Perfil clínico-epidemiológico dos pacientes com neoplasias malignas da região de cabeça e pescoço atendidos no serviço de radioterapia da santa casa de misericórdia de sobral

Abstract

Introduction: Head and neck cancer (HNC) is the sixth most prevalent malignant neoplasm worldwide and is characterized by a heterogeneous group of tumors that mainly affect the oral cavity, oropharynx and larynx. In Brazil, estimated 11,200 new cases of cancer of the oral cavity in men and 3,500 in women per 100 thousand inhabitants and 6,390 new cases in men and 1,280 in women of laryngeal cancer per 100 thousand inhabitants, the two main sites of HNC involvement, where the main associated risk factors are smoking and alcohol. Objective: To describe the clinical-epidemiological profile of patients with HNC treated at a referral service in radiotherapy in a city in the Northeast region of Brazil. Material and Methods: This study is characterized by being retrospective and transversal with a quantitative character, in which the medical records of patients with head and neck cancer treated in the radiotherapy sector of the Santa Casa de Misericordia de Sobral, Ceara, were analyzed in the period of 2008 to 2018. The variables analyzed included age, sex, profession, race, schooling, smoking and alcohol habits, primary tumor location, TNM, clinical staging, degree of histological differentiation, clinical history and treatment. Data were expressed as absolute and percent frequency and analyzed by Pearson's chi-square test or Fisher's exact test using the Statistical Packing for Social Sciences (SPSS) software version 20.0 for Windows adopting a 95% confidence level. Results: A total of 284 medical records were analyzed of the last 10 years, showing that in the clinical-epidemiological profile the number of HNC increases with age, affecting mainly males and individuals with low schooling. Squamoll Cell Carcinoma (SCC) was the most common histological type and the main site was larynx, related to the most prevalent main complaint that was hoarseness, and higher in stage I/II tumors (p <0.001). Regarding the modality of treatment, radical radiotherapy had a higher percentage (72.4%) in stage III/ IV, besides the greater need for chemotherapy also in this group (39.2%) (p <0.001). Surgery obtained a higher percentage in stage I/II (25.3%). A period of more than 8 months of main complaint was observed more frequently at more advanced stages (p = 0.001). Cutaneous hyperemia with dry desquamation of the cervical region and mucositis were, respectively, the main clinical manifestations during the radiotherapy treatment. Conclusion: The profile shows a higher number of HNC in the male sex, increasing with the progression of age, where in this study the larynx was the main location. Most of the lesions were SCC, with radical radiotherapy being the main modality of treatment. The data obtained could support the development of strate gies for the prevention and early diagnosis of these neoplasms in the sector where the study was performed.