RESUMO
Background: Globally, multiple myeloma (MM) ranks 24th among the most common cancers. The Middle East and Africa are affected by an increasing trend in MM incidence, owing to several underlying factors. This systematic review aims to assess the epidemiology, patient characteristics, and treatment outcomes associated with MM in selected countries in the Middle East and Africa. Methods: An electronic search was performed in the PubMed/MEDLINE database. Abstracts presented at the annual meetings of the American Society of Clinical Oncology, American Society of Hematology, and European Society for Medical Oncology and the GLOBOCAN registry were searched. Qualitative analysis was performed. Results: A total of 412 articles were screened, and 14 were selected. The five-year prevalence per 100,000 gathered from country-wise GLOBOCAN data ranged between 155 in Kuwait and 5,625 in North Africa. The identified treatment options were proteasome inhibitors such as bortezomib, drugs such as thalidomide, lenalidomide, dexamethasone, melphalan, and cyclophosphamide, and newer drugs such as daratumumab. Conclusion: Improved diagnostic capability has increased the incidence of MM in this region. However, advanced drugs and treatment regimens remain unaffordable in many countries of these regions. Therefore, understanding the trends of the disease and improving healthcare settings are imperative.
RESUMO
The incidence of multiple myeloma (MM) has surged globally, particularly in Latin American countries, and is attributable to an aging population and increased life expectancy. This systematic review analyzes the epidemiology, patient characteristics, and treatment outcomes for MM in selected Latin American countries: Brazil, Mexico, Colombia, Argentina, Chile, Peru, and Uruguay. PubMed and the Latin American and Caribbean Health Sciences Literature (LILACS), conference abstracts (between June 2019 and June 2022), and GLOBOCAN registry (January 2010 to June 2022) were electronically searched. Qualitative analysis employed the Joanna Briggs Institute's critical appraisal tool. Among the 586 screened articles, 26 met the inclusion criteria. The participants' median age ranged from 54 to 67 years. GLOBOCAN data revealed that for MM, Brazil and Uruguay had the highest and lowest incidence, 5-year prevalence, and mortality, respectively. Immunoglobulin G was the most common subtype detected. Stage III was frequently diagnosed. Though many approved drugs are available and bispecific antibodies hold promise as a future therapy, limited access, especially for CAR-T cell-based therapy remains a concern. The incidence of MM is increasing in Latin America. Resource constraints and costs hinder access to novel drugs and regimens. Understanding disease patterns and patient characteristics is vital to improve MM management in these countries.
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O câncer de pulmão é considerado uma das principais causas de morte por câncer no Brasil e no mundo. Entre os principais tipos de câncer de pulmão, o tipo não-pequenas células corresponde a aproximadamente 85% dos casos da doença. Sua alta mortalidade pode ser atribuída ao diagnóstico tardio, sendo a maioria dos pacientes diagnosticada com a doença em estádios avançados. O manejo do câncer de pulmão não-pequenas células exige a utilização intensiva de cuidados, além da abordagem multidisciplinar no diagnóstico, tratamento e reabilitação, que em um cenário de recursos finitos, gera importante custo de oportunidade para o sistema de saúde brasileiro em relação à oferta de recursos na assistência oncológica. Assim, o objetivo do presente estudo foi descrever o impacto que o câncer de pulmão não-pequenas células promove na sociedade brasileira, por meio de uma busca na literatura.
Lung cancer is considered the major cause of death due to cancer in Brazil and worldwide. Among the main types of lung cancer, non-small cell lung cancer corresponds to approximately 85% of cases of the disease. The high mortality can be attributed to the late diagnosis once most of the patients are diagnosed when the disease is at an advanced stage. Non-small cell lung cancer management requires an intensive use of cares, besides multidisciplinary approach at diagnoses, treatment and rehabilitation, what in a finite resources set, bring relevant opportunity cost to health system about resource offer in oncologic assistance. Therefore, the aim of this study was to describe the impact that non-small cell lung cancer promotes in Brazilian society, through literature search.
Assuntos
Humanos , Avaliação do Impacto na Saúde , Pulmão , Neoplasias Pulmonares , NeoplasiasRESUMO
A cirurgia e a radioterapia säo modalidades terapêuticas eficazes no tratamento de carcinoma de cabeça e pescoço em estados precoces. Neste caso, pode se obter uma taxa de cura variando entre 50 a 100. Entretanto, em estados avançados o prognóstico é reservado e a quimioterapia surge como um alternativa que pode contribuir para o processo de cura da doença, mais especificamente quando combinada à radioterapia e/ou cirurgia(quimioterapia neoadjuvante), ou quando aplicada concomitantemente à radioterapia(quimioradioterapia). Nestes casos, deve-se avaliar qual das duas modalidades pode trazer melhor benefício, sem nos esquecermos da preservaçäo do órgäo. Em estágios avançados ou na doença recidivante, a quimioterapia é empregada somente como forma paliativa de tratemento, na tentativa de melhorar a disfagia e a dor ou de preservar o órgäo acometido. As drogas quimioterápicas que demonstram eficácia comprovada no tratamento dos tumores de cabeça e pescoço säo: Methotrexate, 5-fluorouracil, Cisplatina, Carboplatina e Bleomicina. Novas drogas estäo sendo estudadas, como a Vinorrelbina e os taxóides. A quimioterapia representa uma adiçäo importante aos algoritmos atuais de tratamento multidisciplinar dos tumores de cabeça e pescoço, seja pela possibilidade de cura ou pela melhora na qualidade de vida dos pacientes, já que pode potencialmente melhorar os resultados locais e até mesmo, em alguns casos, permitir a preservaçäo do órgäo acometido