Sinais e sintomas vestibulares em pacientes que receberam tratamento com drogas derivadas da platina

RESUMO

Objetivo: Identificar a frequência de ocorrência de alteração vestibular em pacientes tratados com derivados da platina, quais são os sinais e sintomas vestibulares que acompanham esses quadros, e se a alteração vestibular preexistente exacerba os sintomas eméticos durante o tratamento.

Métodos: Estudo prospectivo, longitudinal e exploratório. Foram selecionados pacientes adultos que realizaram tratamento com drogas derivadas da platina, submetidos à avaliação vestibular pré e pós-tratamento. O monitoramento vestibular foi composto pelo Dizziness Handicap Inventory (DHI) Brasileiro, manobra de Dix-Hallpike, vecto-eletronistagmografia e pela descrição de sintomas eméticos e tontura durante a quimioterapia e na avaliação vestibular.

Resultados: Quarenta e oito pacientes realizaram a avaliação vestibular antes da quimioterapia, desses 52% apresentaram avaliação vestibular alterada. Dezesseis pacientes submeteram-se ao monitoramento vestibular com avaliação antes e após tratamento, desses 50% apresentaram mudança no quadro vestibular após a quimioterapia. O DHI mostrou escores dentro da normalidade em 100% dos pacientes pré-tratamento e em 81,3% dos pacientes pós-tratamento. A dose de CDDP com piora do quadro vestibular variou entre 160 e 400 mg/m². Dois pacientes foram tratados com carboplatina com doses de 2306 mg/m² e 1801 mg/m². Não houve diferença de manifestação dos sintomas eméticos/tontura entre os pacientes com e sem alteração vestibular prévia.

Conclusão: O aparecimento de alteração vestibular ou a modificação do quadro vestibular ocorreu em 50% dos pacientes oncológicos tratados com derivados da platina que participaram do monitoramento após o tratamento. O sinal mais frequente de alteração nos testes vestibulares foi o predomínio labiríntico na prova calórica, sem sintomas vestibulares evidentes nestes pacientes. As alterações vestibulares preexistentes não exacerbaram os sintomas eméticos durante a quimioterapia.

ABSTRACT

Objective: To identify the frequency of occurrence of vestibular alterations in cancer patients treated with platinum-based chemotherapy, their vestibular signs and symptoms, and whether the pre-existing vestibular alterations exacerbate emetic symptoms during the treatment.

Methods: Prospective, longitudinal and exploratory study. The sample was composed of adults, treated with platinum-based chemotherapy, who underwent vestibular evaluation pre and post-treatment. The vestibular monitoring involved the Brazilian Dizziness Handicap Inventory (DHI), Vestibular Function Tests and the description of emetic symptoms and dizziness during chemotherapy and vestibular evaluation.

Results: Forty-eight patients completed the vestibular evaluation before the chemotherapy treatment, and 52% presented vestibular alteration. Sixteen patients underwent the evaluation before and after treatment, and 50% presented a change in the vestibular function. The DHI showed normal score in all patients in the pre-treatment assessment and in 81,3% of them post-treatment. The dose of cisplatin among patients who had a modification in the vestibular status varied from 160 to 400 mg/m². Two patients were treated with carboplatin with doses of 2306 mg/m2 and 1801 mg/m². There was no difference of emetic symptoms/dizziness among patients with or without previous vestibular alteration.

Conclusion: Vestibular alterations or modifications in the vestibular status were found in 50% of this sample. The most common sign of vestibular alteration was the predominance of labyrinth response in the caloric test with no symptoms in their daily life. The pre-existing vestibular alterations did not exacerbate emetic symptoms during chemotherapy.

Descritores:

Neoplasias - Platina - Sinais e sintomas - Antineoplásicos/toxicidade - Eméticos - Quimioterapia - Testes de função vestibular - Inquéritos e questionários - Vertigem

Keywords:

Neoplasms - Platinum - Signs and symptoms - Antineoplastic agents/toxicity - Emetics - Drug therapy - Vestibular function tests - Surveys and questionnaires - Vertigo

Publikationsverlauf

Eingereicht: 31. Januar 2017

Angenommen: 21. April 2017

Artikel online veröffentlicht:
11. März 2025

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