Efeito da radioterapia na função pulmonar e na fadiga de mulheres em tratamento para o câncer de mama

Assessing the Impact of Organ Failure and Metastases on Quality of Life in Breast Cancer Patients: A Prospective Study Based on Utilizing EORTC QLQ-C30 and EORTC QLQ-BR45 Questionnaires in Romania

Breast cancer (BC) significantly impacts the quality of life (QoL) of affected individuals. This study, conducted at Colțea Clinical Hospital, Bucharest, aimed to assess the impact of organ failures and metastases on QoL in breast cancer patients using EORTC QLQ-C30 and EORTC QLQ-BR45 questionnaires and the survival rate to understand the clinical journey and the quality of life status in breast cancer patients. From January 2019 to October 2022, a prospective, observational study surveyed 874 patients, revealing 201 fatalities, 66 refusals, and 607 eligible participants. Results indicated statistically significant differences in various QoL aspects for patients experiencing heart failure, including physical functioning, pain, insomnia, global health status, and overall summary score. Kidney failure exhibited significance in physical functioning for QLQ-C30 and body image, sexual functioning, and endocrine sexual symptoms for QLQ-BR45. Respiratory failure demonstrated significant differences across multiple QoL domains. Patients with bone metastases reported lower physical functioning (p = 0.006) and increased pain (p = 0.002). This study has revealed an overall 5-year life expectancy of 68.8%, with survival rates of 93.8% for Stage I, 86.3% for Stage II, and 77.2% for Stage III breast cancer. Metastatic cancer patients have shown a 35.6% survival rate over 45 months, with a median survival duration of 36 months. A significant limitation of our study was the administration of the questionnaire only once, preventing us from quantifying the impact of specific treatment types on quality of life. This study emphasizes the necessity of using standardized QoL assessments in clinical practice from the initial presentation to ongoing follow-up.

Respiratory Physiotherapy Intervention Strategies in the Sequelae of Breast Cancer Treatment: A Systematic Review

Breast cancer treatments can trigger respiratory sequelae. Respiratory physiotherapy helps to eliminate or mitigate the sequelae by optimizing respiratory function. This systematic review aims to synthesize the scientific evidence and assess its quality regarding the use of respiratory physiotherapy in the sequelae of breast cancer. The Cochrane Library, Physiotherapy Evidence Database, PubMed, Web of Science, Scientific Electronic Library Online, Cumulative Index of Nursing and Allied Literature Complete, and Scopus were searched. Study quality was determined using the PEDro scale, STROBE Statement, and Single-Case Experimental Design Scale. Ten studies, six clinical trials, one case study, and three observational studies were selected. The mean methodological quality of the clinical trials was 5.6, that of the case study was 7, and that of the observational studies was 56%. Respiratory physiotherapy has been observed to improve respiratory capacity, lung function, respiratory muscle strength, effort tolerance, dyspnea, fatigue, thoracic mobility, upper limb volume, sleep quality and quality of life, as well as sensitivity to adverse physiological reactions, nausea, vomiting, and anxiety. However, it is not effective for vasomotor symptoms. More clinical trials are needed. These studies should homogenize the techniques used, as well as improve their methodological quality.

Association between spirituality and quality of life of women with breast cancer undergoing radiotherapy

OBJECTIVE

To verify whether there is an association between spirituality/religiosity and quality of life of women with breast cancer undergoing radiotherapy.

METHOD

Cross-sectional, quantitative study performed between May and July 2019 in an Oncology Hospital of Porto Alegre state, Brazil. A sociodemographic questionnaire and the instruments EORTC-QLQ-C30 and WHOQOL-SRPB were applied. The data were verified through Shapiro-Wilk test, Pearson correlation coefficient, and Spearman.

RESULTS

The sample comprised 108 women with a mean age of 56, predominantly white, married, and with incomplete primary education. A positive correlation between "Overall quality of life score" with all facets of spirituality, as well as a negative correlation for the symptoms "Fatigue", "Insomnia", and "Diarrhea" with some aspects of spirituality, such as "Faith", were observed.

CONCLUSION

The statistical significance of the correlation has positively associated spirituality/religiosity and quality of life in women with breast cancer undergoing radiotherapy. Understanding spirituality as a preponderant factor in quality of life contributes to positive nursing care interference, with individualized orientation and care to each woman.

Efectos del tratamiento con quimioterapia y radioterapia concomitante sobre los volúmenes pulmonares en mujeres con cáncer de mama en Talca, Chile

Introducción. El cáncer de mama (CM) es la enfermedad crónica no transmisible más frecuente y letal en mujeres. La información disponible sobre el impacto de sus diversos tratamientos en el sistema respiratorio es controversial.Objetivo. Determinar el efecto del tratamiento con quimioterapia y radioterapia concomitante en los volúmenes pulmonares de un grupo de mujeres con CM en Talca, Chile.Materiales y métodos. Estudio de casos y controles. La muestra (n=22) se dividió en dos grupos: control (n=11) y con CM (n=11). Para medir la capacidad vital forzada, los volúmenes pulmonares y la resistencia de las vías aéreas, se usó la prueba de pletismografía corporal. Para determinar la normalidad de los datos, se usó la prueba Shapiro-Wilks y, según sus resultados, se utilizó la prueba de t-Student o la de U de Mann-Whitney; se consideró un nivel de significancia de p<0.05.Resultados. Los flujos ventilatorios no presentaron diferencias significativas entre los dos grupos, mientras que los volúmenes pulmonares en el grupo con CM experimentaron una disminución significativa en las variables capacidad inspiratoria (CI) y volumen residual (VR) (p<0.05).Conclusión. Las mujeres con CM y que fueron tratadas con quimioterapia y radioterapia concomitante experimentaron una disminución en su CI y su VR en comparación con el grupo control, lo que podría impactar su calidad de vida.

Effect of exercise on pain and functional capacity in breast cancer patients

PURPOSE

To assess the influence of combined training on pain, fatigue, maximal oxygen uptake (VO₂ max), body mass index (BMI), flexibility, and strength in patients with breast cancer.

METHODS

A controlled pilot study with 28 patients undergoing chemotherapy, radiation therapy, and clinical observation in a renowned cancer treatment center; the patients were aged from 30 to 59 years old and were not engaged in physical training for three months previously. The Study Group (SG) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20 s and was performed in sets of three repetitions. The Control Group (CG) received only the standard hospital treatment. Participants were evaluated at the beginning of the study to establish a baseline and reevaluated at the end of 12 weeks.

RESULTS

Patients in the SG showed a significant decrease in total pain points (p = 0.0047), pain intensity (p = 0.0082), and the extent to which pain interfered with their daily life (p = 0.0047). There was an increase in maximum oxygen uptake (p = 0.0001), flexibility (p = 0.0001), and strength on both sides (right p = 0.0001 and left p = 0.0008). No significant differences were observed in fatigue (p = 0.0953) or BMI (p = 0.6088).

CONCLUSION

Combined training was effective in decreasing pain and increasing VO₂ max, flexibility and static strength in patients with breast cancer.

TRIAL REGISTRATION

NCT03061773 . Registered on February 19, 2017, 'retrospectively registered'.

Accuracy of the defining characteristics of the nursing diagnosis for fatigue in women under radiotherapy

ABSTRACT Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis for “fatigue in women with breast cancer under radiotherapy”. Method: Study of diagnostic accuracy, with cross-sectional design, performed in 130 women with breast cancer under radiation treatment. A data collection instrument was used to evaluate clinical socio-demographics and to investigate the presence or absence of defining characteristics for fatigue. The latent class analysis model was applied to assess accuracy measurements of the characteristics identified. Results: Fatigue diagnosis was present in 21.9% of the women. The characteristic which showed the highest sensitivity was “Impaired capacity in maintaining the usual level of physical activity”, while “Impaired capacity in maintaining usual routines” and “Lack of interest about the surrounding environment” presented greater specificity. Conclusion: Accurate diagnostics allow devising an action plan directed to the patients' real needs.