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Vol. 12. Issue 5.
Pages 545-561 (September - October 2006)
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Vol. 12. Issue 5.
Pages 545-561 (September - October 2006)
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Cancro do pulmão na mulher: Uma entidade diferente?
Lung cancer in women: A different entity?
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Renato Sotto-Mayor2
2 Chefe de Serviço de Pneumologia. Coordenador do Serviço de Pneumologia do Hospital de Santa Maria, Lisboa. Assistente Convidado da Faculdade de Medicina de Lisboa. Portugal
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Resumo

Nos países desenvolvidos, o cancro do pulmão tem vindo a tornar-se uma verdadeira epidemia e uma das principais causas de morte por neoplasias malignas na mulher.

Embora controverso, é provável que a mulher apresente maior susceptibilidade para o cancro do pulmão do que o homem, estando a decorrer estudos de epidemiologia molecular e genética para a comprovar. Apontam-se especificidades no que se refere à biologia, à história natural, à histopatologia, à resposta à terapêutica e ao prognóstico do cancro do pulmão na mulher, factos ainda não completamente esclarecidos e, em alguns aspectos, não consensuais, havendo necessidade de se implementarem estudos prospectivos alargados para comparação dessas diferenças entre os dois sexos.

Até à data, na prática clínica, só existe uma área em que o determinante sexo poderá ser um factor a con siderar no manejo terapêutico do cancro do pulmão, que diz respeito ao valor do gefitinib e do erlotinib na inibição dos receptores dos factores de crescimento epidermóide, em que estes produtos são claramente mais benéficos em mulheres não fumadoras.

Dado o melhor prognóstico do cancro do pulmão nas mulheres, é recomendado que os futuros protocolos de investigação terapêutica incluam uma estratificação em função do sexo.

Na mulher, tal como no homem, a prevenção do cancro do pulmão é uma medida de saúde pública prioritária, tendo como objectivo obrigatório a luta contra o tabaco, o seu factor etiológico major.

Palavras-chave:
Cancro do pulmão
epidemiologia
biologia molecular
mulher
Abstract

Lung cancer is becoming a real epidemic in developed countries and one of the main causes of cancer death in women.

Although it is controversial to state, it is probable that women are more susceptible to lung cancer than men. Molecular and genetic epidemiology studies are underway to prove this statement.

Several biological factors, such as family history, histopathology, response to treatment and the prognosis for lung cancer in women have a bearing on the case. While these are not completely clear or consensual, there is a need for wide-ranging prospective studies which compare the differences between males and females.

Until now, there has only been one area in which gender could impact on the therapeutic management of lung cancer: the role of gefitinib and erlotinib in inhibiting the epidermal growth factor receptors, since these products are clearly of more benefit to female non-smokers.

Given that women have a better lung cancer prognosis, it is recommended that future research protocols include stratification on gender.

Prevention of lung cancer in both women and men is a priority public health concern. A mandatory aim of this is the fight against smoking, the largest aetiological factor of lung cancer

Key-words:
Lung cancer
epidemiology
molecular biology
women
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Texto apresentado em parte no “39.° Curso de Pneumologia para Pós-Graduados” (Universidade Católica, Lisboa, Março de 2006), na sessão “Cancro do pulmão na mulher”.

Copyright © 2006. Sociedade Portuguesa de Pneumologia
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