Povezanost vrste i učestalosti nuspojava uzrokovanih adjuvantnom endokrinom terapijom i duljine trajanja terapije u pacijentica koje su preboljele hormonski ovisan karcinom dojke

master's thesis

• Title (english): Relationship of the type and frequency of side effects caused by adjuvant endocrine therapy and duration of the therapy in patients who were treated for hormone dependent breast cancer
• Author: Ivana Vrdoljak
• Mentor: Iva Mucalo (mentor)
• Committee member: Iva Mucalo (predsjednik povjerenstva)
• Committee member: Tajana Silovski (član povjerenstva)
• Committee member: Andrea Brajković (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2023-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Karcinom dojke najčešće je dijagnosticirani karcinom kod žena, a 70% dijagnoza čini
hormonski ovisan tip. Visoka stopa preživljavanja posljedica je učinkovitog endokrinog
liječenja koje obuhvaća aromatazne inhibitore (anastrozol, letrozol i eksemestan) i
tamoksifen. Primjena AET pokazuje brojne koristi, ali dugotrajno uzimanje terapije (od 5 do
10 godina) uzrokuje i brojne nuspojave koje utječu na kvalitetu života, pa navedeno doprinosi
i slabijoj adherenciji. Cilj ovog diplomskog rada bio je ispitati vrstu i učestalost nuspojava
uzrokovanih AET-om u ovisnosti o duljini trajanja terapije s ciljem unaprjeđenja pristupa
liječenju i poboljšanja adherencije. Istraživanje se provodilo u Kliničkom bolničkom centru
(KBC) Zagreb od rujna do studenog 2021. godine. Ispitano je 419 punoljetnih pacijentica,
prosječne starosti 57 godina, oboljelih od hormonski ovisnog karcinoma dojke stadija 0-III
koje se liječe antiestrogenskom terapijom duže od 3 mjeseca. U prvom dijelu upitnika
prikupljeni su sociodemografski i klinički podaci dok je drugi dio upitnika Functional
Assestment of Cancer Therapy-Endocrine Symptoms (FACT-ES) korišten za ispitivanje
učestalosti i vrste endokrinih nuspojava.Ispitivanje je pokazalo da pacijentice na terapiji
tamoksifenom imaju veću zastupljenost krvožilnih nuspojava. Prevalencija nuspojave navala
vrućine bila je najveća kod svih ispitanica neovisno o duljini uzimanja terapije tamoksifena
(više od 70%).Kod pacijentica na terapiji AI s duljinom uzimanja terapije opada učestalost
nuspojave navala vrućine, dok je nuspojava bol u zglobovima najviše izražena neovisno o
duljini uzimanja terapije (80%). Istraživanje ovog tipa prvi je put provedeno na pacijenticama
oboljelim od hormonski ovisnog karcinoma dojke u Hrvatskoj te doprinosi boljem
razumijevanju čimbenika koji mogu utjecati na adherenciju. Na pozitivan stav pacijentica
prema terapiji utječe njihov odnos sa zdravstvenim djelatnikom, stoga je potrebno izgraditi
povjerenje koje će utjecati na obostranu informiranost o ishodima terapije, ali i očekivanim
nuspojavama

Abstract (english)

Breast cancer is the most frequently diagnosed cancer in women, and 70% of diagnoses are
the hormone-dependent type. The high survival rate is a result of effective endocrine
treatment that includes aromatase inhibitors (anastrozole, letrozole and exemestane) and
tamoxifen. The use of AET shows numerous benefits, but patient adherence is not
satisfactory. Long-term use of therapy (from 5 to 10 years) also causes numerous side effects
that influence the quality of life, so these are considered factors of poor adherence.The aim of
this thesis was to examine the type and frequency of side effects caused by AET depending on
duration of therapy with aim of improving treatment access and adherence. The research was
conducted at Clinical Hospital Center (KBC) Zagreb from September to November 2021.
Patients were of adult age, average of 57 years, with hormone-dependent breast cancer stage
0-III who are treated with anti-estrogen therapy for more than 3 months.First part of the
questionnaire collected sociodemographic and clinical data, while the second part of the
Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES) questionnaire
was used to examine the frequency and type of endocrine side effects.The study showed that
patients on tamoxifen therapy have a higher prevalence of vascular side effects. The
prevalence of the side effect hot flushes was the highest among all subjects regardless of the
length of the therapy (more than 70%).In patients on AI therapy, the frequency of the side
effect hot flushes decreases with the duration of therapy, while the side effect pain in the
joints is the most frequent, regardless of the length of therapy (80%).Research of this type
was conducted for the first time on patients with hormone-dependent breast cancer in Croatia
and contributes to a better understanding of factors that can improve adherence. Positive
attitude of patients towards therapy is influenced by their relationship with the healthcare
professional, therefore it is necessary to build trust that will result with mutual information
about the outcomes of the therapy, as well as its expected side effects.

• Keywords: hormonski ovisan rak dojke; nuspojave lijekova; endokrina terapija
• Keywords (english): hormone dependent breast cancer; drug side effects; endocrine therapy
• Language: croatian
• URN:NBN: urn:nbn:hr:163:915007
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-12-01 11:20:16