Lessons Learned. Pregabalin is a medication that can decrease neuronal hyperexcitability, relieve neuropathic pain, and reach stable plasma levels after a titration period of only a few days.Its use during oxaliplatin infusions was not able to decrease the incidence of chronic, oxalipaltin‐related neuropathic pain, compared with placebo.Background.Patients with colorectal cancer (CRC) receiving oxaliplatin (OXA) develop acute and chronic painful oxaliplatin‐induced peripheral neuropathy (OXAIPN). Acute and chronic OXA‐related neuropathies have different pathophysiological bases, but both lead to a common phenomenon: central sensitization (CS) of nociceptive neuronal networks, leading to increased sensitivity (hyperlgesia, allodynia) in the somatosensory system, the common ground of chronic neuropathic pain. Because CS is related to increased risk of painful OXAIPN, we hypothesized that preemptive use of the anti‐hyperalgesic drug pregabaline (known to decrease CS) during OXA infusions would decrease the incidence of chronic OXAIPN.Methods.Pain‐free, chemotherapy‐naïve CRC patients receiving at least one cycle of modified‐FLOX [5‐FU(500 mg/m2)+leucovorin(20 mg/m2)/week for] 6 weeks+oxaliplatin(85 mg/m2) at weeks 1‐3‐5 every 8 weeks] were randomized (1:1) into the study. Patients received either pregabalin or placebo for 3 days before and 3 days after each OXA infusion and were followed for up to 6 months. Clinical assessments were performed at baseline, at the end of chemotherapy, and after the follow‐up period. The main outcome was average pain at the last visit assessed by the visual analogic scale (0–10) item of the Brief Pain Inventory (BPI). Secondary endpoints were presence of neuropathic pain according to the Douleur Neuropathique‐4 (DN‐4), pain dimensions (short‐ form McGill Pain Questionnaire [MPQ]), Neuropathic Pain Symptom Inventory (NPSI), and changes in nerve conduction studies (NCS) and side effect profile.Results.One hundred ninety‐nine patients (57.0 ± 10.7 years old, 98 female, 101 male) were randomized. Data from 56 patients were not included in the analyses (as they did not receive at least one full cycle of modified FLOX). Data from 78 patients in the pregabalin group and 65 patients in the placebo group were retained for analyses. At the last visit, pain intensity in the pregabalin group was 1.03 (95% confidence interval [CI] = 0.79–1.26), and 0.85 (95% CI = 0.64–1.06) in the placebo group, which did not reach significance. Scores from the BPI, MPQ, DN‐4, NPSI, and NCS and side‐effect profiles and incidence of death did not differ between groups. Quality of life (QoL) score did not differ between groups (placebo = 76.9 ± 23.1, pregabalin group 79.4 ± 20.6). Mood scores were not significantly different between groups (placebo 9.7 [8.1–11.2]; pregabalin 6.8 [5.6–8.0]).Conclusion.The preemptive use of pregabalin during OXA infusions was safe, but did not decrease the incidence of chronic pain related to OXAIPN.

doi: 10.5216/ree.v12i3.6957O constructo subjetivo e multidimensional Qualidade de Vida (QV) consolida-se entre os estudiosos na década de 90. Identificar, mensurar e avaliar os domínios afetados pela doença tem sido a proposta de diversos estudos com delineamentos qualitativos e quantitativos. Os objetivos foram caracterizar a produção científica latinoamericana sobre QV em pacientes oncológicos adultos; identificar aspectos relacionados à QV nesta população; identificar os instrumentos utilizados para avaliar a QV. Uma das estratégias metodológicas para realizar a prática baseada em evidências é a revisão integrativa. A amostra resultou em 25 artigos, nos quais havia uma alta concentração de estudos na subcategoria QV nos diferentes tipos de câncer de cabeça e pescoço (32%), que nos faz refletir sobre os inúmeros efeitos colaterais e secundários do tratamento, como as mutilações, alterações funcionais e estéticas que interferem nas atividades de vida diária dos pacientes. Verificamos uma prevalência na aplicação do instrumento EORTC QLQ-C30 sendo que este explora sintomas específicos do câncer. Considera-se que tais estudos não apresentaram fortes evidências para aplicação clínica. Correspondendo a prática baseada em evidências, concluímos a importância no desenvolvimento de estudos com intervenções efetivas para subsidiar a prática de enfermagem e garantir uma assistência qualificada e consequentemente melhorar QV aos pacientes oncológicos. Descritores: Neoplasias; Qualidade de vida; Enfermagem Oncológica.

RESUmoUma das estratégias metodológicas para realizar a prática baseada em evidências é a revisão integrativa, que neste estudo teve como objetivo buscar e sintetizar as evidências disponíveis na literatura científica sobre os fatores de riscos alimentares para o câncer colorretal relacionado ao consumo de carnes. As bases de dados LILACS, MEDLINE, CINAHL e COCHRANE Library foram consultadas e os estudos pertinentes ao consumo de carnes somaram-se seis. As metanálises demonstraram que a ingestão de carne vermelha está relacionada com o aumento do risco para câncer colorretal em 28% a 35%, enquanto que a carne processada está associada ao risco elevado de 20% a 49%. As evidências apontam a carne vermelha, a carne processada e o total de carne consumida como fatores de risco para o desenvolvimento de pólipos e cân-cer colorretal. Não foi identificado estudo que indicasse a ingestão de frango e peixe como fatores de risco. dEScRiToRES Neoplasias colorretais Fatores de risco Carne Enfermagem oncológica AbSTRAcTThe integrative review is one of the methodologies used for evidence-based practice which, in this study, had the objective of surveying and synthesizing the evidence available in the literature regarding the dietary risks for colorectal cancer related to the consumption of meat. The search was made using the LILACS, MEDLINE, CINAHL, and COCHRANE Library databases, and six studies considered pertinent to the consumption of meat were found. Meta-analyses showed that there is an association between the consumption of red meat and an increased risk for colorectal cancer from 28% to 35%, whereas processed meats are associated with a rise in risk from 20% to 49%. Evidence shows that the consumption of red meat, processed meat, and total meat consumption are risk factors for developing polyps and colorectal cancer. The search did not yield any studies referring to the consumption of chicken or fish as risk factors. dEScRiPToRS Colorectal neoplasms Risk factors Meat Oncologic nursing RESUmEnUna de las estrategias metodológicas para realizar la práctica basada en evidencias es la revisión integradora, que en este estudio objetivó buscar y sintetizar las evidencias disponibles en literatura científica sobre factores de riesgo alimentario para desarrollar cáncer colorrectal en relación al consumo de carne. Se consultaron las bases de datos LILACS, MEDLINE, CINAHL y COCHRANE Library, y los estudios pertinentes al consumo de carnes sumaron seis. Los metanálisis demostraron que la ingestión de carne roja está relacionada con el aumento de riesgo de cáncer colorrectal en 28% a 35%, mientras que la carne procesada se relaciona con un riesgo aumentado entre 20% y 49%. Las evidencias exponen a la carne roja, la carne procesada y al total de carne consumida como factores de riesgo para desarrollo de pólipos y cáncer colorrectal. No existió evidencia que relacionara la ingesta de pollo y pescado como factores de riesgo. dEScRiPToRESNeoplasias colorrectales

Adults with cancer are able to choose between involvement or not with this kind of CAM intervention. Global health could be improved by participating in this type of intervention.

No abstract

A busca de evidências para os fatores de risco alimentares do câncer colorretal: revisão integrativa da literatura Ribeirão Preto 2010

85 Background: In Brazil, breast cancer has the second highest incidence of neoplasms, the most common among women. It is expected there will be 57,120 new cases and a risk 56.09 cases per 100 thousand women. For its treatment, neurotoxic chemotherapeutics that can cause chemotherapy-induced peripheral neuropathy (CIPN) are used. Methods: This is an exploratory descriptive study developed in a cancer treatment reference hospital in the city of Sao Paulo, Brazil. Aim: To search the patients with breast cancer during treatment with neurotoxic agents and evaluate the presence of CIPN with application of Chemotherapy-Induced Peripheral Neuropathy Assessment Tool questionnaire (CIPNAT). Results: The sample was 44 women with a mean age of 52 years (SD = 10.54), 47.7% had local disease, 72.7% were treating with taxanes neurotoxic agents. The main neuropathic symptoms measured at CIPNAT: 75% had motor symptom weakness with an average score for severity of 6.45 causing an average of distress 5.36; 65.9% muscle and joint pain average severity of 6.31 causing an average of 5.59 distress; and 56.8% sensitive symptom numbness in the hands average severity of 4.76 causing an average of 3.52 distress. These symptoms had a negative impact in the activities of daily living (ADL) such as physical exercise (mean score = 5.32), enjoyment of life (mean score = 4.77) and leisure activities (mean score = 4, 03). Although few (13.6%) reported that suffered some injury or accident due to CIPN. Discussion: The results are consistent with those presented in the scientific literature, but measured with other assessment tools such as the NCI CTCAE, WHO and EORTC QLQ-C30 and CIPN20, which also showed that motor disorders (weakness, muscle cramps and loss of strength in the hands) and sensory (numbness and tingling in the hands and feet). Conclusions: The study explores the relationship between CIPN and ADL affected during treatment for breast cancer. Through the motor and sensory symptoms reported by CIPNAT, nursing will have grant to develop educational strategies to prevent and minimize negative impacts on the quality of life of women with breast cancer undergoing treatment with neurotoxic agents.

Supplemental Digital Content is Available in the Text.Mirror limb assessment in the same individual with leprosy showed that neuropathic pain was associated with heat pain thresholds but not with skin innervation.