TOXICIDADE MULTISSISTÊMICA DE TERAPIAS CONTRA O CÂNCER: INTERAÇÕES ENTRE AS VIAS CARDÍACA, RENAL E METABÓLICA
DOI:
https://doi.org/10.56238/levv16n53-094Palavras-chave:
Cardio-oncologia, Nefrotoxicidade, Desregulação Metabólica, Terapia do CâncerResumo
Introdução: O crescente sucesso das terapias oncológicas redefiniu o câncer como uma doença crônica, mas esses avanços são cada vez mais acompanhados por complicações cardiovasculares, renais e metabólicas que ameaçam a sobrevida e a qualidade de vida a longo prazo. A interação entre esses sistemas cria um cenário clínico complexo, no qual a lesão em um órgão frequentemente amplifica a disfunção em outros.
Objetivo: Analisar os mecanismos, as manifestações clínicas e as estratégias diagnósticas associadas à toxicidade multissistêmica das terapias contra o câncer, com foco na interconexão entre alterações cardíacas, renais e metabólicas e nas implicações para o manejo integrado.
Métodos: Uma revisão sistemática narrativa foi realizada por meio de buscas no PubMed, Scopus, Web of Science, Biblioteca Cochrane e Google Acadêmico, incluindo estudos publicados entre 2015 e 2025 que investigaram os efeitos colaterais cardiotóxicos, nefrotóxicos ou metabólicos da quimioterapia, terapia direcionada e imunoterapia.
Resultados e Discussão: Antraciclinas, inibidores de HER2, inibidores de tirosina quinase e inibidores de checkpoint imunológico continuam sendo os agentes mais frequentemente associados à disfunção cardiovascular, enquanto cisplatina, ifosfamida e inibidores de VEGF são proeminentes na lesão renal. Complicações metabólicas, como resistência à insulina, dislipidemia e obesidade sarcopênica, têm sido cada vez mais reconhecidas como sequelas interconectadas. Estudos recentes demonstram que biomarcadores e exames de imagem multimodal facilitam a detecção precoce, enquanto o tratamento multidisciplinar — combinando cardio-oncologia, nefrologia e endocrinologia — reduz desfechos adversos.
Conclusão: A toxicidade multissistêmica dos tratamentos oncológicos constitui um grande desafio para a oncologia contemporânea. Uma abordagem integrada é essencial para manter a eficácia terapêutica, minimizando os danos aos órgãos e preservando a longevidade e o bem-estar do paciente.
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