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Arry Setyawan
Penerapan indeks prognostik recursive partitioning analysis, graded prognostic assesment, dan basic score for brain metastases pada pasien tumor metastasis otak pasca radiasi di Departemen Radioterapi RSUPN Dr. Cipto Mangunkusumo tahun 2012-2014 = The application of recursive partitioning analysis graded prognostic assessment and basic score for brain metastases as prognostic indices among patients with brain metastases treated with radiotherapy at Departement of Radiotherapy RSCM 2012 2014
"ABSTRAK
Latar Belakang Peningkatan insidensi tumor metastasis intrakranial setiap tahunnya, juga diikuti oleh meningkatnya angka disabilitas dan mortalitas pada pasien. Terapi standar pada tumor metastasis otak adalah WBRT, SRS, operasi atau kombinasi dari ketiganya. Dengan semua pilihan terapi yang ada, sangat penting untuk memerhatikan prognosis pasien dengan tumor metastasis otak untuk menentukan jenis terapi yang sesuai, salah satunya dengan menggunakan indeks prognosis. Belum terdapat data yang menggambarkan profil demografis dan kesintasan pasien tumor metastasis otak di Indonesia dengan menerapkan indeks prognosis yang sudah ada.Tujuan dan Metode Penelitian ini merupakan studi cohort retrospektif untuk melihat kesesuaian hasil analisis kesintasan pasien tumor metastasis otak di Departemen Radioterapi RSUPN Dr. Cipto Mangunkusumo tahun 2012-2014 dengan data acuan indeks RPA, GPA, dan BSBM.Hasil Terdapat 62 subyek yang diikutsertakan dalam penelitian ini setelah mendapat persetujuan. Median kesintasan keseluruhan mencapai 9,16 bulan. Hasil analisis kesintasan berdasarkan indeks RPA memperlihatkan median kesintasan Kelas I, Kelas II dan Kelas III, secara berurutan 16.3 bulan, 11.2 bulan, dan 4.7 bulan. Karakteristik dan median kesintasan subyek pengamatan berdasarkan indeks GPA, secara berurutan mulai dari GPA 0-1 sampai GPA 3,5-4 adalah 4.3, 10.4, 12.4, dan 16.3 bulan. Hasil penerapan kedua indeks tersebut terlihat sesuai dengan data acuan penelitian pendahulunya. Namun indeks BSBM tidak mampu memperlihatkan hasil yang sesuai saat diterapkan pada populasi sampel penelitian.Kesimpulan Indeks RPA dan GPA dapat digunakan untuk memprediksi prognosis pasien tumor metastasis otak di RSUPN-CM karena memberikan karakterisitik yang sesuai dengan data acuan. Indeks GPA dianggap lebih baik karena menggunakan variabel yang lebih objektif.
ABSTRACT
Background The incidence of intracranial metastasis has increased annually, which also followed by the increased number of patient rsquo s disability and mortality. Standard therapy in brain metastasis are Whole Brain Radiotherapy WBRT , Stereotactic Radio Surgery SRS , surgery, or combination of all. With all these treatment options available, it is very important to consider the prognosis in order to decide which therapy is appropriate. One of the methods that can be used to determine the prognosis is by using the prognostic indices. Currently, there has been no data or report about the demographic and survival profile of patients with brain metastastis in Indonesia using the available index prognosis.Methods This is a retrospective cohort study to evaluate the survival analysis in patients with brain metastasis that are undergoing treatment in Radiotherapy Department, RSUPN Dr. Cipto Mangunkusumo in 2012 2014 based on RPA, GPA, and BSBM index.Results Sixty two patients are included in this study after obtaining the approved consent. The median of survival rate is 9.16 months. Survival analysis based on RPA index showed median class I, II, and III are 16.3, 11.2, and 4.7 months, respectively. Characteristics and median observer based on GPA, from GPA 0 1 to GPA 3.5 4 are 4.3, 10.4, 12.4, and 16.3 months, respectively. These findings are similar with the previous studies. However, BSBM index does not able to illustrate the result that is appropriate when it is being applied to the subjects of this study.Conclusions RPA and GPA index can be used to predict the prognosis in patients with brain metastasis that are undergoing treatment in RSUPN Dr. Cipto Mangunkusumo because it provides characteristics, which correspond to the reference data. GPA index is considered better because it uses more objective variables."
[, ]: 2016
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UI - Tugas Akhir  Universitas Indonesia Library
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Ayu Santika Santaningrum
Recursive Partitioning Analysis dan Diagnosis-Specific Graded Prognostic Assessment sebagai Indeks Prognostik Pasien Metastasis Otak yang Menjalani Radioterapi = Recursive Partitioning Analysis and Disease-Specific Graded Prognostic Assessment as Prognostic Indices in Patients with Brain Metastases After Radiotherapy
"Tujuan: Menilai kesintasan pasien metastasis otak yang menjalani radioterapi di RSUPN Dr. Cipto Mangunkusumo dan kesesuaian terhadap stratifikasi prognostik indeks Recursive Partitioning Analysis (RPA) dan Diagnosis-Specific Graded Prognostic Assessment (DS-GPA). Metode: Dilakukan studi retrospektif pada 51 pasien metastasis otak yang menjalani radiasi whole brain di RSCM pada Januari 2017-Desember 2019. Data klinis dikumpulkan melalui rekam medis. Stratifikasi pasien dilakukan berdasarkan indeks RPA dan DS-GPA. Kesintasan keseluruhan (OS) diukur sejak pasien menyelesaikan radioterapi hingga meninggal dunia atau follow-up terakhir. Kinerja indeks RPA dan DS-GPA dibandingkan menggunakan model regresi Cox. Kesintasan dinilai dengan uji Kaplan-Meier dan analisis model Cox proportional hazard. Hasil: Median kesintasan keseluruhan subyek adalah 5,3 bulan. Indeks RPA menunjukkan stratifikasi yang signifikan pada primer kanker paru dan kelompok adenokarsinoma paru. Stratifikasi DS-GPA signifikan pada primer kanker payudara dan kanker paru. Stratifikasi RPA lebih unggul dibandingkan DS-GPA pada primer kanker paru (5,752; IK95% 1,523- 21,723; p=0,004 vs 3,231; IK95% 1,008-10,350; p=0,039). Jenis kelamin (p=0,009), KPS (p=0,030), dan jumlah lesi intrakranial (p=0,023) merupakan faktor prognostik yang mempengaruhi kesintasan hidup pasien metastasis otak. Kesimpulan: Dalam populasi studi ini, stratifikasi prognostik indeks DS-GPA sesuai untuk diterapkan pada pasien metastasis otak dengan primer kanker payudara dan kanker paru. Stratifikasi indeks RPA pada kelompok primer kanker paru lebih baik dibandingkan DS-GPA.
Aims: This study was aimed to assess survival of patients with brain metastases after radiotherapy in RSCM and to confirm the validation of Recursive Partitioning Analysis (RPA) and Diagnosis-Specific Graded Prognostic Assessment (DS-GPA). Materials and methods: This retrospective study included 51 patients treated with whole brain radiation between 2017 and 2019. Clinical data collected from hospital medical records were reviewed. Patients were classified by RPA and DS-GPA. Overall survival (OS) was calculated from last day of radiotherapy to death or last follow-up. The performances of RPA and DS-GPA were compared using Cox regression model. Survival was determined using the Kaplan-Meier curves and Cox proportional hazards model. Results: Median OS in this population study was 5.3 months. RPA provided significant stratification in lung cancer primary group and lung adenocarcinoma subgroup. Prognostic stratification of DS-GPA was valid in breast cancer and lung cancer groups. RPA was superior to DS- GPA in patients with lung cancer primary (5.752; 95%CI 1.523-21.723; p=0.004 vs 3.231; 95%CI 1.008-10.350; p=0.039). Sex (p=0.009), KPS (p=0.03), and number of brain lesions (p=0.023) were significant independent prognostic factors for survival in brain metastatic patients. Conclusions: In this study population, prognostic stratification of DS-GPA was valid in brain metastatic patients with breast and lung cancer primaries. RPA was valid and performed better stratification than DS-GPA in patients with lung cancer primary."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Skripsi Membership  Universitas Indonesia Library
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Starleen Ellexia
Analisis Skor Fungsional Pasien Tumor Otak Primer Dewasa di Departemen Bedah Saraf RSCM Tahun 2021-2022 = Analysis Of Functional Score In Adult Primary Brain Tumor Patients In The Department Of Neurosurgery RSCM 2021-2022
"Latar Belakang
Tumor otak adalah neoplasma intrakranial di dalam otak atau di kanal tulang belakang pusat. Tumor otak ganas primer mempengaruhi sekitar 200.000 orang di seluruh dunia setiap tahun. Tumor otak disebabkan oleh pembelahan sel yang abnormal dan tidak terkontrol. Penanganan tumor otak di Indonesia masih belum terintegrasi baik dari segi promotif, preventif, maupun kuratif. Tumor otak sendiri dapat menyebabkan berbagai komplikasi sampai kematian. Oleh karena itu, pada penelitian kali ini dilakukan studi mengenai keterkaitan jenis, letak, dan ukuran tumor dengan skor fungsional berupa skor KPS yang didapatkan pasien pre dan post tindakan serta hubungannya dengan tingkat resektabilitas tumor pasien saat dilakukan operasi. Skor KPS dapat berfungsi sebagai salah satu faktor prognosis kualitas hidup pasien.
Metode
Penelitian ini akan menggunakan metode kohort retrospektif dengan melihat rekam medis pasien tumor otak dari tahun 2021 sampai 2022 yang ditatalaksana di RSCM. Rekam medis akan diambil secara consecutive sampling.
Hasil
Terdapat hubungan antara jenis tumor dengan skor KPS pre operasi dimana nilai median untuk semua jenis adalah 80 namun, adenoma mendapatkan mean skor KPS tertinggi (84,59) dan jenis tumor lain mendapatkan mean skor KPS terendah (73,73). Ukuran tumor dan skor KPS pre operasi tidak didapatkan hubungan korelasi yang kuat yaitu hanya sebesar -0,194 (CI 95% -0,313 - -0,069). Letak tumor dengan skor KPS pre operasi didapatkan ada hubungannya dengan hasil tumor supratentorium memiliki median skor KPS pre operasi lebih tinggi dibandingkan tumor infratentorium. Hasil ini berbeda dengan studi-studi lainnya sehingga diperlukan penelitian lebih lanjut. Demikian juga dengan tingkat resektabilitas dengan skor KPS post operasi dimana didapatkan hasil signifikansi sebesar p=0,107 sehingga hubungannya tidak signifikan. Namun jika dilihat mediannya, (Gross Total Resection) GTR memiliki skor KPS post operasi yang lebih baik dibandingkan dengan (SubTotal Resection) STR yaitu 85 dan 80 secara berurut.
Kesimpulan
Perbedaan jenis tumor mempengaruhi skor KPS pre operasi. Semakin besar ukuran tumor yang dialami pasien, maka semakin rendah skor KPS pre operasi yang didapatkan. Selain itu, skor KPS pre operasi juga berhubungan dengan letak tumor yang dialami pasien. Sedangkan, skor KPS post operasi pada penelitian ini tidak menunjukkan hubungan yang signifikan dengan tingkat resektabilitas tumor pada pasien yang dioperasi.
Introduction
Brain tumors are intracranial neoplasms within the brain or in the central spinal canal. Primary malignant brain tumors affect around 200,000 people worldwide each year. Brain tumors are caused by abnormal and uncontrolled cell division. Management of brain tumors in Indonesia is still not integrated in terms of promotive, preventive and curative. Brain tumors themselves can cause various complications up to death. Therefore, In this study, an investigation was carried out to explore the correlation between the type, location, and size of the tumor and its impact on the functional score, measured by the KPS score, obtained from patients before and after surgery. Additionally, the study examined the association between the level of resectability and the type of tumor. KPS score can be used as one prognostic factor for patient quality of life.
Method
This study will use a retrospective cohort method by looking at the medical records of brain tumor patients from 2021 to 2022 who were treated at RSCM. Medical records will be taken by consecutive sampling.
Results
A correlation exists between tumor types and preoperative KPS scores, with a median value of 80 for all types. Adenomas achieve the highest mean KPS score (84.59), while other tumor types have the lowest mean KPS score (73.73). A weak correlation is observed between tumor size and preoperative KPS scores, with a coefficient of only - 0.194 (95% CI -0.313 to -0.069). There is a relationship between tumor location and preoperative KPS scores, as supratentorial tumors have a higher median preoperative KPS score compared to infratentorial tumors. These findings differ from other studies, suggesting the need for further research. Similarly, the level of resectability and postoperative KPS scores show a non-significant relationship with a p-value of 0.107. However, when looking at the medians, Gross Total Resection (GTR) is associated with a higher postoperative KPS score compared to Subtotal Resection (STR), namely 85 and 80, respectively.
Conclusion
The type of tumor affects preoperative KPS scores. The larger the tumor size, the lower the preoperative KPS score. Additionally, preoperative KPS scores are also associated with tumor location. However, postoperative KPS scores in this study do not show a significant relationship with the resectability of tumors in operated patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Skripsi Membership  Universitas Indonesia Library
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Sihotang, Ely Sakti Panangian
Uji Prognostik Nilai Carcinoembrionic Antigen Terhadap Insiden Metastasis Hepar Pada Kasus Kanker Kolorektal Usia Dewasa Muda Di RSUPN Dr Cipto Mangunkusumo Jakarta = Prognostic value of Serum Carcinoembryonic Antigen Level in Predicting Liver Metastases of Colorectal Cancer Among Young Adult Patient in Cipto Mangunkusumo Hospital Jakarta
"Tujuan. Penelitian ini bertujuan untuk mengetahui nila diagnostic kadar CEA serum sebagai indikator terjadinya metastasis hepar dari kanker kolorektal (KKR) pada usia dewasa muda Metode. Studi potong lintang dilakukan dengan menggunakan data sekunder berupa catatan pasien dalam rekam medis. Pasien berusia <50 tahun yang terdiagnosis kanker kolorektal primer secara histopatologis di Cipto Mangunkusumo Hospital direkrut dalam penelitian ini. Kami mengeksklusi pasien dengan riwayat keganasan lain, telah menjalani tatalaksana operatif untuk kanker kolorektal, dan memiliki komorbiditas penyakit hati. Luaran akhir dari penelitian ini adalah cut off nilai CEA yang didapat dengan kurva ROC, sensitivitas, dan spesifisitas nilai CEA dalam memprediksi metastasis hepar KKR. Hasil. Kami merekrut 181 pasien dengan proporsi 43.6% perempuan. 59 pasien (32.6%) diketahui memiliki metastasis hepar pada saat intraoperatif. Kadar CEA pasien metastasis ditemukan sebesar 208.1 (2.1–12503.2) ng/mL, angka ini jauh lebih tinggi dibandingkan pasien non-metastasis 6.27 (0.8–1099.4) ng/mL (p<0.001). Nilai AUC tercatat sebesar 0,904, dan cut off optimal didapat pada kadar CEA ≥38,765 ng/mL (Indeks Youden = 1,718). Peneliti mencatat sensitivitas dan spesifisitas niali CEA serum ≥38,765 ng/mL, secara berturut-turut, sebesar 91,53% (IK 95%, 81,32%–97,19%) dan 80,3% (72,16%–86,97%). Rasio odds pasien kanker kolorektal usia muda untuk mengalami metastasis hepar adalah sebesar 44,10 (IK 95%, 15,92–122,20) bila nilai CEA serum pasien sebesar ≥38,765 ng/mL. Simpulan. Kadar CEA ≥38,765 ng/mL memiliki sensitivitas dan spesifisitas yang baik, sehingga cukup efektif untuk digunakan sebagai prediktor metastasis hepar pada penderita KKR.
Introduction. This study aims to determine the diagnostic value of serum CEA levels as the liver metastases predictor of colorectal cancer (CRC) in young adults.. Method. A cross-sectional study was conducted using secondary data (patient medical records) from 2015–2021. Patients aged <50 years who were diagnosed histopathologically with primary colorectal cancer at Cipto Mangunkusumo General Hospital were recruited in this study. We excluded patients with a history of other malignancies, who had undergone operative management for colorectal cancer, and preexisting liver disease. The outcome of this study is the cut-off of the CEA value obtained by the ROC curve, the sensitivity and specificity of the CEA value in predicting CR liver metastases. Results. We recruited 181 patients with a proportion of 43.6% women. Fifty-nine patients (32.6%) had liver metastases. The CEA level of metastatic patients was 208.1 (2.1–12503.2) ng/mL; this was much higher than the non-metastatic group, which was recorded at 6.27 (0.8–1099.4) ng/mL (p<0.001). The AUC value was recorded at 0.904, and the optimal cut-off was obtained at CEA levels 38.765 ng/mL (Youden's Index = 1.718). We noted the sensitivity and specificity of serum CEA values 38.765 ng/mL, respectively, of 91.53% (91.5 CI, 81.32%–97.19%) and 80.3% (72.16%– 86.97%). The odds ratio of young colorectal cancer patients to have liver metastases was 44.10 (95% CI, 15.92–122.20) if the patient's serum CEA value was 38.765 ng/mL. Conclusion. CEA level ≥38,765 ng/mL has good sensitivity and specificity in predicting liver metastases among young adults with CRC."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tesis Membership  Universitas Indonesia Library
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Raisa Zalfa Meutia Abubakar
Factors related to blindness in patients with brain tumor treated in the Department of Neurosurgery, RSUPN Dr. Cipto Mangunkusumo = Faktor terkait kebutaan pada penderita tumor otak di Layanan Bedah Saraf RSUPN Dr. Cipto Mangunkusumo
"Pendahuluan: Lesi serebral intrakranial, khususnya tumor, awalnya dapat muncul sebagai gejala oftalmik akibat adanya massa dan/atau peningkatan tekanan intrakranial yang mengganggu jalur penglihatan, jaringan mata, dan saraf. Diagnosis dini tumor otak penting untuk mencegah gangguan penglihatan dan/atau kebutaan yang tidak dapat disembuhkan. Namun, rendahnya kesadaran pasien tentang pentingnya manajemen bedah saraf yang tepat waktu sering mengakibatkan keterlambatan diagnosis dan pengobatan.
Metode: Penelitian ini menggunakan desain cross-sectional analitik untuk mengetahui kebutaan akibat tumor otak. Data dari 54 pasien pada tahun 2020, dikelompokkan berdasarkan karakteristik demografi, dianalisis untuk mengeksplorasi hubungan antara durasi dari timbulnya gejala hingga kunjungan medis pertama dan terjadinya kebutaan pada pasien tumor otak.
Hasil: 35 (64,81%) pasien tumor otak ditemukan mengalami kebutaan. Temuan penelitian ini mengungkapkan adanya hubungan antara kebutaan pada pasien tumor otak dan durasi dari timbulnya gejala hingga kunjungan medis pertama dan konsultasi bedah saraf. Pasien yang mengalami keterlambatan dalam berkonsultasi dengan dokter layanan primer dan/atau bedah saraf sejak gejala awal menunjukkan insiden kebutaan yang lebih tinggi, hal ini menunjukkan pentingnya mencari pertolongan medis segera.
Kesimpulan: Penelitian ini menggarisbawahi pentingnya intervensi medis yang tepat waktu dan konsultasi bedah saraf khusus untuk mengurangi kejadian kebutaan di antara pasien tumor otak. Hal ini menekankan perlunya peningkatan kesadaran masyarakat, sistem rujukan yang efisien, dan pertolongan medis yang cepat untuk meringankan beban kebutaan pada populasi pasien tumor otak.
Introduction: Intracranial cerebral lesions, particularly tumours, can initially present as ophthalmic symptoms due to masses and/or elevated intracranial pressure disturbing the visual pathway, ocular tissues, and nerves. Early diagnosis of brain tumours is crucial to prevent irreversible visual impairment and/or blindness. However, low patient awareness about the importance of timely neurosurgical management often results in delayed diagnosis and treatment.
Methods: This study utilized an analytic cross-sectional design to investigate blindness related to brain tumours. Data from 54 patients in 2020, stratified by demographic characteristics, were analyzed to explore the association between the duration from symptom onset to the first medical visit and the occurrence of blindness in brain tumor patients.
Results: 35 (64.81%) brain tumour patients were found to be blind. The study findings revealed an association between blindness in brain tumour patients and the duration from symptom onset to both the first medical visit and neurosurgery consultation. Patients experiencing delays in consulting a primary care physician and/or a neurosurgeon from the initial onset of symptoms exhibited a higher incidence of blindness, highlighting the importance of seeking prompt medical attention.
Conclusion: This study underscored the critical need for timely medical intervention and specialized neurosurgical consultation to mitigate the incidence of blindness among brain tumour patients. It emphasized the necessity for increased public awareness, efficient referral systems, and prompt medical attention to alleviate the burden of blindness in patients with brain tumour."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Skripsi Membership  Universitas Indonesia Library
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Siregar, Marsintauli Hasudungan
Gambaran klinis radiologis histopatologis dan faktor prognostik tumor otak pada anak = Clinical radiology histopathology features and prognostic factor of child brain tumor
"[ABSTRAK
Tumor otak (TO) merupakan penyebab kematian kedua dari
semua kanker yang terjadi pada anak. TO memiliki gambaran klinis, radiologis
dan histopatologis yang sangat bervariasi karena proses pengembangan sel-sel
jaringan otak masih berlanjut sampai usia 3 tahun. Data penelitian mengenai TO
pada anak masih sedikit.
Tujuan: Untuk mengetahui gambaran klinis, radiologis, histopatologis dan faktor
prognostik TO di Departemen Ilmu Kesehatan Anak FKUI/ RS. Dr.
Ciptomangunkusumo Jakarta periode tahun 2010 - 2015.
Metode Penelitian: Kohort retrospektif dilakukan pada semua anak dengan TO
primer yang berobat/dirawat di Departemen Ilmu Kesehahatan Anak FKUI/RS
Dr. Ciptomangunkusumo Jakarta.
Hasil: Didapatkan 88 pasien TO primer, terdiri dari 16 pasien berusia kurang dari
3 tahun dan 72 pasien berusia lebih dari 3 tahun, laki-laki 53% dan perempuan
47%. Anak usia kurang dari 3 tahun mengalami gejala sakit kepala (63%) dan
kejang (56%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebral
ventrikel (25%) dan cerebellum (24%), berdasarkan histopatologis jenis TO yang
terbanyak adalah Astrositoma (31%) dan Medulloblastoma (25%). Anak usia
lebih dari 3 tahun mengalami gejala sakit kepala (81%) dan gangguan penglihatan
(65%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebellum
(24%) dan suprasellar (10 %), berdasarkan histopatologis jenis TO yang
terbanyak adalah Medulloblastoma (21%), Astrositoma (18%) dan Glioma (17%).
Angka kehidupan TO adalah 37 %. Tidak didapatkan faktor prognostik TO yang
bermakna.
Kesimpulan: Gejala TO tersering adalah sakit kepala, berdasarkan radiologis
letak tumor terbanyak adalah di cerebellum serta berdasarkan histopatologis jenis
tumor terbanyak adalah Medulloblastoma dan Astrositoma. Tidak didapatkan
faktor prognostik TO pada anak.
ABSTRACT
Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor., Background: Primary brain tumors rank second as the most frequent neoplasm in
children. The lesions occurring in neonates or infants have been reported to differ
from those in older children in terms of their clinical presentation, radiology and
histopathology features.
Objective To clarify the clinical presentation, radiology, histopathology features.
and prognostic factor of primary brain tumors in Child Department
Ciptomangunkusumo Hospital Jakarta in 2010 - 2015.
Method: Retrospective cohort using medical records and neuroradiological dan
histopathological studies, we analyzed each patient?s clinical presentation, tumor
location, histopathological diagnosis and treatment then we compared between
under 3 years of age and more 3 years of age . The patients were followed until
their death or until the end of October 2015.
Result: 88 patient of primer brain tumor that consist of 16 patients with under 3
years of age and 72 patients with more 3 years of age. Boys are 53% and girls
are 47% . The most symptoms of children under 3 years of age is headache (63%)
and seizure (56%), based on radiology the most location tumor is cerebral
ventrikel (25%) and cerebellum (24%), based on histopathology the predominant
tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms
of children more 3 years of age is headache (81%) and visual difficulties (65%),
based on radiology the most tumor location is cerebellum (24%) and suprasellar
(10 %), based on histopathology the predominat tumor is Medulloblastoma
(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.
There is no prognostic factor of brain tumor.
Conclusion: The most symptom of brain tumor is headache, based on radiology
the most tumor location is cerebellum, and based on histopathology the
predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic
factor of brain tumor.]"
2016
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Diah Artanti Sekarayu Budi Sarwono
Karakteristik Pasien Kanker Payudara dengan Metastasis Bone only di Rumah Sakit dr. Cipto Mangunkusumo, Jakarta pada Tahun 2017-2022 = Characteristic of Breast Cancer Patients with Bone Only Metastases at RSCM 2017-2022
"Kanker payudara merupakan salah satu jenis kanker yang paling umum. Sebagaimana diketahui, kanker suatu jaringan dapat menyebar atau bermetastasis ke jaringan lain sebagai kanker sekunder, di mana pada kanker payudara 90% kematian selama pengobatan dikaitkan pada metastasis. Penelitian ini fokus kepada karakteristik metastasis bone only sebagai subtipe metastasis tulang kanker payudara yang belum banyak diteliti walaupun angka kelangsungan hidup (survival)nya paling bagus dibandingkan bila metastasis ke organ/tempat lainnya. Gambaran karakteristik pasien KPD BMO yg berobat di RSCM juga belum pernah diteliti. Penelitian ini menggunakan desain penelitian observasional deskriptif dengan desain studi cross sectional dengan teknik sampel total sampling. Terdapat 1278 pasien KPD metastasis yg berobat di RSCM 2017-2022. Didapatkan 148 pasien KPD BMO, namun karena ketidak lengkapan informasi di hasil pemeriksaan penunjang maka yang masuk kriteria inklusi penelitian ini adalah 47 pasien. Dari 47 pasien, ditemukan karakteristik 100% perempuan, rentang usia terbanyak 45-64 tahun (70,2%), 46,8% bersuku Jawa, 85,1% dalam usia menopause, dengan sebagian besar kanker karsinoma duktal invasif (85,1%) grade 2 (68,1%) dan subtipe luminal A (42,6%). Kasus Denovo sebanyak 48,9%. Ditemukan metastasis multiple (91,5%) lesi osteolitik(29,8%) , dan berlokasi di Os. Vertebrae (31,7%). Sejalan dengan penelitian sebelumnya dan faktor risiko metastasis bone only, sehingga dapat dilakukan studi lanjutan berupa studi analitik maupun genomic untuk mengkonfirmasi hubungan kausalitas tiap variabel.
Breast cancer is one of the most common types of cancer. As we know, cancer in one tissue can spread or metastasize to other tissues as secondary cancer, where in breast cancer 90% of deaths during treatment are attributed to these metastases. This study focuses on the characteristics of bone only metastases as a subtype of breast cancer bone metastases that has not been widely studied although its survival is better than breast cancer which metastases to other organs. This research uses a descriptive observational research design with a cross sectional study design with a total sampling technique. We found 1278 breast cancer with metastasis treated in RSCM within 2017-2022. There are 148 breast cancer bone metastasis only, but only 47 patients were included in the research due to the completed radiology data. Of the 47 patients, the characteristics of the 47 patients were 100% female; 70,2% aged 45-64 years-old ;46,8% Javanese ; 85,1% in menopausal age, 68,1% with grade 2 invasive ductal carcinoma and 42,6% luminal A subtype; 48,9% Denovo cases ; 91,5% suffered from Multiple osteolytic lesion metastases and 31,7% were located in Os. Vertebrae. In line with previous research and risk factors for bone only metastasis, further studies can be carried out in the form of analytical or genomic studies to confirm the causal relationship between each variable."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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Mustaqim Prasetya
Profil kebutaan pasien tumor otak dan faktor terkait di layanan bedah saraf RSUPN Cipto Mangunkusumo periode september 2013 februari 2014 = The profile for blindness and other related factors in brain tumor patient treated in the neurosurgery facility Cipto Mangunkusumo hospital September 2013-February 2014
"Latar Belakang: Gangguan penglihatan adalah gejala kedua yang sering muncul pada tumor otak setelah nyeri kepala. Gejala gangguan penglihatan yang paling sering terjadi pada tumor otak adalah penurunan visus atau tajam penglihatan (low vision sampai kebutaan), sedang tanda yang paling sering dijumpai adalah atrofi n. optikus dan papilledema. Penurunan tajam penglihatan yang dialami penderita tumor otak dapat sangat berat hingga berupa kebutaan. Sampai saat ini belum terdapat data angka kejadian gangguan penglihatan sampai kebutaan pada tumor otak di Indonesia.
Metode: Sebagai studi potong lintang analitik, dikumpulkanlah data pasien penderita tumor otak di atas usia 6 tahun yang datang berobat ke poliklinik Bedah Saraf FKUIRSCM pasien September 2013 hingga Februari 2014 dari catatan rekam medis.
Hasil: Jumlah pasien tumor otak yang mengalami buta sebanyak 37 orang (34,6 %) dengan usia rata-rata 45,3 (SD 11,3 tahun). Sebesar 86,5 % penderita berada pada usia produktif 15-54 tahun. Dari 37 pasien tumor otak yang buta terlihat proporsi gejala penyerta terbesar adalah sefalgia (terutama sefalgia kronis), diikuti oleh gangguan oftalmologi lain. Data pemeriksaan funduskopi hanya ditemukan pada kurang dari 50 % penderita, dengan temuan yang terbanyak adalah papil atrofi.
Kesimpulan: Besar angka kebutaan pada pasien tumor otak menunjukkan bahwa kondisi ini tidak hanya menjadi masalah medis saja tetapi juga masalah sosial yang serius. Banyaknya jumlah pasien tanpa data funduskopi menandakan masih lemahnya standar pemeriksaan neurooftalmologi ataupun pencatatan yang ada saat ini, padahal pemeriksaan funduskopi berperan sangat penting mendeteksi dini kejadian tumor otak pada pasien dengan gangguan penglihatan.
Background: Vision impairment is the second most common symptom in brain tumor after headache, with decreased visual acuity or low vision as its most common manifestation, and optic nerve atrophy and papilledema as its most common sign. Blindness may be the final outcome of this impairment. Until now, there is no data regarding the prevalence of vision impairment in brain tumor patient in Indonesia.
Method: As a analytic cross-sectional study, data is collected from the medical record regarding brain tumor patient above the age of 6 years old who were seen in the neurosurgery facility in FKUI-RSCM from September 2013 to February 2014.
Result: As much as 37 patient (34,6%) brain tumor patient were found to be blind; mean age was 45,3 years old (SD 11,3 years old), with 86,5% patient was in the productive age 15-54 years old. The commonest related symptoms was headache (especially chronic headache), followed by other ophthalmologic symptoms. Funduscopy data was found only in less than 50% patient; the commonest finding was optic nerve atrophy.
Conclusion: Blindness rate in brain tumor patient is not just a medical issue, but also a social one. Funduscopy usage must be encouraged more to provide early detection for brain tumor patient with vision impairment."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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Nurul Asyrifah
Studi Teknik Penyinaran Radioterapi Adaptif: Evaluasi Dosimetri pada Pasien Tumor Otak = Study on Adaptive Radiotherapy Beam Delivery Technique: Dosimetry Evaluation in Brain Tumor Patients
"Penelitian ini bertujuan untuk mengevaluasi perhitungan dosis berdasarkan citra Cone Beam Computed Tomography (CBCT) pada pasien dengan diagnosa tumor otak. Perencanaan dan perhitungan dosis berdasarkan citra CBCT fraksinasi ke-16 yang dilakukan terhadap 13 pasien yang disinari menggunakan pesawat linac Elekta Versa HD dan 7 pasien yang disinari menggunakan pesawat linac Halcyon 2.0. Perencanaan dan perhitungan dosis dilakukan pada Treatment Planning System (TPS) Eclipse dan TPS Monaco. Hasil perhitungan dosis berdasarkan citra CBCT dibandingkan dengan citra Computed Tomography (CT) simulator. Penelitian ini memiliki beberapa tahapan, (1) kalibrasi Hounsfield Unit (HU) citra CBCT menggunakan fantom CIRS CT electron density 062M untuk melakukan perhitungan dosis di TPS dengan nilai HU yang sesuai, (2) proses pengumpulan data citra pasien yang memenuhi kriteria penelitian dan dilanjutkan dengan proses registrasi dan perencanaan citra CBCT, (3) analisis Dose Volume Histogram (DVH) untuk mengevaluasi kualitas perencanaan dengan parameter dosis yaitu Conformity Index (CI) dan Homogeneity Index (HI), (4) analisis dosis Organ at Risk (OAR) terhadap dose-constraint (batas dosis) untuk OAR batang otak, kiasma, sumsum tulang belakang, saraf optik, mata dan lensa. Nilai CI pada perencanaan berdasarkan CT tidak berbeda secara signifikan, Berdasarkan CBCT dari pesawat linac Elekta Versa HD diperoleh CI sebesar 0,05±0,21 (p=0,08) dan -0,01 ± 0,06 (p=0,02) berdasarkan CBCT dari pesawat linac Halcyon 2.0. Sementara itu, nilai HI pada perencanaan berdasarkan CBCT diamati berbeda secara signifikan terhadap CT, Berdasarkan CBCT dari pesawat linac Elekta Versa HD diperoleh HI sebesar 0,25 ± 0,43 (p=0,01) dan 0,08 ± 0,04 (p=0,01) berdasarkan CBCT dari pesawat linac Halcyon 2.0.
This research aims to evaluate dose calculations based on Cone Beam Computed Tomography (CBCT) images in patients diagnosed with brain tumors. Planning and dose calculations based on the 16th fraction of CBCT images were performed on 13 patients irradiated using Elekta Versa HD linear accelerator and 7 patients irradiated using Halcyon 2.0 linear accelerator. The planning and dose calculations were conducted using the Treatment Planning System (TPS) Eclipse and TPS Monaco. The results of the dose calculations based on CBCT images were compared with the Computed Tomography (CT) simulator images. The research comprised several stages: (1) calibration of Hounsfield Unit (HU) of CBCT images using CIRS CT electron density 062M phantom to perform dose calculations in TPS with appropriate HU values, (2) data collection of patient images meeting the research criteria followed by image registration and CBCT planning, (3) analysis of Dose Volume Histogram (DVH) to evaluate planning quality using dose parameters such as Conformity Index (CI) and Homogeneity Index (HI), (4) analysis of dose to Organs at Risk (OAR) against dose constraints for OARs such as brainstem, chiasm, spinal cord, optic nerves, eyes, and lenses. The CI values for the planning based on CT were not significantly different. Based on CBCT from Elekta Versa HD linear accelerator, the CI obtained was 0.05 ± 0.21 (p=0.08), and based on CBCT from Halcyon 2.0 linear accelerator, the CI obtained was -0.01 ± 0.06 (p=0.02). However, the HI values for planning based on CBCT significantly differed from CT. Based on CBCT from Elekta Versa HD linear accelerator, the HI obtained was 0.25 ± 0.43 (p=0.01), and based on CBCT from Halcyon 2.0 linear accelerator, the HI obtained was 0.08 ± 0.04 (p=0.01)."
Depok: Fakultas Matematika dan Ilmu Pengetahuan Alam Universitas Indonesia, 2023
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Nia Yuliatri
Nilai prognostik proses Neuroinflamasi pada pasien Cedera Otak : tinjauan khusus tentang kadar Interleukin-6 Serum di FKUI-RSUPNCM periode April 2010-Agustus 2011 = Prognostic factors of Neuroinflammation on Traumatic Brain Injury patients : special refference of Interleukin-6 Serum at Faculty of Medicine University of Indonesia-Cipto Mangunkusumo Hospital April 2010-August 2011 / Nia Yuliatri
"ABSTRAK
Tujuan
Tindakan bedah saraf, diduga dapat mengentikan atau memperlambat cedera otak sekunder, yang berhubungan dengan proses neuroinflamasi. Peneliti bertujuan untuk mengetahui peranan neuroinflamasi (Il-6) terhadap prognosis pasien cedera otak dan untuk mengetahui hubungan tindakan operasi dengan kondisi neuroinflamasi.
Metode
Penelitian ini bersifat prospektif observasional dengan desain cross sectional. Dari 40 pasien cedera otak yang dilakukan tindakan operasi, dilakukan pemeriksaan kadar Il-6 sebelum operasi dan 1 hari pasca tindakan operasi. GCS dinilai saat di UGD (GCS awal) dan sesudah tindakan operasi (GCS hari ke-7). GOS dinilai setelah bulan ke-1 dan bulan ke-3 pasca trauma. Kadar IL-6 sebelum operasi dan 1 hari pasca tindakan operasi dihubungkan dengan nilai GCS awal, GCS hari ke-7, GOS bulan ke-1 dan GOS bulan ke-3 untuk mengetahui hubungan tindakan operasi dengan proses neuroinflamasi dan nilai prognostiknya terhadap pasien cedera otak.
GCS awal. GCS hari ke-7 dikelompokkan menjadi GCS <=8 dan GCS >8. GOS bulan ke-1 dan bulan ke-3 dikelompokkan menjadi GOS favorable (>3) dan unfavorable <=3.
Hasil
Kadar Il-6 awal berhubungan bermakna dengan GCS awal (p: 0.001) dengan OR 11.4 --> pasien dengan kadar Il-6 >100 pg/ml memiliki peluang 11.4 kali mendapatkan nilai GCS <=8. Terdapat perbedaan nilai median kadar Il-6 pasca operasi dibandingkan dengan pre operasi, dengan kecenderungan kadar Il-6 pasca operasi (median=35.55 pg/ml) lebih rendah daripada kadar Il-6 awal (median=76.74 pg/ml)
Kadar Il-6 pasca operasi berhubungan bermakna dengan GCS hari ke-7 (p=0.006), dengan OR 24 --> pasien dengan Il-6 pre op <= 100 pg/ml memiliki peluang 24 kali memperoleh nilai GCS hari ke-7 >8. Kadar Il-6 pasca operasi berhubungan bermakna dengan GOS bulan ke-3 (nilai p= 0.016) dengan OR 11.6 --> pasien dengan kadar Il-6 <=100 pg/ml memiliki peluang sebesar 11.6 kali mencapai GOS bulan ke-3 favorable.
Simpulan
Proses neuroinflamasi memiliki nilai prognostik pada pasien cedera otak, di mana maikin tinggi kadar Il-6 serum awal, makin buruk GCS awal pasien.Tindakan bedah saraf dapat menurunkan proses neuroinflamasi dan berhubungan dengan outcome GCS hari ke-7 (status kesadaran) pasca operasi dan GOS bulan ke-3 (kualitas hidup) yang lebih baik.
ABSTRACT
Objectives
Neurosurgical procedures are performed to stop or slow down the secondary brain injury. This study is aimed to determine the association of neuroinflammation with the prosnosis of brain injury patients and the association of neurosurgical procedure with the neuroinflammation.
Method
The study design is a prospective observation of 40 brain injuty patients who were operated. Examination were carried out top measured Il-6 serum level of pre and one day post operation on brain injury patients, and to analize therir association with GCS,GOS and neurosurgical procedures.
Results
The Il-6 serum level pre surgery was significantly associated with initial GCS (p value=0.001 and OR 11.4). There was significant median difference of Il-6 post surgery compared with pre surgery, with a downward trend of Il-6 post surgery.
The post operative Il-6 level was significantly associated with GCS 7 days post surgery (p=0.006), with OR 24, meaning that patients with post surgery level of Il-6 <= 100 pg/ml had 24 times chance of getting GCS 7 days post trauma >8. The post operative Il-6 serum was significantly associated with GCA 3 months post trauma (p value= 0.016) with OR 11.6, meaning that the patients with post operative Il-6 level <= 100 pg/ml has 11.6 times as much chance of reaching the 3 months post trauma GOS favorable.
Conclusion
Neuroinflammation may have prognostic values in brain injured patients. Neurosurgical procedures can decrease the neuroinflammation process and was associated with better conciousness state (GCS) and neurological outcome (GOS)."
Fakultas Kedokteran Universitas Indonesia, 2013
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