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Fadlun Bukayer
Masa tahan hidup pasien kanker paru jenis karsinoma bukan sel kecil yang mendapat monoterapi dosetaksel sebagai kemoterapi lini kedua dan faktor-faktor yang mempengaruhi = Survival rate of docetaxel as secondline chemotherapy for nsclc patients in persahabatan hospital jakarta
"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.
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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tesis Membership  Universitas Indonesia Library
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Kasum Supriadi
Angka tahan hidup pasien kanker paru kelompok bukan sel kecil non skuamosa yang mendapat terapi target Epidermal Growth Factor Receptor-Tyrosin Kinase Inhibitor dan yang mendapat kemoterapi lini pertama di Rumah Sakit Persahabatan = The survival rate of non squamous by non small cell lung carcinoma patiens who are given by target therapy Epidermal Growth Facttor Receptor-Tyrosin Kinase Inhibitors and those given by first line kemotheraphy treatment at Persahabatan Hospital
"[ABSTRAK
Pendahuluan. 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.
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.]"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T58765
UI - Tesis Membership  Universitas Indonesia Library
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Putu Ayu Diah P S
Efikasi dan toksisiti kemoterapi karboplatin-vinorelbin pada pasien kanker paru jenis karsinoma bukan sel kecil (KPKBSK) stage lanjut di RSUP Persahabatan = Efficacy and toxicity of carboplatin vinorelbine chemotherapy in advanced non small cell lung cancer (NSCLC) patients at Persahabatan Hospital
"ABSTRAK
Latar Belakang : Paduan kemoterapi berbasis platinum dengan generasi ketiga khususnya karboplatin-vinorelbin sudah sering digunakan sebagai kemoterapi paliatif pada pasien KPKBSK stage lanjut di Indonesia khususnya Rumah Sakit Umum Pusat RSUP Persahabatan namun sampai saat ini belum terdapat data mengenai efikasi dan toksisiti paduan kemoterapi ini di RSUP Persahabatan.Metode : Desain penelitian ini adalah survey observasional retrospektif pada pasien KPKBSK stage lanjut IIIB dan IV yang menjalani kemoterapi lini I di RSUP Persahabatan dengan paduan kemoterapi karboplatin-vinorelbin sejak 1 Januari 2015 sampai 30 Maret 2017.Hasil : Total subjek dalam penelitian ini adalah 38 pasien yang mendapatkan paduan kemoterapi Karboplatin AUC-5 pada hari ke-1 dan vinorelbin 30 mg/m2 pada hari ke1 dan ke-8. Paduan kemoterapi karboplatin-vinorelbin mempunyai efikasi yang baik dengan Objective overall response rate ORR 12,5 dan clinical benefit rate CBR 87,5 . Overall survival OS pada penelitian ini adalah 34,2 dengan masa tengah tahan hidup 387 hari 12,9 bulan dan progression free survival 323 hari 10,7 bulan. Toksisiti hematologi dan nonhematologi yang paling sering terjadi adalah anemia derajat 1 38,4 dan keluhan mual, muntah derajat 2 57,9 . Pada penelitian ini terdapat 2 kasus perdarahan saluran cerna derajat 2 namun pasien masih dapat melanjutkan kemoterapi. Kami juga mendapatkan komplikasi tindakan kemoterapi berupa phlebitis ringan pada 24 pasien 65,7 dan phlebitis sedang pada 1pasien 2,6 .Kesimpulan: Paduan karboplatin-vinorelbin sebagai kemoterapi lini I memiliki efikasi yang baik serta efek toksisiti yang masih dapat ditoleransi sehingga aman diberikan pada pasien KPKBSK stage lanjut. Kata kunci: efikasi, toksisiti, hematologi, nonhematologi, objective overall response rate, clinical benefit rate, overall survival, MTTH, TTP, PFS
ABSTRAK
Background Combination of platinum base and third generation drugs Carboplatin and vinorelbine chemotherapy are frequently used as paliative chemotherapy for Non small cell lung cancer NSCLC patients in Indonesia especially in Persahabatan Hospital. But there are still no data about the activity and tolerability of this regiment in Persahabatan Hospital. This study is conducted to evaluate the efficacy and toxicity of this regiment as first line chemotherapy for advanced NSCLC patients in Persahabatan Hospital.Method This study is an observational survey retrospective study for advanced NSCLC patientswho receive carboplatin vinorelbine regiment as fisrt line chemotherapy since 1st January 2015 to 30th March 2017.Result We observea total of 38 patients who receive carboplatin 5 AUC on day 1 and vinorelbine 30mg m2 on day 1 and 8. This regiment has a good efficacy with overall response rate ORR 12,5 and clinical benefit rate CBR 87,5 . The overall survival OS is 34,2 with median of survival time 387 days 12,9 moths and PFS 323 days 10,7 moths . We found grade 1 anemia 38,4 and grade 2 nausea vomiting 57,9 as hematological and non hematological toxicity that frequently occur in this study. We found 2 cases of grade 2 gastrointestinal bleeding but the patients are still able to continue the chemotherapy after doing some correction for the haemoglobin Hb . We also found mild phlebitis in 24 patients 65,7 and 1 moderate phlebitis in 1 patient 2,6 as procedural complication of this chemotherapyConclusion Combination ofcarboplatin and vinorelbine as first line chemotherapy has a good efficacy and tolerability for advanced NSCLC patients. Key word efficacy, toxicity, haematological, non hematological, overall objective response rate ORR , clinical benefit rate CBR , overall survival OS , median time of survival, time to progression TTP and progression free survival PFS ."
2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Enita Mayasari
Perbandingan efikasi dan toksisitas hematologi kemoterapi lini i kanker paru karsinoma bukan sel kecil (kpkbsk) jenis karsinoma sel skuamosa (kss) dengan adenokarsinoma egfr wild type di rsup persahabatan = The comparison of efficacy and hematological toxicity of first line chemotherapy of non small cell lung cancer (nsclc) in squamous cell carcinoma (scc) and egfr-wild type adenocarcinoma in persahabatan hospital-Jakarta
"Latar belakang: Meningkatnya insidens kesakitan dan kematian akibat keganasan alternatif terapi dengan kemoterapi. Rejimen kemoterapi menggunakan obat sitotoksik yang mempunyai batas terapi sangat sempit sehingga memberi efek samping lebih besar dibandingkan manfaat dan angka harapan hidup. Kedua hal ini terjadi pada pasien KPKBSK jenis KSS dan adenokarsinoma EGFR wild type.
Metode: Desain penelitian ini dilakukan dengan metode Survey retrospektif dan studi analitik terhadap faktor yang mempengaruhi prognosis. Data diambil dari Rekam Medis RSUP Persahabatan dengan total sampling pada periode 2011 sampai 2016.
Hasil: Sampel penelitian teridiri dari 30 subjek kelompok KSS dan 30 subjek kelompok adenokarsinoma dengan karakteristik subjek laki-laki 86,7% dan subjek perempuan 13,3% dengan usia (median 57, range 36-66). Mendapatkan median TTP pada kelompok KSS yaitu 150 Hari (IK 95% 123,401-176,599) dan adenokarsinoma memiliki TTP 150 Hari (IK 95% 134,818-165,182).Mendapatkan KSS memiliki median PFS 150 Hari (IK 95% 99,790-200,210) dan adenokarsinoma memiliki PFS 150 Hari (IK 95% 121,597-178,403). Mendapatkan median KSS memiliki median OS 330 Hari (IK 95% 265,558-349,412) dan adenokarsinoma memiliki OS 341 Hari (IK 95% 227,930-404,070). Subjek dengan one year survival rate pada kedua kelompok sama banyak yaitu 47%. Kejadian anemia terbanyak yaitu grade 2 pada kelompok KSS sebanyak 8 subjek dan kelompok adenokarsinoma EGFR wild type sebanyak 5 subjek.
Kesimpulan:Perbandingan Efikasi dan toksisitas hematologi kemoterapi lini I kanker paru karsinoma bukan sel kecil (KPKBSK) jenis karsinoma sel skumosa (KSS) dengan adenokarsinoma EGFR wild typetidak mengalami perbedaan yang signifikan.
Background:The increasing incidence of morbidity and mortality is due to malignancy alternative therapy using chemotherapy. Chemotherapy using cytotoxic agents with narrow margin of safety results in greater side effects and decreasing chance of survival that occur in squamous cell carcinoma and wild-type EGFR adenocarcinoma.
Methods: This is a retrospective survey and analytic study of factors that affect prognosis. Data was obtained from patients’ medical records in RSUP Persahabatan from 2011 to 2016.
Results: The subjects of this study consist of 30 patients with squamous cell carcinoma (SCC) and 30 patients with wild-type EGFR adenocarcinoma, 86,7% of the subjects are male and 13,3% are female with median age 57 (range 36-66). Median TTP in SCC is 150 days (CI 95% 123,401-176,599) and in adenocarcinoma is 150 days (CI 95% 134,818-165,182). Progression free survival in SCC is 150 days (CI 95% 99,790-200,210) and in adenocarcinoma is 150 days (CI 95% 121,597-178,403). Median OS of SCC is 330 days (CI 95% 265,558-349,412) and adenocarcinoma is 341 days (CI 95% 227,930-404,070). One year survival rate subjects in those two groups are similar, which is 47%. Highest incidence of anemia is grade 2 anemia in 8 subjects with SCC and 5 subjects with adenocarcinoma.
Conclusion: First-line chemotherapy has similar efficacy and toxicity both in patient with NSCLC-SCC and NSCLC-wild type EGFR adenocarcinoma."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tugas Akhir  Universitas Indonesia Library
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Alvin Kosasih
Efikasi dan toksisiti kemoradioterapi dengan perhatian khusus pada faktor-faktor prognosis dan angka tahan hidup pada penderita kanker paru jenis karsinoma bukan sel kecil di Rumah Sakit Persahabatan
"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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
T18031
UI - Tesis Membership  Universitas Indonesia Library
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Maududi, Abul A`la, supervisor
Profil klinis, kekerapan, spektrum jamur dan Imunoglobulin G Spesifik Aspergillus pada pasien Kanker Paru Karsinoma Bukan Sel Kecil (kpkbsk) yang belum dikemoterapi di Rumah Sakit Umum Pusat Persahabatan = Clinical profile, frequence, fungal spectrum and Aspergillus Specific Immunoglobulin G in Non Small Cell Lung Carcinoma (nsclc) patients who have not received chemotherapy at Persahabatan Hospital
"Latar Belakang : Pasien kanker paru rentan terhadap infeksi jamur. Candida dan Aspergillus merupakan jenis jamur paling banyak yang menyebabkan infeksi jamur pada pasien kanker. Penelitian ini bertujuan untuk mengetahui profil klinis, spektrum jamur dan imunoglobulin G spesifik Aspergillus pada pasien kanker paru yang belum dikemoterapi di RSUP Persahabatan.
Metode : Penelitian ini berdesain potong lintang. Subjek penelitian adalah pasien KPKBSK yang sudah tegak jenis dan belum dikemoterapi yang berobat di RSUP Persahabatan. Dahak dan serum diperiksakan biakan jamur dan IgG spesifik Aspergillus di Departemen Parasitologi Fakultas Kedokteran Universitas Indonesia. Hasil biakan jamur dan IgG spesifif Aspergillus dianalisis untuk mengetahui hubungannya dengan demografi.
Hasil : Subjek penelitian sebanyak 77 pasien. Hasil biakan dahak yang tumbuh jamur sebanyak 76 subjek (98,7%). Jumlah isolat jamur yang tumbuh ≥ dua spesies sebanyak 35 pasien (45,5%). Isolat jamur yang paling banyak tumbuh adalah Candida albicans (72,3%) dan Aspergillus niger (33,8%). Hasil IgG spesifik Aspergillus pada subjek penelitian yang positif sebanyak 22,1%. Terdapat hubungan bermakna antara umur dan leukosit dengan IgG spesifik Aspergillus dan antara umur dan jenis kelamin dengan biakan Aspergillus.
Kesimpulan : Isolat jamur yang ditemukan di antaranya adalah Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis dan Candida kruseii. Terdapat hasil IgG spesifik Aspergillus positif pada subjek penelitian sebanyak 22,1%. Umur dan nilai leukosit berhubungan dengan IgG spesifik Aspergillus dengan nilai (p = 0,048) dan (p = 0,014), sedangkan umur dan jenis kelamin berhubungan dengan biakan Aspergillus dengan nilai (p = 0,027) dan (p = 0,035).
Background: Lung cancer patients are prone to fungal infections. Candida and Aspergillus are the most common cause of fungal infections in cancer patients. This study aimed to determine the clinical profile, fungal detection spectrum and level of Aspergillus specific immunoglobulin-G (igG) of new lung cancer patients prior to chemotherapy at Persahabatan Hospital.
Methods: We performed a cross-sectional study, involving NSCLC patients in Persahabatan Hospital whose type of cancer had been established and had not received chemotherapy as subjects. Sputum and serum of the patients was examined for fungus and Aspergillus specific IgG cultures in the Department of Parasitology Faculty of Medicine, Universitas Indonesia. The results of Aspergillus specific fungi and IgG were analyzed to determine their relationship with demographics.
Results: The study included 77 patients as subjects. Sputum culture detected fungi growth in 76 subjects (98.7%). Fungal isolates that grew ≥ 2 species were present in 35 patients (45.5%). Candida albicans (72.3%) and Aspergillus niger (33.8%) were found from the cultures. Positive Aspergillus specific IgG was present in 22.1% of the subjects. There was a significant relationship between age, leukocytes concentration, and level of Aspergillus specific IgG and between age, sex and Aspergillus culture.
Conclusion: The fungi isolates in this study were Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis and Candida kruseii. Aspergillus specific IgG results were positive in 22.1% of subjects. Age and leukocyte value are associated with Aspergillus specific IgG with (p=0.048) and (p=0.014), and age and sex are associated with Aspergillus culture with (p=0.027) and (p=0.035)."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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Ratna Andriani
Karakteristik, angka tahan hidup dan faktor prognostik pasien kanker paru jenis karsinoma sel kecil = Characteristics, survival rate and prognostic factors of small cell lung cancer patients
"Kanker paru jenis karsinoma sel kecil (KPKSK) pada umumnya bersifat agresif dibandingkan subtipe kanker paru lainnya. Kanker paru jenis karsinoma sel kecil mempunyai doubling time cepat, fraksi pertumbuhan cepat dan bermetastasis dengan cepat dan luas dibandingkan kanker paru jenis karsinoma bukan sel kecil (KPKBSK). Kanker paru jenis karsinoma sel kecil bersifat kemosensitif dan radiosensitif meskipun 95% pasien akhirnya meninggal. Penelitian ini ingin melihat karakteristik, angka tahan hidup dan faktor yang mempengaruhi.
Metode: Penelitian dilakukan dengan metode kohort retrospektif dari rekam medis pasien kanker paru jenis karsinoma sel kecil di RSUP Persahabatan periode 1 Januari 2008 hingga 31 Desember 2012. Data diuji dengan analisis kesintasan Kaplan Meier.
Hasil: Subjek dalam penelitian ini diperoleh 34 orang dengan jenis kelamin laki-laki 32 subjek (94,1 %) dengan usia rata-rata 59 tahun, 34 subjek (100 %) perokok. Keluhan utama subjek paling banyak sesak napas dan keluhan tambahan paling dominan adalah berat badan turun dan sebagian besar subjek tidak mendapat terapi baik kemoterapi maupun radioterapi (38,2 %). Karakteristik tumor paling dominan stage ekstensif 32 subjek (94,1 %), status tampilan PS ≤ 2 pada 30 subjek (88,2 %) dan metastasis paling dominan adalah efusi pleura pada 23 subjek (67,6 %). Masa tengah tahan hidup pasien KPKSK adalah 78,75 hari (2,5 bulan) untuk stage terbatas adalah 365 hari (12 bulan) dan stage ekstensif adalah 61 hari (2 bulan). Masa tengah tahan hidup pasien KPKSK yang diterapi adalah 182 hari (6 bulan) dan yang tidak diterapi adalah 27 hari (1 bulan). Faktor yang mempengaruhi angka tahan hidup adalah tampilan dan terapi.
Kesimpulan: Angka tahan hidup 1 tahun pasien KPKSK 11,8 % dan masa tengah tahan hidup 78,75 hari. Faktor yang mempengaruhi angka tahan hidup pasien KPKSK adalah tampilan dan terapi.
Small cell lung cancer (SCLC) are generally aggressive than other subtypes of lung cancer. Small cell lung cancer has a rapid doubling time, rapid growth fraction and could metastasize rapidly and widely compared to non-small cell lung cancer (NSCLC). Small cell lung cancer is chemosensitive and radiosensitive although 95% of patients eventually died after underwent therapy. This study aims to determine the characteristics, survival rate and factors which influenced SCLC patients.
Method: The study was conducted by using retrospective cohort of SCLC patients medical records in Persahabatan Hospital, Jakarta, Indonesia from January 1, 2008 until December 31, 2012. Data obtained were tested by Kaplan Meier analysis of survival.
Results: Subjects in this study were 34 SCLC patients, with majority of male 32 subjects (94.1%), mean age of 59 years old and all of the subjects (100%) were smokers. The majority chief complaint was shortness of breath, the additional complaint was weight loss and most of the subjects did not receive either chemotherapy or radiotherapy treatment (38.2%). The majority of tumor characteristics were extensive disease in 32 subjects (94.1%), performance status ≤ 2 in 30 subjects (88.2%) and the most common metastatic was pleural effusion in 23 subjects (67.6%). Median survival time of SCLC patients were 78.75 days (2.5 months). Median survival time of SCLC patients with limited disease were 365 days (12 months) and extensive disease were 61 days (2 months). Median survival time of SCLC patients treated were 182 days (6 months) and not treated were 27 days (1 month). Factors which influenced median survival time were performance status and treatment.
Conclusion: The 1-year survival rate of SCLC patients was 11.8 % and median survival time was 78.75 days. Factors which influenced the median survival rate of SCLC patients were performance status and treatment."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tesis Membership  Universitas Indonesia Library
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Erlina Burhan
Angka tahan hidup penderita kanker paru jenis karsinoma bukan sel kecil yang layak dibedah
"Insidens kanker paru terus meningkat baik di negara maju maupun negara berkembang. Saat ini berkembang berbagai modaliti gabungan yang dianggap berperan dalam menurunkan morbiditi dan memperpanjang usia. Terapi pilihan kanker paru jenis karsinoma bukan sel kecil (KPKBSK) bila masih memungkinkan adalah pembedahan. Dua puluh lima persen sampai 45% dari seluruh kasus KPKBSK yang dilaporkan, dapat menjalani pembedahan. Pembedahan pada stage yang tepat akan memberikan masa tahan hidup yang lebih panjang terutama bagi penderita KPKBK. Di Rumah Sakit Persahabatan, pembedahan dilakukan terhadap 10% kasus kanker paru. Kasus dengan stage yang rendah mempunyai angka tahan hidup 5 tahun atau 5 year survival rate yang baik. Pembedahan pada stage yang tepat mempunyai angka tahan hidup 5 tahun yang meningkat pada KPKBSK. Kemoterapi dan radioterapi dianjurkan pada kasus yang tidak mungkin dibedah. Angka tahan hidup penderita pascabedah dipengaruhi oleh berbagai faktor di antaranya stage, jenis histologis, usia, jenis pembedahan dan jenis kelamin serta penggunaan, terapi neoadjuvan I adjuvan. Angka tahan hidup secara sederhana dapat dihitung memakai metoda life table.
Radiasi atau kemoterapi saja dapat memperbaiki kualiti hidup penderita tetapi tidak meningkatkan angka tahan hidup 5 tahun. Jenis histologis juga merupakan faktor yang berpengaruh terhadap angka tahan hidup penderita. Faktor lain yang berperan dalam prognosis KPKBSK adalah usia dan jenis kelamin dan jenis reseksi. Terapi neoadjuvan ditujukan bagi kasus stage IIIA yang akan dibedah. Multimodaliti ini meningkatkan angka tahan hidup secara bermakna."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2004
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UI - Tesis Membership  Universitas Indonesia Library
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Jamaluddin M
Efikasi dan toksisiti erlotinib/gefitinib sebagai terapi lini kedua pada pasien kanker paru jenis karsinoma bukan sel kecil = Efficacy and toxicity erlotinib/gefitinib as second line therapi in non small cell lung cancer patients
"ABSTRAK
Tesis ini menilai efikasi dan toksisiti Erlotinib/Gefitinib sebagai terapi lini kedua
pada pasien KPKBSK yang mengalami progresifitas. Ini adalah sebuah penelitian
kohor retrospektif antara tahun 2009 sampai 2013 dari rekam medis pasien
KPKBSK yang mengalami progresifitas. Respons (subjektif, semisubjektif dan
objektif) dievaluasi setiap bulan. Toksisiti dinilai setiap minggu sejak pemberian
Erlotinib/Gefitinib berdasarkan kriteria WHO. Hasil evaluasi respons objektif,
tidak ada pasien yang memberikan respons komplit. Best overall response rate
dari 31 pasien, 48,8% menetap, 22,6% perburukan,12,9% respons sebagian dan
6,5% tidak dinilai/inevaluable. Pada penilaian respons semisubjektif didapatkan
19.4% peningkatan berat badan, 51,6% penurunan berat badan dan 29,0%
menetap. Waktu tengah tahan hidup mencapai 18 bulan, rerata masa tahan hidup
1 tahunan 80,6% dan masa tahan hidup keseluruhan 6,50%. Data menunjukkan
tidak ada timbul toksisiti hematologi berat (grade ¾) dan data penilaian toksisiti
non hematologi sangat jarang timbul toksisiti berat (grade ¾). Efikasi monoterapi
EGFR-TKI (Erlotinib/Gefitinib) cukup tinggi dengan toksisiti yang ditimbulkan
tidak berat. Dengan demikian Erlotinib/Gefitinib sebagai terapi lini kedua cukup
baik.ABSTRACT This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second
line therapy in NSCLC patients. This is a retrospective cohort study between 2009
and 2013 from the medical records of patients who experienced progression
NSCLC. Therapeutic response was evaluated every month. Toxicity assessed
every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results
of objective response evaluation none of the patients complete response. Best
overall response rate of 31 patients with the most stable response are 48.8%. Most
semisubjective response obtained are 51.6% weight loss. The middle survival time
reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall
survival. The data showed no hematologic toxicity arise severe (grade ¾) and
non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR
TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not
severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good. ;This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second
line therapy in NSCLC patients. This is a retrospective cohort study between 2009
and 2013 from the medical records of patients who experienced progression
NSCLC. Therapeutic response was evaluated every month. Toxicity assessed
every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results
of objective response evaluation none of the patients complete response. Best
overall response rate of 31 patients with the most stable response are 48.8%. Most
semisubjective response obtained are 51.6% weight loss. The middle survival time
reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall
survival. The data showed no hematologic toxicity arise severe (grade ¾) and
non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR
TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not
severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good. "
Fakultas Kedokteran Universitas Indonesia, 2015
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Hapsari Retno Dewanti
Profil dan angka tahan hidup 1 tahun kanker paru bukan sel kecil (kpkbsk) jenis adenokarsinoma paru dengan mutasi epidermal growth factor receptor (egfr) exon 20 t790m primer di rsup persahabatan = The characteristics and one year survival of lung adenocarcinoma patients with primary exon 20 t790m epidermal growth factor receptor mutation treated at persahabatan hospital Jakarta, Indonesia
"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.
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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tugas Akhir  Universitas Indonesia Library
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