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foi usado para quantificar o estado nutricional dos doentes&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> O PG-SGA permite uma classifica&#231;&#227;o global em desnutri&#231;&#227;o moderada&#44; desnutri&#231;&#227;o grave ou sem desnutri&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> O <span class="elsevierStyleItalic">scored</span> PG-SGA &#233; um desenvolvimento adicional do PG-SGA que inclui uma pontua&#231;&#227;o num&#233;rica usada para definir interven&#231;&#245;es nutricionais&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o da QdV foi efectuada atrav&#233;s do European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 EORTC QLQ-C30 com o m&#243;dulo espec&#237;fico para cancro do pulm&#227;o&#44; o European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer Module &#40;EORTC QLQ-LC13&#41;&#46; Estes s&#227;o os m&#233;todos para avalia&#231;&#227;o da QdV mais usados na Europa e revelaram-se como os melhores instrumentos desenvolvidos at&#233; &#224; data&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;16</span></a> O QLQ-C30 &#233; composto por escalas e itens individuais que reflectem a multidimensionalidade da QdV&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> As escalas e itens individuais s&#227;o cotados de 0 a 100&#37;&#46; Um score elevado no estado de sa&#250;de global e nas escalas funcionais representa um elevado n&#237;vel de funcionamento e portanto melhor QdV&#44; um score elevado para a escala de sintomas representa um elevado n&#237;vel de sintomatologia&#47;problemas e assim pior QdV&#46; A codifica&#231;&#227;o foi realizada segundo o preconizado pela EORTC&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> O QLQ LC13 &#233; composto por treze quest&#245;es sobre a sintomatologia do cancro do pulm&#227;o&#44; os efeitos secund&#225;rios relacionados com o tratamento e a medica&#231;&#227;o para a dor&#46; A codifica&#231;&#227;o do QLQ-LC13 &#233; id&#234;ntica ao princ&#237;pio aplicado nas escalas de sintomas&#47;itens individuais do QLQ-C30&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lise de dados</span><p id="par0045" class="elsevierStylePara elsevierViewall">Os participantes foram agrupados em dois grupos de acordo com o estadio de doen&#231;a&#58; grupo 1 &#40;estadio I&#44; II e IIIA&#41; e grupo 2 &#40;estadio IIIB e IV&#41;&#46; Atendendo a que um estadio IIIA permite op&#231;&#245;es terap&#234;uticas mais radicais e sobreviv&#234;ncia superiores aos estadios IIIB e IV&#44; optou-se por incluir este estadio no grupo 1&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Os dados do PG-SGA foram organizados em duas classes&#44; sem desnutri&#231;&#227;o e desnutri&#231;&#227;o moderada&#47;grave&#46; A QdV foi analisada de acordo com as classes de PG-SGA e estimou-se a associa&#231;&#227;o entre QdV e desnutri&#231;&#227;o&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Calcularam-se os par&#226;metros de localiza&#231;&#227;o e de dispers&#227;o para as vari&#225;veis cont&#237;nuas e as frequ&#234;ncias absolutas e relativas para as vari&#225;veis categ&#243;ricas&#46; Como as distribui&#231;&#245;es dos par&#226;metros cont&#237;nuos avaliados n&#227;o eram normais&#44; utilizou-se a Prova de <span class="elsevierStyleItalic">Mann-Whitney U</span>&#46; Compararam-se as distribui&#231;&#245;es de frequ&#234;ncias pela prova de Qui-quadrado&#44; ou pela t&#233;cnica de <span class="elsevierStyleItalic">Fisher</span> quando o valor esperado em 20&#37; &#40;ou menos&#41; das c&#233;lulas era inferior a 5&#46; Calculou-se o coeficiente de correla&#231;&#227;o de <span class="elsevierStyleItalic">Spearman</span> para avaliar a associa&#231;&#227;o entre QdV e o estado nutricional&#46; O n&#237;vel de signific&#226;ncia foi de 5&#37;&#46; A an&#225;lise estat&#237;stica foi realizada utilizando o SPSS 14&#46;0 para Windows&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">A presente amostra inclui 56 doentes com diagn&#243;stico de CPNPC &#40;14 do sexo feminino e 42 do sexo masculino&#41; com m&#233;dia de idades de 64&#44;3 anos &#40;desvio padr&#227;o<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44;8 anos&#41;&#46; O grupo 1 &#233; constitu&#237;do por 14 doentes e o grupo 2 por 42 doentes&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Os doentes do sexo feminino t&#234;m idade superior aos do sexo masculino e a maioria apresenta uma baixa escolaridade&#46; O tipo histol&#243;gico mais frequente &#233; o adenocarcinoma e a maioria dos doentes n&#227;o apresenta antecedentes familiares de neoplasia&#46; O tratamento anterior mais comum nos doentes do grupo 1 foi a cirurgia&#47;cirurgia com terap&#234;uticas adjuvantes&#44; enquanto nos doentes do grupo 2 foi a quimioterapia&#46; A maioria dos doentes do grupo 1 &#40;78&#44;6&#37;&#41; n&#227;o se encontrava a fazer qualquer tipo de tratamento na altura de avalia&#231;&#227;o para o presente estudo&#46; No entanto&#44; 15 doentes do grupo 2 encontravam-se a fazer quimioterapia &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Oito doentes &#40;57&#44;1&#37;&#41; do grupo 1 aumentaram de peso&#44; enquanto 22 doentes &#40;52&#44;4&#37;&#41; do grupo 2 diminu&#237;ram o seu peso desde a altura dos primeiros sintomas at&#233; ao momento da recolha de dados&#46; Sessenta e quatro por cento dos doentes do grupo 1 apresentaram uma classifica&#231;&#227;o num&#233;rica total relativa ao PG-SGA compreendida entre 4 e 8&#44; enquanto 57&#44;1&#37; dos doentes do grupo 2 apresentaram uma classifica&#231;&#227;o num&#233;rica total &#8805; 9&#46; Apesar de 35&#44;7&#37; dos doentes do grupo 2 apresentarem desnutri&#231;&#227;o moderada e 9&#44;5&#37; dos doentes desnutri&#231;&#227;o grave&#44; apenas um doente &#40;7&#44;1&#37;&#41; do grupo 1 foi categorizado na classe de risco de desnutri&#231;&#227;o&#47;desnutri&#231;&#227;o moderada &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Analisando a QdV estratificada de acordo com as classes do estado nutricional&#44; os doentes desnutridos apresentavam um estado de sa&#250;de global &#47;QdV inferior &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; e pior funcionamento f&#237;sico&#44; desempenho&#44; emocional e social&#46; Apresentavam tamb&#233;m mais frequentemente fadiga &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; n&#225;useas e v&#243;mitos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; dor &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#44; falta de apetite &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e obstipa&#231;&#227;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Analisando a QdV pelo QLQ-C30 estratificada de acordo com as classes de estadio de doen&#231;a&#44; podemos observar que as diferen&#231;as n&#227;o apresentam significado estat&#237;stico&#46; No entanto&#44; os estadios avan&#231;ados de doen&#231;a est&#227;o associados a pior QdV&#44; de acordo com o estado de sa&#250;de global&#47;QdV e escalas funcionais&#46; Quanto &#224; sintomatologia&#44; os doentes do grupo 2 apresentaram uma propor&#231;&#227;o inferior de sintomas como ins&#243;nia ou propor&#231;&#227;o id&#234;ntica de sintomas &#40;n&#225;useas e v&#243;mitos&#44; dor&#44; falta de apetite&#44; obstipa&#231;&#227;o&#44; diarreia e dificuldades financeiras&#41; comparativamente aos doentes do grupo 1&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Analisando a QdV pelo QLQ-LC13&#44; ap&#243;s estratifica&#231;&#227;o por estado nutricional&#44; observamos que os doentes desnutridos apresentam mais frequentemente disfagia &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; N&#227;o se encontraram diferen&#231;as com significado estat&#237;stico para nenhum dos itens considerados quando analisados de acordo com o estadio de doen&#231;a&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Existe uma associa&#231;&#227;o com significado estat&#237;stico entre desnutri&#231;&#227;o e o estado de sa&#250;de global&#47;QdV&#44; as escalas funcionais &#40;excepto funcionamento emocional&#41;&#44; as escalas de sintomas com excep&#231;&#227;o da dispneia&#44; ins&#243;nia&#44; diarreia e dificuldades financeiras&#46; A falta de apetite apresentou uma correla&#231;&#227;o elevada com a desnutri&#231;&#227;o &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;7&#41; e foram encontradas correla&#231;&#245;es moderadas entre desnutri&#231;&#227;o e os par&#226;metros fadiga&#44; n&#225;useas e v&#243;mitos e obstipa&#231;&#227;o &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Analisando a associa&#231;&#227;o entre a QdV &#40;avaliada pelo QLQ LC-13&#41; e a desnutri&#231;&#227;o&#44; apenas existe uma associa&#231;&#227;o fraca com significado estat&#237;stico entre a dispneia e a disfagia e o PG &#8211; SGA &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">Os doentes com CPNPC em estadios avan&#231;ados de doen&#231;a apresentam uma elevada frequ&#234;ncia de desnutri&#231;&#227;o &#40;35&#44;7&#37;&#41; e esta condi&#231;&#227;o est&#225; associada a pior QdV&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">N&#227;o foram encontradas diferen&#231;as na QdV por estadio de doen&#231;a&#46; No entanto&#44; analisando a QdV estratificada por classes de estado nutricional&#44; foram identificadas diferen&#231;as em v&#225;rios par&#226;metros&#46; De acordo com o esperado&#44; os doentes desnutridos apresentam pior estado de sa&#250;de global&#47;QdV&#44; bem como pior funcionamento f&#237;sico&#44; emocional&#44; social e de desempenho e tamb&#233;m mais sintomatologia do que os doentes sem desnutri&#231;&#227;o&#46; Foi encontrada uma elevada correla&#231;&#227;o entre a desnutri&#231;&#227;o e falta de apetite e correla&#231;&#227;o moderada entre a desnutri&#231;&#227;o e a fadiga&#44; n&#225;useas e v&#243;mitos e a obstipa&#231;&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Estes resultados s&#227;o concordantes com os de diversos trabalhos&#44; que demonstraram pior QdV em doentes oncol&#243;gicos desnutridos&#46; Ovesen <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44; num estudo efectuado em 104 doentes com cancro do pulm&#227;o pequenas c&#233;lulas&#44; cancro da mama e cancro do ov&#225;rio&#44; demonstraram que os doentes com uma perda de peso moderada tinham mais <span class="elsevierStyleItalic">stress</span> psicol&#243;gico e pior QdV&#46; Andreyev <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> num estudo efectuado em 1555 doentes com cancro esof&#225;gico&#44; g&#225;strico&#44; pancre&#225;tico e colo-rectal&#44; observaram que a perda de peso estava associada a um comprometimento significativo da QdV&#46; Ravasco <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> num estudo realizado em 271 doentes com carcinoma da cabe&#231;a-pesco&#231;o&#44; esof&#225;gico&#44; g&#225;strico e colo-rectal&#44; observaram que a perda de peso e a reduzida ingest&#227;o energ&#233;tica e proteica estava associada a uma pior QdV&#46; Gupta <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> num estudo efectuado em 58 doentes com diagn&#243;stico de cancro colo-rectal&#44; evidenciaram que doentes sem desnutri&#231;&#227;o apresentavam melhor QdV&#46; Nourissat <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> num estudo efectuado em 907 doentes com diagn&#243;stico de cancro colo-rectal&#44; g&#225;strico&#44; hep&#225;tico&#44; esof&#225;gico&#44; ov&#225;rio&#44; pancre&#225;tico&#44; pulm&#227;o&#44; prost&#225;tico&#44; mam&#225;rio&#44; cervical e da bexiga&#44; identificaram uma associa&#231;&#227;o entre a perda de peso e pior QdV&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Este estudo tem v&#225;rios pontos fortes&#46; Os doentes inclu&#237;dos s&#227;o provenientes de apenas um centro&#44; permitindo uma amostra mais homog&#233;nea&#46; Uma vez que diferentes tipos de cancro e diferentes tipos histol&#243;gicos apresentam diferentes tipos de comportamentos&#44; restringimos a amostra a um &#250;nico sub-tipo histol&#243;gico de cancro do pulm&#227;o &#40;CPNPC&#41; de modo a aumentar a sua homogeneidade&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Para a caracteriza&#231;&#227;o nutricional&#44; utiliz&#225;mos um instrumento validado de modo a fazer uma descri&#231;&#227;o mais correcta e detalhada&#46; O PG-SGA &#233; o m&#233;todo de refer&#234;ncia para avalia&#231;&#227;o do estado nutricional em doentes oncol&#243;gicos e &#233; reconhecido pelo <span class="elsevierStyleItalic">Oncology Nutrition Dietetic Group</span> da <span class="elsevierStyleItalic">American Dietetic Association</span> como o m&#233;todo de refer&#234;ncia para avalia&#231;&#227;o nutricional em doentes oncol&#243;gicos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Esta escolha representa um avan&#231;o comparativamente a estudos pr&#233;vios que avaliaram o estado nutricional em doentes oncol&#243;gicos&#44; que se basearam apenas na perda de peso para definir desnutri&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#8211;21&#44;23</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Todos os dados foram recolhidos pela mesma investigadora limitando a possibilidade de varia&#231;&#227;o inter-observador&#46; As caracter&#237;sticas demogr&#225;ficas como a idade e sexo s&#227;o compar&#225;veis &#224;s caracter&#237;sticas encontradas previamente num estudo efectuado pela Comiss&#227;o de Trabalho de Pneumologia Oncol&#243;gica da Sociedade Portuguesa de Pneumologia&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">A natureza transversal do presente estudo constitui uma limita&#231;&#227;o&#44; impossibilitando o estudo de uma rela&#231;&#227;o causal&#46; O reduzido tamanho da amostra n&#227;o permite uma an&#225;lise multi-variada para avaliar a associa&#231;&#227;o da desnutri&#231;&#227;o e QdV independentemente de outros factores relacionados com estas condi&#231;&#245;es&#44; como estadio de doen&#231;a&#44; efeitos secund&#225;rios de tratamentos e resultado do tratamento&#46; O baixo n&#250;mero de observa&#231;&#245;es em determinados par&#226;metros pode ter aumentado a possibilidade de erros tipo II&#44; devido &#224; falta de poder estat&#237;stico&#46; O facto de elevada propor&#231;&#227;o da amostra n&#227;o ter sido avaliada logo ap&#243;s o diagn&#243;stico&#44; e&#44; tendo j&#225; efectuado ou estando na altura da avalia&#231;&#227;o para o presente estudo&#44; a efectuar diversas op&#231;&#245;es terap&#234;uticas&#44; poder&#225; contribuir para estimativas mais elevadas da frequ&#234;ncia da desnutri&#231;&#227;o&#46; A presente amostra &#233; heterog&#233;nea incluindo doentes em diferentes fases da evolu&#231;&#227;o da doen&#231;a&#44; contudo&#44; ilustra o tipo de doentes em tratamento numa unidade prestadora de cuidados de sa&#250;de desta natureza&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Em resumo&#44; os doentes com CPNPC apresentam elevadas frequ&#234;ncias de desnutri&#231;&#227;o em estadios avan&#231;ados de doen&#231;a &#40;estadios precoces de doen&#231;a&#58; 1&#44;8&#37; <span class="elsevierStyleItalic">vs&#46;</span> estadios avan&#231;ados de doen&#231;a&#58; 33&#44;9&#37;&#41;&#46; Os doentes desnutridos apresentam pior estado de sa&#250;de global&#47;QdV&#44; funcionamento f&#237;sico&#44; emocional&#44; social e desempenho&#46; Apresentam tamb&#233;m mais sintomatologia&#44; nomeadamente a fadiga&#44; as n&#225;useas e v&#243;mitos&#44; a dor&#44; a ins&#243;nia&#44; a falta de apetite e a disfagia&#46; A desnutri&#231;&#227;o encontra-se associada a pior QdV&#44; especificamente&#58; falta de apetite&#44; fadiga&#44; n&#225;useas e v&#243;mitos e obstipa&#231;&#227;o&#46; Estes resultados representam uma primeira abordagem a este assunto que refor&#231;a a import&#226;ncia da avalia&#231;&#227;o do estado nutricional e da QdV em doentes com CPNPC&#44; uma vez que estes par&#226;metros podem ser modificados quando precocemente e devidamente avaliados&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesse</span><p id="par0135" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesse&#46;</p></span></span>"
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        "resumen" => "<span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O cancro est&#225; associado a uma deteriora&#231;&#227;o do estado nutricional e da qualidade de vida &#40;QdV&#41;&#44; mas n&#227;o se conhece a dimens&#227;o destas consequ&#234;ncias nos doentes com cancro do pulm&#227;o n&#227;o pequenas c&#233;lulas &#40;CPNPC&#41;&#46; O objectivo deste estudo foi avaliar a associa&#231;&#227;o entre a qualidade de vida e a desnutri&#231;&#227;o em doentes com CPNPC&#46; O estado nutricional foi avaliado pelo <span class="elsevierStyleItalic">Patient Generated &#8211; Subjective Global Assessment</span> e a QdV foi avaliada atrav&#233;s do <span class="elsevierStyleItalic">European Organization for Research and Treatment of Cancer Quality of Life &#8211; C30</span> e do m&#243;dulo espec&#237;fico para doentes com cancro do pulm&#227;o&#46; Foi avaliada uma amostra com cinquenta e seis doentes diagnosticados com CPNPC&#46; Uma elevada propor&#231;&#227;o de doentes encontra-se desnutrida &#40;35&#44;7&#37;&#41;&#44; dos quais 1&#44;8&#37; em estadios precoces <span class="elsevierStyleItalic">vs</span> 33&#44;9&#37; em estadios avan&#231;ados de doen&#231;a&#46; A desnutri&#231;&#227;o est&#225; associada a dimens&#245;es de QdV como a falta de apetite &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;70&#41;&#44; fadiga &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;54&#41;&#44; n&#225;useas e v&#243;mitos &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;52&#41; e tamb&#233;m obstipa&#231;&#227;o &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;56&#41;&#46; Os doentes com CPNPC apresentam elevada frequ&#234;ncia de desnutri&#231;&#227;o nos estadios avan&#231;ados de doen&#231;a&#46; Os doentes desnutridos apresentam mais sintomatologia e piores estado de sa&#250;de global&#44; de funcionamento f&#237;sico&#44; emocional&#44; social e de desempenho&#44; do que os doentes sem desnutri&#231;&#227;o&#46; A desnutri&#231;&#227;o est&#225; associada com pior QdV&#44; especificamente nos par&#226;metros&#58; falta de apetite&#44; n&#225;useas e v&#243;mitos&#44; obstipa&#231;&#227;o e fadiga&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cancer is related to a deterioration of nutritional status and quality of life &#40;QoL&#41;&#44; but the extent of these conditions in patients with Non Small Cell Lung Cancer &#40;NSCLC&#41; has not been studied&#46; The aim of the present study was to assess the association between QoL and undernutrition in NSCLC patients&#46; Nutritional status was evaluated with Patient Generated &#8211; Subjective Global Assessment and QoL using the European Organization for Research and Treatment of Cancer Quality of Life &#8211; C30 and also with the specific module for lung cancer patients&#46; A consecutive sample of fifty six patients diagnosed with NSCLC was evaluated&#46; A high proportion of patients is undernourished &#40;35&#46;7&#37;&#41;&#44; 1&#46;8&#37; in early stages <span class="elsevierStyleItalic">vs</span> 33&#46;9&#37; in advanced stages of disease&#46; Undernutrition is related to measured dimensions of QoL&#58; lack of appetite &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;70&#41;&#44; fatigue &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;54&#41;&#44; nausea and vomiting &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;52&#41; and constipation &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;56&#41;&#46; Undernourished patients have worse global health status&#44; physical&#44; emotional&#44; social and role functioning&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Patients with NSCLC have high frequency of undernutrition in advanced stages of disease&#46; Undernourished patients present more symptoms&#44; a worse global health status&#47;QoL&#44; physical&#44; role&#44; emotional and social functioning than patients without undernutrition&#46; Undernutrition is associated with worse QoL&#44; specifically in the parameters&#58; appetite loss&#44; nausea and vomiting&#44; constipation and fatigue&#46;</p></span>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">dp&#58; desvio padr&#227;o&#59; CPNPC&#58; Cancro do Pulm&#227;o N&#227;o Pequenas C&#233;lulas&#59; QT&#58; Quimioterapia&#59; RT&#58; Radioterapia&#59; PG-SGA&#58; <span class="elsevierStyleItalic">Patient Generated Subjective Global Assessment&#46;</span></p>"
          "tablatextoimagen" => array:1 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo 1&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo 2&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Idade &#40;anos&#41; M&#233;dia &#40;dp&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;2 &#40;10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;3 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;28&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;23&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;71&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;76&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tempo diagn&#243;stico &#40;meses&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mediana <span class="elsevierStyleItalic">&#40;m&#237;nimo- m&#225;ximo&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;4 &#40;1-60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;5 &#40;0-111&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tipo histol&#243;gico</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Adenocarcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;64&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;52&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Epiderm&#243;ide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;21&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Carcinoma indiferenciado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;21&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;26&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tratamentos anteriores</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nenhum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;30&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirurgia&#47; Cirurgia com terap&#234;uticas Adjuvantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;64&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;26&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>QT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;31&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>QT e RT Concomitantes&#47;sequenciais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;9&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tratamento actual</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nenhum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;78&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;64&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>QT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;35&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">PG-SGA</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleItalic">&#40;categorias&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sem desnutri&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;92&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;54&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Desnutri&#231;&#227;o moderada&#47;grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;45&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas da amostra&#46;</p>"
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      1 => array:7 [
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        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">QdV&#58; Qualidade de Vida&#59; n&#46;s&#46;&#58; n&#227;o significativo&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Sem desnutri&#231;&#227;o</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Desnutri&#231;&#227;o</span><span class="elsevierStyleItalic">&#40;moderada&#47;grave&#41;</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Estado de sa&#250;de global&#47;QdV</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Escala funcional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento f&#237;sico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#44;3 &#40;40&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0 &#40;20&#44;0-73&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Desempenho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-83&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento emocional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;3 &#40;16&#44;7-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento cognitivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#44;0 &#40;33&#44;3-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;0 &#40;16&#44;7-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento social&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#44;0 &#40;16&#44;7-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Escala&#47;itens sintomas</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fadiga&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0 &#40;22&#44;2-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Na&#250;seas e v&#243;mitos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dispneia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ins&#243;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Falta de apetite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Obstipa&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diarreia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dificuldades financeiras&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Avalia&#231;&#227;o da QdV pelo EORTC QLQ-C30&#44; de acordo com o PG-SGA&#46;</p>"
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          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">n&#46;s&#46;&#58; n&#227;o significativo&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Sem desnutri&#231;&#227;o</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Desnutri&#231;&#227;o</span><span class="elsevierStyleItalic">&#40;moderada&#47;grave&#41;</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dispneia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;2 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#44;9 &#40;0&#44;0-88&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Tosse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hemoptises&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Mucosites&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Disfagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Neuropatia perif&#233;rica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Alop&#233;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dor no peito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dor no bra&#231;o ou ombro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dor noutra parte do corpo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Avalia&#231;&#227;o da QdV pelo EORTC QLQ-LC13&#44; de acordo com o PG-SGA&#46;</p>"
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Artigo Original
Desnutrição e Qualidade de Vida em Doentes com Cancro do Pulmão Não Pequenas Células
Undernutrition and Quality of Life in Non Small Cell Lung Cancer Patients
S. Xaráa,
Corresponding author
soniaxara@gmail.com

Autor para correspondência.
, T.F. Amaralb, B. Parentec
a Nutricionista, Centro Hospitalar de Vila Nova de Gaia / Espinho EPE
b Professora Associada, Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto
c Directora do Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia / Espinho EPE
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que engloba um largo espectro de situa&#231;&#245;es&#44; desde a perda de peso at&#233; um estado associado&#44; a uma acentuada incapacidade geral que conduz &#224; morte&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A QdV &#233; uma importante dimens&#227;o na avalia&#231;&#227;o do resultado da doen&#231;a e do seu tratamento e representa uma preocupa&#231;&#227;o crescente no controlo da doen&#231;a&#46; A QdV &#233; descrita como um factor de progn&#243;stico na sobreviv&#234;ncia de doentes com Cancro do Pulm&#227;o N&#227;o Pequenas C&#233;lulas &#40;CPNPC&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> No entanto&#44; a extens&#227;o destas condi&#231;&#245;es em doentes com CPNPC est&#225; ainda por avaliar&#46; O objectivo do presente estudo foi avaliar a associa&#231;&#227;o entre a QdV e a desnutri&#231;&#227;o em doentes com CPNPC&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material e M&#233;todos</span><p id="par0015" class="elsevierStylePara elsevierViewall">Foi realizado um estudo transversal que incluiu doentes seguidos em regime de ambulat&#243;rio na Unidade de Pneumologia Oncol&#243;gica do Centro Hospitalar de Vila Nova de Gaia&#47;Espinho&#44; Portugal&#46; Foram crit&#233;rios de inclus&#227;o ser caucasiano&#44; com idade superior a dezoito anos e ter o diagn&#243;stico de CPNPC&#46; N&#227;o se inclu&#237;ram no estudo os doentes que tinham tido acompanhamento pr&#233;vio em consultas de nutri&#231;&#227;o e que eram incapazes de preencher os question&#225;rios de auto-administra&#231;&#227;o utilizados&#46; Inclu&#237;ram-se consecutivamente no estudo os doentes admitidos nesta unidade entre Outubro de 2007 e Maio de 2008&#44; que cumpriam os crit&#233;rios estabelecidos&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">O protocolo do estudo foi aprovado pela Comiss&#227;o de &#201;tica e Conselho de Administra&#231;&#227;o da institui&#231;&#227;o onde foi realizado&#46; Todos os doentes assinaram uma declara&#231;&#227;o de consentimento informado&#44; de acordo com o preconizado na declara&#231;&#227;o de Hels&#237;nquia&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Recolha de dados</span><p id="par0025" class="elsevierStylePara elsevierViewall">Toda a informa&#231;&#227;o foi recolhida pela mesma entrevistadora &#40;SX&#41; atrav&#233;s de um question&#225;rio estruturado&#44; com a excep&#231;&#227;o dos par&#226;metros validados para serem avaliados por auto-administra&#231;&#227;o&#46; Foram obtidas informa&#231;&#245;es sobre caracter&#237;sticas sociais e demogr&#225;ficas&#44; tempo de diagn&#243;stico &#40;n&#250;mero de meses compreendidos entre a data de diagn&#243;stico e a data de avalia&#231;&#227;o no decurso do estudo&#41; e aspectos cl&#237;nicos relevantes como os tratamentos pr&#233;vios e actuais e antecedentes familiares de neoplasia&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Realizou-se avalia&#231;&#227;o antropom&#233;trica de acordo com procedimentos padronizados&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> A percentagem de perda de peso &#40;&#37; perda de peso&#41;&#44; foi calculada considerando-se como peso habitual o peso anterior aos primeiros sintomas ou registado no processo cl&#237;nico na primeira consulta&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">O <span class="elsevierStyleItalic">Patient Generated Subjective Global Assessment</span> &#40;PG-SGA&#41; foi usado para quantificar o estado nutricional dos doentes&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> O PG-SGA permite uma classifica&#231;&#227;o global em desnutri&#231;&#227;o moderada&#44; desnutri&#231;&#227;o grave ou sem desnutri&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> O <span class="elsevierStyleItalic">scored</span> PG-SGA &#233; um desenvolvimento adicional do PG-SGA que inclui uma pontua&#231;&#227;o num&#233;rica usada para definir interven&#231;&#245;es nutricionais&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o da QdV foi efectuada atrav&#233;s do European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 EORTC QLQ-C30 com o m&#243;dulo espec&#237;fico para cancro do pulm&#227;o&#44; o European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer Module &#40;EORTC QLQ-LC13&#41;&#46; Estes s&#227;o os m&#233;todos para avalia&#231;&#227;o da QdV mais usados na Europa e revelaram-se como os melhores instrumentos desenvolvidos at&#233; &#224; data&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;16</span></a> O QLQ-C30 &#233; composto por escalas e itens individuais que reflectem a multidimensionalidade da QdV&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> As escalas e itens individuais s&#227;o cotados de 0 a 100&#37;&#46; Um score elevado no estado de sa&#250;de global e nas escalas funcionais representa um elevado n&#237;vel de funcionamento e portanto melhor QdV&#44; um score elevado para a escala de sintomas representa um elevado n&#237;vel de sintomatologia&#47;problemas e assim pior QdV&#46; A codifica&#231;&#227;o foi realizada segundo o preconizado pela EORTC&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> O QLQ LC13 &#233; composto por treze quest&#245;es sobre a sintomatologia do cancro do pulm&#227;o&#44; os efeitos secund&#225;rios relacionados com o tratamento e a medica&#231;&#227;o para a dor&#46; A codifica&#231;&#227;o do QLQ-LC13 &#233; id&#234;ntica ao princ&#237;pio aplicado nas escalas de sintomas&#47;itens individuais do QLQ-C30&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lise de dados</span><p id="par0045" class="elsevierStylePara elsevierViewall">Os participantes foram agrupados em dois grupos de acordo com o estadio de doen&#231;a&#58; grupo 1 &#40;estadio I&#44; II e IIIA&#41; e grupo 2 &#40;estadio IIIB e IV&#41;&#46; Atendendo a que um estadio IIIA permite op&#231;&#245;es terap&#234;uticas mais radicais e sobreviv&#234;ncia superiores aos estadios IIIB e IV&#44; optou-se por incluir este estadio no grupo 1&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Os dados do PG-SGA foram organizados em duas classes&#44; sem desnutri&#231;&#227;o e desnutri&#231;&#227;o moderada&#47;grave&#46; A QdV foi analisada de acordo com as classes de PG-SGA e estimou-se a associa&#231;&#227;o entre QdV e desnutri&#231;&#227;o&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Calcularam-se os par&#226;metros de localiza&#231;&#227;o e de dispers&#227;o para as vari&#225;veis cont&#237;nuas e as frequ&#234;ncias absolutas e relativas para as vari&#225;veis categ&#243;ricas&#46; Como as distribui&#231;&#245;es dos par&#226;metros cont&#237;nuos avaliados n&#227;o eram normais&#44; utilizou-se a Prova de <span class="elsevierStyleItalic">Mann-Whitney U</span>&#46; Compararam-se as distribui&#231;&#245;es de frequ&#234;ncias pela prova de Qui-quadrado&#44; ou pela t&#233;cnica de <span class="elsevierStyleItalic">Fisher</span> quando o valor esperado em 20&#37; &#40;ou menos&#41; das c&#233;lulas era inferior a 5&#46; Calculou-se o coeficiente de correla&#231;&#227;o de <span class="elsevierStyleItalic">Spearman</span> para avaliar a associa&#231;&#227;o entre QdV e o estado nutricional&#46; O n&#237;vel de signific&#226;ncia foi de 5&#37;&#46; A an&#225;lise estat&#237;stica foi realizada utilizando o SPSS 14&#46;0 para Windows&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">A presente amostra inclui 56 doentes com diagn&#243;stico de CPNPC &#40;14 do sexo feminino e 42 do sexo masculino&#41; com m&#233;dia de idades de 64&#44;3 anos &#40;desvio padr&#227;o<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44;8 anos&#41;&#46; O grupo 1 &#233; constitu&#237;do por 14 doentes e o grupo 2 por 42 doentes&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Os doentes do sexo feminino t&#234;m idade superior aos do sexo masculino e a maioria apresenta uma baixa escolaridade&#46; O tipo histol&#243;gico mais frequente &#233; o adenocarcinoma e a maioria dos doentes n&#227;o apresenta antecedentes familiares de neoplasia&#46; O tratamento anterior mais comum nos doentes do grupo 1 foi a cirurgia&#47;cirurgia com terap&#234;uticas adjuvantes&#44; enquanto nos doentes do grupo 2 foi a quimioterapia&#46; A maioria dos doentes do grupo 1 &#40;78&#44;6&#37;&#41; n&#227;o se encontrava a fazer qualquer tipo de tratamento na altura de avalia&#231;&#227;o para o presente estudo&#46; No entanto&#44; 15 doentes do grupo 2 encontravam-se a fazer quimioterapia &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Oito doentes &#40;57&#44;1&#37;&#41; do grupo 1 aumentaram de peso&#44; enquanto 22 doentes &#40;52&#44;4&#37;&#41; do grupo 2 diminu&#237;ram o seu peso desde a altura dos primeiros sintomas at&#233; ao momento da recolha de dados&#46; Sessenta e quatro por cento dos doentes do grupo 1 apresentaram uma classifica&#231;&#227;o num&#233;rica total relativa ao PG-SGA compreendida entre 4 e 8&#44; enquanto 57&#44;1&#37; dos doentes do grupo 2 apresentaram uma classifica&#231;&#227;o num&#233;rica total &#8805; 9&#46; Apesar de 35&#44;7&#37; dos doentes do grupo 2 apresentarem desnutri&#231;&#227;o moderada e 9&#44;5&#37; dos doentes desnutri&#231;&#227;o grave&#44; apenas um doente &#40;7&#44;1&#37;&#41; do grupo 1 foi categorizado na classe de risco de desnutri&#231;&#227;o&#47;desnutri&#231;&#227;o moderada &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Analisando a QdV estratificada de acordo com as classes do estado nutricional&#44; os doentes desnutridos apresentavam um estado de sa&#250;de global &#47;QdV inferior &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; e pior funcionamento f&#237;sico&#44; desempenho&#44; emocional e social&#46; Apresentavam tamb&#233;m mais frequentemente fadiga &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; n&#225;useas e v&#243;mitos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; dor &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#44; falta de apetite &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e obstipa&#231;&#227;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Analisando a QdV pelo QLQ-C30 estratificada de acordo com as classes de estadio de doen&#231;a&#44; podemos observar que as diferen&#231;as n&#227;o apresentam significado estat&#237;stico&#46; No entanto&#44; os estadios avan&#231;ados de doen&#231;a est&#227;o associados a pior QdV&#44; de acordo com o estado de sa&#250;de global&#47;QdV e escalas funcionais&#46; Quanto &#224; sintomatologia&#44; os doentes do grupo 2 apresentaram uma propor&#231;&#227;o inferior de sintomas como ins&#243;nia ou propor&#231;&#227;o id&#234;ntica de sintomas &#40;n&#225;useas e v&#243;mitos&#44; dor&#44; falta de apetite&#44; obstipa&#231;&#227;o&#44; diarreia e dificuldades financeiras&#41; comparativamente aos doentes do grupo 1&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Analisando a QdV pelo QLQ-LC13&#44; ap&#243;s estratifica&#231;&#227;o por estado nutricional&#44; observamos que os doentes desnutridos apresentam mais frequentemente disfagia &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; N&#227;o se encontraram diferen&#231;as com significado estat&#237;stico para nenhum dos itens considerados quando analisados de acordo com o estadio de doen&#231;a&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Existe uma associa&#231;&#227;o com significado estat&#237;stico entre desnutri&#231;&#227;o e o estado de sa&#250;de global&#47;QdV&#44; as escalas funcionais &#40;excepto funcionamento emocional&#41;&#44; as escalas de sintomas com excep&#231;&#227;o da dispneia&#44; ins&#243;nia&#44; diarreia e dificuldades financeiras&#46; A falta de apetite apresentou uma correla&#231;&#227;o elevada com a desnutri&#231;&#227;o &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;7&#41; e foram encontradas correla&#231;&#245;es moderadas entre desnutri&#231;&#227;o e os par&#226;metros fadiga&#44; n&#225;useas e v&#243;mitos e obstipa&#231;&#227;o &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Analisando a associa&#231;&#227;o entre a QdV &#40;avaliada pelo QLQ LC-13&#41; e a desnutri&#231;&#227;o&#44; apenas existe uma associa&#231;&#227;o fraca com significado estat&#237;stico entre a dispneia e a disfagia e o PG &#8211; SGA &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Tabela 4</a>&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">Os doentes com CPNPC em estadios avan&#231;ados de doen&#231;a apresentam uma elevada frequ&#234;ncia de desnutri&#231;&#227;o &#40;35&#44;7&#37;&#41; e esta condi&#231;&#227;o est&#225; associada a pior QdV&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">N&#227;o foram encontradas diferen&#231;as na QdV por estadio de doen&#231;a&#46; No entanto&#44; analisando a QdV estratificada por classes de estado nutricional&#44; foram identificadas diferen&#231;as em v&#225;rios par&#226;metros&#46; De acordo com o esperado&#44; os doentes desnutridos apresentam pior estado de sa&#250;de global&#47;QdV&#44; bem como pior funcionamento f&#237;sico&#44; emocional&#44; social e de desempenho e tamb&#233;m mais sintomatologia do que os doentes sem desnutri&#231;&#227;o&#46; Foi encontrada uma elevada correla&#231;&#227;o entre a desnutri&#231;&#227;o e falta de apetite e correla&#231;&#227;o moderada entre a desnutri&#231;&#227;o e a fadiga&#44; n&#225;useas e v&#243;mitos e a obstipa&#231;&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Estes resultados s&#227;o concordantes com os de diversos trabalhos&#44; que demonstraram pior QdV em doentes oncol&#243;gicos desnutridos&#46; Ovesen <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44; num estudo efectuado em 104 doentes com cancro do pulm&#227;o pequenas c&#233;lulas&#44; cancro da mama e cancro do ov&#225;rio&#44; demonstraram que os doentes com uma perda de peso moderada tinham mais <span class="elsevierStyleItalic">stress</span> psicol&#243;gico e pior QdV&#46; Andreyev <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> num estudo efectuado em 1555 doentes com cancro esof&#225;gico&#44; g&#225;strico&#44; pancre&#225;tico e colo-rectal&#44; observaram que a perda de peso estava associada a um comprometimento significativo da QdV&#46; Ravasco <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> num estudo realizado em 271 doentes com carcinoma da cabe&#231;a-pesco&#231;o&#44; esof&#225;gico&#44; g&#225;strico e colo-rectal&#44; observaram que a perda de peso e a reduzida ingest&#227;o energ&#233;tica e proteica estava associada a uma pior QdV&#46; Gupta <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> num estudo efectuado em 58 doentes com diagn&#243;stico de cancro colo-rectal&#44; evidenciaram que doentes sem desnutri&#231;&#227;o apresentavam melhor QdV&#46; Nourissat <span class="elsevierStyleItalic">et al</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> num estudo efectuado em 907 doentes com diagn&#243;stico de cancro colo-rectal&#44; g&#225;strico&#44; hep&#225;tico&#44; esof&#225;gico&#44; ov&#225;rio&#44; pancre&#225;tico&#44; pulm&#227;o&#44; prost&#225;tico&#44; mam&#225;rio&#44; cervical e da bexiga&#44; identificaram uma associa&#231;&#227;o entre a perda de peso e pior QdV&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Este estudo tem v&#225;rios pontos fortes&#46; Os doentes inclu&#237;dos s&#227;o provenientes de apenas um centro&#44; permitindo uma amostra mais homog&#233;nea&#46; Uma vez que diferentes tipos de cancro e diferentes tipos histol&#243;gicos apresentam diferentes tipos de comportamentos&#44; restringimos a amostra a um &#250;nico sub-tipo histol&#243;gico de cancro do pulm&#227;o &#40;CPNPC&#41; de modo a aumentar a sua homogeneidade&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Para a caracteriza&#231;&#227;o nutricional&#44; utiliz&#225;mos um instrumento validado de modo a fazer uma descri&#231;&#227;o mais correcta e detalhada&#46; O PG-SGA &#233; o m&#233;todo de refer&#234;ncia para avalia&#231;&#227;o do estado nutricional em doentes oncol&#243;gicos e &#233; reconhecido pelo <span class="elsevierStyleItalic">Oncology Nutrition Dietetic Group</span> da <span class="elsevierStyleItalic">American Dietetic Association</span> como o m&#233;todo de refer&#234;ncia para avalia&#231;&#227;o nutricional em doentes oncol&#243;gicos&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Esta escolha representa um avan&#231;o comparativamente a estudos pr&#233;vios que avaliaram o estado nutricional em doentes oncol&#243;gicos&#44; que se basearam apenas na perda de peso para definir desnutri&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#8211;21&#44;23</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Todos os dados foram recolhidos pela mesma investigadora limitando a possibilidade de varia&#231;&#227;o inter-observador&#46; As caracter&#237;sticas demogr&#225;ficas como a idade e sexo s&#227;o compar&#225;veis &#224;s caracter&#237;sticas encontradas previamente num estudo efectuado pela Comiss&#227;o de Trabalho de Pneumologia Oncol&#243;gica da Sociedade Portuguesa de Pneumologia&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">A natureza transversal do presente estudo constitui uma limita&#231;&#227;o&#44; impossibilitando o estudo de uma rela&#231;&#227;o causal&#46; O reduzido tamanho da amostra n&#227;o permite uma an&#225;lise multi-variada para avaliar a associa&#231;&#227;o da desnutri&#231;&#227;o e QdV independentemente de outros factores relacionados com estas condi&#231;&#245;es&#44; como estadio de doen&#231;a&#44; efeitos secund&#225;rios de tratamentos e resultado do tratamento&#46; O baixo n&#250;mero de observa&#231;&#245;es em determinados par&#226;metros pode ter aumentado a possibilidade de erros tipo II&#44; devido &#224; falta de poder estat&#237;stico&#46; O facto de elevada propor&#231;&#227;o da amostra n&#227;o ter sido avaliada logo ap&#243;s o diagn&#243;stico&#44; e&#44; tendo j&#225; efectuado ou estando na altura da avalia&#231;&#227;o para o presente estudo&#44; a efectuar diversas op&#231;&#245;es terap&#234;uticas&#44; poder&#225; contribuir para estimativas mais elevadas da frequ&#234;ncia da desnutri&#231;&#227;o&#46; A presente amostra &#233; heterog&#233;nea incluindo doentes em diferentes fases da evolu&#231;&#227;o da doen&#231;a&#44; contudo&#44; ilustra o tipo de doentes em tratamento numa unidade prestadora de cuidados de sa&#250;de desta natureza&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Em resumo&#44; os doentes com CPNPC apresentam elevadas frequ&#234;ncias de desnutri&#231;&#227;o em estadios avan&#231;ados de doen&#231;a &#40;estadios precoces de doen&#231;a&#58; 1&#44;8&#37; <span class="elsevierStyleItalic">vs&#46;</span> estadios avan&#231;ados de doen&#231;a&#58; 33&#44;9&#37;&#41;&#46; Os doentes desnutridos apresentam pior estado de sa&#250;de global&#47;QdV&#44; funcionamento f&#237;sico&#44; emocional&#44; social e desempenho&#46; Apresentam tamb&#233;m mais sintomatologia&#44; nomeadamente a fadiga&#44; as n&#225;useas e v&#243;mitos&#44; a dor&#44; a ins&#243;nia&#44; a falta de apetite e a disfagia&#46; A desnutri&#231;&#227;o encontra-se associada a pior QdV&#44; especificamente&#58; falta de apetite&#44; fadiga&#44; n&#225;useas e v&#243;mitos e obstipa&#231;&#227;o&#46; Estes resultados representam uma primeira abordagem a este assunto que refor&#231;a a import&#226;ncia da avalia&#231;&#227;o do estado nutricional e da QdV em doentes com CPNPC&#44; uma vez que estes par&#226;metros podem ser modificados quando precocemente e devidamente avaliados&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesse</span><p id="par0135" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesse&#46;</p></span></span>"
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        "titulo" => "Resumo"
        "resumen" => "<span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O cancro est&#225; associado a uma deteriora&#231;&#227;o do estado nutricional e da qualidade de vida &#40;QdV&#41;&#44; mas n&#227;o se conhece a dimens&#227;o destas consequ&#234;ncias nos doentes com cancro do pulm&#227;o n&#227;o pequenas c&#233;lulas &#40;CPNPC&#41;&#46; O objectivo deste estudo foi avaliar a associa&#231;&#227;o entre a qualidade de vida e a desnutri&#231;&#227;o em doentes com CPNPC&#46; O estado nutricional foi avaliado pelo <span class="elsevierStyleItalic">Patient Generated &#8211; Subjective Global Assessment</span> e a QdV foi avaliada atrav&#233;s do <span class="elsevierStyleItalic">European Organization for Research and Treatment of Cancer Quality of Life &#8211; C30</span> e do m&#243;dulo espec&#237;fico para doentes com cancro do pulm&#227;o&#46; Foi avaliada uma amostra com cinquenta e seis doentes diagnosticados com CPNPC&#46; Uma elevada propor&#231;&#227;o de doentes encontra-se desnutrida &#40;35&#44;7&#37;&#41;&#44; dos quais 1&#44;8&#37; em estadios precoces <span class="elsevierStyleItalic">vs</span> 33&#44;9&#37; em estadios avan&#231;ados de doen&#231;a&#46; A desnutri&#231;&#227;o est&#225; associada a dimens&#245;es de QdV como a falta de apetite &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;70&#41;&#44; fadiga &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;54&#41;&#44; n&#225;useas e v&#243;mitos &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;52&#41; e tamb&#233;m obstipa&#231;&#227;o &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;56&#41;&#46; Os doentes com CPNPC apresentam elevada frequ&#234;ncia de desnutri&#231;&#227;o nos estadios avan&#231;ados de doen&#231;a&#46; Os doentes desnutridos apresentam mais sintomatologia e piores estado de sa&#250;de global&#44; de funcionamento f&#237;sico&#44; emocional&#44; social e de desempenho&#44; do que os doentes sem desnutri&#231;&#227;o&#46; A desnutri&#231;&#227;o est&#225; associada com pior QdV&#44; especificamente nos par&#226;metros&#58; falta de apetite&#44; n&#225;useas e v&#243;mitos&#44; obstipa&#231;&#227;o e fadiga&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cancer is related to a deterioration of nutritional status and quality of life &#40;QoL&#41;&#44; but the extent of these conditions in patients with Non Small Cell Lung Cancer &#40;NSCLC&#41; has not been studied&#46; The aim of the present study was to assess the association between QoL and undernutrition in NSCLC patients&#46; Nutritional status was evaluated with Patient Generated &#8211; Subjective Global Assessment and QoL using the European Organization for Research and Treatment of Cancer Quality of Life &#8211; C30 and also with the specific module for lung cancer patients&#46; A consecutive sample of fifty six patients diagnosed with NSCLC was evaluated&#46; A high proportion of patients is undernourished &#40;35&#46;7&#37;&#41;&#44; 1&#46;8&#37; in early stages <span class="elsevierStyleItalic">vs</span> 33&#46;9&#37; in advanced stages of disease&#46; Undernutrition is related to measured dimensions of QoL&#58; lack of appetite &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;70&#41;&#44; fatigue &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;54&#41;&#44; nausea and vomiting &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;52&#41; and constipation &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;56&#41;&#46; Undernourished patients have worse global health status&#44; physical&#44; emotional&#44; social and role functioning&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Patients with NSCLC have high frequency of undernutrition in advanced stages of disease&#46; Undernourished patients present more symptoms&#44; a worse global health status&#47;QoL&#44; physical&#44; role&#44; emotional and social functioning than patients without undernutrition&#46; Undernutrition is associated with worse QoL&#44; specifically in the parameters&#58; appetite loss&#44; nausea and vomiting&#44; constipation and fatigue&#46;</p></span>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">dp&#58; desvio padr&#227;o&#59; CPNPC&#58; Cancro do Pulm&#227;o N&#227;o Pequenas C&#233;lulas&#59; QT&#58; Quimioterapia&#59; RT&#58; Radioterapia&#59; PG-SGA&#58; <span class="elsevierStyleItalic">Patient Generated Subjective Global Assessment&#46;</span></p>"
          "tablatextoimagen" => array:1 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo 1&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo 2&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Idade &#40;anos&#41; M&#233;dia &#40;dp&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;2 &#40;10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#44;3 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;28&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;23&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;71&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;76&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tempo diagn&#243;stico &#40;meses&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mediana <span class="elsevierStyleItalic">&#40;m&#237;nimo- m&#225;ximo&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;4 &#40;1-60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;5 &#40;0-111&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tipo histol&#243;gico</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Adenocarcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;64&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;52&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Epiderm&#243;ide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;21&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Carcinoma indiferenciado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;21&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;26&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tratamentos anteriores</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nenhum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;30&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirurgia&#47; Cirurgia com terap&#234;uticas Adjuvantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;64&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;26&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>QT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;31&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>QT e RT Concomitantes&#47;sequenciais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;9&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Tratamento actual</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nenhum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;78&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;64&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>QT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;35&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>RT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">PG-SGA</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleItalic">&#40;categorias&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sem desnutri&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;92&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;54&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Desnutri&#231;&#227;o moderada&#47;grave&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;45&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas da amostra&#46;</p>"
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      1 => array:7 [
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        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">QdV&#58; Qualidade de Vida&#59; n&#46;s&#46;&#58; n&#227;o significativo&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Sem desnutri&#231;&#227;o</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Desnutri&#231;&#227;o</span><span class="elsevierStyleItalic">&#40;moderada&#47;grave&#41;</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Estado de sa&#250;de global&#47;QdV</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Escala funcional</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento f&#237;sico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#44;3 &#40;40&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0 &#40;20&#44;0-73&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Desempenho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-83&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento emocional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;3 &#40;16&#44;7-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento cognitivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#44;0 &#40;33&#44;3-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#44;0 &#40;16&#44;7-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Funcionamento social&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#44;0 &#40;16&#44;7-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Escala&#47;itens sintomas</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fadiga&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#44;0 &#40;22&#44;2-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Na&#250;seas e v&#243;mitos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dispneia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ins&#243;nia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Falta de apetite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Obstipa&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diarreia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dificuldades financeiras&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Avalia&#231;&#227;o da QdV pelo EORTC QLQ-C30&#44; de acordo com o PG-SGA&#46;</p>"
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          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">n&#46;s&#46;&#58; n&#227;o significativo&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Sem desnutri&#231;&#227;o</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Desnutri&#231;&#227;o</span><span class="elsevierStyleItalic">&#40;moderada&#47;grave&#41;</span>&#40;&#37;&#41; mediana&#40;m&#237;nimo-m&#225;ximo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dispneia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;2 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#44;9 &#40;0&#44;0-88&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Tosse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hemoptises&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Mucosites&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-33&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Disfagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Neuropatia perif&#233;rica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;7 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Alop&#233;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dor no peito&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dor no bra&#231;o ou ombro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dor noutra parte do corpo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;0 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#40;0&#44;0-100&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Avalia&#231;&#227;o da QdV pelo EORTC QLQ-LC13&#44; de acordo com o PG-SGA&#46;</p>"
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Article information
ISSN: 08732159
Original language: Portuguese
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