Riscos cardiovasculares em mulheres sobreviventes ao câncer de mama: uma revisão sistemática
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Data
2023-06-19
Tipo de documento
Artigo Científico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
SILVA, Iasmim Nascimento
MORAES, Isabelle Gomes de Carvalho
Orientador
LOPES, Paloma
Coorientador
Resumo
INTRODUÇÃO: O câncer de mama é o tipo de neoplasia mais comum entre mulheres, no Brasil e no mundo. A radioterapia é amplamente utilizada como tratamento da neoplasia para prevenir recorrência locorregional, porém riscos cardíacos potenciais a longo prazo tem sido avaliados. OBJETIVO: Identificar os fatores de riscos cardiovasculares em mulheres sobreviventes ao câncer de mama que foram submetidas a radioterapia como tratamento. MATERIAIS E MÉTODOS: Trata-se de um estudo de revisão sistemática, conduzido de acordo com os critérios estabelecidos pelo PRISMA. Artigos classificados como Ensaios Clínicos Randomizados Controlados (E.C.R.C), Estudos de Coorte, Caso Controle, Série de Casos e Relato de Casos foram pesquisados nas bases de dados PubMed/MEDLINE e Portal Regional da BVS. Foram adicionados estudos que apresentaram como amostra populacional mulheres diagnosticadas com câncer de mama, tratadas com radioterapia; artigos disponíveis na íntegra e de forma gratuita. RESULTADOS: Foram identificados 3.522 artigos nas bases de dados, 2.864 foram excluídos a partir da aplicação de filtros, 15 por estarem duplicados e 593 por não estarem relacionados ao tema, restando 50 artigos para leitura dos resumos. Destes, 3 foram excluídos por delineamento do estudo, 9 por não trazer informações da população e tratamento, e 34 por não estarem disponíveis na integra de forma gratuita, restando 5 que após a leitura na íntegra foram inclusos na revisão. CONCLUSÃO: Dentre os artigos inclusos nesta revisão, verifica-se a relação de riscos basais pré-existentes, assim como a presença e extensão de cálcio nas artérias coronárias, fatores preditores e potencializadores para riscos cardíacos após a exposição à radiação, com influência da dose média, área irradiada e presença ou não dos linfonodos no campo irradiado, para desenvolvimento eventos coronarianos agudos, disfunção subclínica do ventrículo esquerdo, dentre outros riscos cardíacos associado a radiação e características de cada paciente.
Palavras-chave: Riscos Cardiovasculares; Câncer de Mama; Radioterapia.
INTRODUCTION: Breast cancer is the most common type of neoplasm among women in Brazil and worldwide. Characterized by a malignant tumor that occurs due to genetic alterations in the cells of the mammary glands, in which the proliferation of these cancer cells occurs quickly and disorderly, leading to the formation of the nodule. Radiotherapy is widely used as a treatment for neoplasia to prevent locorregional recurrence, however, potential long-term cardiac risks have been evaluated. OBJECTIVE: To identify cardiovascular risk factors in breast cancer survivors who underwent radiotherapy as a treatment. MATERIALS AND METHODS: This is a systematic review study, conducted according to the criteria established by PRISMA. Articles classified as Randomized Clinical Trials Controlled (R.C.T.C.), Cohort Studies and Case Control. Case series and case reports were searched in the PubMed/MEDLINE and VHL Regional Portal databases. Studies were added that presented as a population sample women diagnosed with breast cancer, treated with radiotherapy, articles available in full for free. RESULTS: Included 5 observational studies, bringing the correlation between baseline risks for future postradiotherapy cardiac events, mechanisms that lead to acute coronary events, relationships of patient characteristics and treatment related to dose exposure to the heart associated with development for cardiac events, and the impact of calcium on the coronary artery in the development of acute coronary events with cardiac exposure to radiation. CONCLUSION: Among the articles included in this review, there is a relationship of preexisting baseline risks, as well as the presence and extent of calcium in the coronary arteries, predictive and potentiating factors for cardiac risks after exposure to radiation, with influence of the average dose, irradiated area and presence or absence of lymph nodes in the irradiated field, for the development of acute coronary events, subclinical left ventricular dysfunction, among other cardiac risks associated with radiation and characteristics of each patient.
INTRODUCTION: Breast cancer is the most common type of neoplasm among women in Brazil and worldwide. Characterized by a malignant tumor that occurs due to genetic alterations in the cells of the mammary glands, in which the proliferation of these cancer cells occurs quickly and disorderly, leading to the formation of the nodule. Radiotherapy is widely used as a treatment for neoplasia to prevent locorregional recurrence, however, potential long-term cardiac risks have been evaluated. OBJECTIVE: To identify cardiovascular risk factors in breast cancer survivors who underwent radiotherapy as a treatment. MATERIALS AND METHODS: This is a systematic review study, conducted according to the criteria established by PRISMA. Articles classified as Randomized Clinical Trials Controlled (R.C.T.C.), Cohort Studies and Case Control. Case series and case reports were searched in the PubMed/MEDLINE and VHL Regional Portal databases. Studies were added that presented as a population sample women diagnosed with breast cancer, treated with radiotherapy, articles available in full for free. RESULTS: Included 5 observational studies, bringing the correlation between baseline risks for future postradiotherapy cardiac events, mechanisms that lead to acute coronary events, relationships of patient characteristics and treatment related to dose exposure to the heart associated with development for cardiac events, and the impact of calcium on the coronary artery in the development of acute coronary events with cardiac exposure to radiation. CONCLUSION: Among the articles included in this review, there is a relationship of preexisting baseline risks, as well as the presence and extent of calcium in the coronary arteries, predictive and potentiating factors for cardiac risks after exposure to radiation, with influence of the average dose, irradiated area and presence or absence of lymph nodes in the irradiated field, for the development of acute coronary events, subclinical left ventricular dysfunction, among other cardiac risks associated with radiation and characteristics of each patient.
Palavras-chave
riscos cardiovasculares, câncer de mama, radioterapia