient Safety", "Antineoplastics". After applying the inclusion and exclusion criteria, 25 articles were selected, read in full, classified and organized according to the theme, and critically analyzed. Results: From the analysis of the studies, it was possible to delimit the main actions and knowledge of nurses in the management and guarantee of patient safety in the face of antineoplastic extravasation, as well as promising new managements in the prevention and treatment of this aggravation. Conclusion: Nurses' knowledge of specific measures for antineoplastic drug leakage is incipient, and there is a clear need for research to minimize the gaps in innovative knowledge in nursing practice with the aim of preventing extravasation.

Objetivo: Identificar las medidas de seguridad del paciente y los protocolos clínicos adoptados por el personal de enfermería en el caso de extravasación de antineoplásicos. Metodología: El abordaje de la investigación se basó en una revisión bibliográfica integradora que utilizó la estrategia PICo para estructurar la pregunta de investigación. Las pesquisas bibliográficas fueron realizadas en las bases de datos MEDLINE, Lilacs, BDENF, SciELO y PubMed, utilizando los siguientes términos de acuerdo con el DeCS: "Protocolos clínicos", " Extravasación de material terapéutico y de diagnóstico", "Enfermería oncológica", "Seguridad del paciente", "Antineoplásicos". Tras aplicar los criterios de inclusión y exclusión, se seleccionaron 25 artículos, que fueron leídos en su totalidad, clasificados y organizados según el tema, y analizados críticamente. Resultados: A partir del análisis de los estudios, fue posible delinear las principales acciones y conocimientos de las enfermeras en el manejo y garantía de la seguridad del paciente ante la extravasación de antineoplásicos, así como nuevos manejos promisorios en la prevención y tratamiento de este agravamiento. Conclusión: El conocimiento de las enfermeras sobre las medidas específicas para la fuga de fármacos antineoplásicos es incipiente, existiendo una clara necesidad de investigación para minimizar las lagunas de conocimiento innovador en la práctica enfermera con el objetivo de prevenir la extravasación.

Objetivo: Identificar quais são as medidas de segurança do paciente e protocolos clínicos adotados pelos enfermeiros no extravasamento de antineoplásicos. Metodologia: A abordagem da pesquisa se deu a partir de uma revisão integrativa da literatura que se utilizou da estratégia PICo para estruturar a questão de pesquisa. Foram realizados levantamentos bibliográficos utilizando as bases de dados MEDLINE, Lilacs, BDENF, SciELO e PubMed utilizando os termos segundo o DeCS: "Protocolos Clínicos", "Extravasamento de Materiais Terapêuticos e Diagnósticos", "Enfermagem Oncológica", "Segurança do paciente", "Antineoplásicos". Após a aplicação dos critérios de inclusão e exclusão, foram selecionados 25 artigos lidos na íntegra, classificados e organizados conforme a temática, e analisados criticamente. Resultados: A partir da análise dos estudos, foi possível delimitar as principais ações e conhecimentos dos enfermeiros no manejo e garantia da segurança do paciente diante do extravasamento de antineoplásicos, assim como novos manejos promissores na prevenção e tratamento deste agravo. Conclusão: Incipiente é o conhecimento dos enfermeiros sobre as medidas específicas diante do extravasamento de antineoplásicos, com evidente necessidade de pesquisas que minimizem as lacunas no conhecimento inovador na prática da enfermagem com desígnio de prevenir  o extravasamento.

Is trimodal therapy the current standard for muscle-invasive bladder cancer?

OBJECTIVE: The aim of this review is to summarize the current evidence and future perspectives of bladder-sparing treatment for MIBC. METHODS: A non-systematic literature search in Medline/Pubmed was performed in October 2023 with the following keywords "bladder cancer", "bladder-sparing", "trimodal therapy", "chemoradiation", "biomarkers", "immunotherapy", "neoadjuvant chemotherapy", "radiotherapy". RESULTS: Urology guidelines recommend radical cystectomy as the standard curative treatment for muscle-invasive urothelial bladder cancer, reserving radiotherapy for patients who are unfit or who want to preserve their bladder. Given the morbidity and mortality of cystectomy and its impact on quality of life and bladder function, modern oncologic therapies are increasingly oriented toward organ preservation and maximizing functional outcomes while maintaining treatment efficacy. Trimodal therapy, which incorporates maximal transurethral resection followed by radiotherapy with concurrent radiosensitizing chemotherapy, is an effective regimen for bladder function preservation in well-selected patients. Despite the absence of comparative data from randomized trials, the two approaches seem to provide comparable oncologic outcomes. Studies are evaluating the expansion of eligibility criteria for trimodal therapy, the optimization of radiotherapy and immunotherapy delivery to further improve outcomes, and the validation of biomarkers to guide bladder preservation. CONCLUSIONS: Trimodal therapy has shown acceptable outcomes for bladder preservation; therefore, it provides a valid treatment option in well-selected patients.

Levels of depression and self-esteem in women with cancer of the endometrium and cervix receiving chemotherapy treatment in Türkiye.

OBJECTIVE: Endometrium and cervical cancer is a common and important health problem that affects women in many physical, emotional and psychological aspects. This study aimed to determine the levels of depression and self-esteem in women with endometrial and cervical cancer receiving chemotherapy, determine the factors affecting them, and examine the relationship between the levels of depression and self-esteem. METHODS: This descriptive and cross-sectional study was conducted with 158 women who came to the gynecology-oncology policlinic and chemotherapy unit of a training and research hospital in Izmir, western Türkiye, between April 2022 and April 2023. Data were collected with the "Descriptive Information Form", "Beck Depression Inventory" and "Rosenberg Self-Esteem Scale". Descriptive and inferential statistics were performed to analyse the association between the study variables. RESULTS: In this study, 52.5% of women were diagnosed with endometrial cancer and 47.5% with cervical cancer. Beck Depression Inventory mean total score was 11.28 ±â€¯6.35, and 20.3% of them were at risk of depression (BDI ≥ 17). Rosenberg Self-Esteem Scale mean total score was 21.06 ±â€¯3.85, and 97.5% of them had high self-esteem. There was a statistically significant and strong negative correlation between the mean total scores of the Beck Depression Inventory and Rosenberg Self-Esteem Scale (r = 0.723; p < 0.05). It was determined that an increase in the Rosenberg Self-Esteem Scale mean total score by 1 unit decreased the Beck Depression Inventory mean total score by 1.2 units and was responsible for 52% of the variance (B = -1.192; R2 = 0.523). CONCLUSION: It was determined that one-fifth of women experienced moderate/severe depression and the majority of them had high self-esteem. The increase in women's depression levels decreased their self-esteem. Health professionals and oncology nurses should perform screenings to determine the depression and self-esteem levels of women with endometrial and cervical cancer and provide necessary education, counseling, and care to women.

Intra and peritumoral PET radiomics analysis to predict the pathological response in breast cancer patients receiving neoadjuvant chemotherapy.

OBJECTIVE: The aim of our study was to evaluate the contribution of 18Fluorine-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) radiomic data obtained from both the tumoral and peritumoral area in predicting pathological complete response (pCR) in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy (NAC). METHODS: Female patients with a diagnosis of invasive ductal carcinoma who received NAC were evaluated retrospectively. The volume of interest (VOI) of the primary tumor (VOI-T) was manually segmented, then a voxel-thick VOI was added around VOI-T to define the peritumoral area (VOI-PT). Morphological, intensity-based, histogram and texture parameters were obtained from VOIs. The patients were divided into two groups as pCR and non-complete pathological response (npCR). A "radiomic model" was created with only radiomic features, and a "patho-radiomic model" was created using radiomic features and immunohistochemical data. RESULTS: Of the 66 patients included in the study, 21 were in the pCR group. The only statistically significant feature from the primary tumor among patients with pCR and npCR was Morphological_Compacity-T (AUC: 0.666). Between response groups, a significant difference was detected in 2 morphological, 1 intensity, 4 texture features from VOI-PT; no correlation was found between Morphological_Compacity-PT and NGTDM_contrast-PT. The obtained radiomic model's sensitivity and accuracy values were calculated as 61.9% and 75.8%, respectively (AUC: 0.786). When HER2 status was added, sensitivity and accuracy values of the patho-radiomic model increased to 85.7% and 81.8%, respectively (AUC: 0.903). CONCLUSIONS: Evaluation of PET peritumoral radiomic features together with the primary tumor, rather than just the primary tumor, provides a better prediction of the pCR to NAC in patients with breast cancer.

Efectos secundarios oculares de las terapias oncológicas. Revisión / Ocular side effects of oncological therapies: Review

Con el avance de la terapia contra el cáncer en los últimos años, ha aumentado el conocimiento de los mecanismos involucrados en esta enfermedad, lo que ha supuesto un aumento de la calidad de vida y de la supervivencia de los pacientes con afecciones tumorales anteriormente consideradas incurables o refractarias al tratamiento. El número de fármacos utilizados ha sufrido un aumento exponencial, y a pesar de que la toxicidad implícita es menor que la de la terapia antineoplásica convencional, conllevan la aparición de nuevos efectos adversos asociados, que el oftalmólogo debe reconocer y manejar.(AU)

With the advance of cancer therapy in recent years, the knowledge of the mechanisms involved in this disease has increased, which has meant an increase in the quality of life and survival of patients with tumor pathologies previously considered incurable or refractory to treatment. The number of drugs used has increased exponentially in number, and although the implicit toxicity is lower than that of conventional antineoplastic therapy, they lead to the appearance of new associated adverse effects that the ophthalmologist must recognize and manage.(AU)

Ocular side effects of oncological therapies: Review.

With the advance of cancer therapy in recent years, the knowledge of the mechanisms involved in this disease has increased, which has meant an increase in the quality of life and survival of patients with tumor pathologies previously considered incurable or refractory to treatment. The number of drugs used has increased exponentially in number, and although the implicit toxicity is lower than that of conventional antineoplastic therapy, they lead to the appearance of new associated adverse effects that the ophthalmologist must recognize and manage.

Factores relacionados a flebitis química en personas con quimioterapia, revisión sistemática de la literatura

Objetivo: Describir los factores asociados a la flebitis química en personas con diagnóstico de cáncer que reciben quimioterapia, evidenciados en la literatura. Metodología: Se realizó una revisión sistemática de la literatura, según recomendaciones de Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Resultados: Los factores que aumentaron el riesgo de flebitis química hallados en la evidencia fueron la edad mayor de 57 años, sexo femenino, antecedentes de cáncer, enfermedad metastásica, hipertensión arterial, neutropenia, tabaquismo, vaciamiento ganglionar, hipoalbuminemia, uso de medicamentos citotóxicos, epirrubicina, fosaprepitant, antraciclina y vinorelbina, presentación premezclada de los fármacos, dilución en 50 cc de solución salina normal, tiempo de administración mayor a 60 minutos, catéteres de calibres grandes como 18 G o 20 G y ubicación anatómica del catéter en antebrazo o fosa antecubital. Conclusión: los factores relacionados a la flebitis química hallados en la literatura fueron principalmente elementos inherentes al paciente y a su tratamiento, algunos de estos no son modificables.

Objective: To describe the factors related to chemical phlebitis in patients diagnosed with cancer undergoing chemotherapeutic treatment. Methodology: A systematic review of the literature was carried out, according to recommendations of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Results: The factors that increase the risk of chemical phlebitis were: age older than 57 years, female sex, history of cancer, metastatic disease, arterial hypertension, neutropenia, smoking, lymph node emptying, hypoalbuminemia, use of cytotoxic drugs, epirubicin, fosaprepitant, anthracycline and vinorelbine, premixed presentation, dilution in 50 cc of Normal Saline Solution, administration time greater than 60 minutes, catheters of large gauges such as 18 G or 20 G and anatomical location of the catheter in the forearm or antecubital fossa. Conclusion: Factors related to chemical phlebitis found in the literature were features inherent to the patient and their treatment. Therefore, some of these are not modifiable.

Características epidemiológicas y microbiológicas de los episodios de Neutropenia Febril (NF) en niños con cáncer en el Hospital del Niño - Dr. José Renán Esquivel (HNJRE)

Introducción: La neutropenia febril (NF) constituye una complicación frecuente, considerada una urgencia infectológica en los pacientes con cáncer que reciben tratamiento mielosupresor. Metodología: Se realizó un estudio retrospectivo descriptivo a través de la revisión de los expedientes de todos los episodios de NF secundarios a quimioterapia ingresados en el Hospital del Niño - Dr. José Renán Esquivel durante el periodo de enero a diciembre de 2017. Resultados: El estudio consistió en la evaluación de características epidemiológicas e identificación de agentes infecciosos en 49 casos de NF, y 104 eventos febriles. Se observó que el 51% de los casos eran varones, con una edad promedio de 7 años, y recuperación de NF en los primeros 7 días del 68%. La mayoría de las hospitalizaciones (53,8%) duraron de 1 a 7 días, con una relación directa con los días de fiebre y la presencia de neutropenia. La letalidad registrada fue de 6.1%. Los agentes etiológicos más frecuentes fueron la Pseudomonas aeruginosa, los Estafilococos coagulasa negativos y Staphylococcus aureus meticilino sensible. Conclusión: Los hallazgos permiten conocer la epidemiología actual de los pacientes con NF que se admiten al hospital, con el fin de optimizar el tratamiento para reducir la tasa de letalidad. (provisto por Infomedic International)

Introduction: Febrile neutropenia (NF) constitutes a frequent complication, considered an infectious emergency in cancer patients receiving myelosuppressive treatment. Methodology: A descriptive retrospective study was conducted by reviewing the records of all episodes of NF secondary to chemotherapy admitted to the Hospital del Niño - Dr. José Renán Esquivel during the period from January to December 2017. Results: The study consisted of the evaluation of epidemiological characteristics and identification of infectious agents in 49 cases of NF, and 104 febrile events. It was observed that 51% of the cases were male, with a mean age of 7 years, and recovery from NF in the first 7 days of 68%. Most hospitalizations (53.8%) lasted from 1 to 7 days, with a direct relationship with the number of days of fever and the presence of neutropenia. The case fatality rate was 6.1%. The most frequent etiological agents were Pseudomonas aeruginosa, coagulase-negative Staphylococci and methicillin-sensitive Staphylococcus aureus. Conclusion: The findings provide insight into the current epidemiology of patients with NF admitted to the hospital, in order to optimize treatment to reduce the case-fatality rate. (provided by Infomedic International)

Fatores associados à punção venosa periférica difícil em adultos submetidos à quimioterapia antineoplásica / Factors associated with difficult peripheral venipuncture in adults undergoing antineoplastic chemotherapy / Factores asociados a la venopunción periférica difícil en adultos sometidos a quimioterapia antineoplásica

Objetivo: identificar os fatores associados à punção venosa periférica difícil em adultos submetidos à quimioterapia antineoplásica. Método: estudo transversal, observacional, analítico e quantitativo realizado em uma Unidade de Alta Complexidade em Oncologia (UNACON) da região amazônica brasileira. Os dados foram analisados por meio de estatística descritiva e inferencial, onde a razão de possibilidades foi calculada. Resultados: a maioria dos participantes foi do sexo feminino (64,6%), autodeclarados como pardos (51,2%). Em relação à localização do câncer, a maioria possuía a doença no aparelho digestório (46,4%) ou reprodutor (45,2%). Pacientes que tinham histórico de punção venosa difícil, veias não visíveis ou não palpáveis apresentaram mais chance de apresentar a punção venosa difícil (OR 1,6, 1,5 e 1,3, respetivamente). Conclusão: os preditores encontrados relacionados à punção venosa periférica difícil em pacientes adultos submetidos à quimioterapia antineoplásica foram: histórico de punção difícil e veias não visíveis ou não palpáveis.

Objective: to identify factors associated with difficult peripheral venipuncture in adults undergoing antineoplastic chemotherapy. Method: cross-sectional, observational, analytical, and quantitative study carried out in a High Complexity Oncology Unit (UNACON) in the Brazilian Amazon region. Data were analyzed using descriptive and inferential statistics, where the odds ratio was calculated. Results: majority of participants were female (64.6%), self-declared as brown (51.2%). Regarding the location of the cancer, the majority had the disease in the digestive (46.4%) or reproductive (45.2%) systems. Patients who had a history of difficult venipuncture, non-visible or non-palpable veins were more likely to have difficult venipuncture (OR 1.6, 1.5 and 1.3, respectively). Conclusion: found predictors related to difficult peripheral venipuncture in adult patients undergoing antineoplastic chemotherapy were: history of difficult puncture and non-visible or non-palpable veins.

Objetivo: identificar los factores asociados a la dificultad de la venopunción periférica en adultos sometidos a la quimioterapia antineoplásica. Método: estudio transversal, observacional, analítico y cuantitativo realizado en una Unidad de Oncología de Alta Complejidad (UNACON) en la Amazonía brasileña. Se analizaron los datos mediante estadística descriptiva e inferencial, donde se calculó el odds ratio. Resultados: la mayoría de los participantes era del sexo femenino (64,6%), se auto declaró morena (51,2%). En cuanto a la ubicación del cáncer, la mayoría tenía la enfermedad en el sistema digestivo (46,4%) o reproductivo (45,2%). Los pacientes que tenían antecedentes de venopunción difícil, venas no visibles o no palpables tenían más probabilidades de tener venopunción difícil (OR 1,6, 1,5 y 1,3, respectivamente). Conclusión: Los predictores encontrados relacionados con la punción venosa periférica difícil en pacientes adultos sometidos a quimioterapia antineoplásica fueron antecedente de punción difícil y venas no visibles o no palpables.

Resting energy expenditure changes after antineoplastic treatment in gynecological cancer: a prospective pilot study / Cambios en el gasto energético en reposo tras el tratamiento antineoplásico en cáncer ginecológico: estudio piloto prospectivo

Introduction: energy metabolism in cancer patients is influenced by different factors. However, the effect of antineoplastic treatment is not clear, especially in women. Objective: to evaluate resting energy expenditure (REE) by indirect calorimetry (IC) before (T0) and after (T1) first cycle period of antineoplastic therapy: radiotherapy (RT), chemotherapy (CT), and concomitant chemoradiation therapy (CRT), quality of life (QoL) and accuracy of REE were compared with international guidelines recommendations per kilogram (European Society for Clinical Nutrition and Metabolism [ESPEN]). Methods: an observational, longitudinal study was conducted in women with gynecological cancer diagnosis undergoing antineoplastic treatment: RT, CT and CRT. Weight loss, actual body weight and height were measured. REE was evaluated in T0-T1 and compared with ESPEN recommendations. Kruskal-Wallis test and Bland-Alman analysis were used to determine the agreement (± 10 % of energy predicted) of REE adjusted by physical activity (TEE) compared with ESPEN recommendations, respectively. Results: fifty-four women with cancer were included: 31.5 % (n = 17) for RT group, 31.5 % (n = 17) for CT group and 37 % (n = 20) for CRT group. REE showed statistical differences between T0 and T1 in the total population (p = 0.018), but these were not associated with anticancer therapy groups (p > 0.05). QoL had no significant changes after treatment (p > 0.05). Accuracy of 25 and 30 kcal/kg compared to TEE was less than 30 %. Conclusion: REE in women with gynecological cancer decreased after antineoplastic treatments but this is not associated with a particular antineoplastic therapy. It is needed to develop research to determine the accuracy of ESPEN recommendations with TEE estimated by IC and clinical factors in women with cancer. (AU)

Antecedentes: el metabolismo energético en pacientes con cáncer está influenciado por diferentes factores. Sin embargo, el efecto sobre el tratamiento antineoplásico no es claro, especialmente en mujeres. Objetivo: evaluar el gasto energético en reposo (GER) mediante calorimetría indirecta (CI) antes (T0) y después (T1) del primer ciclo del tratamiento antineoplásico: radioterapia (RT), quimioterapia (QT) y quimio-radioterapia concomitante (QRT), calidad de vida (CdV) y precisión del GER con las con las recomendaciones internacionales por kilogramo de peso (European Society for Clinical Nutrition and Metabolism [ESPEN]). Métodos: se realizó un estudio longitudinal, observacional en mujeres con diagnóstico de cáncer ginecológico en tratamiento antineoplásico. Se evaluó el GER en T0 y T1. Se midieron la pérdida de peso, el peso corporal y la talla. Se usaron las pruebas de Kruskal-Wallis y el análisis Bland-Altman para determinar la concordancia (± 10 % de GER) del REE ajustado por actividad física (TEE) en comparación con las recomendaciones de ESPEN. Resultados: se incluyeron 54 mujeres con cáncer; 31,5 % (n = 17) en el grupo RT, 31,5 % (n = 17) en el de QT y 37 % (n = 20) en el de QRT. GER mostró diferencias estadísticas entre T0 y T1 en la población total (p = 0,018); no se asoció con la terapia contra el cáncer (p > 0,05). La calidad de vida no tuvo cambios significativos después del tratamiento (p > 0,05). La precisión de 25 y 30 kcal/kg en comparación con TEE fue inferior al 30 %. Conclusión: el GER en mujeres con cáncer ginecológico disminuyó después del tratamiento antineoplásico, pero no se asoció a una terapia antineoplásica en particular. Es fundamental desarrollar más investigaciones que compare las recomendaciones de ESPEN y con los valores de la CI comparando más factores clínicos para ofrecer una intervención nutricional precisa (AU)

Resting energy expenditure changes after antineoplastic treatment in gynecological cancer: a prospective pilot study.

Introduction: Introduction: energy metabolism in cancer patients is influenced by different factors. However, the effect of antineoplastic treatment is not clear, especially in women. Objective: to evaluate resting energy expenditure (REE) by indirect calorimetry (IC) before (T0) and after (T1) first cycle period of antineoplastic therapy: radiotherapy (RT), chemotherapy (CT), and concomitant chemoradiation therapy (CRT), quality of life (QoL) and accuracy of REE were compared with international guidelines recommendations per kilogram (European Society for Clinical Nutrition and Metabolism [ESPEN]). Methods: an observational, longitudinal study was conducted in women with gynecological cancer diagnosis undergoing antineoplastic treatment: RT, CT and CRT. Weight loss, actual body weight and height were measured. REE was evaluated in T0-T1 and compared with ESPEN recommendations. Kruskal-Wallis test and Bland-Alman analysis were used to determine the agreement (± 10 % of energy predicted) of REE adjusted by physical activity (TEE) compared with ESPEN recommendations, respectively. Results: fifty-four women with cancer were included: 31.5 % (n = 17) for RT group, 31.5 % (n = 17) for CT group and 37 % (n = 20) for CRT group. REE showed statistical differences between T0 and T1 in the total population (p = 0.018), but these were not associated with anticancer therapy groups (p > 0.05). QoL had no significant changes after treatment (p > 0.05). Accuracy of 25 and 30 kcal/kg compared to TEE was less than 30 %. Conclusion: REE in women with gynecological cancer decreased after antineoplastic treatments but this is not associated with a particular antineoplastic therapy. It is needed to develop research to determine the accuracy of ESPEN recommendations with TEE estimated by IC and clinical factors in women with cancer.

Introducción: Antecedentes: el metabolismo energético en pacientes con cáncer está influenciado por diferentes factores. Sin embargo, el efecto sobre el tratamiento antineoplásico no es claro, especialmente en mujeres. Objetivo: evaluar el gasto energético en reposo (GER) mediante calorimetría indirecta (CI) antes (T0) y después (T1) del primer ciclo del tratamiento antineoplásico: radioterapia (RT), quimioterapia (QT) y quimio-radioterapia concomitante (QRT), calidad de vida (CdV) y precisión del GER con las con las recomendaciones internacionales por kilogramo de peso (European Society for Clinical Nutrition and Metabolism [ESPEN]). Métodos: se realizó un estudio longitudinal, observacional en mujeres con diagnóstico de cáncer ginecológico en tratamiento antineoplásico. Se evaluó el GER en T0 y T1. Se midieron la pérdida de peso, el peso corporal y la talla. Se usaron las pruebas de Kruskal-Wallis y el análisis Bland-Altman para determinar la concordancia (± 10 % de GER) del REE ajustado por actividad física (TEE) en comparación con las recomendaciones de ESPEN. Resultados: se incluyeron 54 mujeres con cáncer; 31,5 % (n = 17) en el grupo RT, 31,5 % (n = 17) en el de QT y 37 % (n = 20) en el de QRT. GER mostró diferencias estadísticas entre T0 y T1 en la población total (p = 0,018); no se asoció con la terapia contra el cáncer (p > 0,05). La calidad de vida no tuvo cambios significativos después del tratamiento (p > 0,05). La precisión de 25 y 30 kcal/kg en comparación con TEE fue inferior al 30 %. Conclusión: el GER en mujeres con cáncer ginecológico disminuyó después del tratamiento antineoplásico, pero no se asoció a una terapia antineoplásica en particular. Es fundamental desarrollar más investigaciones que compare las recomendaciones de ESPEN y con los valores de la CI comparando más factores clínicos para ofrecer una intervención nutricional precisa.

CHEMOBRAIN: estudio descriptivo sobre la función cognitiva en personas con una condición de salud oncológica en tratamiento quimioterapéutico / CHEMOBRAIN: descriptive study on cognitive function in people with a oncological health condition under chemotherapeutic treatment

Objetivos: el objetivo principal de este estudio descriptivo es analizar la presencia de deterioro cognitivo en personas con una condición de salud oncológica sometidas a tratamiento quimioterapéutico. Método: se trata de un estudio descriptivo, observacional, correlacional y transversal, en el que participan 55 pacientes del Hospital Universitario de Salamanca. Los instrumentos utilizados son el cuestionario Evaluación Rápida de las Funciones Cognitivas; el Cuestionario de Fallos de Memoria de la vida Cotidiana; y la Escala de Ansiedad y Depresión Hospitalaria. Resultados: los resultados muestran que un 54,5% de la muestra presenta deterioro cognitivo objetivo y subjetivo (con una correlación significativa de p=0,038). Además, el 65,4% de la muestra presenta síntomas ansioso-depresivos. Sin embargo, ambas variables, no se hanpodido correlacionar de manera estadística significativa. Sí se han establecido correlaciones significativas entre la edad y el deterioro cognitivo (p=0,030). Conclusión: podemos concluir que la presencia de deterioro cognitivo y síntomas ansioso-depresivos es común entre las personas con una condición de salud oncológica, aumentando el deterioro cognitivo con la edad.(AU)

Objective: Cancer is a leading contributor to morbidity and mortality in Spain. While oncological treatments used to combat the disease, they have various side effects, including cognitive impairment or complaints commonly known as "chemobrain." Method: This descript ive, observational,correlational, and cross-sectional study involved 55 patients from the University Hospital of Salamanca. The instruments employed included the Rapid Assessment of Cognitive Functions Questionnaire; the Everyday Life Memory Failure Questionnaire, and the Hospital Anxiety and Depression Scale. Results: The results show that 54.5% of the sample exhibits both objective and subjective cognitive impairment, with a significant correlation of p=0.038. Furthermore, 65.4% of the sample exhibits anxious-depressive symptoms. However, both variables could not be statistically significantly correlated. Significantly, correlations have been established between age and cognitive impairment (p=0.030). Conclusion: Consequently, it can be concluded that cognitive impairment and anxious-depressive symptoms are common among individuals with an oncological health condition, with cognitive impairment being more prevalent among older individuals.(AU)

Three-Year Survival in a Cohort of Women with Breast Cancer from an Insurance Company in Cali, 2017-2020 / SUPERVIVENCIA A TRES AÑOS EN UNA COHORTE DE MUJERES CON CÁNCER DE MAMA DE UNA ASEGURADORA EN CALI 2017-2020

INTRODUCTION: Breast cancer, in particular, is a significant concern in public health due to its high mortality rate. This research focuses on understanding the factors related to the 3-year survival of women with breast cancer in Cali, contributing to addressing this health challenge. OBJECTIVE: To determine the socio-demographic, clinical, and healthcare-related factors associated with the 3-year survival of women with breast cancer affiliated with an insurance provider in Cali from 2017 to 2020. This study aims to generate scientific evidence for decision-making within the insurance provider and the region. METHODOLOGY: A study was conducted in women with breast cancer in Cali to identify factors linked to 3-year survival. Data from a cohort of women with breast cancer affiliated with an insurance provider were analyzed, applying inclusion and exclusion criteria. Socio-demographic, clinical, and healthcare-related factors were assessed. Data were collected from secondary sources and analyzed to determine variables associated with survival. Ethical and confidentiality considerations were adhered to throughout the process. RESULTS: The most significant finding of our study, based on a three-year follow-up of 140 women with breast cancer, is the alarming mortality rate of 21.4%. We emphasize the importance of diagnosing the disease at its early stages, which can make a difference in the survival and prognosis of patients. CONCLUSION: The study highlights the high vulnerability of the cohort of women with breast cancer affiliated with the insurance provider. Although a longer survival time was observed in certain groups, the mortality rate remains significant.

INTRODUCCIÓN: El cáncer de mama, en particular, es una preocupación significativa en la salud pública debido a su alta mortalidad. Esta investigación se centra en comprender los factores relacionados con la supervivencia a 3 años de mujeres con cáncer de mama en Cali, contribuyendo a abordar este desafío de salud. OBJETIVO: determinar los factores socio demográficos, clínicos y de atención en salud asociados a la supervivencia a 3 años de mujeres con cáncer de mama afiliadas a una aseguradora en Cali 2017-2020, generando evidencia científica para la toma de decisiones tanto en la aseguradora como en la región. METODOLOGIA: Se realizó un estudio en mujeres con cáncer de mama en Cali para identificar factores vinculados a la supervivencia a 3 años. Se analizaron datos de una cohorte de mujeres con cáncer de mama afiliadas a una aseguradora, aplicando criterios de inclusión y exclusión. Se evaluaron factores sociodemográficos, clínicos y de atención en salud. Los datos se recopilaron de fuentes secundarias y se analizaron para determinar las variables relacionadas con la supervivencia. Se cumplieron consideraciones éticas y de confidencialidad en el proceso. RESULTADOS: El hallazgo más significativo de nuestro estudio, basado en un seguimiento de tres años a 140 mujeres con cáncer de mama, es la alarmante tasa de mortalidad del 21.4%. Destacamos la importancia de diagnosticar la enfermedad en sus estadios iniciales, lo que puede marcar la diferencia en la supervivencia y el pronóstico de las pacientes. CONCLUSION: Estudio destaca la alta vulnerabilidad de la cohorte de mujeres con cáncer de mama afiliadas a la EAPB. Aunque se observó un mayor tiempo de supervivencia en ciertos grupos, la tasa de mortalidad sigue siendo significativa.

Sobrevida del adenocarcinoma ductal de páncreas

El objetivo de este trabajo es analizar la presentación epidemiológica y la sobrevida de los pacientes con adenocarcinoma ductal de páncreas de acuerdo con su estadío clínico y al tipo de intervención realizada, en una cohorte de pacientes atendidos en una clínica en Lima, Perú. Estudio de cohortes retrospectivas que evaluó desde enero del 2015 a febrero del 2021 a pacientes con diagnóstico de adenocarcinoma ductal de páncreas considerando diversos factores epidemiológicos, radiológicos, estadiaje oncológico, haber recibido quimioterapia neoadyuvante o adyuvante, haber sido sometidos a cirugía y la sobrevida posterior a alguna de las intervenciones realizadas. De los 249 pacientes analizados, se encontró que 75 de ellos requerían cirugía resectiva. Entre los principales resultados obtenidos, se observó que aquellos con un nivel de CA 19-9 menor a 200 U/mL presentaban una media de sobrevida más alta en comparación con aquellos cuyo nivel de CA 19-9 era superior a 200 U/mL (HR: 1,96; IC95%: 0,18-0,53; p≤0,001). Asimismo, al comparar a los pacientes según su etapa, se encontró que aquellos con tumores resecables tenían una media de sobrevida de 37,72 meses, mientras que aquellos con tumores localmente avanzados tenían una media de sobrevida de 13,47 meses y aquellos con tumores metastásicos tenían una media de sobrevida de 7,69 meses (HR: 0,87; IC95%: 0,31-0,25; p≤0,001). Igualmente, se observó que recibir tratamiento neoadyuvante se asociaba con un mejor pronóstico de sobrevida para los pacientes (HR: 0,32; IC95%: 0,19-0,53; p≤0,001). Asimismo, se llevaron a cabo 5 pancreatectomías con resección metastásica en pacientes oligometastásicos tratados con quimioterapia de rescate, y se encontró que la media de sobrevida para estos pacientes fue de 22,51 meses. Conclusión: La cirugía resectiva en un estadío clínico temprano , presentar valores de CA 19-9 por debajo de 200 U/mL y haber recibido quimioterapia neoadyuvante se correlaciona estadísticamente con una mayor esperanza de sobrevida.

The objective of this study is to analyze the epidemiological presentation and survival of patients with pancreatic ductal adenocarcinoma according to their clinical stage and the type of intervention performed, in a cohort of patients treated at a clinic in Lima, Peru. A retrospective cohort study evaluated patients diagnosed with pancreatic ductal adenocarcinoma from January 2015 to February 2021, considering various epidemiological factors, radiological findings, oncological staging, receipt of neoadjuvant or adjuvant chemotherapy, undergoing surgery, and post-intervention survival. Out of the 249 patients analyzed, 75 of them required resective surgery. Among the main findings, it was observed that those with a CA 19-9 level below 200 U/mL had a higher median survival compared to those with a CA 19-9 level above 200 U/mL (HR: 1.96; 95% CI: 0.18-0.53; p≤0.001). Furthermore, when comparing patients according to their stage, those with resectable tumors had a median survival of 37.72 months, while those with locally advanced tumors had a median survival of 13.47 months, and those with metastatic tumors had a median survival of 7.69 months (HR: 0.87; 95% CI: 0.31-0.25; p≤0.001). Additionally, receiving neoadjuvant treatment was associated with a better prognosis of survival for patients (HR: 0.32; 95% CI: 0.19-0.53; p≤0.001). Furthermore, 5 pancreatectomies with metastatic resection were performed in oligometastatic patients treated with salvage chemotherapy, and the median survival for these patients was 22.51 months. Conclusion: Resective surgery at an early clinical stage, CA 19-9 levels below 200 U/mL, and receiving neoadjuvant chemotherapy are statistically correlated with a higher overall survival.

Predicción de toxicidad de la quimioterapia y radioterapia en el paciente oncológico quirúrgico

Fundamento la toxicidad asociada a los tratamientos de quimioterapia y radioterapia eleva la morbilidad y la mortalidad en los pacientes oncológicos. Objetivo diseñar un modelo predictivo de toxicidad de la quimioterapia y la radioterapia en el paciente oncológico quirúrgico. Métodos estudio analítico, de casos y controles, en pacientes oncológicos quirúrgicos que cumplieron los criterios de inclusión para la predicción de toxicidad preoperatoria, en el periodo enero a diciembre de 2022, en el Hospital Provincial Docente Oncológico María Curie, de Camagüey. Mediante el paquete estadístico Statistical Package for the Social Sciences, se seleccionó una muestra aleatoria de 334 pacientes, 197 sin toxicidad (grupo control) y 137 con toxicidad (grupo de estudio). Se realizó estimación de predictores de toxicidad mediante regresión logística binaria. Se seleccionó el modelo de mejor ajuste. Resultados el modelo en el paso tres predice un porcentaje global de 83,5 % con respecto a los valores observados. La sensibilidad resultó ser de 81,8; y la especificidad, 84,8. El modelo presentó buen poder discriminativo. Las variables en la ecuación fueron: hipertensión arterial, fracción de eyección del ventrículo izquierdo y anemia. La comparación de la predicción con la realidad, mediante curva Receiver Operating Characteristic determinó un área bajo la curva de 0,901. Conclusión se obtuvo una función de regresión logística que permitió la estimación de la probabilidad de toxicidad en pacientes oncológicos quirúrgicos electivos, la cual proporcionó una herramienta para su predicción desde el preoperatorio.

Foundation the toxicity associated with chemotherapy and radiotherapy treatments increases morbidity and mortality in cancer patients. Objective to design a predictive model of chemotherapy and radiotherapy toxicity in surgical cancer patients. Methods analytical, case-control study, in surgical oncology patients who met the inclusion criteria for the prediction of preoperative toxicity, from January to December 2022, at the María Curie Provincial Teaching Oncology Hospital in Camagüey. Using the Statistical Package for the Social Sciences, a random sample of 334 patients was selected, 197 without toxicity (control group) and 137 with toxicity (study group). Toxicity predictors were estimated using binary logistic regression. The model with the best fit was selected. Results the model in step three predicts an overall percentage of 83.5% with respect to the observed values. The sensitivity turned out to be 81.8; and the specificity, 84.8. The model presented good discriminative power. The variables in the equation were: arterial hypertension, left ventricular ejection fraction, and anemia. The comparison of the prediction with reality, using the Receiver Operating Characteristic curve, determined an area under the curve of 0.901. Conclusion a logistic regression function was obtained that allowed the estimation of the toxicity probability elective surgical cancer patients, which provided a tool for its prediction from the preoperative period.

Comportamiento de la anemia por toxicidad a la quimioterapia en pacientes con cáncer de pulmón

Fundamento: la anemia constituye una de las toxicidades más frecuentes con factores de riesgo intrínsecos en el paciente. La anemia por toxicidad debido a la quimioterapia se considera una disfunción hematopoyética de una sola estirpe de causa iatrogénica por su relación al tratamiento. Objetivo: caracterizar el comportamiento de la anemia por toxicidad a la quimioterapia en los pacientes con cáncer de pulmón. Método: se realizó un estudio descriptivo y retrospectivo en pacientes con cáncer de pulmón que recibieron tratamiento con quimioterapia en el Hospital Provincial Docente Oncológico María Curie de la provincia Camagüey, en el período de enero del 2020 a diciembre del 2022. La población objeto de estudio estuvo constituida por 101 pacientes que cumplieron con los criterios de inclusión. Las variables estudiadas fueron: edad, sexo, estadiamiento, condición al egreso y anemia por toxicidad. Se empleó como método el análisis documental, a través de la revisión de las historias clínicas. Resultados: predominó el sexo masculino con 73,3 % de los casos de cáncer de pulmón, no se evidenciaron diferencias en cuanto a la edad acorde al sexo. La mayor parte de los pacientes se encontraron en los estadios IIIA 36,6 % y IIIB 33,6 %. El 56,4 % egresaron en condición de vivo y el 21,8 % de los pacientes que recibieron quimioterapia desarrollaron anemia por toxicidad. Conclusiones: predominó el sexo masculino, la mayoría de los pacientes se encontraron en los estadios IIIA y IIIB, el mayor porciento de pacientes egresó vivo y un número considerable de los que recibieron quimioterapia desarrollaron anemia por toxicidad.

Foundation: anemia constitutes one of the most frequent toxicities with intrinsic risk factors in the patient. Anemia due to toxicity due to chemotherapy is considered a single-line hematopoietic dysfunction of iatrogenic cause due to its relationship to treatment. Objective: to characterize the behavior of anemia due to toxicity to chemotherapy in patients with lung cancer. Method: a descriptive and retrospective study was carried out in patients with lung cancer who received chemotherapy treatment at the María Curie Provincial Teaching Oncology Hospital in Camagüey province, from January 2020 to December 2022. The population under study the study consisted of 101 patients who met the inclusion criteria. The variables studied were: age, sex, staging, condition at discharge and anemia due to toxicity. Documentary analysis was used as a method, through the review of medical records. Results: the male sex predominated with 73.3 % of the cases of lung cancer, there were no differences in terms of age according to sex. Most of the patients were found in stages IIIA 36.6 % and IIIB 33.6 %. 56.4 % were discharged alive and 21.8 % of the patients who received chemotherapy developed anemia due to toxicity. Conclusions: the male sex predominated, most of the patients were in stages IIIA and IIIB, the highest percentage of patients were discharged alive and a considerable number of those who received chemotherapy developed anemia due to toxicity.

Alterações osteometabólicas em pacientes em tratamento antineoplásico: revisão de escopo / Osteometabolic changes in patients under antineoplastic treatment: scoping review

Objetivo: sintetizar as principais evidências acerca das alterações osteometabólicas presentes nos pacientes em tratamento antineoplásico. Métodos: trata-se de uma revisão de escopo, seguindo a metodologia do Instituto Joanna Briggs, nas bases de dados PubMed/MedLine, Cochrane Library, LILACS, The British Library e Google Scholar. A revisão está protocolada no Open Science Framework. Resultados: muitos antineoplásicos possuem efeito na arquitetura óssea, reduzindo sua densidade, tais como moduladores seletivos de receptores de estrogênio, inibidores da aromatase, terapia de privação androgênica, e glicocorticoides. Para evitar tais desfechos, o tratamento e prevenção podem ser realizados pela suplementação de cálcio e vitamina D, exercícios físicos, uso de bifosfonatos, denosumab, e moduladores seletivos do receptor de estrogênio. Conclusão: pessoas com maior risco de desenvolver câncer também possuem maior risco de osteopenia e osteoporose, quando processo já estabelecido e em tratamento antineoplásico, devido ao compartilhamento de fatores de risco. Torna-se evidente a necessidade da densitometria óssea nos pacientes em tratamento contra o câncer para de prevenção e promoção de saúde óssea nesses pacientes, além de mais pesquisas com alto nivel de evidência para subsidiar tal uso.

Objective: To summarize the main evidence regarding osteometabolic changes in patients undergoing antineoplastic treatment. Methods: This is a scoping review, following the methodology of the Joanna Briggs Institute, using PubMed/MedLine, Cochrane Library, LILACS, The British Library, and Google Scholar. This review is registered in the Open Science Framework. Results: Many antineoplastics affect bone architecture by reducing its density, such as selective estrogen receptor modulators, aromatase inhibitors, androgen deprivation therapy, and glucocorticoids. To avoid such outcomes, treatment and prevention can be achieved by calcium and vitamin D supplementation, physical exercise, use of bisphosphonates, denosumab, and selective estrogen receptor modulators. Conclusion: people at a higher risk of developing cancer also have a higher risk of osteopenia and osteoporosis when the process is already established and undergoing antineoplastic treatment because of the grouping of risk factors. The need for bone densitometry in patients undergoing cancer treatment to prevent and promote bone health in these patients is evident, in addition to more research with a high level of evidence to support such use.

Guías antieméticas: ¿hemos incorporado los cambios referentes a carboplatino y antraciclinas? / Antiemetic guidelines: Have we incorporated the changes concerning carboplatin and anthracyclines?

Objetivo: en 2016 se publicaron las guías de la MASCC/ESMO que incorporaron los esquemas de antraciclinas como quimioterapia altamente emetógena (QAE) proponiendo la triple terapia antiemética, así como para los esquemas de carboplatino. Los objetivos fueron analizar el nivel de concordancia entre las guías y la profilaxis antiemética utilizada en el hospital de día de hematooncología, evaluar su efectividad y determinar el ahorro de la inclusión de netupitant/palonosetrón (NEPA) oral con dexametasona intravenosa (NEPAd) respecto a fosaprepitant con ondansetrón y dexametasona (FOD intravenosa). Método estudio observacional prospectivo registrando variables demográficas, esquema de quimioterapia recibido, localización tumoral, riesgo emetógeno del paciente, pauta antiemética prescrita, concordancia con guía MASCC/ESMO y su efectividad, utilización de medicación de rescate y registro de visitas a urgencias o ingresos por emesis.Se llevó a cabo un estudio farmacoeconómico de minimización de costes. Resultados se incluyeron 61 pacientes, 70% mujeres, mediana edad 60,5.Los esquemas de platino fueron más frecuentes en el periodo 1, siendo el 87,5% respecto al 67,6% en el periodo 2. Los esquemas con antraciclinas fueron del 21,6 y 10% respectivamente en cada periodo. Un 21,1% de las pautas antieméticas no coincidían con las recomendaciones MASCC/ESMO, siendo en su totalidad en el periodo 1. La puntuación de los cuestionarios de efectividad fue de protección total en el 90,9% en las náuseas agudas, del 100% en los vómitos agudos y en las náuseas retardadas, y del 72,7% en los vómitos retardados. La frecuencia de uso de medicación de rescate fue del 18,7% en el periodo 1 y no fue necesaria en el periodo 2.No se detectaron visitas a urgencias ni ingresos en ninguno de los periodos. El uso de NEPAd comportó una reducción del 28% de los costes con respecto al empleo de FOD. Conclusiones: ... (AU)

Objective: Latest MASCC/ESMO guidelines of the recommendations for the prophylaxis of acute and delayed emesis induced by moderately emetogenic chemotherapy was published in 2016 incorporating anthracycline schemes as highly emetogenic chemotherapy (HEC), proposing triple antiemetic therapy to control nausea and vomiting. Likewise, they recommend triple therapy for carboplatin. The objectives of this study were to analyze the degree of concordance between guidelines and antiemetic prophylaxis used in the Chemotherapy Outpatient Unit in patients undergoing treatment with HEC and carboplatin, to evaluate its effectiveness and to determine the savings due to the use of netupitant/palonosetron (NEPA) oral (or) with intravenous (iv) dexamethasone (NEPAd) compared to iv Fosaprepitant with ondansetron and dexamethasone (FOD iv).MethodsProspective observational study recording demographic variables, chemotherapy protocol, tumor location, patient emetogenic risk, antiemetic regimen prescribed, concordance with the MASCC/ESMO guideline, and effectiveness, evaluated by MASCC survey, use of rescue medication and visits to the Emergency Department or hospitalization due to emesis.A cost minimization pharmacoeconomic study was carried out. Results 61 patients were included; 70% women; median age 60.5. Platinum schemes were more frequent in period 1, being 87.5% compared to 67.6% in period 2. Anthracycline schemes were 21.6% and 10% respectively in each period.A 21.1% of the antiemetic regimens did not coincide with the MASCC/ESMO recommendations, being entirely in period 1. The score of the effectiveness questionnaires was total protection in 90.9% in acute nausea, from 100% in acute vomiting and delayed nausea, and 72.7% in delayed vomiting.The frequency of use of rescue medication was 18.7% in period 1 and was not necessary in period 2.No visits to the emergency room or admissions were detected in any of the periods. Conclusions: ...(AU)

Asociación Linfoma-Tuberculosis ganglionar: Un reto diagnóstico y terapéutico

La tuberculosis, una enfermedad infectocontagiosa, de amplia distribución mundial constituye en una de las causas de morbi-mortalidad más frecuentes en países subdesarrollados. Por otra parte, el linfoma de Hodgkin, una neoplasia linfoide maligna, poco frecuente, tiende a tener un diagnóstico diferencial amplio, incluyendo la tuberculosis extrapulmonar. Se presenta el caso de un paciente masculino de 10 años, procedente de un área endémica para tuberculosis, con cuadro de un mes de evolución de aumento de volumen abdominal, asociado a fiebre vespertina y pérdida de peso, tratado inicialmente como cuadro gastroentérico, sin embargo, con múltiples estudios se logró documentar Tuberculosis ganglionar y Linfoma de Hodgkin clásico en su variante esclerosis nodular en estadio IV b, constituyéndose en un reto diagnóstico y terapéutico.   (provisto por Infomedic International)

Tuberculosis, an infectious disease with a wide global distribution, constitutes one of the most frequent causes of morbidity and mortality in underdeveloped countries. On the other hand, Hodgkin lymphoma, a rare lymphoid malignancy, tends to have a wide differential diagnosis, including extrapulmonary tuberculosis. We present the case of a 10-year-old male patient, from an endemic area for tuberculosis, with a one-month history of increased abdominal volume, associated with evening fever and weight loss, initially treated as gastroenteric symptoms, however , with multiple studies it was possible to document lymph node tuberculosis and classical Hodgkin lymphoma in its variant nodular sclerosis in stage IV b, constituting a diagnostic and therapeutic challenge. (provided by Infomedic International)

Factores de riesgo de deterioro cognitivo asociado a cáncer en pacientes con carcinoma de mama y colon que reciben tratamiento con quimioterapia / Risk factors for cancer-related cognitive impairment in breast and colorectal cancer patients who undergo chemotherapy

Fundamento: Nuestro estudio se plantea con el objetivo deevaluar el impacto de diferentes factores individuales sobre eldeterioro cognitivo relacionado con el cáncer en pacientes tratados con quimioterapia. Material y métodos: Estudio unicéntrico longitudinal prospectivo. Incluyó pacientes con carcinoma de mama y colon tratados con quimioterapia. Se recogieron variables clínicas y genéticas del paciente (polimorfismos de nucleótido simple, SNP). Los pacientes fueron evaluados neurocognitivamente con oncetest validados, en tres momentos: basal previo a quimioterapia(M0), entre una y cuatro semanas tras finalizar quimioterapia(M1) y entre 24-30 semanas tras finalizar quimioterapia (M2). Resultados: Se incluyeron 62 pacientes, 82% mujeres, con mediana de edad de 56 años (rango 30-74), un 64,5% con cáncer demama. La edad <55 años, tener estudios superiores, ausenciade comorbilidades y presencia de la variante CC de rs471692(TOP2A) se asociaron, en general, con mejores resultados cognitivos en M0. Se observó un empeoramiento significativo deM0 a M1 en los test RAVLT y Letras y números, y recuperaciónen M2 respecto a M0 en los test de memoria visual, FAST, clavede números, y cubos. La edad ≥55 años, la quimioterapia adyuvante, las comorbilidades, el consumo de tabaco y de alcoholy la variante GT de rs1800795 se relacionaron con el deterioroentre M0 y M1 en el modelo multivariante. Conclusiones: La edad mayor de 55 años, el sexo femenino, lapresencia de comorbilidades y el nivel básico de estudios serelacionan con un mayor riesgo de deterioro cognitivo tras eltratamiento con quimioterapia.(AU)

Background: Our study aims to evaluate the impact of differentfactors on cancer-related cognitive impairment in patients whoundergo chemotherapy.Methodology: Prospective longitudinal single-centre studythat included patients with breast and colon carcinoma whounderwent chemotherapy as part of their treatment. Clinicaland genetic characteristics of the patients (single nucleotidepolymorphisms, SNPs) were collected. Patients’ neurocognitivestatus was assessed using eleven validated tests at three timepoints: before chemotherapy (M0 - baseline), between one andfour weeks after completing chemotherapy (M1), and between24-30 weeks after completing chemotherapy (M2).Results: Sixty-two patients were included in this study; 82% werefemale, median age was 56 years (range 30-74), and 64.5% had beendiagnosed with breast cancer. Overall, better cognitive results atM0 were associated with age < 55 years, higher educational level,absence of comorbidities, and the CC variant rs471692 (TOP2A).Significant decline was found between M0 to M1 in the Rey Auditory Verbal Learning Test and the Letter and Number test, with evidence of recovery in M2 compared to M0 regarding the followingtest: Visual Memory, Functioning Assessment Short Test (FAST),Digit Symbol Substitution and Cube. In the multivariate analysis,being ≥55 years of age, adjuvant chemotherapy, presence of comorbidities, tobacco and alcohol use, and GT variant rs1800795were associated with cognitive decline between M0 and M1.Conclusion: Being ≥55 years of age, female, presence of comorbidities and basic education level are related to a higher risk ofcognitive impairment after chemotherapy.(AU)