Terapêutica da hipercalcemia em neoplasias sólidas - Análise retrospectiva num serviço de Medicina Interna
Keywords:
therapy of hypercalcemia, solid neoplasmsAbstract
The authors present a retrospective study on the therapy of hypercalcemia used in patients with solid neoplasms, hospitalized in Medicine II Service of HUC. 171 patients were submitted to study, 45 (26,3%) of which had hypercalcemia ( calcium :::,_10,4 mg/ d ajter correction by albuminemia). ln the cases were analised used therapies, optional criterions (level of calcemia, symptomatology, bone metastization), obtained response and relati on with the therapy of the solid neoplasm. From the obtained results they underline: A) The therapi es used were: hydratation only (n = 27) and associ ated with drugs (n = 18), include always furosemide), {corticoids ( n = 6), calcitonin ( n = 9), bisphos phonates (n = 12)}. B) ln the 10 patients with se rious hypercalcemia (:::,_ 13 mgldl) all made thera peutic associations, while only 6 ofthe 29 with slight hypercalcemia (:::,_ 10,4 - 11,5 mgldl) used them ln the patients with serious symptoms (n = 14) at tributed to hypercalcemia, only 7 made associati ons beyond hydration. ln the patients with documented bone metastization ( n = 15) predominated the use of calcitonin or bisphosphonates. C) The regression of the symptomatology was more considerable in the group that used bisphosphonates. ln the patients subjected to the therapy, there was temporary control of calcemia, more relevant with various drugs in association. ln a third of the patients that used bisphosphonates or calcitonin there was an ease of pain. D) The death rate in hospitalization and delay was about twice more than the total of the hospitalized patients.
Conclusions: 1) Significant predominance of the metabolic disturbance (26%) in the solid neoplasms.
2) The hypercalcemia was valorized being subjected to the therapeutic measures besides the hydration 40% of the patients. 3) The therapeuic option was more specifically based on the leveis of calcemia rather than on the symptoms, and the bone metastization influenced the use of calcitonin and bisphosphonates. 4) The symptomatic improvement in a significant number of patients and the tempo rary control of the leveis of calcium, are factors which improved the quality of life of these patients, counter balacing them until measures of basis are adopted, what occurred in a third ofthe cases.
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