Avaliação de reações adversas imediatas à infusão de quimioterápicos em pacientes ambulatoriais : uma revisão de literatura

Abstract

Cancer is one of the most prominent public health problems in the world and stands out for its uncontrolled cell growth. The treatment that stands out for this condition is antineoplastic chemotherapy, which is mainly administered orally and intravenously, the latter being performed in hospital and outpatient settings. Antineoplastic agents act indiscriminately on cancerous and normal cells, produce adverse reactions, which can be immediate or delayed, and are related to increased morbidity and mortality. Immediate adverse reactions are commonly associated with the infusion of antineoplastic agents and their occurrence in the clinic is relevant, given the difficulty of monitoring it. Reporting studies of these reactions promote a greater understanding of the problems presented by cancer patients, establishing the meaning of the reaction and contributing to adequate intervention and follow-up. Thus, this study aimed to identify and analyze the technical-scientific evidence about immediate adverse reactions to chemotherapy infusion in outpatients. A non-systematic review of the literature on the assessment of RAII in outpatients in the last ten years was carried out. The overall incidence of RAII ranged between 1.9% and 8.9%. The studies reviewed showed a total of 1222 patients with RAII, with a higher prevalence in females (65.3%) compared to males (34.7%) and with the average agr ranging between 54,6 and 65 years. In addition to gender and age, risk factors such as the presence of comorbidities and previous allergies, as well as the lack of premedication, contributed to the increase and/or worsening of RAII from chemotherapy. The most reported adverse reactions were dyspnea or shortness of breath; redness; hypotension; pruritus and erythema, appearing as hypersensitivity reactions. The severity of adverse reactions was assessed by the Common Terminology Criteria for Adverse Events in most studies, and they were classified mainly into grade 1 and 2, with their sum ranging between 42.5% and 90%. These reactions were mainly associated with taxanes, platinum agents and monoclonal antibodies, in agreement with the literature. The drug infusion was interrupted with the appearance of the reaction in 92.3% of the reviewed studies and symptomatic medications were used in 76.8%, with hospitalization (23.1%) being the procedure for more severe cases. The incidence of RAII is heterogeneous and varies essentially according to socio-demographic, clinical and pharmacological factors, requiring monitoring and reporting of these reactions, seeking safety and abetter quality of life for the patient.