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Previous issue date: 2014-02-26 / O c?ncer tem contribu?do drasticamente em termos de morbidade, mortalidade e custos para
os sistemas de sa?de no mundo. O manejo desses pacientes ? complexo e novas tecnologias
t?m emergido para o seu melhor cuidado. A tomografia por emiss?o de p?sitrons associada ?
tomografia computadorizada (PET/CT) ? um m?todo diagn?stico dispon?vel mais
recentemente no Brasil e determinou uma mudan?a de paradigma no fluxo do
acompanhamento para muitos dos pacientes com c?ncer. Nesse sentido, o objetivo desse
trabalho ? avaliar o acesso ao exame 18F-FDG PET/CT Oncol?gico no Estado do Rio Grande
do Norte, segundo as caracter?sticas dos usu?rios, as indica??es e as fontes de financiamento
do m?todo. Trata-se de um estudo individuado, observacional e transversal. Foram inclu?dos
todos os pacientes que realizaram o exame 18F-FDG PET/CT com fins oncol?gicos na Liga
Norteriograndense Contra o C?ncer no per?odo de 01/05/2011 a 30/04/2013. Coletaram-se
dados relativos ? data de realiza??o do exame, sexo, idade, indica??o (diagn?stico /
estadiamento / monitoriza??o da resposta ao tratamento / reestadiamento / suspeita de recidiva
e controle), tipo de c?ncer ou condi??o que determinou a realiza??o do exame e a fonte de
financiamento (p?blico ou particular). Nos dois anos que compreenderam o per?odo de coleta
de dados do estudo, foram realizados 924 exames 18F-FDG PET/CT, em 718 pacientes. A
m?dia de idade foi 51,4 (19,1) anos, variando entre 4 e 88 anos. Houve maior realiza??o do
exame entre as mulheres, com um total de 539 exames (58,3%). Observou-se aumento da
realiza??o do exame do primeiro ano (37,4%) para o segundo ano (62,6%). Quanto ?s
indica??es do exame 18F-FDG PET/CT, foram realizados 3,8% com fins de diagn?stico, 6,6%
para estadiamento, 1,0% para monitoriza??o da resposta ao tratamento, 49,8% para
reestadiamento e 38,9% na suspeita de recidiva/controle, ou seja, apenas 10,4% dos exames
foram realizados como estrat?gia inicial (diagn?stico e estadiamento). Em rela??o ao
financiamento do 18F-FDG PET/CT, a maioria dos exames foi realizada com o conv?nio
firmado com a Secretaria de Estado de Sa?de P?blica (45% dos exames). Os principais tipos
de c?ncer encaminhados para o exame foram o linfoma (36,7%), c?ncer colorretal (10,6%),
pulm?o (9,7%) e mama (8,5%). Foram realizados poucos exames PET/CT em alguns tipos de
c?ncer, em especial es?fago (0,4%), p?ncreas (0,9%), est?mago (1,2%) e cabe?a e pesco?o
(2,1%). De todos os exames em pacientes classificados como estrat?gia inicial, apenas 21%
tiveram acesso ao exame pelo sistema p?blico, o que denota a pouca realiza??o do 18F-FDG PET/CT Oncol?gico no estado para esse fim. Para os sistemas de sa?de, ? fundamental
promover o uso racional desse m?todo / Cancer has contributed dramatically in terms of morbidity, mortality and costs for healthcare
systems in the world. The management of these patients is complex and new technologies
have emerged for their best care. Positron emission tomography associated with computed
tomography (PET/CT) is a diagnostic method available more recently in Brazil and led to a
paradigm shift in the management for many cancer patients. Therefore, the aim of this study
is to analyse the access to the exam 18F-FDG PET/CT in Oncology in the State of Rio
Grande do Norte, according to the users characteristics, indications and sources of funding.
This is an individual, observational and transversal study. All patients who underwent 18FFDG
PET-CT examinations for oncologic purposes at Liga Norteriograndense contra o
C?ncer from 01/05/2011 to 30/04/2013 were included. Data on the date of the examination,
sex, age, indication (diagnosis / staging / monitoring response to treatment / restaging /
suspected recurrence and control), type of cancer or condition that determined the exam and
the source financing (public or private) were collected. During the two years that comprised
the period of data collection for the study, 924 18F-FDG PET/CT exams were performed in
718 patients. The mean age was 51.4 (19.1) years, ranging from 4 to 88 years. There were
more exams among women with a total of 539 examinations (58.3%). Increases were
observed in the exams from the first year (37.4%) for the second year (62.6%). Accordingly,
the 18F-FDG PET/CT indications were: 3.8% for diagnostic purposes, 6.6% for staging, 1.0%
for monitoring response to treatment, 49.8% for restaging and 38.9% in suspected
recurrence/control, only 10.4% of the exams were performed as initial strategy (diagnosis and
staging). Regarding the financing of 18F-FDG PET/CT, the majority of tests were carried out
with the agreement signed with the State Department of Public Health (45% of the exams).
The main types of cancer referred for examination were lymphoma (36.7%), colorectal cancer
(10.6%), lung (9.7%) and breast (8.5%). Few PET/CT studies were performed in some
cancers, especially oesophagus (0.4%), pancreas (0.9%), stomach (1.2%) and head and neck
(2.1%). Among those patients classified as initial strategy, only 21% had access to the exam
by the public system, which demonstrates the low access of 18F-FDG PET/CT in Oncology
in the state for this purpose. For health systems, it is essential to promote the rational use of
this method.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/19743 |
| Date | 26 February 2014 |
| Creators | Mosmann, Marcos Pretto |
| Contributors | 50337157472, http://lattes.cnpq.br/5835673385014578, Souza, Dyego Leandro Bezerra de, 00902557475, http://lattes.cnpq.br/9953301230987878, Godoy, Gustavo Pina, 85762997472, http://lattes.cnpq.br/5655149996985928, Lima, Kenio Costa de |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM SA?DE COLETIVA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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