Geographic Distribution of Childhood Cancer in Brazil and the Time between the Diagnosis and the Start of Treatment: An Analysis of Hospital-Based Cancer Registries, 2010-2016

Objective: To analyze the distribution of childhood cancer in Brazil and the time between the diagnosis and the start of treatment, according to hospital-based cancer registries (2010-2016). Material and Methods: This was an observational descriptive study using secondary data (36,187 records) from hospital databases of the National Cancer Institute (INCA) and the Onco-center Foundation of São Paulo (FOSP). Epidemiological data were obtained, and compliance with Federal Law 12,732/12 was verified, which establishes a maximum period of 60 days to start cancer therapy after the diagnosis. Absolute and percent frequencies, central tendency and dispersion measures, and the coefficient of prevalence of childhood cancer were calculated. Results: The mean age of the pediatric patients was 9.3 years (± 6.2); 54.1% (n=19,586) of them were males; 32.0% (n=11,440) were aged 0 to 4 years; and 43.4% (n=11,338) had a self-reported mixed-race skin color. The Southeast region of Brazil accounted for 40.2% (n=14,564) of the cases, of which 63.0% (n=9,178) corresponded to solid neoplasms, as opposed to the North region, where hematological neoplasms prevailed (53.9%, n=1,535). Most registered patients aged 0 to 19 years were treated in 60 days or less (77%, n=27,929). However, for 24.0% (n = 2,207) of adolescents (15 to 19 years) this time was more than 60 days after the diagnosis. Conclusion: The characteristics related to childhood cancer varied across the Brazilian geographic regions, and most patients were properly treated within the time enforced by law

Characterization of childhood cancer in Brazil from the hospital-based cancer registries, 2000-2016 / Caracterização do câncer infantojuvenil no Brasil a partir dos Registros Hospitalares de Câncer (RHC), 2000-2016

Objective: To characterize childhood cancer in Brazil, based on the national and regional investigation of hospital-based cancer registrie, from 2000 to 2016. Methods: Observational, retrospective and secondary-based study, with a sample of 71,925 records containing information of children and adolescents (0 to 19 years old). Results: Childhood cancer was more frequent in males (54.3%), among children aged 0 to 4 years (31.1%), with brown skin color (40.4%), and residents of the region Northeast (59.7%). Leukemias, myeloproliferative diseases and myelodysplastic diseases (28.8%) were the most relevant pathologies. There was a predominance of solid tumors (58.5) and chemotherapy was the most commonly administered therapy at the beginning of treatment (48.7%). It was noticed that 78.6% of the individuals started the treatment within 60 days after diagnostic confirmation. Conclusion: It was possible to know the demographic, clinical and care profile of children and adolescents with cancer in Brazil, and by region.Objetivo: Caracterizar el cáncer infantil en Brasil, con base en la investigación nacional y regional de registros hospitalarios de cáncer (RHC), de 2000 a 2016. Métodos: Estudio observacional, retrospectivo y secundario, con una muestra de 71,925 registros que contienen información de niños. y adolescentes (0 a 19 años). Resultados: El cáncer infantil fue más frecuente en hombres (54,3%), entre niños de 0 a 4 años (31,1%), con piel morena (40,4%) y residentes de la región Nordeste (59,7%). Las leucemias, las enfermedades mieloproliferativas y las enfermedades mielodisplásicas (28,8%) fueron las patologías más relevantes. Hubo predominio de los tumores sólidos (58,5) y la quimioterapia fue la terapia más administrada al inicio del tratamiento (48,7%). Se observó que el 78,6% de los individuos inició el tratamiento dentro de los 60 días posteriores a la confirmación del diagnóstico. Conclusión: fue posible conocer el perfil demográfico, clínico y de atención de niños y adolescentes con cáncer en Brasil y por región.Objetivo: caracterizar o câncer infantojuvenil no Brasil, a partir da investigação nacional e regional dos registros hospitalares de câncer (RHC), no período de 2000 a 2016. Métodos: estudo observacional, retrospectivo e de base secundária, com amostra de 71.925 registros contendo informações de crianças e adolescentes (0 a 19 anos). Resultados: o câncer infantojuvenil foi mais frequente no sexo masculino (54,3%), entre crianças de 0 e 4 anos de idade (31,1%), com cor de pele parda (40,4%), e residentes da região Nordeste (59,7%). As leucemias, doenças mieloproliferativas e doenças mielodisplásicas (28,8%) foram as patologias mais relevantes. Houve predominância dos tumores sólidos (58,5) e a quimioterapia foi a terapêutica mais administrada no início do tratamento (48,7%). Percebeu-se que 78,6% dos indivíduos iniciaram o tratamento até 60 dias após comprovação diagnóstica. Conclusão: foi possível conhecer o perfil demográfico, clínico e assistencial das crianças e adolescentes com câncer no Brasil, e por regiões.

Impact of COVID-19 on Oral Healthcare for Oncopediatric Patients: The Setting in a Reference Hospital in Northeast Brazil

Objective: To describe the impact of the COVID-19 pandemic on dental care provided to pediatric cancer patients assisted in a referral hospital. Material and Methods: This is an observational, retrospective study based on secondary data extracted from worksheets of dental procedures for patients aged between 0 and 19 years assisted in the pediatric oncology sector of a hospital in João Pessoa, PB, Brazil. Dental procedures performed by the interdisciplinary team of researchers from August 2018 to February 2020 (19 months prior to the pandemic) and from April 2020 to October 2021 (19 months during the pandemic) were totaled and compared. A descriptive analysis of the data was performed. Results: There was a reduction of 80.2% in dental interventions implemented in the sector during the pandemic, with the number of procedures decreasing from 6,210 (the period before the pandemic) to 1,229 (during the pandemic). Most procedures in both periods were performed for patients assisted in beds, for whom there was a reduction of care provided for 81.2% from 5,275 to 994 procedures. Dental procedures in the outpatient clinic decreased by 74.9%, from 935 to 235. Conclusion: The COVID-19 pandemic negatively impacted dental care provided to pediatric oncology patients by restricting dental procedures to emergency demands, compromising performance prevention and health promotion actions

Associação entre alterações motoras e mucosite oral em crianças e adolescentes com câncer

The antineoplastic treatment can cause adverse effects that affect the physical and psychosocial well-being, besides limiting the day to day of the child, thus compromising the motor activities. Other changes observed three times more in children than in adults are complications of the oral cavity, such as oral mucositis. The objective of the study was to associate the motor alterations and oral mucositis of children and adolescents with cancer, who underwent antineoplastic treatment at the Hospital Napoleão Laureano, in the city of João Pessoa - PB. It is an observational, cross-sectional and analytical study, carried out from April to September 2017, with a sample of 70 children and adolescents aged 2 to 19 years. A semi-structured questionnaire was used, as well as the Oral Assessment Guide (OAG), and domains of the International Classification of Functioning Disability and Health (CIF), with clinical data collected by a calibrated examiner (Kappa> 0.75). Logistic regression was performed by the backward method, adopting a significance level of 5%. Oncopediatrous patients presented a predominance of males (54.3%, n = 38), with a mean of 10.9 years, prevalence of self-reported brown color (52.9%; n = 37); (68.6%, n = 48), and with monthly family income of up to 2 minimum wages (87.1%, n = 61). The majority of children and adolescents presented haematological type neoplasia (51.4%, n = 36), and (30.0%; 21) had a diagnosis of acute lymphoid leukemia. As for solid tumors (48.6%; n = 34), the highest prevalence was Osteosarcoma (14.3%; n = 10). Regarding the most widely used antineoplastic treatment, chemotherapy was the most cited (42.9%; n = 30). The presence of oral mucositis (31.4%; n = 22), and the predominance of mild impairment in walking ability (30.0%; n = 21) and dislocation (28.6%; = 20), as well as a mild and severe impairment in the health care capacity (25.7%; n = 18). The chance of developing oral mucositis was associated with primary education (OR = 4.6, [2.9171, 6.2255]), hematological tumor (OR = 5.4, [-1.2202, 1.5868]), severe difficulty in maintaining (OR = 9.9, [8.1778, 11.8044]) and severe difficulty in walking ability (OR = 26.8, [23.1818, 29.6235]). The study reveals that motor changes may influence the development of oral mucositis.NenhumaO tratamento antineoplásico pode provocar efeitos adversos que afetam o bem-estar físico e psicossocial, além de limitar o dia a dia da criança, comprometendo, assim, as atividades motoras. Outras alterações observadas três vezes mais em crianças que em adultos são as complicações da cavidade bucal, a exemplo da mucosite oral. O objetivo do estudo foi associar as alterações motoras e a mucosite oral de crianças e adolescentes com câncer, submetidos ao tratamento antineoplásico no Hospital Napoleão Laureano, no município de João Pessoa – PB. Trata-se de um estudo observacional, transversal e analítico, realizado no período de abril a setembro de 2017, com uma amostra composta de 70 crianças e adolescentes de 2 a 19 anos. Utilizou-se um questionário semiestruturado, assim como o Oral Assessment Guide (OAG), e domínios da Classificação Internacional de Funcionalidade Incapacidade e Saúde (CIF), sendo os dados clínicos coletados por um examinador calibrado (Kappa>0,75). Foi realizado a Regressão Logística pelo método de backward, adotando-se um nível de significância de 5%. Os pacientes oncopediátricos apresentam predominância do sexo masculino (54,3%; n=38), com uma média de 10,9 anos, prevalência de cor autorreferida parda (52,9%; n=37); cursando ensino fundamental (68,6%; n=48), e com renda familiar mensal de até 2 salários mínimos (87,1%; n=61). A maioria das crianças e adolescentes apresentaram neoplasia do tipo hematológica (51,4%; n=36), sendo (30,0%; 21) com diagnóstico de Leucemia Linfoide Aguda. Quanto aos tumores sólidos (48,6%; n=34), a maior prevalência foi de Osteossarcoma (14,3%; n=10). Em relação ao tratamento antineoplásico mais utilizado, a quimioterapia foi o mais citado (42,9%; n=30). Verificou-se a presença de mucosite oral (31,4%; n=22), e a predominância de comprometimentos leve na capacidade de andar (30,0%; n=21) e deslocar-se (28,6%; n=20), assim como comprometimento leve e grave na capacidade de cuidados da própria saúde (25,7%; n=18). A chance de desenvolver a mucosite oral esteve associado ao ensino fundamental (OR=4,6; [2.9171; 6.2255]), tumor hematológico (OR=5,4; [-1.2202; 1.5868]), dificuldade grave na capacidade de manter a posição do corpo (OR= 9,9; [8.1778; 11.8044]) e dificuldade grave na capacidade de andar (OR=26,8; [23.1818;29.6235]). O estudo revela que as alterações motoras podem influenciar no desenvolvimento da mucosite oral

Impactos da Pandemia da Covid-19 na Qualidade de Vida no Trabalho dos Gestores do IFPB, campus João Pessoa, em Atividades Home Office

O objetivo do estudo foi analisar os impactos da pandemia da covid-19 na Qualidade de Vida no Trabalho (QVT) dos gestores do Instituto Federal de Educação, Ciência e Tecnologia da Paraíba (IFPB), campus João Pessoa, em atividades home office. Tratou-se de estudo de caso aplicado, exploratório-descritivo, com amostra (n=39) não probabilística, selecionada por acessibilidade e conveniência. Os dados foram coletados por meio de envio de questionário eletrônico, tratados e analisados por meio da estatística descritiva. Houve predominância do sexo masculino (53,8%), com faixa etária entre 30 e 39 anos (43,6%), doutores (33%) e com função gratificada (61,5%). As percepções dos gestores – quanto aos aspectos organizacionais, ambientais e comportamentais na QVT em home office no contexto pandêmico – foram positivas em sua maioria, porém que exigem a melhoria no cotidiano organizacional

Severe Oral Mucositis in Pediatric Cancer Patients: Survival Analysis and Predictive Factors

This paper investigates the occurrence of severe oral mucositis and associated factors in blood and solid cancer pediatric patients subjected to cancer treatment, using a survival analysis. A longitudinal, descriptive, observational and inductive study of 142 pediatric patients aged from 0 to 19 years was conducted from 2013 to 2017. Data were collected using a form to record the sociodemographic characteristics and health-related aspects of patients and the modified Oral Assessment Guide (OAG). Survival analysis was performed using the Kaplan–Meier method and Cox semiparametric model. The median times to occurrence of severe oral mucositis were 35.3 and 77.1 days for patients with hematologic malignancies and solid tumors, respectively. The Cox model showed that white cell changes and platelet counts as well as the use of natural chemotherapeutic agents are risk factors for the occurrence of oral mucositis among patients with hematologic malignancies. Nonetheless, among patients with solid tumors, the occurrence of oral mucositis was associated with female sex, mixed ethnicity, the presence of metastasis, abnormal creatinine levels, a combination of chemotherapy, radiotherapy, and surgery, and the administration of chemotherapeutic agents included in the miscellaneous group. The time to occurrence of severe oral mucositis and its associated factors varied according to cancer type

Factors Contributing to the Duration of Chemotherapy-Induced Severe Oral Mucositis in Oncopediatric Patients

This study analyzes the factors contributing to the duration of severe oral mucositis in oncopediatric patients. A longitudinal study was conducted in the pediatric department of a cancer referral hospital between 2013 and 2017. Seventy-three patients diagnosed with cancer undergoing chemotherapy protocols were analyzed. Oral evaluations were performed using the Modified Oral Assessment Guide criteria, and the data were collected from the patients’ records. The Kaplan-Meier method was used to estimate survival curves. Most patients were males (52.1%), of mixed race (“pardo”) (49.3%), with a mean age of 7.56 years (±5.34). There was a predominance of patients diagnosed with solid tumors (52.1%), with no metastasis (86.3%), using natural product chemotherapeutics (56.2%), who had not undergone a bone marrow transplant (97.3%); amputation was observed in 35.6% of patients, while death rates were as high as 8.2%. The survival analysis estimated a mean time of 30.6 days until complete remission of severe oral mucositis. The regression analysis showed that patients over 10 years old had a median mucositis duration 1.4 times greater than those at the age of 10 years or younger. Patients without metastasis had a median mucositis duration 1.7 times greater than those with metastasis (p-value ≤ 0.10). Increasing age and the absence of metastasis were conditions that prolonged the duration of severe oral mucositis