Avaliação da função cardíaca em pacientes com câncer de mama esquerda que realizaram radioterapia adjuvante
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Data
2019-02-28
Autores
Oliveira, Ana Beatriz Paludetto de
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Universidade Estadual Paulista (Unesp)
Resumo
O câncer de mama permanece como o segundo tipo de câncer mais frequente no mundo, depois do câncer de pele não melanoma, e o primeiro entre as mulheres e responde por cerca de 25% dos casos novos de câncer a cada ano. Em 2018, para o Brasil são esperados cerca de 59.700 casos novos de câncer de mama. A radioterapia é parte integrante no tratamento do câncer de mama como adjuvância de cirurgias de setorectomia ou mastectomia. O coração é um órgão de risco e a parede anterior da área cardíaca está muito próxima do limite interno dos campos de irradiação. A proposta deste estudo é avaliar possíveis alterações na função cardíaca de pacientes submetidas à radioterapia da mama esquerda, comparando os procedimentos radioterápicos realizados com a técnica convencional bidimensional (RT-2D) com a técnica tridimensional conformada (RTC-3D). A pesquisa analisou doze pacientes que foram submetidas à radioterapia, a função cardíaca das pacientes foram avaliadas por cintilografias miocárdicas realizadas previamente e posteriormente à radioterapia. Os parâmetros de análises foram a fração de ejeção (FEVE) e a função ventricular global do ventrículo esquerdo, ambos apontados no laudo do exame de medicina nuclear. Apenas uma paciente apresentou alteração significativa da FEVE entre as duas cintilografias miocárdicas. Para os casos clínicos analisados, não foi possível estabelecer uma relação direta entre alterações da função cardíaca com a técnica radioterápica aplicada.
Breast cancer remains the second most common cancer in the world after non-melanoma skin cancer, and the first among women and accounts for about 25% of new cases of cancer each year. In 2018, about 59,700 new cases of breast cancer are expected in Brazil. Radiotherapy is an integral part of the treatment of breast cancer as adjuvant of cosmetic surgery or mastectomy surgeries. The heart is a risk organ and the anterior wall of the cardiac area is very close to the inner boundary of the irradiation fields. The purpose of this study was to evaluate possible alterations in the cardiac function of patients submitted to left-sided radiotherapy, comparing the radiotherapy procedures performed with the conventional two-dimensional technique (RT-2D) with the conformal three-dimensional technique (RTC-3D). The study analyzed twelve patients who underwent radiotherapy, and the patients' cardiac function was assessed by myocardial scintigraphy performed before and after radiotherapy. The parameters of analysis were ejection fraction (LVEF) and left ventricular global ventricular function, both of which were pointed out in the nuclear medicine examination report. Only one patient had a significant alteration of the LVEF between the two myocardial scintigraphies. For the clinical cases analyzed, it was not possible to establish a direct relationship between cardiac function changes and the applied radiotherapy technique.
Breast cancer remains the second most common cancer in the world after non-melanoma skin cancer, and the first among women and accounts for about 25% of new cases of cancer each year. In 2018, about 59,700 new cases of breast cancer are expected in Brazil. Radiotherapy is an integral part of the treatment of breast cancer as adjuvant of cosmetic surgery or mastectomy surgeries. The heart is a risk organ and the anterior wall of the cardiac area is very close to the inner boundary of the irradiation fields. The purpose of this study was to evaluate possible alterations in the cardiac function of patients submitted to left-sided radiotherapy, comparing the radiotherapy procedures performed with the conventional two-dimensional technique (RT-2D) with the conformal three-dimensional technique (RTC-3D). The study analyzed twelve patients who underwent radiotherapy, and the patients' cardiac function was assessed by myocardial scintigraphy performed before and after radiotherapy. The parameters of analysis were ejection fraction (LVEF) and left ventricular global ventricular function, both of which were pointed out in the nuclear medicine examination report. Only one patient had a significant alteration of the LVEF between the two myocardial scintigraphies. For the clinical cases analyzed, it was not possible to establish a direct relationship between cardiac function changes and the applied radiotherapy technique.
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Palavras-chave
câncer de mama, função cardíaca, radioterapia, cintilografia miocárdica, breast cancer, cardiac function, radiotherapy, myocardial scintigraphy