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"Latar Belakang: Kanker serviks adalah keganasan ginekologi terbanyak kedua pada perempuan di seluruh dunia dengan angka kematian yang tinggi. Stadium IIIB kanker serviks didefinisikan sebagai perluasan tumor yang mengenai dinding panggul atau adanya hidronefrosis. Jika disertai dengan gangguan ginjal, angka morbiditas dan mortalitas pasien akan meningkat. Penelitian ini bertujuan untuk mengkaji perbedaan data patologi, respon terapi, masa rawat, dan angka kesintasan satu tahun pada pasien kanker serviks stadium IIIB dengan dan tanpa gangguan ginjal. Metode: Dengan menggunakan metode potong lintang dilakukan pengambilan data 941 sampel pasien kanker serviks stadium IIIB di RSCM Jakarta antara bulan Juli 2010 - Juli 2015. Hasil: Hasil penelitian menunjukkan terdapat perbedaan signifikan jumlah pasien ditinjau dari keterlibatan dinding panggul, keterlibatan KGB, derajat dan simetrisitas hidronefrosis, rerata kadar ureum, kreatinin, dan kalium serum pada pasien kanker serviks dengan dan tanpa gangguan ginjal (p<0.001). Juga ditemukan perbedaan bermakna jumlah pasien yang menjalani terapi diversi urin , dialisis, dan kemoterapi. Untuk analisis kesintasan, didapatkan hazard ratio 0.307 (IK95% 0,160-0,589). Kesimpulan: Dengan gambaran data tersebut, perlu diusulkan suatu entitas klasifikasi baru untuk kanker serviks stadium IIIB dengan gangguan ginjal (IIIB plus), mengingat kasus ini membutuhkan penanganan yang lebih kompleks dan holistik dengan melibatkan banyak keahlian (penyakit dalam, urologi, ginjal hipertensi, gizi klinik dan paliatif) serta prognosis yang berbeda bermakna secara statistik

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Background: Cervical cancer is the second most common gynecological cancer in women globally. Stage IIIB cervical cancer is defined as a local extension of tumor that affects the pelvic wall or hydronephrosis or kidney disease. If accompanied by kidney disease, the complication will increase thereby increasing patient's morbidity and mortality. The aim of this study is to know whether there are differences in the clinical data, therapy, duration of hospital, and one-year survival rate in cervical cancer patient with and without kidney disease.

Methods: This research uses cross-sectional method with samples of stage IIIB cervical cancer patients in Cipto Mangunkusumo between July 2010 and July 2015.

Results: The results showed significant difference in the number of patients with pelvic wall involvement, lymph node involvement, degree and symmetry of hydronephrosis, the serum urea, creatinine, and potassium level between cervical cancer patients with and without kidney disease (p <0.001). There are also significant differences in the number of patients undergoing urinary diversion therapy, dialysis and chemotherapy. For survival analysis, the hazard ratio obtained is 0.307 (IK95% 0.160 - 0.589).

Conclusion: With the results obtained, we suggest new entitiy for cervical cancer stage IIIB with kidney disease ( IIIB plus), according to there is an obligation of more complex involvement of specialist (internist, urologist, renal hypertension expert, clinical nutrition and palliative expert) and statistically the prognosis is different"

"Latar Belakang: Pasien kanker serviks di Indonesia 70 % datang pada stadium lanjut, 45,2% dengan stadium IIIB dan radiasi menjadi terapi utama. Radioresistensi menjadi masalah utama saat ini, namun radiosensitizer yang tersedia memiliki efek toksisitas tinggi. Curcumin sebagai fitofarmaka bisa menjadi alternatif radiosensitizer dengan cara menekan aktivitas enzim antioksidan thioredoxin reductase-1 dan memicu terjadinya proses apoptosis. Tujuan: Menilai efikasi Biocurcumin dalam menekan aktifitas thioredoxin reductase-1 dan pengaruhnya terhadap indeks apoptosis Metode: Penelitian payung uji klinis ini dilakukan di Divisi Ginekologi Onkologi Departemen OBGYN FKUI serta Departemen Biokimia FKUI. Dilakukan penelusuran archived data jaringan dari penelitian uji klinis utama. Pemeriksaan aktifitas thioredoxin reductase-1 pre dan pasca radiasi dilakukan pada 18 sampel yang diberi terapi radiasi dan BCM-95 serta 19 sampel dengan radiasi dan plasebo. Metode McCord dan Fridovich dipakai menggunakan kit human TrxR1(Thioredoxin Reductase-1) Elabscience. Dilakukan analisis perbedaaan kadar thioredoxin reductase-1 sebelum dan sesudah radiasi serta hubungan antara perubahan kadar thioredoxin reductase-1 dengan indeks apoptosis pada kedua kelompok. Hasil: Terdapat perbedaan bermakna perubahan rerata kadar thioreduxin reductase-1 pada kelompok yang mendapat terapi radiasi dan Biocurcumin dibandingkan kelompok yang mendapat terapi radiasi dan plasebo, nilai p = 0,02 (p < 0,05). Namun, tidak terdapat hubungan yang bermakna antara perubahan rerata Indeks Apoptosis pada kedua kelompok (nilai p>0,05). Selain itu juga tidak ada perbedaan nilai median pada perubahan kadar thioredoxin reductase-1 maupun perbedaan nilai rerata pada perubahan Indeks Apoptosis sebelum dan sesudah radiasi diantara keduanya (p > 0,05). Kesimpulan: BCM-95 efektif menurunkan rerata kadar thioredoxin reductase-1, namun tidak terdapat perbedaan indeks apoptosis pada kedua kelompok.

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Background: Cervical cancer patients in Indonesia 70% come at an advanced stage, 45.2% with stage IIIB and radiation being the main therapy. Radioresistence is a major problem nowadays, but available radiosensitizers have a high toxicity effect. Curcumin as phytopharmaceuticals can be an alternative radiosensitizer by suppressing the activity of antioxidant enzyme thioredoxin reductase-1 and triggering the occurrence of apoptosis process. Objective: Assessing the efficacy of Biocurcumin in suppressing thioredoxin reductase-1 activity and its effect on apoptosis index Method: This clinical trial umbrella research was conducted in the Division of Oncology Gynaecology, OBGYN Department FMUI as well as the Department of Biochemistry FMUI. Archived network data from major clinical trial research. Examination of thioredoxin reductase-1 pre and post radiation activity was conducted on 18 samples given radiation therapy and BCM-95 and 19 samples with radiation and placebo. The McCord and Fridovich methods were used using the Human TrxR1(Thioredoxin Reductase-1) Elabscience kit. An analysis of the difference in thioredoxin reductase-1 levels before and after radiation and the relationship between changes in thioredoxin reductase-1 levels and apoptosis index in both groups. Results: There was a meaningful difference in the average level of thioreduxin reductase-1 in the group that received radiation therapy and Biocurcumin compared to the group that received radiation therapy and placebo, the value p = 0.02 (p < 0.05). However, there is no meaningful relationship between the changes in the average of Apoptosis Index in both groups (p>0.05). In addition, there was no difference in the median value in the change in thioredoxin reductase-1 levels or the difference in average value in the changes in the Apoptosis Index before and after radiation between the two (p > 0.05). Conclusion: BCM-95 effectively lowered average levels of thioredoxin reduxtase-1, but there was no difference in apoptosis index in both groups."