Bendito o homem que se fia em Deus, cuja confiança é Deus. Ele é como uma árvore plantada junto da água, que lança suas raízes para a corrente: não teme quando chega o calor, sua folhagem permanece verde; em ano de seca não se preocupa e não para de produzir frutos" Jeremias 17. 7-8
RESUMOSilva WN. Caquexia em pacientes com carcinoma pulmonar de células não pequenas: influência da aptidão física sobre o prognóstico [tese].
das Neves Silva, minha mãe que com sua vida de luta, dedicação e trabalho me ensinou a buscar por mim mesmo e a construir o caminho através do trabalho, dedicação e autonomia. À minha esposa Eliene Barbosa das Neves, que como companheira esteve ao meu lado, me apoiando a cada dia.
PurposeWe determine the frequency of cachexia among head and neck squamous cell carcinoma patients treated with cisplatin-based chemoradiation with curative intent and presenting no evidence of disease. MethodsConsecutive patients were included from January 2014 to February 2017. Participants were over 18 y.o. and diagnosed with head and neck squamous cell carcinomas previously treated with definitive or adjuvant chemoradiation. Eligible patients were in regular follow-up for at least 2 years, with no evidence of disease. Body weight, height, mid-arm muscle circumference, muscle strength, and nutritional status were measured, and blood tests were obtained. The main outcome was the presence of cachexia, and self-reported dysphagia. Results120 patients were included, 73% were male, and age was 59 y.o. (range, 21–78). The most common primary site was oropharynx (42%). Median follow-up was 42 mo. (range, 24–125 mo.). Most patients presented locally advanced disease at diagnosis: 73% T3-T4 and 72% N+. Dysphagia was a major complaint (73%). Cachexia was diagnosed in 23 (20.7%) and 10 (8.6%) patients according to Fearon and Evans criteria, respectively. Cachectic patients presented lower mid-arm muscle circumference (p < 0.05). In addition, lower muscle strength levels (p<0.05) were found among cachectic patients according to Evans criteria, and there was an association between the presence of dysphagia and the diagnosis of cachexia. ConclusionsHead and neck squamous cell carcinoma patients with no evidence of disease frequently present cachexia after chemoradiation in a long-term follow-up. More effective preventive and therapeutic strategies for cachexia are required in this scenario.
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