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"Kadar CRP serum dapat digunakan sebagai prediktor penurunan berat badan dan indikator prognostik inflamasi. Penelitian ini dilakukan untuk mengetahui korelasi kadar CRP serum dengan penurunan berat badan dan mukositis oral pada pasien kanker kepala leher yang menjalani radioterapi. Penelitian ini adalah penelitian observasional dengan desain potong lintang pada pasien kanker kepala leher yang telah menjalani terapi radiasi minimal 25 kali di Departeman Radioterapi RSUPNCM Jakarta dengan usia ge;18 ndash;65 tahun. Hasil penelitian menunjukkan bahwa sebagian besar subyek 71,2 memiliki kadar CRP serum normal, mengalami penurunan berat badan ge;5 dalam waktu sebulan 76,9 dengan rerata penurunan berat badan -9,42 7,76 , dan juga mengalami mukositis oral 65,4 dengan persentase terbanyak yaitu derajat 1 59,6 . Tidak terdapat mukositis oral derajat 3 dan 4. Tidak terdapat korelasi antara kadar CRP serum dengan penurunan berat r=0,166; p=0,239 , dan mukositis oral r=0,137; p=0,331 . Kesimpulan adalah kadar CRP serum saat radioterapi tidak memengaruhi penurunan berat badan dan mukositis oral. Sebagian besar subyek tetap mengalami penurunan berat badan selama menjalani radioterapi sehingga pemasangan NGT yang lebih awal yaitu sebelum terapi radiasi dimulai NGT profilaksis perlu dilakukan, namun hal ini membutuhkan penelitian lebih lanjut.

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Serum CRP levels can be used as a predictor of weight loss and prognostic indicator of inflammation. This study was conducted to determine the correlation of serum CRP levels with weight loss and oral mucositis in patients with head and neck cancer undergoing radiotherapy. This study was an observational study in the head and neck cancer patients who have undergone radiation therapy at least 25 times at the Department of Radiotherapy RSUPNCM Jakarta with aged ge 18 ndash 65 years old. Our study results showed that most of the subjects 71,2 had normal serum CRP levels, weight loss of ge 5 in one month 76,9 , and also experienced oral mucositis 65,4 . Mostly had grade 1 oral mucositis 59,6 . There were no grade 3 and 4 oral mucositis.There were no correlation between serum CRP levels with weight loss r 0,166 p 0,239 , and oral mucositis r 0,137 p 0.331 . In conclusion, serum CRP levels did not influence weight loss and oral mucositis in patients with head and neck cancer undergoing radiotherapy. Most of the subjects still experienced weight loss during radiotherapy. Therefore, NGT prophylaxis is needed, but this requires further study."

"Albumin serum, berat badan dan kekuatan genggaman merupakan parameter penilaian status gizi yang berhubungan dengan kadar protein tubuh. Penelitian ini dilakukan untuk mengetahui korelasi antara kadar albumin serum terhadap persentase penurunan berat badan dan kekuatan genggaman. Penelitian dengan desain potong lintang pada pasien kanker kepala leher dengan usia ≥18–65 tahun yang telah menjalani radiasi ≥25 kali di Departemen Radioterapi RSUPNCM. Hasil penelitian menunjukkan sekitar 55,76% subjek memiliki kadar albumin <3,4 g/dL. Rerata penurunan berat badan selama radiasi – 9,42 ± 7,76%, dengan 79,6% subyek mengalami penurunan berat badan ≥5%. Rerata kekuatan genggaman tangan dominan 39,48 ± 9,15 kg. Tidak terdapat korelasi antara kadar albumin serum dengan persentase penurunan berat badan (r = - 0,129; p = 0,364) dan kekuatan genggaman tangan (r = 0,048; p = 0,733). Kesimpulan, kadar albumin serum tidak memengaruhi penurunan berat badan dan kekuatan genggaman selama radiasi. Sangat penting untuk mempertahankan status gizi selama menjalani radioterapi salah satunya dengan pemakaian NGT di awal radiasi. Diperlukan penelitian lebih lanjut dengan desain kohort prospektif untuk mendapatkan data yang lebih konklusif.

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Serum albumin, body weight and hand grip strength is a parameter of assessment of nutritional status related to body protein. This study was conducted to determine the correlation between serum albumin levels with the percentage of weight loss and hand grip strength. A cross sectional study design in the head neck cancer patients with ge 18 65 years of age who have undergone radiation at least 25 times in the Department of Radiotherapy RSUPNCM. The results showed approximately 55,76 of the subjects had levels of albumin below 3,4 g dL. Mean weight loss during radiation ndash 9,42 7,76 , with 79,6 of subjects experienced weight loss ge 5 . Mean dominant hand grip strength 39,48 9,15 kg. There is no correlation between serum albumin levels with percentage of body weight loss r 0,129 p 0,364 and hand grip strength r 0,048 p 0,733 . Conclussion, serum albumin levels did not affect body weight loss and handgrip strength during radiation. It is essential for head and neck cancer patients undergoing radiotherapy to maintain nutritional status with NGT in the initial radiation. Further research with prospective cohort design is needed to obtain more conclusive data. Keywords Serum albumin, weight loss percentage, handgrip strength, head and neck cancer, radiotherapy "

"Latar belakang: Pasien kanker kepala leher (KKL) yang mendapatkan kemoradiasi berisiko mengalami malnutrisi dan meningkat hingga 88 % saat akhir kemoradiasi. Efek samping kemoradiasi berupa xerostomia, mukositis, mual atau muntah menambah penurunan status nutrisi dan kapasitas fungsional. Monitoring status nutrisi melalui penilaian berat badan (BB) dan kekuatan genggam tangan (KGT) sebagai cara sederhana dan minimal invasif dibandingkan alat pemeriksaan lain seperti pengukur komposisi tubuh dan Dual Energy X-Ray Absorptiometry (DEXA). Belum diketahui frekuensi kunjungan optimal ke poli gizi selama menjalani kemoradiasi. Metode: Penelitian ini menggunakan metode potong lintang, dilakukan di Radioterapi RSCM (IPTOR RSUPNCM).Penelitian ini bertujuan melihat korelasi frekuensi kunjungan pasien KKL yang menjalani kemoradiasi terhadap BB dan KGT, dengan kriteria inklusi adalah pasien KKL dewasa, usia 19 hingga 59 tahun, yang menjalani kemoradiasi pada 10 fraksi terakhir, dan bersedia masuk dalam penelitian. Pengukuran BB menggunakan timbangan merk Omron® Karada-HBF-375, kekuatan genggam tangan menggunakan Jamar® handgrip pada tangan kanan dominan subjek. Hasil: Rerata BB 55,65±12,34 kg, rerata KGT 29,24±10,74 kg, dan rerata frekuensi 1 kali. Rerata asupan energi 1225,96±501,22 kkal, protein median 41 g, rerata lemak 33,5±18,8g dan KH 182,2±78,3g. Korelasi antara frekuensi kunjungan terhadap BB (r= 0,61, p= 0,66) dan KGT (r=0,06, p= 0,64). Kesimpulan: Tidak terdapat korelasi antara frekuensi kunjungan terhadap BB dan KGT.

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Background: Head and neck cancer patients who get chemoradiated are at risk of malnutrition and an increase in malnutrition of up to 88% at the end of chemoradiation. Side effects of chemoradiation in the form of xerostomia, mucositis, nausea or vomiting add to the decrease : Luana Lidwina in nutritional status and functional capacity. Monitoring nutritional status, one of which is carried out by assessing body weight (BW) and hand-holding strength (HGS). BW and HGS assessments are a simple and minimally invasive way for people with head and neck cancer (HNC) compared to other examination tools such as body composition measuring devices, Dual Energy X-Ray Absorptiometry (DEXA), and require high costs. It is not yet known the frequency of optimal visits of HNC patients to the nutrition poly during the moradiation period.

Methods: This study used the cross section method, conducted in RSCM Radiotherapy (IPTOR RSUPNCM). This study aims to see a correlation between the frequency of visits by HNC patients undergoing morbidity to BW and HGS. Subjects included as inclusion criteria were adult HNC patients, ages 19 to 59, who underwent chemoradiation in the last 10 fractions, and were willing to enter the study to be taken. BW measurements using omron® Karada- HBF-375 brand scales, hand grip strength using Jamar® handgrip on the dominant right hand of the subject.

Result: The weight of the subjects had an average of 55.6 5±12.34 kg, HGS had an average of 29.24±10.74 kg, and an average frequency of 1 time. Average energy intake 1225.96±501.22 kcal, median protein 41 g, average fat 33.5±18.8g and KH 182.2±78.3g. Correlation between the frequency of visits to BW (r= 0.61, p= 0.66) and HGS (r=0.06, p= 0.64).

Conclusion: There was no correlation between the frequency of visits to BB and KGT."

"Glutamin merupakan asam amino yang berperan penting dalam menjaga homeostasis dari fungsi sel tertentu, di antaranya adalah proliferasi sel limfosit. Penurunan kadar glutamin plasma terjadi pada hewan coba dengan kanker, yang berdampak pada peningkatan kerentanan terhadap infeksi. Beberapa penelitian melaporkan bahwa suplementasi glutamin dapat mencegah terjadinya mukositis oral akibat radiasi, sehingga dapat meningkatkan kualitas hidup pasien kanker kepala leher dengan radioterapi. Penelitian dengan desain potong lintang ini dilakukan di Departemen Radioterapi RSUPN dr. Cipto Mangunkusumo, Jakarta, yang bertujuan untuk mengetahui korelasi antara kadar glutamin plasma terhadap total lymphocyte count TLC dan kualitas hidup pada pasien kanker kepala leher dengan radioterapi. Dari total 52 subjek yang mengikuti penelitian ini, didapatkan median usia 50,50 18-62 tahun dan 63,46 adalah subjek laki-laki. Nasofaring merupakan lokasi kanker tersering. Sekitar 70 subjek berada pada stadium IV dan mendapatkan kombinasi radioterapi dan kemoterapi. Status gizi sebagian besar subjek masih tergolong normal. Hasil penelitian ini menunjukkan bahwa tidak ada korelasi antara kadar glutamin plasma terhadap TLC dan kualitas hidup pada pasien kanker kepala leher dengan radioterapi. Meskipun demikian, beberapa data dalam penelitian ini dapat memberikan gambaran mengenai adanya masalah nutrisi yang dialami pasien kanker kepala leher dengan radioterapi. Data tersebut antara lain lebih dari 60 subjek memiliki asupan kalori dan protein harian yang kurang, kemudian didapatkan juga kadar glutamin plasma semua subjek yang sangat rendah, dengan rerata 7,77 3,32 ?mol/l. Beberapa faktor yang diduga menjadi penyebab terjadinya hal tersebut adalah proses penyakit kanker, lokasi pertumbuhan kanker, efek samping terapi, serta kebutuhan yang sangat tinggi akan glutamin untuk fungsi fisiologis tubuh.

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Glutamin is an amino acid that plays an important role in maintaining the homeostasis of many cells, including the proliferation of lymphocytes. A decrease in plasma glutamine level was observed in rats with cancer, which could increase the susceptibility to infection. Several studies showed that glutamine supplementation could prevent oral mucositis induced by radiation, so this could increase the quality of life of head and neck cancer patients receiving radiotherapy. This cross sectional study conducted at Radiotherapy Department, RSUPN dr. Cipto Mangunkusumo, Jakarta, aimed to investigate the correlations of plasma glutamin level with total lymphocyte count TLC and quality of life in head and neck cancer patients receiving radiotherapy. A total of 52 subjects participated in this study, with median age 50,50 18 62 years old and 63,46 subjects were male. Nasopharynx was the most common site affected. About 70 subjects were at stage IV cancer and receiving a combination of radiotherapy and chemotherapy. Most of the subjects had a normal nutritional status according to body mass index BMI.

The results of this study showed no correlations of plasma glutamine level with TLC and quality of life in head and neck cancer patients receiving radiotherapy. However, data from this study revealed nutritional problems that happened in head and neck cancer patients receiving radiotherapy. These data include more than 60 of subjects had below normal limit daily calorie and protein intakes, and the plasma glutamine level of all subjects was very low, with mean 7,77 3,32 mol l. Several factors predicted to be the cause of these problems are the process of the disease, cancer growth location, side effects of therapy, as well as a high need of glutamine for physiological functions of the body. "

"Tujuan penelitian ini adalah untuk mengetahui korelasi antara penilaian risiko malnutrisi menggunakan skor PG-SGA dengan kadar CRP serum sehingga dapat digunakan untuk memprediksi tingkat inflamasi pada pasien kanker kepala dan leher stadium I_IV guna mencegah terjadinya kaheksia. Malnutrisi hingga kaheksia pada kanker terjadi karena interaksi faktor tumor, faktor pejamu dan faktor-faktor lainnya. Faktor tumor berupa sitokin pro-inflamasi akan memicu respons pejamu untuk memproduksi protein fase akut seperti CRP. Protein fase akut memerlukan sejumlah substrat yaitu asam amino yang berasal dari otot rangka. Otot rangka akan mengalami degradasi sehingga menyebabkan wasting otot rangka. Oleh karena itu, CRP selain dapat digunakan sebagai marker inflamasi sistemik juga dapat digunakan sebagai salah satu indikator faktor risiko yang berperan dalam terjadinya malnutrisi dan kaheksia. Efek wasting otot rangka yang ditimbulkan secara tidak langsung oleh CRP dapat dinilai dengan terdapatnya penurunan BB maupun berkurangnya massa otot yang juga merupakan komponen dalam penilaian PG-SGA. Penelitian ini merupakan studi potong lintang dengan menggunakan consecutive sampling yang melibatkan 51 subjek kanker kepala dan leher stadium I_IV yang belum mendapatkan terapi. Hasil penelitian didapatkan rerata usia 46,6 13,9 tahun, sebanyak 76,5 berjenis kelamin laki-laki. Kanker nasofaring merupakan kanker terbanyak 80,4 , dan stadium terbanyak yaitu stadium IVA. Rerata indeks massa tubuh IMT yaitu 20,6 4,0 kg/m2, dan sebanyak 37,3 subjek berada pada IMT normal. Berdasarkan skor PG-SGA sebanyak 64,7 subjek berisiko tinggi malnutrisi dengan rerata skor PG-SGA 11,7 6,2. Nilai median CRP yaitu 6,4 0,4_170,4 . Penelitian ini memperoleh korelasi positif yang signifikan antara skor PG-SGA dengan kadar CRP serum dengan kekuatan korelasi lemah r = 0,372; p = 0,007.

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The purpose of this study was to determine the correlation between the malnutrition risk assessment using PG SGA score with serum CRP levels so that it can be used to predict the levels of inflammation in head and neck cancer patients stage I IV to prevent cachexia. Malnutrition and cancer cachexia occurs due to the interaction of tumor factors, host factors and other factors. Tumor factors such as pro inflammatory cytokines will trigger a response of the host to produce acute phase proteins such as CRP. Acute phase protein which require a number of amino acids derived from skeletal muscle. Skeletal muscles will be degraded, causing skeletal muscle wasting. Therefore, CRP can be used as a marker of systemic inflammation and can be used as one indicator of the risk factors also that contribute to malnutrition and cachexia. Effect of skeletal muscle wasting which caused indirectly by the CRP can be assessed by the weight loss and reduced muscle mass which is a component in the assessment of PG SGA also. This study is a cross sectional study using consecutive sampling, 51 subjects head and neck cancer stage I IV who had not received treatment participated in this study. Data showed the mean age of subjects was 46.6 13,9 years, and 76 were male. Most cancer sites were as nasopharyngeal 80,4, and mostly in stage IVA. The mean body mass index BMI is 20,6 40 kg m2, with most of the BMI is normal 37,3. Based on PG SGA score 64,7 of the subjects at high risk of malnutrition, and the PG SGA mean score is 11,7 6,2. The median value of CRP is 6,4 0,4 170,4. The result of this study showed a significant positive correlation between PG SGA score with serum CRP levels with the strength of correlation is weak r 0,372 p 0,007. "

"Latar Belakang: Hitung limfosit total berhubungan dengan prognosis serta harapan hidup pasien kanker kepala leher. Regulasi limfosit dipengaruhi berbagai hal termasuk nutrisi. Salah satu zat gizi yang berperan dalam proliferasi limfosit adalah asam amino rantai cabang. Penelitian ini bertujuan untuk melihat korelasi antara asupan asam amino rantai cabang dengan hitung limfosit total pada pasien kanker kepala dan leher.Metode: Studi potong lintang ini dilakukan pada subjek dewasa dengan kanker kepala leher yang belum menjalani terapi di poliklinik radioterapi dan hematologi onkologi medik RSCM. Asupan asam amino rantai cabang dinilai dengan 3 x 24-h food recall dan FFQ semi kuantitatif. Hitung limfosit total diukur dengan differential blood cell counter.Hasil: Sebanyak 85 subjek penelitian dengan rerata usia 53 tahun, dengan sebagian besar laki-laki, terdiagnosis kanker nasofaring dengan jenis karsinoma sel skuamosa dan stadium IV. Rerata subjek memiliki status gizi normal, dengan rerata asupan energi 29,99 ± 0,95 kkal/kgBB dan protein 1,39 ± 0,05 g/kgBB dengan penilaian FFQ semi kuantitatif. Rerata asupan AARC pada subjek sebesar 10,92 ± 0,48 gram dengan FFQ semi kuantitatif. Sebagian besar subyek memiliki hitung limfosit total pada rentang normal. Terdapat sebanyak 17.6% subyek dengan hitung limfosit total yang rendah. Terdapat korelasi lemah antara asupan asam amino rantai cabang dengan hitung limfosit total (r=0,230, p=0,029).Kesimpulan: Terdapat korelasi bermakna yang lemah antara asupan AARC dengan hitung limfosit total pada subjek kanker kepala leher yang belum menjalani kemoradioterapi.

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Background: Total lymphocyte count is related with prognosis and survival rate of head and neck cancer patients. Lymphocyte regulation is affected by multiple factors, including nutrition. One of the nutrients that plays role in lymphocyte proliferation is branched-chain amino acids. This study aims to investigate the correlation between branched-chain amino acid and total lymphocyte count in head and cancer patients.

Method: This cross-sectional study was conducted on adults with head and neck cancer who had not undergone therapy at the radiotherapy and medical hematology oncology clinic at RSCM. Branched-chain amino acid intake was assessed using 3x24-h food recall and semi quantitative FFQ. Total lymphocyte count was measured with differential blood cell counter.

Results: Eighty-five subjects with a mean age of 53 years, mostly are male, diagnosed with nasopharyngeal cancer, with histopathology appearance of squamous cell carcinoma, and stage IV cancer. The average subject had normal nutritional status, with an average intake of 29.99 ± 0.95 kcal/kgBW of energy and 1.39 ± 0.05 g/kgBW of protein with a semi quantitative FFQ assessment. The average branched-chain amino acid intake in subjects was 10,92 ± 0,48 gram with semi quantitative FFQ. There were 17.6% subjects with low total lymphocyte count. There was a low correlation between intake of branched-chain amino acids and total lymphocyte count (r=0,230, p=0,029).

Conclusion: There was a significant low correlation between branched-chain amino acids intake with total lymphocyte count in head and neck cancer subjects who had not undergone chemoradiotherapy."

"Latar Belakang: Pengobatan Kanker kepala leher (KKL) melalui terapi radiasi maupun kemoradiasi sering menimbulkan efek samping. Efek samping terapi radiasi pasien KKL menyebabkan gangguan asupan yang meningkatkan kejadian malnutrisi. Ketersediaan jalur nutrisi enteral merupakan salah satu tata laksana nutrisi yang dapat diberikan untuk mencegah penurunan asupan dan status gizi pasien KKL. Penelitian ini bertujuan melihat korelasi antara ketersediaan jalur nutrisi enteral dengan pemenuhan nutrisi dan status gizi.Metode: Studi potong lintang dilakukan pada subjek dewasa dengan KKL pasca terapi radiasi di poliklinik radioterapi RSCM. Pemenuhan nutrisi dinilai dengan FFQ semi kuantitatif sedangkan status gizi diukur dengan menghitung indeks massa tubuh (IMT). Ketersediaan jalur nutrisi enteral didapatkan melalui wawancara dan rekam medis pasien.Hasil: Sebanyak 41 subjek penelitian dengan rerata usia 51 tahun ikut serta dalam penelitian. Sebagian besar subjek adalah laki-laki, diagnosis kanker nasofaring, stadium IV, dan jalur nutrisi oral. Rerata IMT subjek 20,5 ± 3,6 kg/m2 dan rerata asupan subjek 1336,7 ± 405,5 kkal/hari. Rerata IMT subjek dengan jalur nutrisi enteral lebih rendah dibandingkan dengan jalur nutrisi oral yaitu 18,2 ± 2,6 kg/m2 dibanding 21,2 ± 3,5 kg/m2. Rerata total asupan energi subjek dengan jalur nutrisi enteral lebih tinggi dibandingkan dengan jalur nutrisi oral yaitu 1498,1 ± 430,6 kkal/hari dibanding 1291,4 ± 393,3 kkal/hari. Terdapat korelasi nagatif sedang antara ketersediaan jalur nutrisi enteral dengan status gizi (r=-0,346, p=0,027) dan korelasi positif lemah dengan pemenuhan nutrisi (r=0,216, p=0,174). Meskipun demikian pada penelitian ini ditemukan bahwa proporsi subjek yang mendapat jalur nutrisi enteral dan mengalami penurunan IMT lebih sedikit dibandingkan dengan proporsi subjek yang menggunakan jalur oral, yaitu 22,2% dengan 43,8%.Kesimpulan: Terdapat korelasi negatif sedang yang signifikan antara ketersediaan jalur nutrisi enteral dengan status gizi dan korelasi positif lemah dengan pemenuhan nutrisi yang masih dipengaruhi oleh faktor perancu penelitian.

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Background: Treatment of head and neck cancer (HNC) through radiation therapy or chemoradiation often lead to side effects. The side effect of radiation therapy in HNC patients might deteriorate food intake that increase the incidence of malnutrition. The availability of enteral nutrition is one of nutritional interventions that can be provided to prevent detrimental of food intake and nutritional status in HNC patients. This study aims to evaluate the correlation between the availability of enteral nutrition with nutritional fulfillment and nutritional status.

Method: A cross sectional study was conducted on adult HNC patients after radiation therapy at Radiotherapy Outpatient Clinic of Dr. Cipto Mangunkusumo Hospital. Nutritional fulfillment was assessed by semi-quantitative food frequency questionnaire (FFQ) while nutritional status was measured by calculating body mass index (BMI). The availability of enteral route was obtained through interviews and patients medical records.

Results: A total of 41 subjects with a mean age of 51 years participated in the study. Most of the subjects were male, with stage IV nasopharyngeal cancer and oral nutrition route. The mean of BMI was 20,5 ± 3,6 kg/m2 and the mean food intake was 1336,7 ± 405,5 kcal/day. The mean BMI of subjects with enteral nutrition was lower than those on oral nutrition, which was 18,2 ± 2,6 kg/m2 compared to 21,2 ± 3,5 kg/m2. The mean total energy intake of subjects with enteral nutrition route was higher than oral nutrition route, which was 1498,1 ± 430,6 kcal/day compared to 1291,4 ± 393,3 kcal/day. There was a moderate negative correlation between the availability of enteral nutrition and nutritional status (r=-0,346, p=0,027), meanwhile there was a weak positive correlation with nutritional fulfillment (r=0,216, p=0,174). However, in this study we found that the proportion of subjects with enteral nutrition who experienced a decrease of BMI was less than the proportion of subjects on the oral route, which was 22,2% compared to 43,8%, respectively.

Conclusion: There is a moderate negative correlation between the availability of enteral nutrition which was statistically significant with nutritional status and a weak correlation with nutritional fulfillment which was still influenced by confounding factors."

"Gen P53 atau TP53 merupakan gen yang memicu pembentukan protein tumor p53 yang berfungsi sebagai tumor suppressor. Polimorfisme genetik p53 berpengaruh terhadap erjadinya kanker kepala dan leher (KKL). Penelitian ini bertujuan untuk mengidentifikasi keterkaitan antara polimorfisme gen p53 dengan kanker kepala dan leher di Indonesia. Analisis dengan PCR-RFLP (enzim BstUI) pada 50 sampel penderita KKL dan 50 sampel non KKL untuk melihat polimorfisme gen p53. Persentase distribusi genotip polimorfisme P53 pada sampel KKL sebesar 70% dan pada sampel non KKL sebesar 58%. Terdapat perbedaan bermakna pada distribusi genotip polimorfisme gen p53 antara penderita KKL dengan non KKL (p value = 0.004).

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The gene P53 or TP53 is a gene that targets the formation of p53 tumor protein that functions as a tumor suppressor. Genetic polymorphism of p53 gene has been associated with the development of head and neck cancer. This study aims to identify the relationship between p53 gene polymorphism with head and neck cancer in Indonesia. Analysis with PCR-RFLP (BstUI enzyme) in 50 samples of head and neck cancer patients and 50 control samples to see p53 gene polymorphism. The percentage of polymorphic genotype in HNC samples is 70% and in non HNC is 58%. There are significant differences in the genotype distribution of p53 gene polymorphisms between HNC patients and non-HNC patients (p value = 0.004)."

"Kanker kepala dan leher merupakan kanker yang menggambarkan berbagai tumor ganas yang berasal dari saluran aerodigestif atas, yang meliputi kanker pada mata, telinga, rongga hidung, sinus paranasal, nasofaring, orofaring, hipofaring, laring, kelenjar saliva, dan kelenjar tiroid. Penelitian ini bertujuan untuk mengetahui pengaruh terapi akupunktur manual terhadap kadar MDA dan skor NAS dibandingkan dengan akupunktur manual sham pada penderita kanker kepala dan leher pasca terapi radiasi. Uji klinis acak tersamar tunggal dengan kontrol dilakukan terhadap 30 pasien kanker kepala dan leher yang dibagi secara acak menjadi kelompok akupunktur manual n=15 dan kelompok akupunktur manual sham n=15. Pemeriksaan kadar MDA dilakukan sebelum perlakuan dan setelah sesi ke-12. Penilaian skor NAS dilakukan pada saat sebelum perlakuan, setelah sesi ke-6, dan setelah sesi ke-12. Hasil penelitian menunjukkan tidak terdapat perbedaan bermakna antara kelompok akupunktur manual dengan kelompok akupunktur manual sham terhadap penurunan kadar MDA sebelum dan sesudah perlakuan p=0,787. Terdapat perbedaan bermakna antara kelompok manual dengan akupunktur manual sham terhadap penurunan skor NAS sebelum dan sesudah perlakuan yang diukur pada sesi ke-6 p=0,001 dan sesi ke-12 p=0,003. Kesimpulan penelitian ini terapi akupunktur manual efektif untuk menurunkan skor NAS, namun kurang efektif untuk menurunkan kadar MDA pada penderita kanker kepala dan leher pasca terapi radiasi.

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Head and neck cancer encompasses a wide range of malignant tumours arising from the upper aerodigestive tract, includes eyes, ears, nasal cavities, paranasal sinuses, nasopharynx, oropharynx, hypopharynx, larynx, salivary glands, and thyroid gland.

This study aims to determine the effect of manual acupuncture therapy on MDA levels and NAS scores compared with manual sham acupuncture in patients with head and neck cancer post radiation therapy. Single blinded randomized clinical trials with control were performed on 30 head and neck cancer patients divided randomly into manual acupuncture groups n = 15 and the sham manual acupuncture group n = 15. The examination of MDA levels is performed before treatment and after the 12th session. Assessment of NAS scores is performed before the treatment, after the 6th session, and after the 12th session.

The result showed no significant difference between manual acupuncture group and sham manual acupuncture group to decrease MDA level before and after treatment p = 0,787. There was a significant difference between manual group and sham manual acupuncture on NAS score decrease before and after treatment measured at 6th session p = 0,001 and 12th session p = 0,003.

The conclusion: manual acupuncture therapy effectively decrease NAS scores, but statistically less effective to reduce levels of MDA in patients with head and neck cancer after radiotherapy."

"Penelitian ini merupakan penelitian potong lintang di Departemen Radioterapi Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta, yang bertujuan untuk mengetahui korelasi antara kadar asam lemak omega-3 terhadap massa otot dan kekuatan genggam pada subjek kanker kepala leher yang mendapatkan radioterapi. Kaheksia kanker sering terjadi pada kanker kepala leher akibat peningkatan sitokin proinflamasi yang menyebabkan hipermetabolisme, peningkatan kebutuhan nutrisi, anoreksia, penurunan massa otot dan berat badan. Asam lemak omega-3 berperan dalam menurunkan inflamasi, meningkatkan massa otot, dan kekuatan genggam. Dari 52 subjek yang sudah mendapatkan radioterapi ge;25 kali, 57 adalah laki-laki dengan rerata usia di atas 50 tahun. Lokasi kanker paling banyak di area nasofaring, sebagian besar sudah berada pada stadium IV dan mendapatkan kombinasi radioterapi dan kemoterapi. Sebesar 38,5 dan 32,7 subjek berada pada kategori indeks massa tubuh normal dan kurang. Data yang diperoleh dari penelitian ini dapat memberikan gambaran kurangnya asupan energi, protein, lemak, dan asam lemak omega-3, serta massa otot sebagian besar subjek yang tergolong kecil 28,4 4,7 , dengan kekuatan genggam sebagian besar subjek tergolong normal, dan kadar asam lemak omega-3 plasma seluruh subjek yang tergolong rendah 2,5 0,8 . Data tersebut menunjukkan adanya masalah nutrisi pada pasien kanker kepala leher. Terdapat korelasi yang kuat antara kadar asam lemak omega-3 plasma terhadap massa otot r =0,6, p 50?60 Gy dan 50 Gy.

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This cross sectional study conducted in the Department of Radiotherapy Dr. Cipto Mangunkusumo Hospital, aimed to investigate the correlation between omega 3 fatty acids plasma levels with muscle mass and hand grip muscle strength in subjects with head and neck cancer undergoing radiotherapy. Cancer cachexia is common in head and neck cancer as a result of the increasing of proinflammatory cytokines that cause hipermetabolisme, increased nutritional needs, anorexia, decreased muscle mass and body weight. Omega 3 fatty acids play a role in reducing inflammation, as well as improving muscle mass and hand grip. There were 52 subjects who had received radiotherapy ge 25 times, 57 were male with a mean age of 50 years. Most cancer sites were at nasopharynx area, mostly in stage IV and received a combination of radiotherapy and chemotherapy. There were 38,5 of the subjects in the normal body mass index and 32,7 were in low body mass index. The data from this study showed inadequate intake of energy, protein, fat, and omega 3 fatty acids, as well as muscle mass majority was small 28,4 4,7 , with most of the hand grip classified as normal, and the plasma levels of omega 3 fatty acids all of the subjects were low 2,5 0,8 . The data showed that there were nutritional problems in patients with head and neck cancer. There was strong correlation of plasma levels of omega 3 fatty acids with muscle mass r 0,8, p 50 60 Gy and 50 Gy. "