Objective: To investigate the work of nurses in the extravasation of antineoplastic chemotherapeutic drugs. Methods: A cross-sectional study with a quantitative approach was performed with a sample of 21 nurses in a referral cancer hospital.Data were collected with a semi-structured questionnaire from October to November 2015 and analyzed through simple and percentage frequency. Results: Nurses had sufficient knowledge about risk factors, prevention, and recognition of signs and symptoms of occurrence of extravasation of chemotherapeutic drugs. However, the same was not observed regarding questions about classification of antineoplastic drugs and interventions aimed at the occurrence of this health condition. Conclusion:The results found are important, as they point to questions that must be reflected upon by hospital managers and educational institutions, apart from professionals concerned with the improvement of health care for the population affected by such disease.Keywords: Extravasation of therapeutic materials and diagnoses; Antineoplastic drugs; Nursing care. resumen Objetivo: Investigar la actuación de los enfermeros en la extravasación de quimioterápicos antineoplásicos. Métodos: Estudio transversal, cuantitativo, realizado en un hospital de referencia en oncología, con una muestra de 21 enfermeros. La recolección de datos se produjo entre octubre y noviembre de 2015, mediante la aplicación del cuestionario semiestructurado; analizados por frecuencia simple y percentual. Resultados: Los participantes demostraron suficiente conocimiento acerca de los factores de riesgo, la prevención y el reconocimiento de los signos y síntomas de la ocurrencia de extravasación por la quimioterapia. No fueron consultados para cuestiones relacionadas con: clasificación de los fármacos antineoplásicos e intervenciones dirigidas a la ocurrencia del agravo. Conclusión: Los resultados de este estudio son importantes y apuntan para cuestiones que deben ser reflejadas por los gerentes de hospitales y centros de formación, así como los profesionales que se preocupen con la mejoría de la asistencia a la población afectada por esta enfermedad.

RESUMOObjetivo: conhecer a atuação dos enfermeiros em serviços de radioterapia. Método: estudo com delineamento transversal, descritivo com abordagem quantitativa, desenvolvido de junho a julho de 2015. Amostra composta por oito enfermeiros. Os dados foram coletados por meio de um questionário estruturado e analisados por meio de estatística descritiva. Resultados: foi verificado que o enfermeiro não fica restrito apenas à assistência, atua na supervisão da equipe de enfermagem, monitora o processo de trabalho, elabora plano de ação, seleciona materiais e equipamentos, agenda as consultas. Além disso, foi possível observar a importância da consulta de enfermagem para a individualização do cuidado e efetivação do tratamento para o paciente. Conclusão: constata-se que para um bom andamento do serviço de radioterapia, existe a necessidade de uma equipe de enfermagem capacitada com condições de lidar com a complexidade e exigências que esta modalidade de tratamento demanda. Palavras-chave: Neoplasias; radioterapia; enfermagem; assistência de enfermagem. ABSTRACT:Objective: to ascertain nurses' role in radiotherapy services. Method: in this quantitative, descriptive, cross-sectional study, data were collected by structured questionnaire from a sample of eight nurses, from June to July 2015, and analyzed using descriptive statistics. Results: it was found that nurses are not restricted to care alone, but supervise nursing staff, monitor the work process, prepare action plans, select materials and equipment, and schedule appointments. We also observed that nursing appointments were important in individualizing care and effecting patient treatment. Conclusion: for the radiotherapy service to function properly requires a trained nursing staff in a position to deal with the complexity and demands that this type of treatment. Keywords: Nursing; neoplasms; radiotherapy; nursing care. RESUMENObjetivo: identificar el papel de las enfermeras en los servicios de radioterapia. Método: estudio con diseño transversal, descriptivo con enfoque cuantitativo, desarrollado entre junio y julio de 2015. La muestra se compone de ocho enfermeras. Los datos fueron recolectados a través de un cuestionario estructurado y analizados mediante estadística descriptiva. Resultados: se encontró que el enfermero no se limita sólo a la asistencia, trabaja en la supervisión del personal de enfermería, supervisa el proceso de trabajo, elabora un plan de acción, selecciona materiales y equipos, programa citas. Además, se observó la importancia de la consulta de enfermería para la individualización de la atención y el tratamiento eficaz para el paciente. Conclusión: Se observa que, para una buena marcha del servicio de radioterapia, se necesita un personal de enfermería capacitado que pueda hacer frente a la complejidad y exigencias que este tipo de tratamiento pide.

No abstract

2636 Background: With the advancements of immunotherapy procedures and, more specifically, immunological checkpoint inhibitors (ICIs), the scenario of cancer treatment, whether in its early or advanced stages, have changed. With the expansion of ICIs usage, cardiovascular toxicities have been reported, but more robust data are needed to guide the follow-up of patients and toxicity prevention. Methods: This research is a single-centered, prospective observational cohort study that evaluated patients treated with ICIs regardless of indication, with or without chemotherapy combination. Patients underwent echocardiography evaluation with global longitudinal strain (GLS) and myocardial work, electrocardiogram, and collection of biomarkers before the start of treatment, in the second month after treatment started, and every 3 months, subsequently. Evaluations stopped once treatment completed one year, or the medication was discontinued either due to toxicity or disease progression. Cardiotoxicity (CT) was defined by ≥ 10% reduction in left ventricular ejection fraction (LVEF) by less than 50%, troponin elevation by ≥ 0,30 ng/ml, or reduction in relative GLS by ≥ 15%. Frequencies were compared using Fisher's comparative test, as appropriate, and Mann-Whitney test for numerical variables. Statistical significance will be considered as p < 0.05 for two-tailed tests. Results: Outof the 98 patients scheduled for treatment, 39 patients underwent at least 2 evaluations and had their exams analyzed. There was a 26% incidence of overall CT, with half of these patients by LVEF reduction criteria and, considering only patients with lung cancer, there was an incidence of 35% with CT. Dividing the total sample into CT and non-CT groups, a higher number of men, smokers and patients with lung cancer was observed, as well as a lower LVEF baseline (67% vs 62.50, p = 0.014) in the CT group. Concomitant chemotherapy or higher baseline coronary calcium scores did not appear to increase the risk of CT among patients, but the use of beta-blockers was restricted to patients who did not develop an event. There was a reduction in myocardial work parameters in the 2nd month assessment: global index (GWI) 1833 vs 2334, p = 0.006, constructive work (GCW) 2299 vs 2683, p = 0.040, and work efficiency (GWE) 83 vs 95, p = 0.025 and tendency towards increased myocardial work loss (GWW) 286 vs 116, p = 0.064, in the comparison between groups. Those who met CT criteria had a longer overall survival, as did those who developed other immune-mediated adverse events and metformin users. Conclusions: This was the first study that carried out cardiotoxicity surveillance in patients undergoing immunotherapy, with a surprising finding of events in a small but high-risk sample. The development of immune-mediated toxicities seems to be related with therapeutic response. Also, the use of metformin seems to contribute to this response, as already demonstrated in preclinical studies.

e14604 Background: The rise of Immune Checkpoint Inhibitors (ICI) as a cancer treatment has been followed by the increase of cardiotoxicity events reports. Retrospective studies with anthracycline revealed a relationship between increased myocardial 18F-FDG uptake (MGU) and a slight drop in Left Ventricular Ejection Fraction (LVEF) values, suggesting that this may be a useful tool for early detection of cardiotoxicity. Our study is intended to evaluate the prognostic impact of the variation in MGU in advanced lung cancer undergoing treatment with ICI. Methods: This is a unicentric, retrospective study, that evaluated lung cancer patients treated with ICI from 2016 to 2020 and submitted to at least two positron emission tomography (PET-CT). The primary objective was to evaluate the MGU variation during ICI treatment (ΔSUV) and its impact on survival outcomes. Numerical variables are described using a median and interquartile range. Categorical variables are described using absolute and relative frequencies. Mann-Whitney test was applied to compare the median between groups. progression-free survival and overall survival were calculated using the Kaplan-Meier method and the Log Rank test was used to compare survival curves. Alpha level = 0.05. Results: 43 patients fulfilled all inclusion criteria. 51% received Immunotherapy plus chemotherapy and 49% received only immunotherapy. Global median ΔSUV was +0.14; among patients in the disease control group, the median ΔSUV was +0.3, while the median ΔSUV of the disease progression group was -0.47. Considering patients with positive myocardial ΔSUV versus negative ΔSUV, there was a median increase of progression-free survival (PFS) of 112 days in favour of the positive myocardial ΔSUV group (p = 0.087). The overall survival (OS) of patients that used beta-blockers(BB) was higher than those who did not, with an increase of 575 days on median OS (p = 0.159). The increase in the PFS median by 112 days on those patients who presented a positive ΔSUV may suggest that better treatment outcomes are related to the rise of myocardial SUV, although the sample size was not sufficient to reach statistical significance. Another important association, albeit not statistically significant, was the growth of PFS mean by 575 days with the usage of BB, such growth was not evidenced on the patients which used ACE inhibitors or ARBs; indicating that BB could have a supporting role on ICI treatment. Those findings correlate to recent evidence that shows an increase in MGU after BB usage and that BB may work as immune-modulating agents improving ICI therapies. Conclusions: The increase in MGU was associated with better outcomes, suggesting that it could be studied as a predictor of treatment response, in addition to the benefit also shown with the use of BB, which strengthens their possible synergistic effect in treatment. However, more robust studies are needed to better understand the MGU role on ICI treatment.