Ordem de infusão de medicamentos antineoplásicos no tratamento de tumores de mama, pulmão e colorretal: uma revisão sistemática

Abstract

Establishing the order of administration of antineoplastic agents is crucial for optimizing therapeutic effects, reducing toxicities, and avoiding drug interactions that could compromise treatment. The aim of this study was to identify the most appropriate infusion order for the treatment of breast, lung, and colorectal cancers. The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (International Prospective Register of Systematic Reviews), including phase III clinical trials involving adults diagnosed with breast, lung, and colorectal cancer who received more than one intravenous antineoplastic on the same day. A bibliographic search was conducted in the MEDLINE/PubMed, BVS, CINAHL, and Embase databases, and the studies were classified according to the Grading of Recommendations Assessment, Development and Evaluations (GRADE) levels of evidence hierarchy. Five articles were included, each analyzing a different infusion order. Among these, four proposed administration sequences based on research results, with the following protocols: docetaxel and cyclophosphamide; epirubicin and paclitaxel; irinotecan and fluorouracil; and gemcitabine and vinorelbine. The results indicate that the order of administration influences the effectiveness and toxicity of treatments. However, the lack of specific studies on the infusion order underscores the need for further research to guide clinical practice.