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"Efusi pleura ganas (EPG) sebagai bentuk perluasan dari keganasan sering muncul pada penderita kanker paru, mempersulit penatalaksanaan kanker paru, dan membuat prognosis pasien memburuk dengan rerata angka ketahanan hidup 6 bulan. Penelitian ini bertujuan untuk melihat karakteristik dan ketahanan hidup pasien kanker paru dengan EPG di RS Kanker Dharmais Jakarta tahun 2009-2013. Desain penelitian ini adalah kohort longitudinal dengan analisis univariat dan ketahanan hidup. Sampel penelitian ini adalah pasien kanker paru dengan EPG (stadium IIIB atau IV) dari metastasis kanker paru berdasarkan pemeriksaan sitologi atau biopsi dan memiliki rekam medik lengkap. Hasil penelitian menunjukkan bahwa rata-rata umur pasien adalah 58,73 tahun, berjenis kelamin laki-laki, tidak merokok, dan status pekerjaan terbanyak adalah pensiunan. Mayoritas pasien mengeluhkan gangguan respirasi saat pertama berobat, memiliki jenis sel kanker adenokarsinoma, sudah mencapai stadium IV, dan lokasi efusi berada di paru-paru kanan. Sekitar 68.5% pasien bertahan hidup 6 bulan setelah diagnosis dan median survival adalah 12,5 bulan. Diharapkan ada KIE bagi masyarakat, terutama terkait kebiasaan merokok dan ditujukan untuk populasi berisiko, mengenai kanker paru untuk mengurangi jumlah pasien yang baru berobat setelah kanker mencapai stadium lanjut.

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Malignant pleural effusion (MPE) often appears in patients with lung cancer and deteroriates prognosis of patients with mean survival rate of 6 months. This study aims to look at the characteristics and survival of lung cancer patients with MPE (stage IIIB or IV) at Dharmais Cancer Hospital Jakarta in 2009-2013. Study design was longitudinal cohort with univariate and survival analysis. Sample was lung cancer patients with metastatic MPE based on cytology test or biopsy with complete medical record.

Results showed average age of patients was 58.73; most were male, nonsmoker, and pensioner. Majority of patients had respiratory disorder, adenocarcinoma cancer type, reached stage IV, and effusion in the right lung. Approximately 68.5% of patients surviving 6 months after diagnosis and median survival were 12.5 months. IEC is needed for community; especially population with lung cancer risk, to help reducing number of new patients seeking treatment after cancer reaches advanced stage."

"[ABSTRAKPraktik Spesialis Keperawatan Medikal Bedah Kekhususan Respirasi di RSUP Persahabatan Jakarta bertujuan untuk mengaplikasikan peranners spesialis da1am mengelola pasien dengan gangguan sistem respirasi melalui pendekatan Model Adaptasi Roy (MAR). Seorang ners spesialis memiliki target memberikan asuhan keperawatan sebanyak 30 pasien sebagai resume dan 1 pasien sebagai laporan kelolaan utama pada pasien kanker paro. Peran ners spesialis juga menerapkan tindakan keperawatan berbasis bukti ilmiah (evidence based musing practice) dengan memberikan latihan progressive muscle relaclation (PMR) dalam mengontrol breathlessness pada pasien kanker peru, Selain itu ners spesialis sebagai pembaharu melakukan inovasi Water Seal Drainoge (WSD) Pionir 1 botol, etas dasar aspek estetika, quality and safety guna meningkatkan kualitas pelayanan keperawatan dan rumah sakit. Hasil praktik menunjukkan bahwa MAR. Efektif digunakan pada pasien dengan gangguan sistem respirasi dan PMR memiliki kecenderungan mengon1ro1 breathlessness pada pasien kanker pam dan kegiatan inovasi mendapat respon positif dari pibak rumah sakit untuk menjadi agenda penelitian bersama.

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ABSTRACTSurgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda., Surgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda.]"

"ABSTRAKLatar belakang: Penyebab kematian pada kanker paru seringkali tidak tergambarkan dengan jelas. Penelitian ini untuk mengetahui gambaran penyebab kematian pada kanker paru dan faktor-faktor yang mempengaruhinya di RS Persahabatan dan untuk mengetahui kesesuaian antara penyebab kematian yang terdapat dalam lembar kematian dengan penyebab kematian sesuai dengan audit kematian. Metode: Penelitian potong lintang ini dilakukan di RS Persahabatan dengan subjek penelitian adalah semua pasien kanker paru yang mengalami kematian pada Januari 2010 – Desember 2011. Penyebab kematian langsung dan tidak langsung pada pasien kanker paru dicatat dari rekam medis kemudian dilakukan audit kematian dan dinilai kesesuaian dengan penyebab kematian langsung dan tidak langsung yang tertulis di rekam medis dengan audit kematian. Hasil: Total data kematian dari 96 rekam medis. Penyebab kematian langsung berdasarkan rekam medis adalah efusi pleura masif 19 kematian (19,8%) sedangkan penyebab kematian tidak langsung menurut rekam medis adalah sepsis s 44 kematian (45,8%) Sementara itu, penyebab kematian langsung berdasarkan audit kematian terbanyak adalah efusi pleura masif 48 kematian (50%), penyebab kematian tidak langsung menurut audit kematian adalah sepsis 16 kematian (16,7%). Lembar kematian yang sesuai dengan rekam medis adalah 43 kasus (44,8%) dan yang tidak sesuai 53 kasus (55,2%) sedangkan SOP yang dijalankan adalah 37 kasus (38,5%) dan SOP yang tidak dijalankan 59 kasus (61,5%). Alasan mengapa SOP tidak dijalankan adalah karena keadaan umum pasien yaitu 12 kasus (20,3%) sedangkan karena biaya dan administrasi 47 kasus (79,6%). Dari hasil uji statistik yang menilai hubungan antara SOP yang dijalankan dengan faktor pembiayaan ternyata tidak didapatkan hubungan yang bermakna (p=0,48). Diskusi : Audit kematian memang bukan standar baku emas penentuan penyebab kematian melainkan dengan autopsi klinis. Dalam konteks sosial dan budaya di Indonesia, autopsi klinis tidak mudah dilakukan sebagai penentu penyebab kematian. Dalam penelitian ini audit kematian mempunyai peran jaminan dan kendali mutu layanan kesehatan. Ketidaksesuaian penyebab kematian antara rekam medis dan kematian, serta seberapa banyak SOP yang dijalankan dan mengapa SOP tidak dijalankan dapat diungkapkan. Walaupun dari penelitian ini menunjukkan tidak terdapat hubungan bermakna antara faktor pembiayaan dengan SOP yang dijalankan atau tidak..

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ABSTRACTIntroduction: The causes of death for patients with lung cancer were inadequately described. This study objectives were to describe the causes of death in lung cancer and contributing factors in Persahabatan Hospital and to describe discrepancies between the causes of death from medical records and death audit. Method: A cross sectional study was held in PersahabatanHospital involving lung cancer patients who were died between January 2010 to December 2011. The immediate and indirect causes of death from medical records were assessed and compared with death audit. The discrepancies between were analysed. Result: A total of 96 cases were found from medical record, massive pleural effusion was found as the immediate causes in 19 cases (19.8%), while sepsis was found as the indirect causes 44 cases (45.8%). From the death audit, massive pleural effusion was found as immediate causes in 48 cases (50%), while sepsis was found asthe indirect causes 16 cases (16.7%). The discrepancies between both were found in 53 cases (55.2%). SOP was executed in 37 cases (38.5%) and unexecuted in 59 cases (61.5%). The reason of unexecuted SOP due to cost was found in 47 cases (79.6%). There is no significant correlation between the executed SOP with cost was found in factors (p=0.48). Discussion : The death audit is not the gold standard method in determining the causes of death but the clinical autopsy. This study reveals that death audit have roles inhealth care quality control and assurance. The causes of death discrepancies, the unexecueted SOP, and why SOP could not be executed could be revealed from this study."

"[ABSTRAKLatar belakang: Kasus baru dan kematian kanker paru semakin meningkat. Rokok tembakau sangat berperan tetapi hanya 15% yang menderita kanker paru. Oleh karena itu faktor genetik diduga berperan pada kanker paru. Penelitian-penelitian kohort selama ini menunjukan hubungan bermakna risiko kanker paru dengan riwayat kanker di keluarga. Tujuan: Tujuan utama dari penelitian ini adalah untuk menentukan proporsi subjek kanker paru dengan riwayat kanker pada keluarga.Metode: Penelitian ini adalah studi observasi deskriptif potong lintang dengan subjek kanker paru yang berobat jalan maupun inap di RSUP Persahabatan Jakarta 1 Januari 2013 sampai 31 Mei 2015.Hasil: Subjek penelitian 380 dengan komposisi laki-laki lebih banyak dibandingkan perempuan (72,9% banding 27,1%) dengan median 56 tahun dan nilai minimum dan maksimum 20-86 (66) tahun. Sebanyak 65.3% subjek adalah perokok. Dari total subjek yang merokok, 33,2% termasuk perokok dengan Indeks Brickman (IB) sedang. Jenis sel kanker terbanyak adalah masuk kelompok Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) yaitu adenokarsinoma 73,4%. Sebagian besar subjek terdiagnosis pada stage lanjut baik pada kelompok KPKBSK maupun Kanker Paru Karsinoma Sel Kecil (KPKSK). Proporsi subjek dengan riwayat kanker keluarga sebesar 8,2% dengan subjek laki-laki lebih besar dibandingkan perempuan (5,8% dibandingkan 2,4%). Nilai minimum-maksimum usia 35-72 tahun, median 55 tahun. Subjek yang merokok hanya ditemukan pada laki-laki sebanyak 71% dan jenis kanker terbanyak adenokarsinoma 71%. Hubungan keluarga 1 orang lebih banyak ditemukan dibandingkan lebih 1 orang (64,4% banding 35,6%) dengan dominasi ayah (25,8%). Jenis kanker keluarga paling banyak bukan kanker paru dibandingkan kanker paru (85,4% banding 14,6%). Kesimpulan: Proporsi subjek kanker paru dengan riwayat kanker pada keluarga adalah 8,2%. Subjek dengan 1 anggota keluarga yang memiliki kanker paling banyak 64,4% dengan dominasi ayah 25,8%. Jenis kanker paru dengan riwayat kanker keluarga terbanyak adenokarsinoma 71%. Jenis kanker keluarga lebih banyak adalah bukan kanker paru 85,4%.

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ABSTRACTBackground: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer.Objective: To determine the proportion of lung cancer?s subjects with a cancer history in the family.Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer?s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject?s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%.;Background: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer.Objective: To determine the proportion of lung cancer?s subjects with a cancer history in the family.Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer?s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject?s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%., Background: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer. Objective: To determine the proportion of lung cancer’s subjects with a cancer history in the family. Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer’s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject’s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%.]"

"Latar Belakang: Usia lanjut dan hubungannya dengan kesintasan kanker paru karsinoma bukan sel kecil sudah diteliti sebelumnya, namun kesintasannya di rumah sakit di Indonesia belum diteliti. Belum banyak penelitian lain yang memperhitungkan faktor perancu antara lain derajat keparahan penyakit, status fungsional, komorbiditas, dan indeks massa tubuh dalam meneliti pengaruh pertambahan usia dengan kesintasan kanker paru karsinoma bukan sel kecil. Tujuan: Mengetahui adakah perbedaan kesintasan satu tahun pasien kanker paru karsinoma bukan sel kecil usia lanjut dan bukan usia lanjut yang diterapi di semua stadium dengan mempertimbangkan functional status, indeks massa tubuh, dan komorbiditas. Metode: Kohort retrospektif dengan pendekatan analisis kesintasan terhadap 227 pasien kanker paru karsinoma bukan sel kecil yang berobat jalan maupun rawat inap di RS Cipto Mangunkusumo dan RS Kanker Dharmais tahun 2002-2012, terbagi 2 kelompok berdasarkan usia saat diagnosis (<60 tahun dan >60 tahun). Kurva Kaplan-Meier digunakan untuk mengetahui kesintasan satu tahun masingmasing kelompok. Analisis bivariat menggunakan uji log-rank, analisis multivariat menggunakan cox proportional hazard regression. Besarnya hubungan variabel usia dengan kesintasan dinyatakan dengan crude HR dan IK 95% serta adjusted HR dan IK 95% setelah dimasukkan variabel perancu. Hasil dan Pembahasan: Terdapat 227 pasien adalah kanker paru karsinoma bukan sel kecil yang diterapi dimana karakteristik kedua kelompok (<60 tahun dan >60 tahun) sebanding kecuali jenis kelamin, merokok, ada tidaknya komorbiditas, dan jumlah komorbiditas. Persentase mortalitas satu tahun adalah 68,0% dan 61,9% untuk kelompok usia <60 dan >60 tahun dengan median kesintasan 8 dan 9 bulan bulan. Analisis bivariat tidak menunjukkan hubungan bermakna antara usia dengan kesintasan satu tahun. Simpulan: Tidak ada pengaruh usia terhadap kesintasan satu tahun pasien kanker paru karsinoma bukan sel kecil yang diterapi di RS Cipto Mangunkusumo dan RS Kanker Dharmais di semua stadium dengan mempertimbangkan functional status, indeks massa tubuh, dan komorbiditas.

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Background: Old age and its relations to non-small cell lung carcinoma survival has been studied before but its survival in Indonesia has not been studied before. Not many studies that have considered confounders, such as stage, functional status, comorbidities and body mass index, in the study between advancing age and non-small cell lung cancer carcinoma survival.

Aim: To evaluate differences of treated non-small cell lung carcinoma one year survival between non-elderly and elderly considering stages, functional status, body mass index and comorbidities.

Methods: Retrospective cohort design and survival analysis were used to 227 patients with non-small cell lung cancer that being treated at Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital between 2002 and 2012 that divided into 2 groups according to age at diagnosis (<60 years and >60 years). Kaplan-Meier curve was used to evaluate the one year survival of each group. Bivariate analysis was conducted using log-rank test, multivariate analysis was conducted using cox proportional hazard regression. The extend of relation between advancing age and survival was expressed with crude HR with 95% CI and adjusted HR with 95% CI after adjusting for confounders.

Results and Discussion: There were 227 non-small cell lung carcinoma being treated whereas the characteristics between two groups (<60 years and >60 years) were the same except for sex, smoking status, comorbidities and number of comorbidities. One year mortality percentage were 68.0% and 61.9% to <60 years and >60 years groups, respectively, with the survival median of 8 and 9 months. Bivariate analysis didn’t find statistically significant relation between age and one year survival.

Conclusion: Age didn’t influence one year survival of treated non-small cell lung carcinoma at Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital considering stage, functional status, comorbidities and body mass index."

"Gangguan yang paling sering dikeluhkan oleh pasien kanker paru adalah adanya kesulitan bernapas dan kecemasan yang menyebabkan pasien menjadi tidak relaks.Tujuan dari penelitian ini adalah untuk mengetahui pengaruh program latihan pursed lip breathing (PLB) dan Progressive Muscle Relaxation (PMR) terhadap peningkatan saturasi oksigenasi dan tingkat relaksasi pada pasien kanker paru. Metode penelitian yang digunakan adalah Quasi eksperiment dengan desain pre dan post test without control group. Jumlah sampel yang digunakan sebanyak 19 orang. Alat ukur yang digunakan yaitu oksimetri nadi untuk menilai saturasi oksigen dan lembar monitoring subjektif dan objektif untuk menilai tingkat relaksasi.Hasil penelitian menunjukkan bahwa ada perbedaan yang signifikan antara nilai saturasi oksigen sebelum dan sesudah latihan PLB dan PMR (p value < 0,05) dan ada perbedaan yang signifikan antara tingkat relaksasi sebelum dan sesudah latihan PLB dan PMR (p value < 0,05). Hasil analisis multivariate didapatkan bahwa usia menjadi prediktor terhadap peningkatan saturasi oksigen.Penelitian ini menyimpulkan bahwa latihan PLB dan PMR dapat meningkatkan saturasi oksigen dan tingkat relaksasi sebagai terapi komplementer pendamping terapi oksigen standar. Rekomendasi dari penelitian ini adalah perlunya terapi pengaturan napas dan teknik relaksasi untuk meningkatkan saturasi oksigen dan tingkat relaksasi pada pasien kanker paru stadium III dan IV.

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The most common symptoms in lung cancer are dyspnea and anxiety that cause patients restlessness.

This study aimed to find out the influence of PLB and PMR training program on the increase oxygen saturation and relaxation level in patients with lung cancer. This study employed a Quasy Experiment with pre test and post test without control group. There were 19 participants in this study. The instruments used were pulse oxymetry to measure oxygen saturation and monitoring form to measure subjective and objective relaxation level.

The results show that there is a significant difference on oxygen saturation before and after PLB and PMR training program (p value < 0,05) and a significant difference on relaxation level before and after PLB and PMR training program (p value < 0,05). A Multivariate analysis shows that age becomes a strong predictor of oxygen saturation.

This study concludes that PLB and PMR training program apllied to patient with lung cancer increases oxygen saturation and relaxation level as a complementary therapyalong with oxygen standart therapy. This study sugests breathing and relaxation training program to increase oxygen saturation and relaxation level for patient with lung cancer at grade III and IV."

"Latar Belakang : Efusi pleura masif merupakan salah satu masalah pada tatalaksana kanker paru dan menyebabkan kematian. Pemasangan kateter intrapleura merupakan tatalaksana utama keganasan dengan efusi pleura masif. Kateter yang digunakan yaitu water sealed drainage, indwelling pleural catheter atau pigtail catheter. Water sealed drainage saat ini merupakan kateter yang terbanyak digunakan.Tujuan : Penelitian ini adalah penelitian pendahuluan untuk mengetahui penggunaan (toleransi dan efikasi) water sealed drainage, indwelling pleural catheter dan pigtail catheter pada penatalaksanaan kanker paru dengan efusi pleura masif.Metode : Penelitian observasional kohort retrospektif pada pasien kanker paru tegak jenis dengan efusi pleura masif yang terpasang kateter intrapleura (WSD, IPC atau pigtail catheter). Data diambil dari rekam medis Rumah Sakit Umum Pusat Persahabatan Jakarta pada periode 1 Januari 2012 sampai 31 Desember 2015 dan dilakukan penilaian tolerasi (komplikasi akut dan lanjut) dan efikasi (lama penggunaan, lama rawat dan alasan pencabutan) pemasangan kateter intrapleura.Hasil : Subjek penelitian 77 pasien dengan karakteristik laki-laki (55,8%), median usia 57 tahun, range 26-84 tahun, adenokarsinoma (84,4%) dan terapi kemoterapi (32,5%). Komplikasi akut sebesar 70,1%, komplikasi terbanyak nyeri lokasi pemasangan kateter (58,4%). Komplikasi lanjut sebesar 54,5%, komplikasi terbanyak nyeri lokasi kateter bertambah atau menetap (29,9%). Rerata lama rawat pasca pemasangan kateter 14,14 hari, median 10 hari dan range 1-72 hari. Rerata lama pemakaian kateter 55,98 hari, median 30 hari dan range 2-310 hari. Alasan pencabutan kateter terbanyak adalah produksi cairan minimal (46,75%).Kesimpulan : Toleransi dan efikasi penggunaan kateter intrapleura pada pasien kanker paru dengan efusi pleura masif cukup baik dan aman. Diperlukan penelitian kohort prospektif dengan jumlah sampel yang sama pada tiap kelompok kateter, sehingga penggunaan kateter dapat dianalisis perbandingannya dan penelitian dengan kelompok pembanding, contohnya tindakan pleurodesis, yang merupakan baku emas tatalaksana efusi pleura ganas.Background : Massive pleural effusion is one of the problems in lung cancer treatment that cause death. The main treatment of cancer patient with massive pleural effusion is the placement of intrapleural catheter. Catheters that can be used are water sealed drainage, indwelling pleural catheter or pigtail catheter. Currently, water sealed drainage is the most catheter used.Objective : This is a preliminary study which is aimed to assess tolerancies and efficacies of water sealed drainage, indwelling pleural catheter or pigtail catheter for treatment of lung cancer with massive pleural effusion.Methods : This study is a retroscpective observational cohort study. Subjects are lung cancer patients with massive pleural effusion and catheterized with intrapleural catheter (WSD, IPC or pigtail catheter). The datas were taken from medical record at RSUP Persahabatan between 1 January 2012-31 December 2015 and assessed for tolerancies (acute or late complication) and efficacies ((length of hospital admission after catheter placement, duration and the reason of retraction) of intrapleural catheterResults: Subjects of study are 77 patients, with characteristic, male (55,8%), median age 57 years old, range from 26 to 84 years old, adenocarcinoma (84,4%) and the most main therapy is chemotherapy (32,5%). Acute complication obtained in 70,1% patients, with the most common complication is pain in catheter location (58,4%). Late complication obtained in 54,5% patients with the most common complication is pain in the catheter location (29,9%). The mean of length of staying in hospital after the placement of catheter are 14,14 days, median 10 days, range from 1 to 72 days. The mean of duration of catheter placement is 55.98 days, median 30 days, range from 2 to 310 days. Minimal fluid production (46,75%) are the most reason of intrapleural catheter retraction.Conclusion: Tolerancies and efficacies of intrapleural catheter (WSD, IPC or pigtail catheter) in lung cancer patients with massive pleural effusion are quite good and safe. Prospective cohort studies are needed in the future to determine which type of intrapleural catheter is better for the treatment of massive pleural effusion in lung cancer patients and studies with comparison group for example pleurodesis, which is the gold standard for treatment of malignant pleural effusion."

"Tesis ini menilai efikasi dan toksisiti Erlotinib/Gefitinib sebagai terapi lini kedua pada pasien KPKBSK yang mengalami progresifitas. Ini adalah sebuah penelitian kohor retrospektif antara tahun 2009 sampai 2013 dari rekam medis pasien KPKBSK yang mengalami progresifitas. Respons (subjektif, semisubjektif dan objektif) dievaluasi setiap bulan. Toksisiti dinilai setiap minggu sejak pemberian Erlotinib/Gefitinib berdasarkan kriteria WHO. Hasil evaluasi respons objektif, tidak ada pasien yang memberikan respons komplit. Best overall response rate dari 31 pasien, 48,8% menetap, 22,6% perburukan,12,9% respons sebagian dan 6,5% tidak dinilai/inevaluable. Pada penilaian respons semisubjektif didapatkan 19.4% peningkatan berat badan, 51,6% penurunan berat badan dan 29,0% menetap. Waktu tengah tahan hidup mencapai 18 bulan, rerata masa tahan hidup 1 tahunan 80,6% dan masa tahan hidup keseluruhan 6,50%. Data menunjukkan tidak ada timbul toksisiti hematologi berat (grade ¾) dan data penilaian toksisiti non hematologi sangat jarang timbul toksisiti berat (grade ¾). Efikasi monoterapi EGFR-TKI (Erlotinib/Gefitinib) cukup tinggi dengan toksisiti yang ditimbulkan tidak berat. Dengan demikian Erlotinib/Gefitinib sebagai terapi lini kedua cukup baik.

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This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second line therapy in NSCLC patients. This is a retrospective cohort study between 2009 and 2013 from the medical records of patients who experienced progression NSCLC. Therapeutic response was evaluated every month. Toxicity assessed every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results of objective response evaluation none of the patients complete response. Best overall response rate of 31 patients with the most stable response are 48.8%. Most semisubjective response obtained are 51.6% weight loss. The middle survival time reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall survival. The data showed no hematologic toxicity arise severe (grade ¾) and non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good."

"ABSTRAKPendahuluanPenyakit infeksi paru dan kanker paru termasuk 5 penyakit respirasi terbanyak ditemukan di dunia. Infeksi pernapasan akut menyebabkan 4 juta kematian per tahun dan kanker paru sebanyak 1,18 juta kematian secara terpisah. Penyakit infeksi juga merupakan bagian dari perjalanan penyakit kanker paru dan menjadi salah saru penyebab kematian tersering pada kanker paru berkisar 50-70% kasus. Tren munculnya patogen baru dan meningkatnya angka resistensi obat menyebabkan penanganan infeksi ini menjadi lebih sulit.Metode Studi deskriptif potong lintang pada pasien kanker paru yang dilakukan bilasan bronkus dan diperiksakan biakan mikroorganisme dari bahan bilasan tersebut. Jumlah sampel adalah total sampling dalam kurun waktu 1 tahun. Penelitian dilakukan di SMF Paru RSUP Persahabatan.HasilBakteri yang banyak ditemukan pada pasien kanker paru merupakan golongan gram negatif dengan species terbanyak adalah K. pneumonia dan B. cephacia. Ditemukan resistensi obat pada hampir semua jenis bakteri dan minimal dari 2 golongan antibiotik. Jenis jamur yang terbanyak dari genus Candida yaitu C. Albicans. Ditemukan resistensi obat anti jamur golongan azol pada species C. tropicalis, C. krusei dan A. Flavus. Hanya ditemukan 2 pasien kanker paru dengan biakan M. tuberculosis positif dari 108 pasien yang diperiksa dan tidak ditemukan resistensi obat anti tuberkulosis (OAT) lini pertama.KesimpulanPemeriksaan jenis mikroorganisme pada saluran napas bawah pasien kanker paru perlu dilakukan sebagai dasar pemberian terapi empiris bila terjadi infeksiIntroduction: Lung infections and lung cancer include in 5 most common respiratory diseases in the world. Acute respiratory infection and lung cancer caused 4 million deaths per year and 1.18 million deaths respectively. Infectious diseases are part natural course of lung cancers and become one of the most common causes of death in lung cancer patients ranging from 50-70%. The emergence of new pathogens and the increasing numbers of drug resistance causing infections treatment become more difficult. Method: A cross-sectional descriptive study obtaining cultured microorganisms results in lung cancer patients who have been performed bronchial washings. These have been a total sampling within a period of 1 year. Research has been conducted in the Department of Pulmonology Persahabatan Hospital. Result: Most common bacteria type found in lung cancer patients belong to gram-negative group with K. pneumoniae and B. cepacia as the most common species. Drug resistance found in most of bacteria from at least two classes of antibiotics. Most common types of fungi come from Candida genus, namely C. albicans. Drugs resistance in antifungal drug, azole, was found in C. tropicalis, and C. krusei. Only 2 lung cancer patients had M. tuberculosis positif culture from 108 patients were examined and first line anti-tuberculosis drugs resistance was not found. Conclusion: Microorganism culture obtained from lower respiratory tract in lung cancer patient is neccesary as basis of empiric therapy when infection occurs"