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"Pendahuluan: Sindrom Vena Kava Superior (SVKS) merupakan kegawatan onkologi yang membutuhkan penanganan segera, walaupun belum ada hasil histologi. Sebagian besar pasien dengan SVKS dapat ditangani dengan radioterapi. Metode penelitian: Penelitian ini menggunakan metode kohort retrospektif. Kami mengumpulkan data dari catatan rekam medis pasien keganasan rongga toraks dengan SVKS setelah radioterapi-segera di Rumah Sakit Persahabatan dalam jangka waktu Maret 2009 sampai Februari 2012. Analisis Kaplan-Meier digunakan untuk menilai angka tahan hidup pasien. Hasil Penelitian: Seluruh subjek berjumlah 104 orang. Subjek penelitian sebagian besar laki-laki (83,7%) dengan sebagian besar usia di atas 51 tahun (52,9%). Sebanyak 86 kasus merupakan kanker paru dengan jenis histologi terbanyak adenokarsinoma (61,5%), disusul dengan karsinoma sel skuamosa sebanyak 10 subjek (9,6%). Germ cell dan limfoma ditemukan masing-masing sebanyak 8 subjek (7,7%) dan 6 subjek (5,8%). Kesimpulan: Angka tahan hidup 1 tahun pasien keganasan rongga toraks dengan SVKS pasca radioterapi-segera sebesar 27%, dengan masa tengah tahan hidup (MTTH) 11 minggu, masa tahan hidup (MTH) 125 minggu, dan rerata lama hidup 13,3 minggu. Jenis kelamin perempuan, jenis keganasan tumor mediastinum dan kemoterapi merupakan faktor prognosis yang baik. Tidak ada perbedaan bermakna angka tahan hidup antara pasien kanker paru dengan jenis histologi adenokarsinoma dan non-adenokarsinoma.

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Introduction: The superior vena cava syndrome (VCSS) is considered to be an oncologic emergency that requires immediate therapeutic action, even before a histologic diagnosis is obtained. Most patients with VCSS can be successfully managed with medical or radiation therapy. Methods: This study used the retrospective cohort method. We collected the data from medical records of thoracic malignancy with VCSS patients after cito-radiotherapy in Persahabatan Hospital, within March 2009 until February 2012. The Kaplan-Meier analysis was done to obtain patients survival rate. Results: Subjects in this study were mostly male (83,7%) with predominant age group of over 51 years old (52,9%). Lung carcinoma were 86 cases with predominant histopathologic type of adenocarcinoma (61,5%), squamous cell carcinoma were 10 subjects (9,6%), germ cell were 8 subjects (7,7%) and lymphoma were 6 subjects (5,8%). Conclusion: The 1-year survival rate of thoracic malignancy patients with VCSS after radiotherapy-cito in Persahabatan Hospital was 27%, with median survival time of 11 weeks, survival time of 125 weeks and mean survival time of 13,3 weeks. We found that sex of female, mediastinum tumor and chemotheraphy were good prognostic factors. There is no significant difference survival rate between adenocarcinoma and non-adenocarcinoma."

"Latar belakang. Sindrom vena kava superior adalah kumpulan gejala akibat penekanan atau infiltrasi terhadap vena kava superior dan merupakan kegawatdaruratan medis yang perlu ditatalaksana segera. Penilaian karakteristik dan kesintasan penting dalam menentukan diagnosa dan tatalaksana pasien SVKS. Tujuan. Mengetahui karakteristik dan kesintasan 90 hari pasien SVKS di Rumah Sakit Cipto Mangunkusomo dan Rumah Sakit Kanker Dharmais. Metode. Studi menggunakan desain kohort retrospektif yang dilakukan melalui catatan rekam medik pasien SVKS selama bulan Januari 2000 hingga Desember 2011 di Rumah Sakit Cipto Mangunkusomo dan Rumah Sakit Kanker Dharmais. Hasil. Dari 151 subjek penelitian, terbanyak didapatkan pada jenis kelamin laki-laki (76,2 %), rentang umur 46-60 tahun (46,3%) dengan manifestasi yang sering ditemukan berupa sesak napas, distensi vena leher dan bengkak di wajah. Gambaran radiologis massa yang tersering adalah di bagian mediastinum superior. Non small cell lung cancer merupakan jenis penyebab SVKS yang terbanyak. Kesintasan kumulatif pasien SVKS dalam 90 hari adalah 54% dengan rerata kesintasan adalah 42,5 (SE 5,2) hari serta gambaran kesintasan yang menetap mulai hari ke-60. Kesimpulan. Kejadian SVKS terbanyak ditemukan pada pasien non small cell lung cancer, jenis kelamin laki-laki dan rentang usia 46-60 tahun dengan manifestasi klinis yang sering ditemukan adalah sesak napas, distensi vena leher dan bengkak pada wajah. Kesintasan kumulatif pasien SVKS dalam 90 hari adalah 54% dengan rerata kesintasan adalah 42,5 (SE 5,2) hari serta gambaran kesintasan yang menetap mulai hari ke-60.

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Introduction. Superior vena cava syndrome is a syndrome due to compression or infiltration to superior vena cava and is a medical emergency that needs to be managed immediately. The study of characteristic and survival rate of SVCS patients. is important to determine the diagnosis and treatment.

Objective. To obtain the characteristic and 90 days survival rate of SVCS patients in Cipto Mangunkusomo and Dharmais Cancer Hospital.

Methods. This is a restrospective cohort study conducted through medical record of SVCS patients during January 2000 to December 2011 in Cipto Mangunkusomo and Dharmais Cancer Hospital.

Result. The study population was 151 subjects and most of the patients were male (76.2%). The age of the patient mostly range from 46 to 60 years old (46,3%). Dyspnoe, neck vein distention and facial swelling were the frequent chief complains. The location of the mass based on radiological examination was found mostly in superior mediastinum. Non small cell lung cancer is the most common etiology of SVCS patient. The cumulative survival of SVCS patient in 90 days is 54 %, mean survival was 42.5 (SE 5.2) and the survival rate showed plateau appearance from the day of 60th.

Conclusion. Superior Vein Cava Syndrome patients in this study mostly due to non small cell lung cancer, found mostly in males and the age range was 46-60 years old. Dyspnoe, neck vein distention and facial swelling were the frequent chief complains. The cumulative survival of SVCS patient in 90 days is 54 %, mean survival was 42.5 (SE 5.2) and the survival rate showed plateau appearance from the day of 60th."

"Latar belakang: Laju penurunan VEP1 dan VEP1/KVP pada pasien PPOK dari beberapa data yang ada menunjukkan penurunan yang lebih tajam dibandingkan normal, namun untuk penelitian yang dilakukan selama 1 tahun belum pernah diperbarui di RSUP Persahabatan. Penelitian ini mencoba untuk mengetahui laju penurunan nilai VEP1, VEP1/KVP pada pasien PPOK setelah 1 tahun pengobatan. Metode: Penelitian kohort retrospektif ini dilakukan untuk mengukur laju penurunan nilai VEP1, VEP1/KVP pasien PPOK di klinik Asma PPOK RSUP Persahabatan setelah pengobatan selama 1 tahun. Hasil: Laju penurunan nilai VEP1 setelah 1 tahun pengobatan adalah sebesar 121,53 120ml/tahun sedangkan laju penurunan nilai VEP1/KVP setelah 1 tahun pengobatan adalah sebesar 2,75 0,47 p10 80,6, derajat GOLD 2 64,5 , mengkonsumsi LABACs 64,5 dan usia terdiagnosis ≥60 tahun 64,5 . Laju penurunan VEP1 lebih banyak terjadi pada kelompok D 110ml/tahun sedangkan laju penurunan VEP1/KVP lebih banyak terjadi pada kelompok B 3,29. Kesimpulan: Pada penelitian ini diketahui sebagian besar pasien mengalami laju penurunan VEP1 dan VEP1/KVP yang bermakna secara statistik dan sebagian kecil yang mengalami kenaikan meskipun tidak bermakna secara statistik. Tidak didapatkan hubungan yang berbeda bermakna baik antara jenis kelamin, usia, keluhan respirasi, riwayat merokok, IB, jenis rokok, komorbid, tingkat pendidikan, usia terdiagnosis, IMT, kelompok A-B dan C-D, kelompok A-C dan B-D, riwayat eksaserbasi, CAT, derajat obstruksi dan pemberian terapi LABACs dengan laju penurunan nilai VEP1 dan VEP1/KVP. Kata kunci: Penurunan fungsi paru, PPOK.

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Background: The rate of decline in FEV1 and FEV1/FVC in COPD patients from some of the available data shows more decline than normal, but for a 1 year study has not been updated in Persahabatan Hospital. This study attempted to determine the rate of FEV1 and FEV1/FVC decline in COPD patients after 1 year treatment.

Methods: This retrospective cohort study was conducted to measure the rate of FEV1 and FEV1/FVC decline in COPD patients at Asthma COPD Clinic Persahabatan Hospital after 1 year treatment.

Results: The rate of decline in FEV1 after 1 year treatment was 121.53 120ml/year while the rate of decline in FEV1/FVC after 1 year treatment was 2.75 0.47 p 10 80.6 , GOLD 2 64.5 , with LABACs treatment 64.5 and diagnosed ge;60 years 64.5 . The rate of decline in FEV1 was more prevalent in group D 110ml/year while the rate of decline in FEV1/FVC was more prevalent in group B 3.29.

Conclusions: In this study most patients have a statistically significant rate of decline in FEV1 and FEV1/FVC, however a small proportion of patients experienced increases in FEV1 and FEV1/FVC although it does not reach statistical treshhold. No significant differences are found between sex, age, respiratory complaints, smoking history, BI, type of cigarette, comorbid, educational level, diagnosed age, BMI, AB and CD group, AC and BD group, history of exacerbations, CAT, obstruction and treatment of LABACs with rate of decline in VEP1 and VEP1 / KVP. "

"Hemoptisis dapat diartikan sebagai batuk darah yang disebabkan perdarahan saluran pernapasan. Penyebab hemoptisis sangat bervariasi di beberapa tempat, tergantung dari area geografis. TB pulmonal masih merupakan penyebab utama hernoptisis pada beberapa negara, sedangkan pada beberapa negara berkernbang, bronkiektasis, kanker paru serta bronkitis rnerupakan penyebab tersering hemoptisis .. Foto toraks dan CT Scan Toraks rnerupakan modaIitas radiologi yang dapat digunakan untuk skrining penyebab hernoptisis. Tujuan penelitian ini adalah untuk.menillai garnbaran CT Scan toraks dan toto toraks dalam rnengevaluasi kelainan paru pada penderita hemoptisis, pada 55 pasien dewasa yang datang ke Instalasi Radiologi yang dikirirn oleh poli paru maupun IGD Paru RS Persahabatan. Pasien dengan batuk darah dilakukan perneriksaan toto toraks dan dilakukan evaluasi. Kemudian pada pasien yang sarna, dilakukan pemeriksaan CT Scan toraks, dengan jeda waktu yang tidak lebih dari 1 bulan dari pemeriksaan toto toraks. Penilaian gambaran toto toraks dan CT Scan toraks dilakukan oleh peneliti ~ang dikonfirmasi kepada satu orang spesialis radiologi konsultan toraks. Statistik deskriptif ptong Iintang yang didapatkan dengan internal comparison untuk mengetahui penyebab hemoptisis terbanyak dengan menggunakan CT Scan toraks dan foto toraks. Didapatkan hasil bahwa penyebab hemoptisis terbanyak dengan menggunakan toto toraks yaitu TB paru ( 40%), tumor pam (18,1 %), bronkiektasis (3,6%), sedangkan dengan CT Scan toraks didapatkan hasil TB pam (60%), bronkiektasis (52,7%) dan tumor paru (32,7%). CT Scan toraks bermakna secara statistic unutk menentukan penyebab hemoptisis dibandingkan toto toraks, sehingga CT Scan toraks sebaiknya dirnasukan dalam penataIaksanaan pasien hemoptisis.

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Hemoptysis can be interpreted as coughing blood due to respiratory tract bleeding. The cause of hemoptysis vary widely in some places, depending on the geographical area. Pulmonary TB is still a major cause of hemoptysis in some countries, while in some developing countries, bronchiectasis, lung cancer and bronchitis is a common cause hemoptisis. Chest radiograph and thoracic CT scan is a radiology modality that can be used for screening the cause of hemoptysis. The purpose of this research is an overview to evaluate thoracic CT scan and chest radiograph to evaluate lung abnormalities in patients with hemoptysis. We performed a prospective cross sectional study of 55 adult patients with hemoptysis who were attending outpatient Persahabatan Hospital, from February until April 2014, that come to the Radiology sent by lung and pulmonary policlinic or emergency room. The patient's was done the chest x-ray examination and evaluation. Later in the same patients, thoracic CT scan performed, with a time lag of no more than I month of chest X-ray. Assessment overview chest radiograph and thoracic CT scan performed by a researcher who was confirmed to the consultant thoracic radiology specialists. This research are showed that most caused of hemoptysis us10g the chest radiograph are pulmonary tuberculosis (40%), lung tumors (18.1%), bronchiectasis (3 .6%), whereas the thoracic CT scan showed pulmonary tuberculosis (60%), bronchiectasis (52.7%) and lung tumors (32.7%). Bronchiectasis seen five times more on thoracic CT scans beside chest radiography. Thoracic CT scan are statistically significant to determine the cause of hemoptysis compared chest radiograph, chest so CT scan should be included in the management of patients hemoptysis."

"Latar Belakang: Kanker paru menjadi penyebab kematian utama akibat keganasan pada laki-laki sebesar 31% dan perempuan sebesar 27%. Pada pasien adenokarsinoma paru dengan mutasi pada exon 20 T790M memberikan respons yang buruk terhadap terapi EGFR-TKI generasi pertama maupun generasi kedua. Tujuan: Mengetahui profil serta angka tahan hidup 1 tahun pasien kanker paru jenis Adenokarsinoma dengan mutasi exon 20 T790M primer. Metode: Penelitian menggunakan desain kohort terhadap pasien-pasien adenokarsinoma paru stadium IV dengan mutasi exon 20 T790M primer dari bulan September 2015 sampai Desember 2017 di RSUP Persahabatan. Variabel yang diteliti adalah karakteristik klinis dan angka kesintasanberdasarkan kurva Kaplan Meier. Hasil analisis dinyatakan berbeda bermakna apabila nilai p<0,05. Hasil: Didapatkan 27 subjek penelitian dengan rerata usia 58,5 tahun dan berjenis kelamin laki-laki (70,6%). Keluhan utama berupa sesak napas (73,5%) dan nyeri dada (55,9%). Mutasi genetik tunggal pada Exon 20 T790M (64,7%), sedangkan mutasi Exon 20 T790M dengan Exon 21 L858R (11,8%) dan mutasi Exon 20 T790M dengan 21 L861Q (8,8%). Organ target metastasis adalah efusi pleura (73,5%), tulang (26,5%) dan otak (20,6%). Angka kesintasan 360 dan 990 hari sebesar 35% dan 20% dengan median kesintasan sebesar 213 hari. Kesimpulan: Mutasi exon 20 T790M pada adenokarsinoma paru memegang peranan penting terhadap kesintasan dan prediktor responsterhadap terapi yang diberikan.

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Background: Lung cancer causes mortality in men (31%) and in women (27%). Lung adenocarcinoma patients with exon 20 T790Mepidermal growth factor receptor(EGFR) mutation showed poor response to the first generation and second generation of EGFR tyrosine kinase inhibitor (TKI) therapy.

Purpose: This study aims to reveal the characteristics and one year survival rate of lung adenocarcinoma patients with primary exon 20 T790M EGFR mutations treated at Persahabatan Hospital Jakarta, Indonesia.

Methods: The cohort study involved patients with primary exon 20 T790M EGFR mutation between September 2015 to December 2017 in Persahabatan Hospital Jakarta, Indonesia. The survival rate was observed from Kaplan Meier estimator curve and was statistically analyzed.

Results: There were 27 subjects with mean age of 58.5 years and were predominated male (70.6%). The most common chief complaints were shortness of breath (73.5%) and chest pain (55.9%). The EGFR mutations detected were exon 20 T790M (64.7%), exon 20 T790M with exon 21 L858R (11.8%) and exon 20 T790M with exon 21 L861Q (8.8%). Metastatic target organs were pleural effusions (73.5%), bone (26.5%) and brain (20.6%). Survival rate of 360 and 990 days was 35% and 20% respectively with median survival rate was 213 days.

Conclusion: Exon 20 T790M EGFR mutation in lung adenocarcinoma was revealed to be an important factor in survival and in predicting response to EGFR TKI chemotherapy."

"Latar belakang: Trombosis vena dalam merupakan komplikasi tersering yang dijumpai pada keganasan. Insidens trombosis vena dalam pada kanker paru sangatlah tinggi bila dibandingkan dengan populasi umum. Saat ini belum ada pedoman alur diagnosis yang dapat menegakkan diagnosis trombosis vena dalam pada kanker paru. Selain itu, penelitian serupa juga belum pernah dilakukan di Indonesia sehingga hasil penelitian ini dapat menjadi penelitian pendahuluan yang menitikberatkan pada trombosis vena dalam pada kanker paru.Tujuan: Tujuan penelitian ini adalah untuk menilai proporsi trombosis vena dalam menggunakan kriteria klinis yaitu skor Wells’ pada pasien kanker paru yang dirawat di RS Persahabatan.Metode: Desan penelitian ini menggunakan metode potong lintang. Kami melakukan pemeriksaan pada pasien kanker paru yang dirawat sejak September 2012 hingga Februari 2013. Kami menyingkirkan pasien kanker paru dengan penyakit infeksi serta pasien kanker paru dengan sediaan histopatologi yang belum tegak. Pemeriksaan fungsi hemostasis seperti PT, APTT dan D-dimer tetap dilakukan bersama dengan penggunaan kriteria klnis skor Wells’. Diagnosis trombosis vena dalam ditentukan apabila skor Wells berat.Hasil: Subjek dalam penelitian ini terbanyak adalah laki-laki (69,2%) dengan kelompok usia terbanyak yaitu kelompok usia 51-60 tahun (33,3%). Jenis histopatologi yang terbamyak ditemukan adalah jenis adenokarsinoma (57,7%). Hampir sebagian besar pasien yaitu 64 pasien (82,1%) memiliki D-dimer >500 dan hanya 14 pasien (17,9%) dengan D-dimer normal. Penelitian ini mengungkapkan proporsi trombosis vena dalam menggunakan skor Wells adalah 23,1%.%. Faktor-faktor seperti jenis kelamin, usia, riwayat merokok, jenis tumor, stadium tumor, status penampilan, serta fungsi hemostasis tidak berpengaruh terhadap trombosis vena dalam namun nilai D-dimer >500 berpengaruh terhadap trombosis vena dalam.Kesimpulan: Proporsi trombosis vena dalam pada pasien kanker paru di RS Persahabatan hampir sama jumlahnya dengan penelitian-penelitian di negara lain yaitu sekitar 21%. Penelitian ini menunjukkan bahwa skor Wells masih mempunyai peran penting dalam menentukan trombosis vena dalam mengingat penggunaannya mudah dan praktis. Penelitian selanjutnya diperlukan untuk menilai metode yang mudah dan sederhana digunakan dalam praktek sehari-hari bersama dengan skor Wells dalam menentukan trombosis vena dalam pada kanker paru.

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Background: Deep vein trombosis (DVT) is the common complication found in malignancy. Its incidence in lung cancer is much higher than in general population. Since there were no current diagnosis guideline which could help identify DVT in lung cancer and there were no similar study conducted before in Indonesia, thus this study could be a pilot study for further research focusing DVT in lung cancer.

Objective: The objective of this study is to find deep vein trombosis proportion among lung cancer patients which is determined by clinical criteria such as Wells’ score in Persahabatan Hospital.

Method: The study design is using a cross-sectional method. We examined the lung cancer patients who were hospitalized within September 2012 to Februari 2013. We excluded the lung cancer patients with infection comorbidity or who had not yet had histopathological confirmation. The hemostatis work up included PT, APTT, and D-dimer were conducted along with clinical Wells’ score criteria. Deep vein trombosis among the patients is determined by severe Wells’ score.

Results: Subjects in this study were mostly male (69,2%) with predominant age group of 51-60 years old (33,3%). Predominant histopathologic sub type was adenocarcinoma (57,7%). Mostly, 64 patients (82,1%) had D-dimer >500 and only 14 patients (17,9%) with normal D-dimer. This study found that deep vein trombosis proportion is 23,1% using Wells’ score. Clinical characteristics such as sex, age, smoking history, tumor cell type, tumor staging, performance status and hemostasis function does not have correlation with DVT but score of D-dimer >500 have correlation with DVT.

Conclusion: The DVT proportion among lung cancer patients in Persahabatan Hospital is similar found in some studies in other countries which is approximately 21%. This study revealed that the simple and practical application of Wells’ score in determining DVT is still have valueable role. Further study is needed to find the best simple and easy methods along with Wells’ score in determining DVT in daily practice."

"[ABSTRAKPendahuluan. Kanker paru jenis karsinoma bukan sel kecil (KPKBSK) terdiri dari nonskuamosa dan skuamosa. Kanker paru jenis karsinoma bukan sel kecil nonskuamosa adalah adenokarsinoma dan karsinoma sel besar. Saat ini terapi kanker paru sangat berkembang dari agen kemoterapi sampai terapi target terutama EGFR-TKI. Penelitian ini bertujuan untuk menilai angka tahan hidup pasien KPKSBK nonskuamosa yang mendapat kemoterapi lini pertama dibandingkan terapi EGFR-TKI di RSUP Persahabatan.Metode. Penelitian ini adalah penelitian retrospektif antara tahun 2010 sampai 2013 dari rekam medis pasien KPKBSK non skumosa yang mendapatkan kemoterapi lini pertama dan EGFR-TKI. Pasien dikemoterapi dengan platinum baseddan EGFR-TKI diterapi gefitinib 1x250 mg/hari atau erlotinib 1x150 mg/hari. Angka tahan hidup dinilai dari mulai tegak diagnosis sampai pasien meninggal atau saat penelitian dihentikan.Hasil. Dari 96 sampel KPKBSK non skuamosa terdiri dari 48 pasien yang mendapat kemoterapi lini pertama dan 48 pasien yang diterapi EGFR-TKI. Berdasarkan karakteristik pasien, usia terbanyak adalah 40-60 tahun (kemoterapi 32 (66,7%) dan EGFR-TKI 31 (64,6%) dengan jenis kelamin laki-laki yang mendominasi (kemoterapi 25(52,1%), EGFR-TKI 27 (56,2%). Pasien merokok yang mendapat kemoterapi lini pertama 41,7% dan EGFR-TKI 56,3% dengan IB terbanyak untuk kemoterapi (IB ringan 27,1%) dan untuk EGFR-TKI (IB sedang 22,9%). Jenis histologi adenokarsinoma 95,8% dengan dominasi stage IV 89,6% (kemoterapi 91,7% dan EGFR-TKI 87,5%) disertai tampilan status 2 59,4%. Angka tahan hidup pasien (ATH) 6 bulan 74%, ATH 1 tahun 22,90% dan ATH 2 tahun 6,20%. Masa tengah tahan hidup (MTTH) pasien yang mendapat EGFR-TKI lebih lama sedikit dibandingkan yang mendapat kemoterapi lini pertama (263 hari versus 260 hari.Kesimpulan. Masa tahan hidup 1 tahun pasien KPKBSK non skuamosa yang diterapi EGFR-TKI sedikit lebih lama dibandingkan kemoterapi lini pertama (263 hari vs 260 hari). Sedangkan ATH 1 tahun pasien kemoterapi lini pertama lebih besar dibandingkan EGFR-TKI (25% vs 20,8%). Faktor yang paling mempengaruhi angka tahan hidup adalah stage dengan nilai p<0,05.

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ABSTRACT Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05., Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.]"

"Kanker paru adalah salah satu jenis penyakit paru yang memerlukan penanganan dan tindakan cepat dan terarah. Penegakan diagnosis penyakit ini membutuhkan ketrampilan, sarana serta pendekatan multidisiplin kedokteran. Penyakit ini membutuhkan kerjasama yang erat dan terpadu antara ahli pare dengan ahli radiologi diagnostik, ahli patologi anatomi, ahli radioterapi, ahli bedah toraks, ahli rehabilitasi medik dan ahli lainnya. Insidensi kanker paru terus meningkat baik di negara maju maupun negara berkembang. Penyakit ini menjadi kanker paling sering di dunia pada laki-laki dan kelima terbanyak pada perempuan serta menjadi penyebab utama kematian laki-laki. Amerika Utara dan sebagian besar negara Eropa. Angka morbiditi dan mortaliti makin meningkat di negara berkembang seiring dengan penambahan populasi, aktiviti merokok serta pengaruh lingkungan, Pengobatan atau penatalaksanaan kanker paru sangat tergantung kepada kecepatan dan ketelitian mendapatkan diagnosis pasti. Penemuan kanker paru pada penderajatan (staging) dini akan sangat membantu penderita memperoleh kualiti hidup lebih baik dalam perjalanan penyakitnya meskipun tidak dapat menyembuhkannya. Pilihan terapi harus dapat segera dilakukan mengingat respons kanker paru yang buruk terhadap berbagai jenis pengobatan. Kontroversi multimodaliti terapi untuk penatalaksanaan optimal dibandingkan dengan efek samping yang ada pada kanker paru masih menjadi perdebatan dan penelitian ini masih terus berlangsung."

"ABSTRAKLatar Belakang: Kanker paru dan tuberkulosis TB adalah dua masalah kesehatan di seluruh dunia dengan angka kesakitan dan kematian yang tinggi. Meningkatnya kasus TB aktif dan reaktivasi TB laten pada pasien kanker paru serta dampak buruknya terhadap prognosis pasien memerlukan upaya untuk melakukan deteksi TB laten pada pasien kanker paru. Penelitian ini bertujuan untuk mengetahui berapa besar proporsi TB laten pada pasien kanker paru, karakteristiknya dan hubungan antar keduanya.Metode: Penelitian ini menggunakan desain potong lintang dan sampel dikumpulkan secara consecutivesampling terhadap 86 pasien kanker paru baru terdiagnosis di Rumah Sakit Umum Pusat Persahabatan Jakarta tahun 2015 hingga 2016. Pemeriksaan sputum Xpert MTB/RIF dilakukan untuk menyingkirkan kemungkinan TB aktif. Penentuan TB laten dilakukan dengan pemeriksaan Interferon Gamma Release Assay IGRA menggunakan alat QuantiFERON-TB Gold-in-Tube QFT-GIT .Hasil: Pemeriksaan TB laten mendapatkan hasil IGRA 11 pasien 12,8 , IGRA - 59 pasien 68,6 dan IGRA indeterminate I 16 pasien 18,6 . Karakteristik sosiodemografi pasien kanker paru dengan TB laten adalah 63,6 laki-laki, rerata usia 56 tahun, 36,4 diimunisasi BCG, 9 dengan kontak erat TB, 72,7 dengan riwayat merokok. Karakteristik klinis pasien tersebut 90 memiliki status gizi normal lebih dengan nilai tengah indeks massa tubuh IMT 19,12 18,24-29,26 kg/m2, nilai tengah hitung limfosit total 1856 1197-4210 sel/ul, 9 dengan komorbid diabetes mellitus, 81,8 tumor paru mengenai lokasi khas predileksi TB paru. Jenis kanker terbanyak adalah adenokarsinoma 81,8 dengan stage lanjut 81,8 dan status tampilan umum 2-3 63,6 . Karakteristik yang menunjukkan hubungan bermakna dengan hasil IGRA adalah lokasi tumor yang mengenai daerah lesi khas TB secara radiologis. Hitung limfosit total yang rendah berhubungan dengan hasil IGRA I dengan nilai tengah 999,88 277-1492,60 sel/ul.Kesimpulan: Proporsi TB laten pada pasien kanker paru di RSUP Persahabatan adalah 12,8 . Karekteristik pasien kanker paru yang berhubungan dengan TB laten adalah lokasi tumor yang mengenai daerah lesi khas TB walaupun belum dapat disimpulkan hubungannya secara biologis. Hasil IGRA I pada pasien kanker paru dengan hitung limfosit total yang rendah menunjukkan keterbatasan sensitivitas IGRA dalam mendeteksi infeksi TB laten pada pasien imunokompromais.Kata Kunci : infeksi TB laten, kanker paru, IGRA, hitung limfosit total

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ABSTRACTBackground Lung cancer and pulmonary tuberculosis TB are two major public health problems associated with significant morbidities and mortalities. The increased prevalence of active TB and latent TB reactivation in lung cancer patients and the negative effect of pulmonary TB in lung cancer prognosis underline the need for a through screening of lung cancer patients for latent TB infection LTBI . The aims of this study are to determine the proportion of LTBI in lung cancer patients, their characteristics and the relationship between them.Methods This study used a cross sectional design and sample was collected using consecutive sampling of the 86 newly diagnosed treatment naive lung cancer patients from a referral respiratory hospital, Rumah Sakit Umum Pusat Persahabatan Jakarta in 2015 to 2016. The presence of LTBI was determined by Quantiferon TB Gold In Tube QFT GIT after having Mycobacterium TB not detected result from Xpert MTB RIF sputum test. Demographic characteristics and cancer related factors associated with LTBI were investigated.Results There are 11 patients 12,8 with IGRA result and 16 patients 18,6 with IGRA indeterminate I result. Sociodemographic characteristics of lung cancer patients with latent TB are 63,6 male, mean of age 56 years, 36,4 with BCG immunization, 9 had TB close contacts history, 72,7 with a history of smoking. The clinical characteristics of these patients are 90 had a normal nutritional status with the median body mass index BMI 19,12 18,24 29,26 kg m2, the median of total lymphocyte count is 1856 1197 4210 cells ul, 9 with diabetes mellitus as comorbid, 81,8 of lung tumour located in the typical predilection for pulmonary tuberculosis. Most types of lung cancer are adenocarcinomas 81.8 with advanced stage 81,8 and the WHO performance status of 2 3 63,6 . Characteristics having significant relationship with IGRA results is the tumour located in the typical TB area radiologically. Low total lymphocyte count is associated with indeterminate IGRA results with median 999,88 277 1492,6 cells ul.Conclusion The proportion of latent TB in lung cancer patients is 12,8 . Characteristics of patients with lung cancer associated with latent TB is the location of the tumor lesions typical of the area although it can not be concluded biologically. Having indeterminate IGRA results in lung cancer patients with a low total lymphocyte count showed the limitations of QFT GIT in detecting latent TB infection in immunocompromised patients.Key words latent TB infection, lung cancer, IGRA, total lymphocyte count "

"Pasien KPKBSK mengalami progresifitas penyakit 8-12 minggu setelah pemberian kemoterapi lini kedua sehingga pemberian kemoterapi lini kedua dapat digunakan untuk meningkatkan ketahanan hidup pasien. Dosetaksel dapat digunakan sebagai kemoterapi lini kedua pada pasien yang mengalami perburukan setelah kemoterapi lini pertama. Namun penelitian pemberian dosetaksel sebagai kemoterapi lini kedua belum ada di Indonesia. Sampai saat ini, kami belum mendapatkan data mengenai efikasi dosetaksel seperti ketahanan hidup toksistitas pada orang Indonesia. Objektif : Tujuan penelitian ini adalah untuk menilai ketahanan hidup pasien KPKBSK yang diberikan dosetaksel sebagai kemoterapi lini kedua di RS Persahabatan. Metode : Desain penelitian ini adalah kohort retrospektif. Kami mengumpulkan catatan rekam medis pasien yang mendapatkan dosetaksel sebagai kemoterapi lini kedua di RS Persahabatan sejak bulan Januari 2011 hingga Februari 2014. Kami melakukan kunjungan rumah atau komunikasi via telepon apabila informasi dalam rekam medis tidak lengkap. Kami melakukan analisis Kaplan-Meier dan uji Log Rank untuk menilai faktor yang mempunyai korelasi terhadap ketahanan hidup pasien. Hasil : Subjek terbanyak yang dijumpai adalah laki-laki (72,7%) dengan kelompok usia >50 tahun sebanyak (79,5%) serta rerata usia 57,00±SD 10,00 dengan rentang 30?74 tahun. Angka tahan hidup 1 tahun yang kami temukan adalah 70,5% dengan masa tengah tahan hidup16,18 bulan. Toksisitas hematologi anemia grade 1 sebanyak (40,9%), anemia grade 2 sebanyak (2,3%), anemia grade 3 sebanyak (2,3%). Toksisitas hematologi leukopenia grade 1 sebanyak (4,5%) dan leukosit grade 1 sebanyak (2,3%) serta toksisitas hematologi neutropenia grade 1 sebanyak (2,3%). Toksisitas nonhematologi yang ditemukan adalah mual-muntah (84,1%), mialgia (90,9%) serta neuropati (97,7%). Tampilan status dan modalitas selain kemoterapi merupakan faktor prognostik yang baik. Berdasarkan uji Cox Regression, tampilan status berperan dalam ketahanan hidup Exp(B) 0,109(95%CI 0,015-0,816; p= 0,031). Kesimpulan : Dosetaksel dapat digunakan sebagai kemoterapi lini kedua karena ketahanan hidup yang didapatkan cukup baik dengan toksisitas ringan. Tampilan status dan pemberian modalitas terapi lain merupakan faktor prognostik yang baik.

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Since NSCLC patients had disease progression after 8-12 weeks after first line chemotherapy so that second line chemotherapy could be applied to prolong survival. Docetaxel could be applied for NSCLC patient who had disease progression. However, research on Docetaxel application as second line chemotherapy had not yet conducted in Indonesia. So far, we had not data on docetaxel efficacy such as its survival rate and its toxicity on Indonesian subjects.

Purpose : The objective of the study to evaluate the survival rate of docetaxel as second line chemotherapy for NSCLC patients in Persahabatan Hospital.

Methode : This study used the cohort retrospective method. We collected the data from medical records of NSCLC patients who had docetaxel as second line chemotherapy in Persabatan Hospital, within Januari 2011 until February 2014. If the medical record didn?t give the information that was needed, we did the phone callor home visit. The Kaplan-Meier analysis was done and continued with Log Rank test to evaluate factors that correlate with patients survival rate.

Result : Subjects in this study were mostly male (72,7%) with predominant age group of over 50 years old (79,5%) and mean age were 57,00±SD 10,00 within range 30?74 years old. Predominant histopathologic type of NSCLC was adenocarcinoma(91%). This study found that 1-year survival rate of patients after docetaxel chemotherapy was 70,5% amd median survival time of 16,18 month. hematological toxicity found were anemia grade 1 (40,9%), grade (2,3%), grade 3 (2,3%), also leucopenia grade 1 (4,5%) grade 2 (2,3%) and neutropenia grade 1 (2,3%). Nonhematological toxicity found were nausea (84,1%), myalgia (90,9%) and neuropathy (97,7%). We found that performance status and additional treatment modality were good prognostic factors on bivariate analysis. Furthermore, only performance status was found as prognostic factors on Cox Regression Exp(B) 0,109 (95%CI 0,015-0,816; p= 0,031).

Conclusion : Docetaxel could be applied as second line chemotherapy since its survival rate was good while its toxicity found was mild. Performance status and additional treatment modality were good prognostic factor."