Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009. / Härtill 6 uppsatser.

Att drabbas av cancer och genomgå cytostatikabehandling kan inverka på patienters sexualitet. Sjuksköterskor bör se till patienters alla behov för att kunna ge en god omvårdnad. Syftet var att beskriva sjuksköterskors reflektioner kring ämnet sexualitet i omvårdnadsarbetet med cytostatikabehandlade vuxna patienter med cancer. Studiens metod var empirisk med deskriptiv design och kvalitativ ansats. Datainsamlingen skedde via semi-strukturerade intervjuer med sex sjuksköterskor från en onkologisk klinik i Mellansverige. I huvudresultatet presenteras två kategorier, information om sexualitet vid start av cytostatikabehandling och omständigheter som påverkade samtal om sexualitet. Sjuksköterskorna ansåg att det var deras ansvar att informera om sexualitet och att information om ämnet var betydelsefullt. Patienters intresse och behov styrde informationen, men alla patienter fick inte information om sexualitet. Anledning till detta kunde vara att sjuksköterskorna inte ville genera patienter. Sjuksköterskorna hade inte erhållit någon kunskap om sexualitet genom utbildning. Kunskapen hade sjuksköterskorna erhållit genom arbetslivserfarenhet. Slutsats, för att som sjuksköterska regelbundet kunna informera patienter om hur sexualiteten kan påverkas av cytostatikabehandling vid cancersjukdom behövs vidare kunskaper. Detta för att kunna minska den spänning som finns kring ämnet sexualitet. / To suffer from cancer and going through treatment with chemotherapy can affect patients’ sexuality. Nurses should pay regard to all needs of the patients to be able to provide good nursing care. The aim of the study was to describe the nurses’ reflections around sexuality as a part of their nursing practice, related to adult patients with cancer going through chemotherapy. The study is based on qualitative interviews with a descriptive design. The interviews were conducted through semi-structured questions and the study group consisted of six nurses who worked at an oncology clinic in the central part of Sweden. The main result showed two categories, information about sexuality at the start of chemotherapy and circumstances that could affect conversation about sexuality. The nurses considered it to be their responsibility to inform the patient about sexuality and that information was meaningful. The patient’s interest and need directed the information, but all patients’ did not get information about sexuality. A reason to this could be that the nurses did not want to embarrass the patients. The nurses had not gained any knowledge about sexuality through education. The knowledge the nurses had gained came from work experience. Conclusion, to inform patients about how their sexuality can be affected by going trough treatment with chemotherapy regularly, nurses need further knowledge. This could reduce the tension that exists around the topic sexuality.

Clinical trials investigating autologous stem cell transplantation (ASCT) have historically excluded elderly patients due to the risk of treatment-related morbidity related to the administration of high dose chemotherapy. While the availability of this procedure continues to expand, the elderly still represent a population for which the role of ASCT needs to be fully defined. 201 patients who underwent autologous stem cell transplantation (ASCT) for Non Hodgkins lymphoma (NHL) at a single institution following BEAM conditioning between January 1, 2000 and December 31, 2007 were retrospectively identified from the Yale University School of Medicine Bone Marrow Transplant Database. 67 patients were older than 60 years at the time of transplantation (median age 65, range 60 75) and were compared to a matched group of 134 patients transplanted during the same time period. These groups were extremely well-matched for all demographics such as gender, NHL histology, performance status, and comorbidities. Most patients had advanced stage disease at diagnosis and were transplanted at first or second remission. Diffuse large B-cell and mantle cell lymphoma were the most common subtypes but other subtypes were represented. The elderly group experienced significantly more serious toxicities within the first 100 days (63%) when compared to the control group (42%). However, there were no statistical differences (p<0.0001) between the groups regarding specific organ system toxicities. The 1-year non-relapse mortality (3%) was not significantly different when compared to the younger cohort (1%). At a median follow-up of 31 months the median overall survival is 85 months in the elderly group and at a median follow up of 33 months in the younger group the median overall survival has not yet been reached. The overall survival at 3 years is 74% and 75% respectively (p=0.91). The disease-free survival at 3 years is 48% in the elderly group compared to 58% in the control group (p=0.66). By univariate analysis, age >60 years (RR 3.1, 95% CI 1.7 5.7, p=0.004) was the only factor predictive of developing a serious toxicity from ASCT within the first 100 days. HCT-CI score (RR 2, 95% CI 1 4, p=0.043) was the only factor associated with significantly worse overall survival. Autologous stem cell transplantation can be safely performed in selected patients older than 60 years with chemosensitive NHL. Although elderly patients appear more likely to develop acute toxicities, the outcomes are similar to that of younger patients with respect to non-relapse mortality, disease-free survival, and overall survival.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2010. / Härtill 5 uppsatser.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.

<p dir="rtl" style="text-align: left;">Karcinom bronha je važna i &scaron;iroko rasprostranjena bolest koja predstavlja veliki problem javnog zdravlja. Kod osoba mu&scaron;kog pola se nalazi na prvom mestu kako po učestalosti obolevanja tako i kao uzrok smrti među svim malignim tumorima, dok se kod osoba ženskog pola nalazi na trećem ili četvrtom mestu po obolevanju, a po umiranju uglavnom na drugom mestu. Kod najvećeg broja bolesnika bolest se otkriva u uznapredovalom ili metatstaskom stadijumu, a hemioterapija predstavlja jedan od vidova lečenja uznapredovale ili metastatske bolesti. Pored toga &scaron;to produžava preživljavanje i pobolj&scaron;ava kvalitet života obolelih praćena je istovremeno i brojnim neželjenim događajima. Iako hemioterapijski protokoli bazirani na preparatima platine ostvaruju najveću efektivnost kod bolesnika sa uznapredovalim nemikrocelularnim karcinomom bronha toksičnost koja je prati predstavlja najveći problem sa kojim se susrećemo. Ali, uprkos ovoj činjenici veliki broj studija je pokazao da je upravo odsustvo mijelotoksičnosti tokom hemioterapije udruženo sa lo&scaron;ijim ishodom lečenja kod obolelih od karcinoma bronha. Iz tog razloga je i predloženo da se hematolo&scaron;ka toksičnost koristi kao mera biolo&scaron;ke aktivnosti citotoksičnih lekova, njen prognostički značaj je evaluiran i proučavan u velikom broju studija. Ciljevi ove doktorske disertacije su bili da se utvrditi uticaj leukopenije, anemije i trombocitopenije kao nezavisnih prognostičkih faktora na preživljavanje bolesnika sa nemikrocelularnim karcinomom bronha; da se utvrditi učestalost hematolo&scaron;ke toksičnosti lečenih hemioterapijskim protokolima Cisplatin/Vepezid i Gemcitabin/Cisplatin i da se utvrdite razlike u preživljavanju bolesnika lečenih hemioterapijskim protokolima Cisplatin/Vepezid i Gemcitabin/Cisplatin. U uzorku je analizirano 200 bolesnika, 76% mu&scaron;kog i 24% ženskog pola, prosečne starosti 61.4 godine. Najzastupljenji su bili bolesnici u IV stadijumu 50.5%, a najče&scaron;ći patohistolo&scaron;ki tip karcinoma u uzorku je bio adenokarcinom sa 51.5%. Nije utvrđeno postojanje statistički značajne razlike u gradusima leukopenije, anemije i trombocitopenije između posmatranih grupa, (<em>X</em>²=2.908, <em>X</em>²=2.264, <em>X</em>²=3.403, p&gt;0.05). U obe grupe je univarijantnom analizom dokazanao da stadijum bolesti i terapijski odgovor imaju statistički značaj kao &bdquo;ne - hematolo&scaron;ki&ldquo; prognostički faktori (p&lt;0.01). U obe grupe su takođe univarijentnom analizom leukopenija, anemija i trombocitopenija identifikovane kao prognostički faktori kod obolelih od NSCLC, dok multivarijantnom analizom ni jedan od analiziranih faktora nije identifikovan kao prognostički. U obe grupe su bolesnici sa leukopenijom, anemijom i trombocitopenijom gradusa 3 i 4 imali statistički značajno duže preživljavanje u odnosu na bolesnike sa gradusom 0. Nije postojala razlika u preživljavanju bolesnika lečenih hemioterapijskim protokolima cisplatin/etopozid I gemcitabin/cisplatin (F=0.069; p&gt;0.05). Nije postojala razlika u preživljavanju bolesnika sa anemijom, leukopenijom i trombocitopenijom između grupa A i B za graduse 0, 3 i 4</p> / <p>Lung cancer is an important and widespread disease which represents a major public health problem. It is the most frequent disease among all malignant diseases at males, among women it is on the third or fourth place among malignant diseases. In most cases the disease is detected at an advanced or metastatic stage and chemotherapy is one of the therapy options of. Despite the fact that chemotherapy prolongs survival and improves quality of life of patients, at the same time chemotherapy causes a number of different adverse events. Although chemotherapy protocols based platinum achieve maximum effectiveness in patients with advanced non-small cell lung cancer, toxicity that accompanies represents a big problem. But despite this fact, a number of studies have shown that the absence of myelotoxicity during chemotherapy is associated with poorer treatment outcomes in patients with bronchial carcinoma. For this reason, it is proposed that hematological toxicity may be used as a measure of the biological activity of the cytotoxic drug, and its prognostic significance was studied and evaluated in a number of studies. The objectives of this dissertation were to determine the effect of leucopenia, anemia andthrombocytopenia as an independent prognostic factor in the survival of patients with Non Small Cell Lung lung cancer, to determine the incidence of hematological toxicity treated with chemotherapy protocols cisplatin/etoposid and gemcitabine/cisplatin and to determine differences in survival patients treated with chemotherapy protocols cisplatin/etoposid and gemcitabine/ cisplatin. We analyzed 200 patients, 76% male and 24% female, mean age 61.4 years. The most frequent were patients in stage IV 50.5%, and the most common histopathological type was adenocarcinoma with 51.5%. We did not find statistically significant differences in grade of leukopenia, anemia and thrombocytopenia between the groups (<em>X</em>²=2.908,<em> X</em>²=2.264, <em>X</em>²=3.403, p&gt;0.05). In both groups, the univariant analysis has shown that the stage of disease and response rate as a non-hematological prognostic factor had statistical significance (p &lt;0.01). In both groups of patients with NSCLC leucopenia, anemia and trombocitopenia has identified with univariant analysis as a prognostic factors, but multivariant analysis did not show that any of analyzed factors are prognostic. In both groups, patients with grade 3 and 4 of leucopenia, anemia and trombocitopenia had statistically longer survival than patients with grade 0. We did not find statistically significant difference in overall survival of patients treated with cisplatin/etoposid i gemcitabin/cisplatin regimes (F=0.069; p&gt;0.05). We did not find any statistically differences in overall survival between group A and B for leucopenia, anemia and trombocitopenia grade 0, 3 and 4.</p>

O tratamento quimioterápico do câncer de cólon e reto pode provocar efeitos adversos que limitam a efetividade da terapia e tem grande impacto nos resultados finais do tratamento, sendo a neutropenia a toxicidade hematológica mais comum decorrente do tratamento quimioterápico. O presente estudo teve como objetivos identificar a ocorrência de neutropenia em pacientes com câncer de cólon e reto submetidos a tratamento quimioterápico adjuvante do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP) e avaliar o risco para o desenvolvimento de neutropenia febril (NF) de acordo com o índice de risco da Associação Multinacional de Cuidados de Assistência ao Câncer (MASCC), em pacientes que apresentaram neutropenia durante o tratamento quimioterápico. Trata-se de um estudo descritivo e retrospectivo, realizado por meio da revisão de 60 prontuários de pacientes com diagnóstico de câncer de cólon e reto submetidos ao tratamento quimioterápico com 5-fluorouracil, ácido folínico e oxaliplatina (FLOX), seguidos no ambulatório de Coloproctologia deste referido hospital, entre os anos de 2010 a 2017. Foi realizada a avaliação dos resultados laboratoriais a cada semana do tratamento quimioterápico nos pacientes elegíveis para este estudo. A idade média dos participantes foi de 63,8 anos. 34 pacientes (56,7%) eram do sexo masculino. A maioria 50 (83,3%) era da raça branca. Quanto ao estado civil 37 (61,7%) eram casados. O tipo de neoplasia mais frequente foi o adenocarcinoma de reto, representado por 38 (63,3%) pacientes, seguido pelo adenocarcinoma de cólon com 22 (36,7%). Os estadiamentos clínicos mais observados foram o IIIb em 18 (30%) pacientes, seguido do IVa em 16 (26,7%). Foi analisado um total de 146 ciclos de quimioterapia com uma média de 2,5 ciclos por paciente, e 876 semanas de tratamento quimioterápico. Dos 60 pacientes participantes no estudo, 41,7% apresentaram neutropenia em algum momento do tratamento quimioterápico. Entre estes 60 pacientes, 21,6% apresentaram um episódio de neutropenia, dois episódios foram observados em 13,3%, quatro episódios em 3,4% e, 3,4% dos pacientes desenvolveram seis episódios de neutropenia. No total, foram identificados 49 episódios de neutropenia. Registrou-se 67 atrasos entre as semanas de tratamento com uma média de 5,02 dias. A redução de doses foi utilizada em 30 pacientes, com um total de 40 ciclos e 218 semanas de tratamento reduzidos, e a suspensão do tratamento ocorreu em 21 pacientes, totalizando 57 semanas de tratamento com suspensão de 27 ciclos. A neutropenia neste estudo esteve entre os principais motivos para os atrasos, reduções de dose e suspensão do tratamento quimioterápico. Quanto a avaliação de risco para o desenvolvimento de NF, 23 pacientes (84%) apresentaram baixo risco, 2 (8%) apresentaram alto risco e 2 (8%) apresentaram baixo e/ou alto risco concomitantemente. Os resultados deste estudo evidenciam que a neutropenia em pacientes com câncer de cólon e reto em tratamento quimioterápico tem uma incidência relativamente baixa em seus diferentes graus, possui baixo risco para o desenvolvimento de NF, e sugere a elaboração e implantação de instrumentos nos serviços de saúde que forneçam o melhor registro de informações da incidência de neutropenia, evitando sua subnotificação / The chemotherapeutic treatment of colon and rectal cancer can entail adverse effects that limit the effectiveness of the therapy and have a great impact on the final results of the treatment, where neutropenia is the most common hematological toxicity resulting from the chemotherapeutic treatment. This study was aimed to identify the occurrence of neutropenia in patients with colon and rectal cancer who underwent adjuvant chemotherapeutic treatment at the Clinical Hospital of the Ribeirão Preto Medical School, which belongs to the University of São Paulo (HCFMRP-USP), and to assess the development of febrile neutropenia (FN), according to the risk index of the Multinational Association for Supportive Care in Cancer (MASCC), in patients who had neutropenia during the chemotherapeutic treatment. This is a descriptive and retrospective study, which was performed through the review of 60 medical charts of patients diagnosed with colon and rectal cancer who underwent chemotherapeutic treatment with 5-fluorouracil, folinic acid and oxaliplatin (FLOX) and were monitored at the outpatient clinic of Coloproctology of this hospital between 2010 and 2017. We performed the assessment of the laboratory results of the chemotherapeutic treatment in patients allowable for this study on a weekly basis. The average age of participants was 63.8 years. A total of 34 patients (56.7%) were male. Most, 50, (83.3%) were white. As for marital status, 37 (61.7%) were married. The most frequent type of neoplasm was rectal adenocarcinoma, represented by 38 (63.3%) patients, followed by colon adenocarcinoma with 22 (36.7%). The most observed clinical staging were IIIb, 18 (30%) patients, followed by IVa, 16 (26.7%). We analyzed a total of 146 chemotherapeutic cycles, with an average of 2.5 cycles per patient, and 876 weeks of chemotherapeutic treatment. Of the 60 patients participants in the study, 41.7% had neutropenia at some time over the chemotherapeutic treatment. Among these 60 patients 21.6% had one episode of neutropenia, two episodes were observed in 13.3%, four episodes in 3.4%, and 3.4% of the patients developed six episodes of neutropenia. Altogether, 49 episodes of neutropenia were identified. We noted 67 delays among the treatment weeks, with an average of 5.02 days. Dose reduction was used in 30 patients, with a total of 40 cycles and 218 weeks of treatment reduced, and treatment suspension happened to 21 patients, totaling 57 treatment weeks with 27 suspension cycles. In this study, neutropenia was among the main reasons for the delays, dose reductions, and suspension of chemotherapeutic treatment. As for the risk assessment for the development of FN, 23 patients (84%) showed low risk, 2 (8%) showed high risk and 2 (8%) showed low and/or high risk concomitantly. The results of this study highlight that neutropenia in patients with colon and rectal cancer undergoing chemotherapeutic treatment has a relatively low incidence in its different stages, has low risk for the development of FN, in addition to suggesting the preparation and implementation of instruments capable of providing the best record of information on the incidence of neutropenia in health services, thus avoiding its underreporting

Foi realizado um estudo retrospectivo, por meio da revisão de 72 prontuários de mulheres com diagnóstico de câncer de mama, submetidas ao tratamento quimioterápico neoadjuvante com epirrubicina e docetaxel e no adjuvante, epirrubicina e ciclofosfamida . Os prontuários revisados foram de mulheres na faixa de 30 a 60, acompanhadas no Ambulatório de Mastologia do Departamento de Ginecologia e Obstetrícia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP) e que receberam o tratamento quimioterápico entre os anos de 2003 e 2006. Resultados: As participantes foram divididas em dois grupos, sendo um das 31 mulheres que apresentaram neutropenia e o outro das 41 que não apresentaram. A média de idade das participantes foi de 47,8 anos. Entre as toxicidades gastrointestinais durante a neoadjuvância e a adjuvância observouse a mucosite (8,4% e 2%), náusea (18,6% e 18%) e vômito (3,3% e 18%). Outra intercorrência observada foi o extravasamento durante o tratamento quimioterápico que ocorreu em 17 (23,6%) mulheres. Observou-se que 43% das mulheres apresentaram neutropenia, que analisadas entre os ciclos de quimioterapia foram estatisticamente significantes para os ciclos dois e três da neoadjuvância com valores de p de 0,0016 e 0,0009 respectivamente, para os ciclos dois e três da adjuvância com valores de p de 0.0014 e 0.0030 respectivamente, para o final do tratamento neoadjuvante, anterior ao tratamento cirúrgico sendo o p-valor=<0.0001 e para o final do tratamento adjuvante, com p-valor=<0.0004. Quanto à ocorrência de anemia, esta não esteve relacionada com a presença ou não de neutropenia, entretanto observou-se que houve uma queda nos valores de HB durante a neoadjuvância, com ligeira recuperação no período de adjuvância, porém, não houve recuperação aos valores médios anteriores ao tratamento quimioterápico. A redução da dose foi utilizada para seis mulheres em decorrência da toxicidade hematológica. Registrou-se 152 atrasos entre os ciclos de quimioterapia. Realizado o teste do Log-Rank para o tempo de tratamento e de sobrevida, concluiu-se que esta foi igual para os dois grupos de mulheres. Conclusão: Por meio dos resultados deste estudo demonstra-se a necessidade de elaboração e implementação de protocolos de cuidados de enfermagem para pacientes oncológicos com a finalidade de avaliação dos eventos adversos e manejo mais adequado dos mesmos / Method: Thais study data were collected retrospectively reviewing the chart of 72 women with breast cancer, underwent to chemotherapy for the first time, that used epirubicin and docetaxel to neoadjuvant treatment and epirubicin and ciclophosphamid to adjuvant treatment. The data collection was done with the charts of women, with 30 to 60 years, treated in 2003 to 2006 in followed in the onco-gynecology and mastology sector- Gynecology and Obstetric Department of the University of São Paulo at Ribeirão Preto Medical School Hospital das Clínicas. Results: The participants had been divided in two groups, one with 31 women who had presented neutropenia and the other with 41 that had not presented. The average of age of the participants was of 47,8 years. The gastrointestinal toxicities during the neoadjuvant and adjuvant treatment observed mucositis (8.4% and 2%), nausea (18.6% and 18%) and vomiting (3.3% and 18%). Another observed toxicity was the extravasation during the chemotherapy treatment that occurred in 17 (23.6%) women. Was observed that 43% of the women had respectively presented neutropenia, who analyzed between the chemotherapy cycles had been statistical significant for cycles two and three of the neoadjuvant with values of p = 0,0016 and 0,0009 respectively, for cycles two and three of the adjuvant with values of p =0.0014 and 0.0030. And for the end of the neoadjuvant treatment, previous treatment to the surgical treatment being p-valor=< 0,0001 and for the end of the adjuvant treatment, with p-valor=< 0.0004. To anemia occurrence, this was not related with the presence or not of neutropenia, however it was observed that had a fall in the values of HB during the neoadjuvant, with fast recovery in the period of adjuvant. However, did not have recovery to previous the average values to the chemoterapy treatment. The reduction of the dose was used for six women in result of the hematologic toxicity. Was registered 152 doses delays between the chemotherapy cycles. The Log-Rank test for the time of treatment and survival, concluded that was equal for both groups. Conclusion: Through the results of this study demonstrates the necessity of develop and implement protocols for nursing care to women with breast cancer in order to assess the adverse events and most appropriate management of them

O tratamento quimioterápico do câncer de cólon e reto pode provocar efeitos adversos que limitam a efetividade da terapia e tem grande impacto nos resultados finais do tratamento, sendo a neutropenia a toxicidade hematológica mais comum decorrente do tratamento quimioterápico. O presente estudo teve como objetivos identificar a ocorrência de neutropenia em pacientes com câncer de cólon e reto submetidos a tratamento quimioterápico adjuvante do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP) e avaliar o risco para o desenvolvimento de neutropenia febril (NF) de acordo com o índice de risco da Associação Multinacional de Cuidados de Assistência ao Câncer (MASCC), em pacientes que apresentaram neutropenia durante o tratamento quimioterápico. Trata-se de um estudo descritivo e retrospectivo, realizado por meio da revisão de 60 prontuários de pacientes com diagnóstico de câncer de cólon e reto submetidos ao tratamento quimioterápico com 5-fluorouracil, ácido folínico e oxaliplatina (FLOX), seguidos no ambulatório de Coloproctologia deste referido hospital, entre os anos de 2010 a 2017. Foi realizada a avaliação dos resultados laboratoriais a cada semana do tratamento quimioterápico nos pacientes elegíveis para este estudo. A idade média dos participantes foi de 63,8 anos. 34 pacientes (56,7%) eram do sexo masculino. A maioria 50 (83,3%) era da raça branca. Quanto ao estado civil 37 (61,7%) eram casados. O tipo de neoplasia mais frequente foi o adenocarcinoma de reto, representado por 38 (63,3%) pacientes, seguido pelo adenocarcinoma de cólon com 22 (36,7%). Os estadiamentos clínicos mais observados foram o IIIb em 18 (30%) pacientes, seguido do IVa em 16 (26,7%). Foi analisado um total de 146 ciclos de quimioterapia com uma média de 2,5 ciclos por paciente, e 876 semanas de tratamento quimioterápico. Dos 60 pacientes participantes no estudo, 41,7% apresentaram neutropenia em algum momento do tratamento quimioterápico. Entre estes 60 pacientes, 21,6% apresentaram um episódio de neutropenia, dois episódios foram observados em 13,3%, quatro episódios em 3,4% e, 3,4% dos pacientes desenvolveram seis episódios de neutropenia. No total, foram identificados 49 episódios de neutropenia. Registrou-se 67 atrasos entre as semanas de tratamento com uma média de 5,02 dias. A redução de doses foi utilizada em 30 pacientes, com um total de 40 ciclos e 218 semanas de tratamento reduzidos, e a suspensão do tratamento ocorreu em 21 pacientes, totalizando 57 semanas de tratamento com suspensão de 27 ciclos. A neutropenia neste estudo esteve entre os principais motivos para os atrasos, reduções de dose e suspensão do tratamento quimioterápico. Quanto a avaliação de risco para o desenvolvimento de NF, 23 pacientes (84%) apresentaram baixo risco, 2 (8%) apresentaram alto risco e 2 (8%) apresentaram baixo e/ou alto risco concomitantemente. Os resultados deste estudo evidenciam que a neutropenia em pacientes com câncer de cólon e reto em tratamento quimioterápico tem uma incidência relativamente baixa em seus diferentes graus, possui baixo risco para o desenvolvimento de NF, e sugere a elaboração e implantação de instrumentos nos serviços de saúde que forneçam o melhor registro de informações da incidência de neutropenia, evitando sua subnotificação / The chemotherapeutic treatment of colon and rectal cancer can entail adverse effects that limit the effectiveness of the therapy and have a great impact on the final results of the treatment, where neutropenia is the most common hematological toxicity resulting from the chemotherapeutic treatment. This study was aimed to identify the occurrence of neutropenia in patients with colon and rectal cancer who underwent adjuvant chemotherapeutic treatment at the Clinical Hospital of the Ribeirão Preto Medical School, which belongs to the University of São Paulo (HCFMRP-USP), and to assess the development of febrile neutropenia (FN), according to the risk index of the Multinational Association for Supportive Care in Cancer (MASCC), in patients who had neutropenia during the chemotherapeutic treatment. This is a descriptive and retrospective study, which was performed through the review of 60 medical charts of patients diagnosed with colon and rectal cancer who underwent chemotherapeutic treatment with 5-fluorouracil, folinic acid and oxaliplatin (FLOX) and were monitored at the outpatient clinic of Coloproctology of this hospital between 2010 and 2017. We performed the assessment of the laboratory results of the chemotherapeutic treatment in patients allowable for this study on a weekly basis. The average age of participants was 63.8 years. A total of 34 patients (56.7%) were male. Most, 50, (83.3%) were white. As for marital status, 37 (61.7%) were married. The most frequent type of neoplasm was rectal adenocarcinoma, represented by 38 (63.3%) patients, followed by colon adenocarcinoma with 22 (36.7%). The most observed clinical staging were IIIb, 18 (30%) patients, followed by IVa, 16 (26.7%). We analyzed a total of 146 chemotherapeutic cycles, with an average of 2.5 cycles per patient, and 876 weeks of chemotherapeutic treatment. Of the 60 patients participants in the study, 41.7% had neutropenia at some time over the chemotherapeutic treatment. Among these 60 patients 21.6% had one episode of neutropenia, two episodes were observed in 13.3%, four episodes in 3.4%, and 3.4% of the patients developed six episodes of neutropenia. Altogether, 49 episodes of neutropenia were identified. We noted 67 delays among the treatment weeks, with an average of 5.02 days. Dose reduction was used in 30 patients, with a total of 40 cycles and 218 weeks of treatment reduced, and treatment suspension happened to 21 patients, totaling 57 treatment weeks with 27 suspension cycles. In this study, neutropenia was among the main reasons for the delays, dose reductions, and suspension of chemotherapeutic treatment. As for the risk assessment for the development of FN, 23 patients (84%) showed low risk, 2 (8%) showed high risk and 2 (8%) showed low and/or high risk concomitantly. The results of this study highlight that neutropenia in patients with colon and rectal cancer undergoing chemotherapeutic treatment has a relatively low incidence in its different stages, has low risk for the development of FN, in addition to suggesting the preparation and implementation of instruments capable of providing the best record of information on the incidence of neutropenia in health services, thus avoiding its underreporting