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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
SP-pdf
UI - Skripsi Membership  Universitas Indonesia Library
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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
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Andry Kelvianto
Asupan protein, Prognostic Nutritional Index dan kualitas hidup pasien kanker kepala Leher yang menjalani radioterapi = Protein Intake, Prognostic Nutritional Index and Quality of Life in Head and Neck Cancer Patients Undergoing Radiotherapy
"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.
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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T58573
UI - Tesis 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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Dedy Hermansyah
CD 105 sebagai faktor prognostik pada pasien kanker payudara stadium lanjut = CD 105 as a prognostic factor for late stage breast cancer patients
"Latar Belakang: Pada tahun 2012, lebih dari 50% pasien kanker payudara di RSCM berada pada stadium lanjut. Five years survival pasien kanker payudara stadium 3 sebesar 72% sedangkan pada stadium 4 hanya 22% meski telah mendapat terapi adekuat. Neoangiogenesis merupakan faktor biologimolekuler yang paling berperan dalam survival rate pasien kanker. Terdapat banyak marker terjadinya neoangiogensis di manusia, namun hanya CD105 yang spesifik menandakan angiogenesis intratumoral.
Metode penelitian: Dilakukan studi kohort retrospektif analitik menggunakan 32 data rekam medis pasien RS Kanker Dharmais dari tahun 2011 – 2014 yang telah dipilih secara random. Sediaan sel kanker dari pasien dibuat blok parafin dan dibaca lalu dilakukan analisis univariate dan multivariat memakai SPSS versi 17.0 dan MedCalc.
Hasil: Hasil analisis bivariat antara ekspresi CD105 dengan survival rate adalah: crude HR 1,724 (IK 95% 0,693-4,288) dengan nilai p= 0,241. Median survival kelompok ekspresi CD105 positif 1113 hari dan kelompok CD105 negatif 794 hari. Dilihat dari klinikopatologi, didapatkan hubungan bermakna antara usia dan ekspresi CD105 (p= 0,034). Terdapat lebih banyak subjek dengan CD105 negatif dibanding yang positif baik pada grade 3B maupun 4 (69% dan 63,3%). Terdapat hubungan terbalik antara ekspresi CD105 dengan reseptor hormonal dan hubungan antara ekspresi PR dengan ekspresi CD105 (p = 0,042) serta terdapat hubungan positif antara ekspresi HER2 dengan CD105.
Kesimpulan: Pada penelitian ini, CD105 belum dapat digunakan sebagai faktor prognostik pada pasien kanker payudara stadium lanjut, namun CD105 yang tinggi memiliki survival yang lebih rendah dibanding dengan CD105 rendah, serta ditemukan hubungan antara ekspresi CD105 dengan usia dan PR.
Background: In 2012, more than 50% of breast cancer patients in Cipto Mangunkusumo Hospital were advanced breast cancer patients. Stage 3 breast cancer patients have five years survival rate by 72%, while whose in stage 4 only by 22% even after receiving adequate treatment. Neoangiogenesis is the most important biomolecular factor which affect the survival rate of cancer patients. There are many angiogensis maker which has proven can describe neoangiogenesis occurrence ini human body, but only CD105, which is specifically describe the intratumoral angiogenesis occurence.
Methods: We studied a retrospective cohort analytic uses 32 randomized datas from patient medical records Dharmais Cancer Hospital from year 2011 - 2014 for the survival analysis and prognostic factors. The preparate of the patient's cancer cells were made into paraffin blocks and and the results analized using univariate and multivariate analysis taking SPSS version 17.0 and medcalc.
Results: The results of the bivariate analysis between the expression of CD105 with the survival rate is: crude HR 1.724 (95% CI 0.693 to 4.288), with p = 0.241. Median survival of CD105 positive group is 1113 when the negative group was 794 days. From the clinicopathologic side, there was a significant relationship between age and CD105 expression (p = 0.034). There is far more subject to the negative than positive CD105 either on grade 3B and 4 (69% and 63.3%). There is an inverse relationship between the expression of CD105 with hormonal receptors and the relationship between the expression of CD105 with PR expression was statistically significant (p = 0.042), meanwhile there’s positive relation between HER2 and CD105 expression.
Conclusion: In this experiment, CD105 cannot be used as prognostic factor in late stage breast cancer patients, but patients with high CD105 has lower survival rate than the low CD105 ones. There are significant relationship between CD105 expression with age and PR."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
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Sudibio
Faktor prognostik klinis Yang mempengaruhi kesintasan pasien dengan glioblastoma multiform = Clinical prognostic factors affecting survival in patients with glioblastoma multiform
"Tujuan: Menilai kesintasan pasien Glioblastoma Multiform (GBM) di RSCM dan mengidentifikasi faktor-faktor yang dapat mempengaruhi kesintasan pasien dengan GBM. Metode: dilakukan studi retrospektif pada 55 pasien GBM yang terdiagnosa secara histopatologis dan menjalani radiasi/kemoradiasi di RSCM pada Januari 2015-Desember
2019. Hasil: Mayoritas pasien adalah laki-laki dengan rasio 1,3:1 dibandingkan
perempuan, rerata usia 45 tahun. Lokasi tumor tersering di lobus frontal (31,5%), lobus
pariteal (26,3%) dan lobus temporal (24,2%). Median ekstensi reseksi tumor (EOR) 77%
dan median volume residu tumor 50cm3. Median interval operasi-radiasi 42 hari dengan
median total dosis radiasi 60 Gy. 69,1% telah mendapatkan terapi sesuai dengan panduan
penatalaksanaan kanker (PPK). Median kesintasan hidup keseluruhan (OS) 13 bulan dan
median kesintasan bebas progresifitas (PFS) 9 bulan. Median OS pasien dengan RTOG
RPA kelas III, kelas IV dan kelas V-VI adalah 18 bulan, 13 bulan dan 6,7 bulan (p<0,001).
Faktor yang memperburuk OS adalah usia ≥50 tahun (p=0,02), KPS<70 (p<0,001),
volume residu tumor >20,4cm3 (p=0,001), interval waktu operasi-radiasi <4minggu
(p=0,01) dan letak tumor di lobus parietal (p=0,02) pada uji univariat. Faktor yang
memperburuk PFS adalah KPS <70 (p=0,001), volume residu tumor>20,4cm3 (p=0,02),
terapi yang tidak sesuai PPK (p=0,004) dan letak tumor di lobus parietal (p=0,03). KPS
merupakan faktor independen yang mempengaruhi OS dan PFS pada uji multivariat.
Kesimpulan: KPS merupakan faktor prognostik independen yang mempengaruhi
kesintasan pasien GBM.
Aims: This study was done to assess the survival of patients with glioblastoma multiform
in RSCM and to identify factors that can affect patient survival. Materials and methods:
From January 2015 to December 2019, 55 patients with histopathologically confirmed
glioblastoma multiform and received adjuvant radiation/chemoradiation in our
department were retrospectively analyzed. Results: Most of the patiens in this study were
men 1,3 times compared to women. Mean ages was 45 years old. The most common
tumors site was frontal lobe (31,5%) followed by parietal lobe (26,3%) and temporal lobe
(24,2%). Median extend of resection (EOR) was 77% with median residual tumor volume
was 50cm3. Most of the patients (69,1%) already treated according to practice guidelines.
The median total radiation dose was 60Gy. Median time to initiate adjuvant radiotherapy
was 42 days. Median overall survival (OS) was 13 months and median progression free
survival (PFS) was 9 months. Median OS in patients with RTOG RPA class III, class IV
and class V-VI were 18 months, 13 months and 6,7 months respectively (p<0,001).
Age≥50 (p=0,02), KPS<70 (p<0,0001), residual tumor volume >20,4cm3 (p=0,001), time
to initiate adjuvant radiotherapy <4 weeks (p=0,01) and parietal lobes tumor site
(p=0,02) were significantly associated with unfavorable OS in univariate analysis.
KPS<70 (p=0,001), residual tumor volume >20,4cm3 (p=0,02), treatment that not in
accordance with practice guidelines (p=0,004) and parietal lobes tumor site (p=0,03)
associated with unfavorable PFS in univariate analysis. KPS was found to be the only
independent factor that affected OS and PFS in multivariate analysis. Conclusions: The
only factor that independently affected OS and PFS was KPS."
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
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Manurung, Mikhael Dito
Umur dan jenis kelamin sebagai faktor prognostik pada pasien osteosarkoma di Rumah Sakit Cipto Mangunkusumo 2006-2011 = Age and gender as prognostic factors for osteosarcoma patients in Cipto Mangunkusumo Hospital 2006-2011
"Walaupun masih kontroversial, jenis kelamin dan umur diduga sebagai faktor prognostik yang mempengaruhi angka kesintasan osteosarkoma (suatu keganasan tulang yang umum terjadi pada anak-anak dan dewasa muda). Oleh karena itu, penelitian ini bertujuan untuk mengetahui angka kesintasan pasien osteosarkoma di RSCM selama periode waktu enam tahun (2006-2011) dan mengaitkannya dengan umur dan jenis kelamin. Studi potong-lintang ini menggunakan rekam medis 167 pasien osteosarkoma di Departemen Ortopedi dan Traumatologi Rumah Sakit Cipto Mangunkusumo (RSCM).
Studi ini menunjukkan bahwa usia lebih muda saat didiagnosis berkaitan dengan respon yang lebih baik terhadap kemoterapi (p=0,028). Jenis kelamin perempuan berkaitan secara signifikan dengan stadium penyakit yang lebih rendah (p=0,04), respon yang lebih baik terhadap kemoterapi (p=0,016), dan berkurangnya risiko metastasis (p=0,008). Median waktu kesintasan pada studi ini adalah 12 bulan, yang disebabkan oleh pendeknya masa pemantauan pasien. Walaupun terdapat keterbatasan, angka kesintasan pasien perempuan lebih baik secara signifikan daripada pasien laki-laki. Angka kesintasan pada golongan usia yang lebih muda menunjukkan kecenderungan lebih baik, walau tidak signifikan secara statistik. Hasil uji multivariate tidak menunjukkan bukti tentang adanya keterkaitan stadium penyakit, respon kemoterapi, dan metastasis terhadap kesintasan. Sebagai kesimpulan, jenis kelamin perempuan berkaitan dengan tumor yang lebih favourable dan angka kesintasan yang lebih tinggi.
In order to improve the plateaued average 70% survival of osteosarcoma patients, prognostic factors has to be identified to improve adjustment according to patient's characteristics. Female gender and younger age at diagnosis have been suggested as good prognostic factors though inconclusive. Therefore, this study aims to determine the survival rate of osteosarcoma patients admitted to Cipto Mangunkusumo Hospital from 2006 to 2011 and correlate it with age and gender. This cross-sectional study used the medical records of osteosarcoma patients admitted in the department of Orthopedics and Traumatology Cipto Mangunkusumo Hospital. Records of 167 patients were retrieved for this study.
This study shown that younger age was associated with better chemotherapeutic response (p=0,028). Meanwhile, female gender was associated with less advanced disease at presentation (p=0,04), better chemotherapeutic response (p=0,016), and less risk for metastasis (p=0,008). The median survival in this study was 12 months, an underestimation due to short followup duration. Still, female patients survived longer than males. We showed a trend of better survival for younger patients, however the result was not significant. Multivariate analysis failed to show any correlation between various tumor-related variables with survival."
Jakarta: Fakultas Kedokteraan Universitas Indonesia, 2013
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Farid Yudoyono
Skoring prognostik cedera otak traumatika berat = Prognostic scoring severe traumatic brain injury patient single indonesian institution study
"[ABSTRAK
Latar Belakang: Cedera otak traumatika akibat kecelakaan lalu lintas masih merupakan salah satu penyebab kematian dan kecacatan utama pada kelompok usia produktif. Cedera otak sekunder dideskripsikan sebagai konsekuensi gangguan fisiologis, seperti iskemia, reperfusi, dan hipoksia pada area otak yang beresiko, beberapa saat setelah terjadinya cedera awal (cedera otak primer). Cedera otak sekunder sensitif terhadap terapi dan proses terjadinya dapat dicegah dan dimodifikasi. Metode: Penelitian kohort retrospektif dengan data primer rekam medis. Data yang terdiri dari beberapa variabel yang dikumpulkan secara retrospektif dari catatan medis pasien. RS. Hasan Sadikin, Bandung Jawa Barat, Indonesia. Pengambilan data dilakukan pada 2011-2014. Jumlah sampel yang diambil sebanyak 647 pasien. Analisis yang dilakukan meliputi analisis univariat, bivariat, dan analisis multivariate cox proportional hazard dengan model matematis yang
selanjutnya akan dibuat model skoring. Analisis roctab digunakan untuk menentukan nilai cut-off setiap variabel numerik. Hasil: Variabel perdarahan otak, tingkat kesadaran, dan edema serebri merupakan
faktor resiko outcome, sedangkan variabel peningkatan tekanan intrakranial, kadar elektrolit natrium dan klorida, serta terapi diuretik merupakan faktor resiko untuk terjadinya outcome kematian pada pasien ensefalitis anak. Berdasarkan hasil analisis multivariat skoring didapatkan urutan faktor prognostik yang dominan menyebabkan kematian, yaitu Variabel usia memilik HR sebesar 1,00, natrium
mempunyai HR 0,8, Perdarahan otak pada CT Scan kepala mempunyai HR sebesar 1,73, edema serebri mempunyai HR 2,53, hipoksia mempunyai HR sebesar 2,13, farktur maksillofascial mempunyai HR sebesar 0,6, hipotensi memiliki HR 0,7 dan pembedahan/trepanasi mempunyai HR 0,388 Berdasarkan analisis tersebut maka natrium, GCS, hipotensi, pembedahan dan MFS fraktur merupakan faktor proteksi outcome sedangkan usia, perdarahan otak pada CT Scan, edema serebri, hipoksia merupakan faktor resiko terjadinya outcome
kematian pada pasien cedera kepala berat. Dari hasil mulitvariat yang telah dilakukan sebelumnya apabila skor -69 s/d -47 mengalami resiko rendah untuk mengalami kematian, skor -46 s/d -20 mengalami resiko sedang untuk terjadinya kematian dan skor >-19 akan mengalami resiko tinggi terjadinya kematian. Kesimpulan: Model skoring prognosis yang telah terbentuk ini mampu memprediksi sebesar 84,75 % faktor faktor yang berhubungan dengan prognosis cedera otak traumatika berat. Apabila ada 100 pasien cedera kepala berat dengan adanya semua variabel maka 76 pasien akan meninggal dan bila 100 pasien
cedera kepala berat tanpa adanya semua variabel maka 25 pasien akan meninggal.
ABSTRACT
Background: Severe traumatic brain injury caused by traffic accidents is still one of the major causes of death and disability in the productive age group. Secondary brain injury is described as a physiological disorders, such as ischemia, reperfusion, and hypoxia in brain areas at risk, some time after the initial injury (primary brain injury). Secondary brain injury is sensitive to therapy it can be preventable and modifiable.
Methods: This cohort study with primary data medical records. The data consists of multiple variables collected retrospectively from patient medical records at Hasan Sadikin Hospital Bandung West Java, Indonesia. Data were collected in 2011-2014. The number of samples was 647 patients. Analysis was conducted on univariate, bivariate, and multivariate Cox proportional hazards analysis with a mathematical model which would then be created scoring models. Roctab analysis
is used to determine the cut-off value of any numeric variable.
Results: Variable brain hemorrhage, level of consciousness and cerebral edema is a risk factor outcomes, while variable increased intracranial pressure, electrolyte levels of sodium and chloride, as well as diuretic therapy is a risk factor for the occurrence of mortality outcomes in patients with severe traumatic brain injury. Based on the results of the multivariate analysis of prognostic factors scoring sequence obtained the dominant cause of death, the age variable having an HR of 1.00, sodium has HR 0.8, brain hemorrhage on CT scan head has a HR of 1.73, had a cerebral edema HR 2,53, hypoxia has a HR of 2.13, fracture maxillofascial have HR of 0.6 and hypotension have HR 0.7, surgery / trepanation HR 0.388, based on the analysis of the sodium, GCS, hypotension, MFS fracture, surgery and outcome protection factor whereas age, brain hemorrhage on a CT scan, cerebral edema, hypoxia is a risk factor for mortality outcomes in patients with severe head injury. From the results multivariate analysis has score of -69 s/d -47
experiencing low risk to experience death, a score of -46 s / d -20 experiencing moderate risk for the occurrence of death and a score of > -19 will experience a high risk of death. Conclusions: This Prognostic model scoring has capable to predict 84.75% factors related to the prognosis of severe traumatic brain injury. If there were 100 patients with severe traumatic brain injury in the presence of all variables and 76 patients will die and when 100 patients with severe traumatic brain injury in the absence of all variables that 25 patients will die., Background: Severe traumatic brain injury caused by traffic accidents is still one
of the major causes of death and disability in the productive age group. Secondary
brain injury is described as a physiological disorders, such as ischemia,
reperfusion, and hypoxia in brain areas at risk, some time after the initial injury
(primary brain injury). Secondary brain injury is sensitive to therapy it can be
preventable and modifiable.
Methods: This cohort study with primary data medical records. The data consists
of multiple variables collected retrospectively from patient medical records at
Hasan Sadikin Hospital Bandung West Java, Indonesia. Data were collected in
2011-2014. The number of samples was 647 patients. Analysis was conducted on
univariate, bivariate, and multivariate Cox proportional hazards analysis with a
mathematical model which would then be created scoring models. Roctab analysis
is used to determine the cut-off value of any numeric variable.
Results: Variable brain hemorrhage, level of consciousness and cerebral edema is
a risk factor outcomes, while variable increased intracranial pressure, electrolyte
levels of sodium and chloride, as well as diuretic therapy is a risk factor for the
occurrence of mortality outcomes in patients with severe traumatic brain injury.
Based on the results of the multivariate analysis of prognostic factors scoring
sequence obtained the dominant cause of death, the age variable having an HR of
1.00, sodium has HR 0.8, brain hemorrhage on CT scan head has a HR of 1.73,
had a cerebral edema HR 2,53, hypoxia has a HR of 2.13, fracture maxillofascial have HR of 0.6 and hypotension have HR 0.7, surgery / trepanation HR 0.388,
based on the analysis of the sodium, GCS, hypotension, MFS fracture, surgery
and outcome protection factor whereas age, brain hemorrhage on a CT scan,
cerebral edema, hypoxia is a risk factor for mortality outcomes in patients with
severe head injury. From the results multivariate analysis has score of -69 s/d -47
experiencing low risk to experience death, a score of -46 s / d -20 experiencing
moderate risk for the occurrence of death and a score of > -19 will experience a
high risk of death.
Conclusions: This Prognostic model scoring has capable to predict 84.75%
factors related to the prognosis of severe traumatic brain injury. If there were 100
patients with severe traumatic brain injury in the presence of all variables and 76
patients will die and when 100 patients with severe traumatic brain injury in the
absence of all variables that 25 patients will die]"
Depok: Universitas Indonesia, 2015
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Rainey Ahmad Fajri Putranta
Luaran Terapi dan Faktor Prognostik Pasien Kanker Serviks Stadium IVB = Treatment Outcome and Prognostic Factors of Stage IVB Cervical Cancer Patients
"Pendahuluan: Kanker serviks stadium IVB terdiri dari 2% kasus kanker serviks diseluruh dunia. Berdasarkan panduan yang ada, tatalaksana kanker serviks IVB bersifat paliatif. Radioterapi lokoregional dosis lengkap menjadi salah satu modalitas yang mungkin berperan dalam tatalaksana kanker serviks IVB. Sintasan keseluruhan kanker serviks IVB adalah 18% dalam 5 tahun. Sintasan keseluruhan dipengaruhi berbagai faktor prognostik. Studi ini menilai peran radioterapi lokoregional dosis lengkap pada kasus kanker serviks IVB dilihat dari sintasan keseluruhan dibandingkan dengan terapi lain sesuai pedoman, serta faktor prognostik untuk sintasan keseluruhan dari kanker serviks IVB. Metode: Studi ini menggunakan desain kohort retrospektif pada pasien kanker serviks IVB di Instalasi Pelayanan Terpadu Onkologi Radiasi (IPTOR) RSUPN Dr. Cipto Mangunkusumo Jakarta (RSCM) pada tahun 2017 hingga yang menyelesaikan terapi pada April 2022. Analisis data menggunakan SPSS versi 27 dan Microsoft Excel. Faktor prognostik dinilai dengan uji multivariat cox-regression, sedangkan peran radioterapi lokoregional dosis lengkap dinilai dengan uji log-rank dan grafik Kaplan-meier. Dilakukan analisis subgrup pada pasien yang dilakukan radioterapi lokoregional untuk menilai peran brakiterapi dan kemoterapi konkuren. Studi ini sudah memperoleh persetujuan dari Komisi Etik Penelitian Kesehatan RSCM. Hasil: Terdapat 23 pasien pada lengan radioterapi dosis lengkap dan 52 pasien yang diberikan terapi lain. Radioterapi lokoregional dosis lengkap meningkatkan median sintasan keseluruhan hingga 15 bulan (22 vs 7 bulan, p=0.001), begitu juga dengan kemoterapi dosis penuh yaitu 14 bulan (22 vs 8 bulan, p=0.033). Brakiterapi dapat meningkatkan sintasan keseluruhan hingga 15 bulan (p=0.004). Radioterapi dosis lengkap (HR=0.24, p<0.001, 95%CI 0.11-0.55), kemoterapi dosis penuh (HR=0.13, p<0.050, 95%CI 0.02-1.00), dan hemoglobin <11g/dL (HR=2.44, p=0.022, 95%CI 1.14-5.21) merupakan faktor prognostik terhadap sintasan keseluruhan pada pasien kanker serviks IVB. Kesimpulan: Studi ini merupakan studi pertama di Indonesia yang membahas keluaran radioterapi lokoregional dosis lengkap pada sintasan keseluruhan pasien kanker serviks IVB. Radioterapi lokoregional dosis lengkap dengan brakiterapi (dilanjutkan dengan kemoterapi dosis penuh) dapat meningkatkan sintasan keseluruhan dan dapat menjadi salah.
Introduction: Stage IVB (metastatic) cervical cancer comprises 2% of cervical cancer cases worldwide. Based on existing guidelines, the principal intent for stage IVB cervical cancer is palliative therapy. Complete dose locoregional radiotherapy is one of the modalities that may play a role in metastatic cervical cancer management. The 5-year overall survival of stage IVB cervical cancer is 18%. Various prognostic factors influenced overall survival. This study assessed the role of complete-dose locoregional radiotherapy in cases of metastatic cervical cancer in terms of overall survival compared to other therapies according to guidelines, as well as prognostic factors for overall survival of IVB cervical cancer. Methods: This study used a retrospective cohort design in IVB cervical cancer patients at the Instalasi Pelayanan Terpadu Onkologi Radiasi (IPTOR) RSUPN Dr. Cipto Mangunkusumo Jakarta (RSCM) in 2017 until completing therapy in April 2022. Data analysis was conducted using SPSS version 27 and Microsoft Excel. Cox-regression multivariate analysis is used to assess prognostic factors. The log-rank test and Kaplan-meier chart defined the role of complete-dose locoregional radiotherapy on overall survival. Subgroup analysis was performed on patients undergoing locoregional radiotherapy to assess the role of brachytherapy and concurrent chemotherapy. This study has received approval from the RSCM Health Research Ethics Commission. Results: 23 patients in the complete-dose radiotherapy arm & 52 others got other therapies. Complete-dose locoregional radiotherapy increased overall survival to 15 months (22 vs 7 months, p=0.001), as did full-dose chemotherapy, by 14 months (22 vs 8 months, p=0.033). Brachytherapy increased overall survival by up to 15 months (p=0.004). Complete-dose radiotherapy (HR=0.24, p<0.001, 95%CI 0.11-0.55), full-dose chemotherapy (HR=0.134, p<0.050, 95%CI 0.018-1.000), and hemoglobin <11g/dL (HR=2.44), p=0.022, 95%CI 1.14-5.21) are prognostic factors for overall survival in cervical cancer patients with IVB. Conclusion: This is the first study in Indonesia to discuss the outcome of complete-dose locoregional radiotherapy on the overall survival of IVB cervical cancer patients. Complete-dose locoregional radiotherapy with brachytherapy can improve overall survival. This therapy (followed by full-dose chemotherapy) can be considered as a new option for therapeutic modality for metastatic cervical cancer mangement."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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M. Agus Aulia
Nilai prognostik proses stres oksidatif pada pasien Cedera Otak : tinjauan khusus tentang kandar Antibodi NR2A dan Glutathion Serum di FKUI-RSUPNCM periode April 2012-Agustus 2011 = Prognostic value of oxidative stress by measuring NR2A Antibody Serum and Glutathione Serum level in Brain Injured patients at Ciptomangunkusumo Hospital Jakarta April 2010-August 2011 / M. Agus Aulia
"ABSTRAK
Latar Belakang :
Cedera Kepala masih menjadi masalah medis sekaligus masalah sosial-ekonomi di Indonesia. Angka mortalitas dan morbiditasnya enderung meningkat. Proses Neuroinflamasi dan Stres Oksidatif berperan dalam proses cedera kepala sekunder setelah trauma. Iskemia otak menjadi pencetus proses ini yang berujung pada kematian sel saraf.
Penelitian ini bertujuan untuk menentukan hubungan antara proses neuroinflamasi dan stres oksidatif dengan prognosis pasien cedera kepala dan hubungannya dengan prosedur bedah saraf dengan neuroinflamasi dan stres oksidatif.
Metode:
Desain Studi penelitian ini adalah prospektif terhadap 40 pasien cedera kepala yang dilakukan tindakan bedah saraf. Dilakukan pemeriksaan serum antibodi terhadap NR2A dan serum glutahion (GSH) sebelum dan satu hari paska operasi pada pasien cedera kepala, kenudian dinilai hubungannya dengan parameter kesaddaran (GCS) dan fungsi (GOS) serta kaitannya dengan tindakan bedah saraf.
Antibodi terhadap NR2A diukur dengan metode ELISA. Sementara kadar Glutathion (GSH) serum diukur bekerjasama dengan departemen biokimia dan moekuler Fakultas Kedokteran Universitas Indonesia.
Hasil :
Dari 40 sampel, sebagian besar adalah lelaki (77,5%) dengan rerata usia 30,78 tahun. Pasien dengan GCS>8 sebanyak 57,5 % sementara dengan GCS < 8 sebanyak 4,7 %. Terdapat peningkatan GCS pada hari ke-7 paska operasi. Diketahui pula terdapat peningkatan GOS pada bulan ke-3 dibandingkan bulan-1 paska operasi.
Kadar serum antibodi NR2A menunjukkan kecenderungan penurunan dibandingkan kadar preoperasi (perbedaan median -1,34 ng/dl).
Tidak terdapat kaitan ntara antibodi NR2A dan GSH serum dengan GCS,GOS dan tindakan bedah saraf.
Kesimpulan :
Pemeiksaan kadar antibodi NR2A serum sebaiknay dilakukan secara serial. Kadar antibodi NR2A masih mungkin memiliki nilai prognostik pada pasien cedera kepala.
ABSTRACT
Background:
Head Injury still a medical and socioeconomic problem in Indonesia. Mortality and morbidity rate tends to increase. Neuroinflamation dan oxidative stress play role in secondary brain damage after head trauma. Brain ischemia causing this process into happenand leads to neuronal death. This study aims to determine the association between neuroinflamation and oxydative stress with prognosis of brain injury patients and the association between neurosurgical procedure with neuroinflamation and oxydative stress.
Method:
The Study design is a prospective observation of 40 brain-injured patients who underwent surgery. NR2A antibodies and GSH (glutathione )level of pre- and 1 day post operation on brain injury patients were measured, and their association with GCS, GOS and neurosurgical proedures were analyzed.
NR2A antibodies serum level were measured by ELISA. GSH (glutathione) serum level were measured in collaboration with department of Biochemistry and molecular Bioloy, Faculty of Medicine, University of Indonesia.
Result:
From 40 patients most are male (77,5%) with mean age 30,78 years. Patient present with favorable GCS (GCS>8) was 57,5 %, while unfavorable GCS (GCS<8) was 42,7%. There was an increase of GCS on day-7 post operation. There was also an increase on patients' GOS on month 3 compared to month-1 post operation.
The postoperative NR2A antibody serum level showed a downward trend compared to preoperative value ( median difference -1,34 ng/dl). There is no significant association of NR2A antibody and GSH serum level with GCS, GOS and neurosurgical procedure.
Conclusion :
Serial postoperative NR2A antibody serum level need to be measured in serial manner.
NR2A antibody serum may have prognostic values in brain -injured patient."
Fakultas Kedokteran Universitas Indonesia, 2012
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