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"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. "

"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."

"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. "

"Kuantitas dan kualitas asupan protein belum sepenuhnya diketahui perannya terhadap kualitas hidup. Prognostic Nutritional Index (PNI) juga belum diketahui dapat mencerminkan kualitas hidup dan apakah bisa ditingkatkan dengan asupan protein. Penelitian dengan desain potong lintang ini bertujuan untuk mengetahui korelasi antara asupan protein dengan PNI dan kualitas hidup serta korelasi PNI dengan kualitas hidup pada pasien kanker kepala leher dengan radioterapi di Departemen Radioterapi Rumah Sakit dr. Cipto Mangunkusumo, Jakarta. Sebanyak 61 subjek didapatkan dari consecutive sampling. Rerata usia subjek adalah 46,3 ± 12,4 dan 65,6% subjek berada pada kanker stadium IV dan mendapatkan terapi kemoradiasi. Sebanyak 32,8% subjek yang memiliki status gizi kurang. Median asupan protein adalah 1,42 (0,26-4,11) g/kg/hari. Nilai PNI pada subjek penelitian memiliki median 45,9 (29,4-54,2). Hasil penelitian menunjukkan adanya korelasi bermakna antara kuantitas asupan protein berdasarkan Food Frequency Questionnaire (FFQ) semikuantitatif dan beberapa aspek gejala pada kualitas hidup yaitu pada aspek pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37;p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). Kualitas asupan protein tidak berkorelasi bermakna dengan kualitas hidup. PNI berkorelasi bermakna terhadap 1 aspek fungsional yaitu physical function (r=0,378; p=0,003) dan 2 aspek gejala yaitu opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Meskipun tidak signifikan secara statistik, namun PNI memiliki arah korelasi yang positif terhadap aspek fungsional lainnya dan memiliki arah korelasi negatif terhadap aspek gejala lainnya yang berarti semakin tinggi PNI maka aspek fungsional semakin baik dan gejala semakin ringan. Studi ini tidak menemukan adanya korelasi bermakna antara asupan protein, baik kualitas maupun kuantitasnya, terhadap PNI. Hasil ini diduga berkaitan dengan penemuan bahwa sebagian besar penderita masih memiliki pola asupan yang mampu mencukupi kebutuhan kalori dan protein harian. Diperlukan studi prospektif yang menelusuri aspek prognostik kanker kepala leher dari segi kualitas hidup untuk mengetahui apakah PNI dapat memprediksi aspek kualitas hidup dengan lebih rinci.

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Quality and quantity of protein intake has not been well understood that it can affect quality of life. Moreover, Prognostic Nutritional Index (PNI) also has not been well studied upon its usage to reflect quality of life of head and neck cancer patients undergoing radiotherapy. This cross sectional study was aimed to determine the correlation between protein intake and PNI and also the correlation between PNI and quality of life in head and neck cancer patients undergoing radiotherapy at Radiotherapy Department, dr. Cipto Mangunkusumo General Hospital, Jakarta. Total of 61 subjects were recruited with consecutive sampling method with mean age of 46,3 ± 12,4 years old and 65,6% subjects were on stage IV cancer and were getting a combination of chemo and radiotherapy. Only 32,8% subjects were on low nutritional status. Median of total protein intake was 1,42 (0,26-4,11) g/kg/day. Median of PNI was 45,9 (29,4-54,2) among subjects. The result of the study showed a significant correlations between quanitity of protein intake based on semiquantitative Food Frequency Questionnaire (FFQ) with several aspects of quality of life, that were pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37; p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). This aspects were all symptomatics. PNI was significantly correlated with 1 functional aspect, which was Physical function (r=0.378; p=0,003) and 2 symptomp aspects, which were opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Although not statistically significant, but there were positive direction of correlation with other functional aspects and negative direction of correlation with other symptomps aspects. This implicates that the higher the PNI, the lower the symptoms and the better the functional status of head and neck cancer patients undergoing radiotherapy. This study did not show a significant correlation between quality and quantity of protein intake with PNI. An adequate intake of calorie and protein in most subjects were found in this study which might explain the result. More studies, preferably prospective one, may be needed to show the usage of PNI to reflect quality of life, especially involving quality of life progresivity."

"Malnutrisi dan Tuberkulosis (TB) memiliki hubungan bidireksional, dimana saling berinteraksi satu sama lain. Pada kondisi infeksi kronis, terjadi ketidakseimbangan antara pemecahan protein dan sintesis protein yang ditandai dengan menurunnya massa bebas lemak. Malnutrisi juga menyebabkan atrofi timus sehingga terjadi penurunan proliferasi limfosit. Kondisi malnutrisi pada pasien TB akan menurunkan kualitas hidup. Kualitas hidup yang baik akan meningkatkan keberhasilan pengobatan, menurunkan mortalitas dan morbiditas. Short Form-36 (SF-36) merupakan kuesioner untuk menilai kualitas hidup yang dapat menilai 2 komponen yaitu komponen fisik (PCS) dan mental (MCS).  Penelitian potong lintang ini bertujuan untuk menilai hubungan asupan protein, massa bebas lemak dan hitung limfosit total dengan kualitas hidup pada pasien TB paru fase intensif di 12 puskesmas yang dipilih secara random di Kota Pekanbaru, Riau. Pengambilan sampel dilakukan secara consecutive sampling, dan didapatkan 72 subjek yang memenuhi kriteria penelitian. Hasil penelitian didapatkan nilai tengah usia adalah 33 tahun dengan usia terendah 18 tahun dan tertinggi 59 tahun. Sebanyak 56,9% subjek adalah laki-laki, sebagian besar berpendidikan menengah dengan pendapatan kurang, perokok aktif dan dengan status gizi kurang (underweight). Sebanyak 59,7% subjek memiliki asupan protein yang kurang, 86,1% dengan massa bebas lemak yang rendah, dan 88,9% subjek memiliki hitung limfosit yang normal. Sebagian besar subjek memiliki kualitas hidup PCS dan MCS yang baik. Hasil penelitian menunjukkan terdapat korelasi dengan kekuatan lemah yang bermakna secara statistik antara massa bebas lemak dengan PCS (r = 0,239, p = 0,044), sedangkan asupan protein dan hitung limfosit total tidak ditemukan adanya korelasi baik terhadap PCS maupun MCS.

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Introduction: Malnutrition and Tuberculosis (TB) have bidirectional relationship, which interact between each other. In chronic infection, there is an imbalance between protein degradation and protein synthesis which marked with the loss of fat free mass (FFM). Malnutrition can cause the atrophy of thymus gland resulted in the reduction of lymphocyte production. Malnutrition in TB patients will reduce quality of life. On the other hand, a good quality of life will increase treatment success rate and decrease the risk of morbidity and mortality. Short Form-36 (SF-36) is a questionnaire used to assess quality of life consists of two different components, physical component score (PCS) and mental component score (MCS).

Methods: This cross-sectional study aimed to assess correlation between protein intake, fat free mass, and total lymphocyte count with quality of life among intensive phase lung tuberculosis patients. Data collected from May to July 2019 in 12 primary health centers chosen randomly in Pekanbaru, Riau Province. Samples selected using consecutive sampling method and 72 subjects fulfilled all research criteria. Interview was used to collect basic characteristic data, dietary intake data, and quality of life score. Anthropometric measurement (body weight, body height, and fat free mass) and laboratory examination (total lymphocyte count) were done. Spearman, Pearson, Mann-Whitney, and Kruskall Wallis test were used in this study.

Results: Research showed median age subjects was 33 years old (18-59 years old). Most of the subjects were male (56.9%), had middle level of education, had low income, were active smoker with underweight nutritional status. Around 59.7% subjects had low protein intake, 86.1% subjects had low fat free mass, and 88.9% subjects had normal lymphocyte count. Most of the subjects had good physical and mental component score of quality of life assessment.

Conclusion: There was a statistically significant weak correlation between fat free mass with PCS (r = 0.239, p = 0.044). However, there was no correlation found between protein intake or total lymphocyte count with PCS or MCS."

"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: Kanker kepala dan leher (KKL) termasuk kanker yang paling umum, menempati urutan keenam secara global. Kanker rongga mulut termasuk dalam entitas KKL, yaitu sekitar 75% kasus. Salah satu modalitas terapi onkologi, yaitu radioterapi (RT) dapat menyebabkan efek samping di oral, contohnya seperti berkurangnya fungsi mengunyah dan menelan, serta penurunan nafsu makan yang kemudian berkaitan dengan penurunan berat badan kritis. Penurunan berat badan kritis (PBBK) didefinisikan sebagai penurunan berat badan yang tidak disengaja sebesar 5% pada 1 bulan atau 10% pada 6 bulan sejak dimulainya RT. Tujuan: Mengetahui faktor yang berhubungan dengan PBBK pada pasien RT kepala dan leher di Rumah Sakit Kanker Dharmais. Metode Penelitian: Analisis observasional retrospektif dengan menggunakan data sekunder (rekam medis) dari 125 pasien kanker mulut di Rumah Sakit Kanker Dharmais periode 2018-2022. Hasil: Rata-rata usia pasien adalah 50,2±14,5 tahun terdiri dari laki-laki sebanyak 68 orang (54,4%) dan perempuan sebanyak 57 orang (45,6%). Pasien yang mengalami PBBK pada satu bulan sejak RT selesai sebanyak 69 orang (72,6%). Analisis bivariat untuk melihat faktor yang berpengaruh terhadap PBBK menunjukkan hanya variabel xerostomia selama RT yang signifikan (p = 0,006). Kesimpulan: Xerostomia selama RT merupakan faktor yang berpengaruh terhadap PBBK. Kolaborasi multidisipliner tim onkologi diperlukan untuk mencegah PBBK, termasuk dokter gigi untuk memantau komplikasi oral selama RT.

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Introduction: Head and neck cancer (HNC) is the sixth most common cancer worldwide. 75% of HNCs are oral cancer. Radiotherapy (RT) is generally an oncology therapy that can develop side effects associated with oral complications due to RT. These complications can interfere with chewing and swallowing, which subsequently cause a decrease in appetite. Furthermore, patients may experience critical weight loss (CWL) defined as involuntary weight loss of 5% at one month or 10% at six months from the start of RT. Objective: To investigate the factor which correlates with CWL in head and neck RT patients treated in Dharmais Cancer Hospital. Methods: A retrospective observational analysis using secondary data (medical records) of 125 oral cancer patients at Dharmais Cancer Hospital in 2018-2022. Results: The mean age of patients was 50,2±14,5 years, with 68 (54,4%) male and 57 (45,6%) female. Sixty-nine patients (72,6%) developed CWL one month after RT, and the only significant factor in CWL was xerostomia during RT (p = 0,006). Conclusion: Xerostomia during RT is an influencing factor of CWL. Multidisciplinary collaboration of the oncology team is needed to prevent CWL, including the dentist to monitor oral complications during RT."

"Proses inflamasi pada kanker kepala dan leher menyebabkan peningkatan sitokin proinflamasi dan sintesis protein fase akut c-reactive protein, CRP yang kemudian menyebabkan perubahan metabolisme dan anoreksia pada penderitanya. Seng merupakan zat gizi yang memiliki peran penting dalam menekan inflamasi, namun dilaporkan sekitar 65 pasien kanker kepala dan leher mengalami kekurangan seng. Penelitian potong lintang ini bertujuan mengetahui korelasi antara asupan seng dan kadar seng serum dengan kadar c-reactive protein CRP sebagai upaya menekan inflamasi sehingga dapat mengurangi morbiditas dan mortalitas pasien kanker kepala leher. Dari 49 subyek yang dikumpulkan secara konsekutif di Poliklinik Onkologi RS Kanker Dharmais, 67,3 adalah laki-laki, rentang usia subyek 46 ndash;65 tahun. Frekuensi terbanyak 65,3 adalah kanker nasofaring dan 69,4 berada pada stadium IV. Seratus persen subyek memiliki asupan seng dibawah nilai angka kecukupan gizi. Rerata kadar seng serum subyek adalah 9,83 2,62 mol/L. Sebanyak 51 subyek memiliki kadar CRP yang meningkat. Terdapat korelasi negatif yang lemah antara kadar seng dengan kadar CRP subyek r =-0,292, p =0,042, namun tidak terdapat korelasi antara asupan seng dengan kadar CRP subyek p =0,86.

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The inflammatory process of head and neck cancer leads to increase the proinflammatory cytokines and the synthesis of c reactive protein CRP , which then causes metabolic alteration and anorexia in the patients. Zinc is one of nutrient that has an important role in suppressing inflammation. It is reported that about 65 of head and neck cancer patients have zinc deficiency. The aim of this cross sectional study is to determine the correlation between zinc intake and serum zinc levels with CRP level as an effort to reduce inflammation to reduce the morbidity and mortality of head and neck cancer patients. Subjects were collected by consecutive sampling in the Oncology Polyclinic Dharmais Cancer Hospital, from 49 subjects 67,3 were men, most subjects were in the age range between 46 ndash 65 years. The highest frequency 65,3 is nasopharyngeal cancer and 69,4 are already in stage IV. All subjects in this study have a zinc intake below the recommended dietary allowance RDA in Indonesia. The mean serum zinc level of the subjects was 9.83 2.62 mol L. Most subjects have elevated CRP levels. There was a weak significant negative correlation between zinc concentration and CRP levels of subjects r 0.292, p 0.042, but there was no correlation between zinc intake and CRP levels of subjects p 0.86. "

"Pada kanker kepala dan leher ditemukan adanya peningkatan kadar radikal bebas dan penurunan aktivitas antioksidan, yaitu Superoksida Dismutase SOD. Salah satu terapi utama pada pasien kanker kepala dan leher adalah terapi radiasi. Efek tidak langsung terapi radiasi adalah meningkatkan kadar radikal bebas. Selain itu efek samping terapi radiasi menyebabkan penurunan kualitas hidup. Penelitian ini dibagi secara acak menjadi dua kelompok, yaitu kelompok akupunktur manual n=15 dan kelompok akupunktur manual sham n=15. Penelitian ini menggunakan titik GV20 Baihui, LI4 Hegu, ST36 Zusanli, SP6 Sanyinjao, dan LR3 Taichong. Terapi dilakukan tiga kali seminggu selama 30 menit sebanyak 12 kali. Hasil penelitian ini menunjukkan bahwa selisih skor SOD tidak ada perbedaan bermakna secara statistik antara kedua kelompok p=0.695 tetapi adanya perbedaan bermakna secara statistik pada selisih skor Organization for Research and Treatment of Cancer EORTC QLQ-C-30 sebelum dan setelah dua belas kali terapi antara kedua kelompok.

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In head and neck cancer found an increase in free radical levels and decreased antioxidant activity, namely Superoxide Dismutase SOD . One of the main therapies in head and neck cancer patients is radiation therapy. The indirect effect of radiation therapy is to increase the levels of free radicals. In addition, side effects of radiation therapy lead to a decrease in the quality of life.

The study was randomly divided into two groups, the manual acupuncture group n = 15 and the manual acupuncture group sham n = 15. This study uses GV20 Baihui point, LI4 Hegu, ST36 Zusanli, SP6 Sanyinjao, and LR3 Taichong. Therapy is done three times a week for 30 minutes as much as 12 times.

The results of this study showed that there was no statistically significant difference in the difference between the two groups p = 0.695 but there was a statistically significant difference in the difference between the QLQ-C-30 Organization for Research and Treatment of Cancer EORTC score before and after twelve times of therapy between the two groups p "