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"PurposePancreatic ductal adenocarcinoma (PDAC) is a lethal disease; however, the frequency of recurrence can be reduced if curative surgery following adjuvant chemotherapy is applied. At present, adjuvant chemotherapy is uniformly performed in all patients, as it is unclear which tumor types are controlled best or worst. We investigated patients with recurrence to establish the optimum treatment strategy.MethodsOf 138 patients who underwent curative surgery for PDAC, 85 developed recurrence. Comprehensive clinicopathological factors were investigated for their association with the survival time after recurrence (SAR).ResultsThe median SAR was 12.6 months. Treatments for recurrence included best supportive care, GEM-based therapy and S-1. The performance status [hazard ratio (HR) 0.12, P < 0.001], histological invasion of lymph vessels (HR 0.27, P < 0.001), kind of treatment for recurrence (HR 5.0, P < 0.001) and initial recurrence site (HR 2.9, P < 0.001) were independent significant risk factors for the SAR. The initial recurrence sites were the liver (n = 21, median SAR 8.8 months), lung (n = 10, 14.9 months), peritoneum (n = 6, 1.7 months), lymph nodes (n = 6, 14.7 months), local site (n = 17, 13.9 months) and multiple sites (n = 25, 10.1 months). A shorter recurrence-free survival (< 1 year) and higher postoperative CA19-9 level were significantly associated with critical recurrence (peritoneal/liver).ConclusionsSeveral risk factors for SAR were detected in this study. Further investigations are needed to individualize the adjuvant chemotherapy for each patient with PDAC."

"Inflamasi kronik adalah proses yang penting dalam patofisiologi adenokarsinoma duktal pankreas (PDAC). Beberapa studi telah meneliti potensi enzim siklooksigenase-2 (COX-2) sebagai faktor prognostik PDAC, dengan hasil yang kontradiktif. Nuclear factor kappa−B (NF−?B), specificity protein 1 (Sp1), dan c−Jun adalah faktor transkripsi gen COX2. Penelitian ini adalah studi observasional eksploratori yang bertujuan untuk mengidentifikasi asosiasi ekspresi protein NF−?B (RelA/ p65), COX−2, Sp1, dan c−Jun dengan kesintasan pasien PDAC. Ekspresi protein tersebut dinilai di jaringan pasien PDAC menggunakan metode imunohistokimia. Diidentifikasi ekspresi keempat protein tersebut dengan overall survival (OS) dan karakteristik klinikopatologis pasien PDAC. Sebanyak 53 jaringan PDAC dari biopsi atau reseksi kanker diikutkan dalam penelitian. Hasilnya terdapat korelasi antara keempat protein di jaringan kanker. Ekspresi NF−?B sitoplasmik (aHR = 0.31; 95% CI 0.11–0.90; p = 0.032) atau nuklear (aHR = 0.22; 95% CI 0.07–0.66; p = 0.007) berhubungan secara independen dengan prognosis pasien yang lebih baik. Protein lainnya tidak berhubungan dengan kesintasan pasien. Hal ini menunjukkan bahwa peran inflamasi di PDAC lebih kompleks dari yang diperkirakan sebelumnya.

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Chronic inflammation is a crucial driver of carcinogenesis in pancreatic ductal adenocarcinoma (PDAC). Several studies have investigated the prognostic significance of cyclooxygenase−2 (COX−2) expression in PDAC patients, obtaining conflicting results. Nuclear factor kappa−B (NF−?B), specificity protein 1 (Sp1), and c−Jun are known as the transcription factors of the COX2 gene. This exploratory observational study investigated the association of the NF−?B, COX−2, Sp1, and c−Jun expressions with patient survival in PDAC. We used the immunohistochemical method to detect the PDAC tissue expressions of NF−?B (RelA/p65), COX−2, Sp1, and c−Jun. The expressions of these proteins were correlated with the overall survival (OS) and other clinicopathological characteristics of PDAC patients. We obtained 53 PDAC specimens from resections and biopsies. There were significant correlations between the four proteins’ expressions in the PDAC tissues. The expression of the cytoplasmic (aHR = 0.31; 95% CI 0.11–0.90; p = 0.032) or nuclear NF−?B (aHR = 0.22; 95% CI 0.07–0.66; p = 0.007) was independently associated with a better prognosis in the PDAC patients. COX−2, Sp1, and c−Jun showed no significant association with a prognosis in the PDAC patients. The PDAC patients who expressed NF−?B had a better prognosis than the other patients, which suggests that the role of inflammation in PDAC is more complex than previously thought."

"Keganasan pankreas merupakan keganasan dengan angka kematian yang tinggi, dengan Adenokarsinoma Duktal Pankreas/Pancreatic Ductal Adenocarcinoma (PDAC) mencakup 85-90% kasus. PDAC memiliki perjalanan penyakit yang sangat agresif, dan seringkali baru terdiagnosis pada stadium lanjut. Penegakan diagnosis pasti PDAC seringkali hanya dapat dilakukan melalui sediaan terbatas baik berupa biopsi maupun endoscopic ultrasound-guided fine-needle aspiration/EUS-FNA. Salah satu tantangannya adalah membedakan PDAC dari jaringan pankreas non-neoplastik/reaktif. Penelitian ini akan membahas mengenai peran von Hippel-Lindau gene product/pVHL dalam membedakan PDAC dengan jaringan pankreas non-neoplastik, serta hubungannya dengan profil klinikopatologiradira PDAC. Penelitian ini merupakan penelitian observasional analitik dengan desain cross-sectional pada kasus PDAC dan jaringan pankreas non-neoplastik yang dilakukan di RSCM pada sampel yang diperoleh pada bulan Januari 2012 hingga September 2023. Sampel penelitian dibagi menjadi 2 kelompok besar, yaitu kelompok PDAC dan pankreas non-neoplastik. Pemilihan sampel dilakukan dengan menggunakan simple random sampling dari kasus-kasus yang memenuhi kriteria inklusi dan tidak termasuk dalam kriteria eksklusi. Dilakukan pulasan imunohistokimia pVHL dan perhitungan Histoscore/H-score serta penentuan cut-offnya untuk membagi ekspresi pVHL menjadi tinggi dan rendah dan hubungannya dengan PDAC dan non-neoplastik, serta profil klinikopatologi pada kelompok PDAC. Penelitian ini menunjukkan tidak terdapat perbedaan ekspresi pVHL pada kelompok PDAC dan non-neoplastik, dan staging pN memiliki hubungan bermakna dengan ekspresi pVHL pada PDAC. Ekspresi pVHL yang rendah lebih banyak ditemukan pada PDAC berdiferensiasi sedang, tidak ditemukan invasi limfovaskular maupun invasi perineural, memiliki batas sayatan yang tidak bebas, memiliki staging pT2, pN0, M0, dan kesintasan > 7 bulan. Sebaliknya, ekspresi pVHL yang tinggi juga lebih banyak ditemukan pada PDAC berdiferensiasi sedang, ditemukan invasi limfovaskular, tidak ditemukan invasi perineural, status batas sayatan yang bebas, staging pT2 dan pT3, pN1 dan pN2, M0, dengan kesintasan ≤ 7 bulan. Temuan ini berbeda dengan penelitian sebelumnya yang mendapati hilangnya ekspresi pVHL pada tumor PDAC, dan sebaliknya pada duktus pankreas non-neoplastik. Hal ini kemungkinan disebabkan oleh perbedaan klon antibodi yang digunakan pada penelitian ini dibandingkan dengan penelitian sebelumnya. Klon antibodi yang digunakan adalah VHL40, sedangkan penelitian-penelitian sebelumnya menggunakan klon FL-181 yang berikatan dengan asam amino yang berbeda dan memiliki klonalitas yang berbeda pula. Selain itu, pada PDAC dapat terjadi mutasi pada gen VHL yang menghasilkan protein VHL yang non-fungsional yang kemungkinan masih dapat terdeteksi dengan ikatan antigen-antibodi pada penelitian ini. 

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Pancreatic malignancy is a malignancy with a high mortality rate, with Pancreatic Ductal Adenocarcinoma (PDAC) accounting for 85-90% of cases. PDAC has a very aggressive disease course, and is often only diagnosed at an advanced stage. Establishing a definite diagnosis of PDAC can often only be done through limited sample from biopsy or endoscopic ultrasound-guided fine-needle aspiration/EUS-FNA. In such limited sample, differentiating PDAC from non-neoplastic/reactive pancreatic tissue can be challenging. This research will discuss the role of von Hippel-Lindau gene product/pVHL in PDAC and non-neoplastic pancreatic tissue, as well as their relationship with PDAC pathological factors. This research is an analytical observational study with a cross-sectional design on cases of PDAC and non-neoplastic pancreatic tissue conducted at RSCM on samples obtained from January 2012 to September 2023. The research samples were divided into 2 large groups, namely the PDAC and non-neoplastic pancreatic groups. Sample selection was carried out using simple random sampling from cases that met the inclusion criteria and were not included in the exclusion criteria. Immunohistochemistry of pVHL was performed along with calculation of Histoscore/H-score and determination of cut-offs to divide pVHL expression into high and low and its relationship with PDAC and non-neoplastic, as well as pathological factors in the PDAC group. This study shows that there is no difference in pVHL expression in the PDAC and non-neoplastic groups, and pN staging has a significant relationship with pVHL expression in PDAC. Low pVHL expression is more often found in moderately differentiated PDAC, no lymphovascular invasion or perineural invasion, non-free incision margins, staging pT2, pN0, M0, and survival > 7 months. In contrast, high pVHL expression was also found more frequently in moderately differentiated PDAC, lymphovascular invasion was found, no perineural invasion was found, free incision margin status, pT2 and pT3 staging, pN1 and pN2, M0, with survival ≤ 7 months. This finding is different from previous studies which found loss of pVHL expression in PDAC tumors, and vice versa. This difference in results is likely due to differences in the antibody clones used in this study compared to previous studies. The antibody clone used was VHL40, whereas previous studies used the FL-181 clone which binds to different amino acids and has different clonality. In addition, in PDAC there is a mutation in the VHL gene which may produce a non-functional VHL protein that still be detectable by antigen-antibody binding in this study."

"Latar Belakang: Karsinoma pankreas umumnya merupakan adenokarsinoma duktus dari pankreas, karena lebih dari 90% tumor pankreas berasal dari epitel duktus dan memiliki angka mortalitas tinggi. Adenokarsinoma pankreas menyebabkan berbagai gejala akibat obstruksi duktus biliaris dan duktus pankreatikus serta hipermetabolisme terkait perubahan metabolik pada kanker. Tindakan kuratif meliputi pembedahan menyebabkan perubahan anatomi fisiologik saluran cerna dan dapat menimbulkan berbagai komplikasi gastrointestinal yang menyebabkan malnutrisi pada pasien. Perubahan metabolik, gejala penyakit, dan tatalaksana adenokarsinoma pankreas dapat menyebabkan malnutrisi dan kaheksia kanker. Terapi nutrisi perioperatif yang adekuat akan menghasilkan outome bedah yang baik, menurunkan morbiditas dan mortalitas pascabedah, dan meningkatkan kualitas hidup pasien. Metode: Laporan serial kasus ini menguraikan empat kasus adenokarsinoma pankreas, yaitu dua kasus adenokarsinoma papila Vateri, satu kasus adenokarsinoma papila Vateri yang sudah infiltrasi ke duodenum, dan satu kasus adenokarsinoma pankreas dari kaput sampai kauda. Keempat pasien serial kasus tergolong kaheksia kanker. Pembedahan pada keempat kasus disesuaikan dengan lokasi dan metastasis kanker. Terapi nutrisi pada serial kasus ini dilakukan sesuai dengan pedoman terapi nutrisi perioperatif. Seluruh pasien mendapat terapi nutrisi mulai dari masa prabedah hingga pascabedah dengan pemberian energi dan makronutrien ditingkatkan bertahap sesuai dengan kondisi klinis dan toleransi pasien. Suplementasi mikronutrien juga diberikan kepada keempat pasien. Pemantauan pasien meliputi keluhan subjektif, hemodinamik, analisis dan toleransi asupan, pemeriksaan laboratorium, antropometri, keseimbangan cairan, dan kapasitas fungsional. Hasil: Selama pemantauan di RS, keempat pasien menunjukkan perbaikan klinis, peningkatan toleransi asupan, outcome bedah yang baik, serta perbaikan kapasitas fungsional dan hasil laboratorium. Kesimpulan: Terapi nutrisi perioperatif pada keempat pasien berperan penting dalam menunjang perbaikan klinis, dan outcome bedah, serta mendukung terapi pada kasus kanker pankreas.

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Background: Pancreatic cancer usually refers to ductal adenocarcinomas of the pancreas, since more than 90% of the tumors are ductal epithelium origin and have high mortality rate. Pancreatic adenocarcinoma causes various symptoms resulted from ductal biliary and pancreatic ducts obstruction, along with hypermetabolism related to metabolic alteration in cancer. Curative management involves surgery will make changes in gastrointestinal anatomy and physiology, and cause various gastrointestinal complication that will lead to malnutrition. Metabolic changes, symptoms of the disease and pancreatic adenocarcinoma therapy will cause malnutrition and cancer cachexia. Adequate perioperative nutrition will have good surgery outcome, reduce postoperative morbidity and mortality and increase patients quality of life.

Methods: This serial case report described four cases of pancreatic adenocarcinoma consist of two cases with adenocarcinoma of the papilla of Vater, one case with adenocarcinoma of the papilla of Vater with duodenum infiltration, and one case with pancreatic adenocarcinoma from head to tail. All patients classified as cancer cachexia. Surgery was carried out corresponds to cancer location and metastasis. Nutrition therapy in this serial case report was conducted in accordance to perioperative nutrition therapy guideline. All patients received nutrition support from preoperative to postoperative with gradual increased of energy and macronutrient adjusted to the clinical condition and food tolerance of the patients. Micronutrients supplementation was given to all patients. Monitoring included patients complaints, hemodynamic, food analysis and intake tolerance, laboratory results, anthropometry, fluid balance and functional capacity.

Results: During monitoring in the hospital, all patients showed improve clinical outcomes, increased food intake tolerance, good surgery outcomes, and improved functional capacity, and laboratory results.

Conclusion: Perioperative nutrition therapy in all patients play an important role in supporting clinical outcome improvement, surgery outcomes, and therapy in pancreatic cancer."

"Pancreatic carcinoma commonly occur in patients over 60 years. It is usually manifested as abdominal pain, jaundice, and pancreatic mass. In this report, a pancreatic carcinoma occured in young woman is presented. A surgical drainage was done and followed by Whipple resection. However the patient passed away three month after the diagnosis.

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Karsinoma pankreas umumnya terjadi pada pasien berusia di atas 60 tahun. Biasanya bermanifestasi sebagai perut nyeri, penyakit kuning, dan massa pankreas. Dalam laporan ini, karsinoma pankreas yang terjadi pada wanita muda adalah disajikan. Drainase bedah dilakukan dan diikuti dengan reseksi Whipple. Namun pasien tersebut meninggal hilang tiga bulan setelah diagnosis."

"ABSTRACTPancreatic complex deep injury extending to the main pancreatic duct (MPD), caused by strong external forces such as traffic accidents, is lethal without emergency surgery. However, the best surgical procedure for this serious injury has not been established. The Bracey procedure is a relatively simple reconstructive technique involving pancreaticogastrostomy, but it is often followed by postoperative complications, such as dilatation of the MPD caused by anastomotic stenosis, as well as subsequent serious sequela such as repetitive pancreatitis and new-onset pancreatic diabetes. It is possible that the combination of ductal mucosal pancreaticogastrostomy (DMPG) and an internal stent might prevent anastomotic stenosis of the MPD. We found that the Bracey procedure was a safe and effective reconstructive procedure for five patients who suffered a pancreatic complex deep injury with MPD involvement. In three of these patients, postoperative dilatation of the MPD was prevented by combining the Bracey procedure with DMPG including an internal stent. Our experience suggests that this procedure is one of the best techniques for treating pancreatic complex deep injury extending to the MPD."

"ABSTRACTPurpose: To establish if the number of pancreatic acinar cells at the pancreatic cut end is a predictor of postoperative pancreatic fistula (POPF).Methods: The number of acinar cells was assessed histologically in 121 consecutive patients who underwent pancreaticoduodenectomy (PD) between April, 2012 and July, 2016.Results: POPF developed in 23 of the 121 patients. Univariate analysis revealed that male sex, long operating time, high volume of blood loss, soft remnant pancreas, large pancreatic duct, and the number of pancreatic acinar cells were significantly associated with POPF. Multivariate analysis revealed that male sex (p = 0.022) and the number of pancreatic acinar cells (p < 0.0001) were independently associated with POPF. In the receiver operating characteristic (ROC) curve analysis, the area under curve was 0.83895 when the cut off value of the number of pancreatic acinar cells to predict POPF was 890. Sensitivity and specificity of the number of pancreatic acinar cells were 82.6 and 77.6%, respectively.Conclusions: A large number of pancreatic acinar cells at the cut end of the stump is predictive of POPF after PD. Although POPF is associated with multiple factors and the number of acinar cells is only one of these, our study is the first to confirm this common intuition of surgeons, which has not been assessed definitively before."

"Tujuan penelitian ini untuk menyusun clinical pathwaykemoterapi adjuvant pada kanker payudara tanpa penyakit komorbid dr RSUP Dr Kariadi Semarang. Penelitian ini merupakan penelitian operasional denganmetode pengambilan data retrospektif. Penelitian dilakukan di RSUP Dr Kariadi Semarang pada tahun 2012 pada instalasi rekam medis, instalasi rawat inap, instalasi farmasi, instalasi laboratorium dan bagian perbekalan farmasi. Sampel dalam penelitian ini adalah pasien yang didiagnosis dengan kanker payudara dengan pada tahun 2012, yang dilakukan kemoterapi. Data primer yang didapatkan meliputi : Jumlah dan identitas pasien kanker payudara yang dilakukan kemoterapi pada tahun 2012, hasil wawancara dan wawancara mendalam, hasil wawancara dalam fokus grup diskusi, hasil pengamatan langsung pada saat kemoterapi dilakukan. Data sekunder didapatkan dari dokumen rekam medis pasien kanker payudara yang dilakukan kemoterapi pada tahun 2012. Instrumen yang digunakan pada penelitian ini yaitu formulir penelitian, pedoman wawancara, pedoman diskusi grup. Karakteristik usia penderita kanker payudara berkisar antara 27 tahun dan yang tertua berusia 93 tahun dengan rerata usia 47,93 + 9,7 tahun. Pembiayaan terbanyak yang digunakan ialah dengan pembiayaan pribadi. Pasien kanker payudara pada tahun 2012 paling banyak berasal dari Semarang. Rata-rata lama hari perawatan pasien kanker payudara yang dilakukan kemoterapi ialah 8,3 hari. Diagnosis kanker payudara dibedakan berdasarkan jenis histopatologi, stadium dan grading. Jenis kanker payudara yang paling banyak pada penelitian ini ialah Karsinoma Duktus Invasif. Stadium yang paling banyak dijumpai yaitu stadium IV. Derajat histopatologi yang paling banyak dijumpai ialah grade II. Jenis pemeriksaan yang paling banyak dilakukan yaitu pemeriksaan darah, pemeriksaan fungsi ekskresi ginjal dan pemeriksaan fungsi ekskresi liver. Pelayanan kemoterapi menggunakan kombinasi obat, dengan rata-rata 2,62 macam obat yang digunakan. Jenis obat yang paling banyak dilakukan yaitu Siklofosfamid, 5 Fluorouracil dan Doksorubisin. Obat nonkemoterapi yang diberikan pada pasien kanker payudara yang akan dilakukan kemoterapi ialah obat anti muntah, obat anti alergi dan obat pencegah sekresi asam lambung. Clinical pathway kemoterapi pada kanker payudara melalui beberapa tahapan yaitu : Tahap pendaftaran kemoterapi, dapat dilakukan melalui instalasi rawat inap ataupun rawat jalan. Tahap persiapan kemoterapi dengan pemeriksaan laboratorium darah rutin, test fungsi ekskresi hepar dan test fungsi ekskresi ginjal.

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The main purpose of this study is to arranging clinical pathway for adjuvant chemotherapy on breast cancer without comorbid disease at dr Kariadi General Hospital Semarang. This research is anoperational research, the data were collected retrospectively. The study was conducted at Dr Kariadi General Hospital Semarang in 2012. The data was taken on the medical records department, inpatient department, pharmacy department, laboratory department and pharmaceuticals department.

The samples in this study were breast cancer patients who underwent chemotherapy in 2012. Primary data that we obtained include: number and identity of patients breast cancer chemotherapy conducted in 2012, the results of interviews and in-depth interviews, the result of consensus making group discussion and direct observation during chemotherapy. Secondary data were obtained from medical records of breast cancer patients who underwent chemotherapy in 2012. Instrument that used in this studies were research form, guidance interviews, group discussion guidelines. Characteristics of breast cancer patients age in this study ranged from 27 years old for the youngest to93 years old for the oldest, with mean age was 47,93 + 9,7 years old. Most of the patient financial state was personal. Most breast cancer patients came from Semarang with average length of stay of 8,3 days.

Breast cancer diagnosis was distinguished by the type of histopathology, staging and grading. Most type of breast cancer in this study was Invasive Ductal Carcinoma, most staging found in this study was stadium IV. Most histopathological degree found was grade II. The examination that performed in patients were blood tests, kidney function tests, and liver function tests. In dr Kariadi General Hospital, the chemotherapy which is used for patients with breast cancers consist more than one drug, with an average of 2.62 different drugs used. The chemotherapy drugs that used frequently were Cyclophosphamide, 5 Fluorouracil and Doxorubicin.

Non-chemotherapy drugs which are given to patients with breast cancer who undergo chemotherapy are anti-vomiting drugs, antihistamines drugs and drugs to prevent gastric acid secretion. Clinical pathway in chemotherapy of breast cancer through several stages: chemotherapy registration phase which can be done through inpatient or outpatient. Chemotherapy preparation phase, with routine blood laboratory tests, liver function tests excretion and renal excretion function test."

"Latar Belakang: Kemoradiasi merupakan upaya yang dapat dilakukan untuk meningkatan kesintasan sel. Diperlukan penelitian in-vitro untuk mengembangkan potensi-potensi agen kemoradiosensitiser tersebut, namun sayangnya tidak banyak laboratorium yang melakukan protokol uji radiosensitivitas sel di Indonesia. Tujuan: Penelitian ini ditujukan untuk membangun protokol clonogenic assay agar radiosensitivitas dan efek radiosensitiser dapat diukur dengan baik. Metode: Lini sel yang digunakan adalah MCF-7 adenokarsinoma payudara dan HeLa yang merupakan adenokarsinoma cervix uteri. Linear accelerator digunakan sebagai cell irradiator. Clonogenic assay digunakan untuk menilai radiosensitivitas sel MCF-7 dan HeLa serta mengexplorasi efek cisplatin sebagai radiosensitiser pada dua sel tersebut. Radiosensitivitas sel akan dipresentasikan pada kurva quadratic linear. Hasil: Didapatkan bahwa Radiosensitivitas sel MCF-7 dan HeLa didapatkan dengan α/β ratio 4.56 dan 4.94. IC50 cisplatin pada Hela adalah 10.4 uM dan MCF-7 adalah 250nM. Cisplatin memiliki potensi sebagai radiosensitiser pada lini sel kanker payudara dengan SER-D10 dan SER-D50 1.83 dan 2.87 pada dosis 50nM, serta SER-D10 dan SER-D50 2.23 dan 3.31 pada dosis 100nM. Kesimpulan: Protokol colony assay dapat dimanfaatkan untuk menentukan kesintasan sel terhadap radiasi, kemoterapi, dan kemoradiasi. Cisplatin memiliki potensi sebagai radiosensitizer terhadap sel MCF-7, yang merupakan lini sel adenokarsinoma payudara.

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Background: Chemoradiation is a therapeutic approach aimed at improving treatment results. There is a lack of laboratories in Indonesia that conduct cell radiosensitivity testing protocols, which hinders the development of potential chemo-radiosensitizer agents through in-vitro research. Methods: The purpose of this research is to develop a clonogenic assay protocol in order to accurately measure radiosensitivity and the impact of the radiosensitivity. We use MCF-7, a breast adenocarcinoma cell line, and HeLa, a cervical cervix adenocarcinoma cell line. The study uses a linear accelerator as a device to irradiate cells. We explore the radiosensitivity of MCF-7 and HeLa cells and investigates the impact of cisplatin, a radiosensitizer, on these two cell types. Clonogenic assays are employed to assess the in-vitro susceptibility of cells to radiation, chemotherapy, and chemoradiation. The cell's radiosensitivity to these three interventions will be presented in a quadratic linear curve. Results: The radiosensitivity of MCF-7 and HeLa cells was determined to have an α/β ratio of 4.56 and 4.94, respectively. The IC50 of cisplatin in Hela cells is 10.4 μM, while in MCF-7 cells it is 250nM. Cisplatin demonstrates potential as a radiosensitizer on the breast cancer cell line, with SER-D10 and SER-D50 values of 1.83 and 2.87 at a dose of 50nM, and SER-D10 and SER-D50 values of 2.23 and 3.31 at a dose of 100nM. Conclusion: the colony assay protocol is a reliable method for assessing cell sensitivity to radiation, chemotherapy, and chemoradiation. Cisplatin exhibits potential as a radiosensitizer against MCF-7 cells, a specific type of breast adenocarcinoma cells."

"Background: chronic and terminal diseases require holistic therapy that covers the biopsychosocial aspect, and it can be found in palliative therapy. Patients who receive palliative therapy exhibit very diverse profiles. As such, researchers are keen to study the general characteristics of palliative patients. In addition, researchers will also assess the patients and their familys insight that influences the success of the therapy and the impact of estimated survival time in making treatment decisions. Methods: this research used cross-sectional descriptive analytic study and secondary data of 300 palliative patients who consult to Psychosomatic Palliative Team at Dr. Cipto Mangunkusumo Hospital. The data were processed using SPSS version 25. The data processed included: sociodemographic characteristics, length of stay, incidence of death in hospital, DNR cases, the patients and their familys insight, and the impact of estimated survival time on treatment decisions. Results: most palliative patients were women (52.0%) aged 51 - 60 years (27.0%), unemployed (29.0%), and suffered from cancer (55.3%). In addition, the patients were generally treated for less than 1 month (83.6%), died in the hospital (37.3%), and consented to DNR orders (36.7%). These DNR cases are highly correlated to the familys understanding regarding the prognosis of the patients condition (p = 0.022). The familys understanding of the diagnosis, prognosis, and treatment goals (92.3%, 81.3%, and 87.7%) was better than the patients (79.0%, 64.0%, and 69.7%). Furthermore, no link was found between the therapy choice (optimal, withholding, and withdrawing therapies) with the patients estimated survival time (p = 0.174). Conclusion: female, elderly, and cancer patiens most often get palliative therapy. The consent for DNR orders to palliative patient is notably frequent. Currently, the familys insight is much better than the patients, which means that health care providers need to improve patient education and information. In addition, patients and families generally still opt for optimal therapy despite low estimated survival time.

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Latar belakang: penyakit kronis dan terminal membutuhkan terapi holistik yang mencakup aspek biopsikososial, dan dapat ditemukan dalam terapi paliatif. Pasien yang menerima terapi paliatif menunjukkan profil yang sangat beragam. Oleh karena itu, peneliti ingin melihat karakteristik umum pasien paliatif. Selain itu, peneliti juga akan menilai tilikan pasien dan keluarga yang mempengaruhi keberhasilan terapi dan pengaruh perkiraan waktu bertahan hidup dalam membuat keputusan pengobatan. Metode: penelitian ini menggunakan studi analitik deskriptif potong lintang dan data sekunder dari 300 pasien paliatif yang berkonsultasi dengan Tim Paliatif Psikosomatik di Rumah Sakit Dr. Cipto Mangunkusumo. Data diproses menggunakan SPSS versi 25. Data yang diproses termasuk karakteristik sosiodemografi, lama tinggal, kejadian kematian di rumah sakit, kasus DNR, tilikan pasien dan keluarga, dan pengaruh perkiraan waktu bertahan hidup terhadap jenis pengobatan yang dipilih.

Hasil: sebagian besar pasien paliatif adalah wanita (52,0%) berusia 51 - 60 tahun (27,0%), tidak bekerja (29,0%), dan menderita kanker (55,3%). Selain itu, pasien umumnya dirawat kurang dari 1 bulan (83,6%), meninggal di rumah sakit (37,3%), dan menyetujui DNR (36,7%). Kasus-kasus DNR ini sangat berkorelasi dengan pemahaman keluarga mengenai prognosis kondisi pasien (p = 0,022). Pemahaman keluarga tentang diagnosis, prognosis, dan tujuan pengobatan (92,3%, 81,3%, dan 87,7%) lebih baik daripada pasien (79,0%, 64,0%, dan 69,7%). Lebih lanjut, tidak ada hubungan yang ditemukan antara pilihan terapi (optimal, pembatasan, dan pengurangan terapi) dengan perkiraan waktu kelangsungan hidup pasien (p=0,174).

Kesimpulan: pasien wanita, lansia, dan kanker paling sering mendapatkan terapi paliatif. Persetujuan untuk DNR pada pasien paliatif sangat sering. Saat ini, tilikan keluarga jauh lebih baik daripada pasien, yang berarti bahwa penyedia layanan kesehatan perlu meningkatkan pendidikan dan informasi ke pasien. Selain itu, pasien dan keluarga umumnya masih memilih terapi yang optimal meskipun waktu perkiraan bertahan hidup yang rendah"