Respiratory Function Tests Clinical Trial
Official title:
Study of Maximal Respiratory Pressures After Exposure to Breast Radiotherapy in Women
Objective: The purpose of this research was to study the Maximal Respiratory Pressures (MRP) after exposure to breast radiation therapy in women. Methods: Prospective observational study performed at the Hospital de cancer Alfred in Campo Grande/MS. The sample of this study consisted of women (N = 16) divided into two groups: women exposed to breast radiotherapy after underwent quadrantectomy surgery (n = 8); and women with no history of cancer (n = 8). We evaluated the strength of respiratory muscles through the Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) using the handset called manovacuometer. The examination was performed before the first session and after the twenty-fifth session related to the last day of the radiation treatment; evaluation of anthropometric data of weight and height to detect the body mass index (BMI); evaluation of clinical respiratory symptoms of dyspnea using the Medical Research Council (MRC) Dyspnea Scale and characterization of cough with Common Pulmonary Toxicity Criteria, in the classification of clinical pneumonitis.
Study design and sample The research consisted of an observational prospective study with
control group. The study was approved by the Ethics Committee of the Federal University of
Mato Grosso do Sul (UFMS) with the number 46913415.7.0000.002. All participants signed an
informed consent form after being informed about the design and objectives of the study
according to Resolution 466/12 of the National Council of Health Ministry of Health (CNS).
The quadrantectomy group participants were selected consecutively among patients who
initiated radiotherapy. While the control group was selected during routine exams of he
image sector from Hospital de Cancer Alfred Abrão.
Research site The execution of the research took place in the Radiotherapy sector of
Hospital de Cancer Alfred Abrão in Campo Grande - Mato Grosso do Sul state, from December
2015 to February 2016.
Radiotherapy Protocol The Quadrantectomy Group sample performed adjuvant radiotherapy with a
linear accelerator, whose the total dosage was 5000 centigray (cGy), the daily dose 200 cGy
distributed into twenty-five sessions, totaling 25 days of treatment.
PROCEDURES Evaluation of maximal respiratory pressures (MRP) Quantification of MIP and MEP
was performed with the portable device called manometer, Wika brand with pressure scale
ranging from -150 to 150 centimeters of water (0 to -150 to (0 to -150 for MIP; 0 to 150 for
MEP). The mouthpiece attached to the device had a hole of 2 mm in diameter, in order to
function as a relief valve of the facial muscles. During the measurement of maximal
respiratory pressures, the survey participants remained in seated position with the trunk in
a 90 ° angle with the lower limbs. A forced expiration was requested until reaching the
residual volume (RV) for the measurement of MIP, followed by a maximal inspiratory effort
against the occluded airway (Maneuver Muller), this maneuver kept for up to 2 seconds. While
the evaluation of MEP, a maximum inspiration was requested to Total Lung Capacity (TLC),
followed by a maximal expiratory effort against the occluded airway (Muller maneuver),
maintained for up to 2 seconds.
Data from Maximal Respiratory Pressures were collected at two phases in the sample of
quadrantectomy group: before the first session of radiotherapy and after the twenty-fifth
session corresponding to the last day of the radiotherapy treatment.
The evaluation of the MRP was performed according to the Brazilian Guidelines for Pulmonary
Function Tests. The results were analyzed according to the predictive values of Neder
regression equations (1999).
Complementary evaluation Anthropometric data evaluated to detect the body mass index (BMI)
were: weight and height. Evaluation of dyspnea and cough symptoms with modified Dyspnea
Medical Research Council scale (MRC) with the Common Pulmonary Toxicity Common Criteria
scale (CTC Version 2.0) was performed to classify the clinic pneumonitis according to the
Common Toxicity Criteria (CTC Version 2.0).
Statistics The variables classified as dependent were the maximal respiratory pressures.
While the independent variables were sex, age, weight, height, BMI.
The comparison data analysis between the control group and quadrantectomy in relation to the
variables: age, height, weight, BMI, MIP and MEP, was performed using the student's t test.
The comparison between the moments before and after the radiotherapy in relation to MIP and
MEP was performed using the student's t test paired, considering a 5% significance level.
The other results of this study were presented in the form of descriptive statistics or in
tables and graphics. Statistical analysis was performed using the sigma plot version 12.5
statistical program.
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Observational Model: Cohort, Time Perspective: Prospective
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