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"Tujuan : Untuk mengetahui pengaruh kadar hemoglobin, kadar hematokrit dan transfusi selama radiasi terhadap respon tumor dan kesintasan pada pasien kanker serviks stadium lanjut lokal (FIGO IIB-IIIB) yang menjalani terapi radiasi. Metode : Dilakukan studi kohort retrospektif terhadap pasien kanker serviks stadium IIB-IIIB yang memenuhi kriteria inklusi-eksklusi, yang berobat di Departemen Radioterapi RSCM periode Januari 2007 - Desember 2011, dianalisa dan dibandingkan respon tumor dan kesintasan antara kadar hemoglobin <11g/dL dengan ≥11g/dL, kadar hematokrit ≤35% dengan >35%, pasien yang ditransfusi dan tidak ditransfusi selama radiasi. Hasil : Respon tumor komplit pada kadar Hb sebelum radiasi <11g/dL dibandingkan dengan ≥11g/dL adalah 77,1% vs 70,2% p=0,34 ; kesintasan 3 tahun 84% vs 75% p=0,42. Respon tumor komplit pada kadar Hb selama radiasi <11g/dL dibandingkan dengan ≥11g/dL adalah 81,3% vs 67,9% p= 0,049 ; kesintasan 3 tahun 82% vs 79% p=0,05. Respon tumor komplit pada kadar Ht sebelum radiasi ≤35% dibandingkan dengan >35% adalah 71,7% vs 75,8% p=0,65 ; kesintasan 3 tahun 86% vs 78% p>0,05. Respon tumor komplit pada kadar Ht selama radiasi ≤35% dibandingkan dengan >35% adalah 72,7% vs 72,7% p=1,00 ; kesintasan 3 tahun 78% vs 87% p=>0,05. Kesintasan 3 tahun pada pasien yang ditransfusi dibandingkan dengan yang tidak ditransfusi 80% vs 84% p=0,95. Kesimpulan : Penelitian ini menunjukkan perbedaan yang bemakna pada pengaruh kadar hemoglobin rerata selama radiasi terhadap respon tumor dan kesintasan, pengaruh kadar hematokrit sebelum dan rerata selama radiasi terhadap respon tumor dan kesintasan.

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Aim : To determine the effect of hemoglobin level, hematocrit level and transfusion during radiation on tumor response and survival rate in patients with locally advanced cervical cancer (FIGO IIB-IIIB) who underwent radiation therapy.

Methods : A retrospective cohort study has done on cervical cancer patients stage IIB-IIIB who met the inclusion-exclusion criteria, which is treated in the Department of Radiotherapy RSCM period January 2007 - December 2011, were analyzed and compared to tumor response and survival rate between hemoglobin level <11g / dL with ≥11g / dL, hematocrit level ≤35% to> 35%, patients with blood transfused or not during radiation.

Results : Complete tumor response in Hb levels before radiation <11g / dL compared with ≥11g / dL was 77.1% vs. 70.2% p = 0.34; 3-year survival rate 84% vs. 75% p = 0.42. Complete tumor response in hemoglobin levels during radiation <11g / dL compared with ≥11g / dL was 81.3% vs. 67.9% p = 0.049; 3-year survival rate 82% vs. 79% p = 0.05. Complete tumor response in hematocrit levels before radiation ≤35% compared to> 35% was 71.7% vs. 75.8% p = 0.65; 3-year survival rate 86% vs. 78% p> 0.05. Complete tumor response in hematocrit levels during radiation ≤35% compared to> 35% was 72.7% vs. 72.7% p = 1.00; 3-year survival rate 78% vs. 87% p => 0.05. 3-year survival rate in patients who were not transfused transfused compared with 80% vs. 84% p = 0.95.

Conclusions : This study shows that differences in the influence of mean hemoglobin levels during radiation on tumor response and survival rate, the influence of mean hematocrit levels before and during radiation on tumor response and survival rate."

"Pendahuluan: Malnutrisi dan hipoksia merupakan faktor yang mempengaruhi kegagalan terapi pada KNF stadium lokal lanjut. Kadar albumin merupakan salah satu pemeriksaan status nutrisi. Hipoksia menyebabkan radioresistensi terhadap radiasi.Tujuan dari penelitian ini adalah mengetahui korelasi antara kadar albumin praradiasi, hipoksia terhadap respon radiasi. Metode penelitian: Penelitian ini merupakan studi kohort retrospektif menggunakan data sekunder terhadap 40 pasien kanker nasofaring stadium lokal lanjut yang memenuhi kriteria inklusi di Departemen Radioterapi dan Departemen Patologi Anatomi RSUP Dr Cipto Mangunkusumo dari Desember 2012 sampai Agustus 2013. Dilakukan pencatatan kadar albumin praradiasi, berat badan serta CT scan sebelum dan sesudah radiasi. Kemudian dilakukan analisa HIF1α dengan pulasan imunohistokimia. Sel yang positif hipoksia dihitung per 10 lapang pandang besar. Setelah itu, dilakukan penilaian respon radiasi berdasarkan kriteria Recist. Hasil: Rerata kadar albumin praradiasi sebesar 3,9 +/- 0,5 g/dL, dan median persentase hipoksia sel yaitu 24,7(1-100)%. Tidak terdapat hubungan yang bermakna antara kadar albumin praradiasi terhadap respon radiasi (p≥0,05). Terdapat hubungan yang bermakna anatara hipoksia terhadap respon radiasi (p<0,05). Korelasi antara kadar albumin praradiasi dan hipoksia menunujukkan korelasi yang lemah dan tidak bermakna (r=-0,24, p=0,324). Kesimpulan: Hasil penelitian ini memperlihatkan bahwa albumin praradiasi tidak berhubungan dengan respon radiasi pada KNF stadium lokal lanjut. Terbukti bahwa hipoksia meningkatkan radioresistensi dan menurunkan respon radiasi. Tidak terdapat korelasi antara albumin praradiasi dan hipoksia.

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Introduction: Malnutrion and hypoxia had been shown to cause irradiation failure. Albumin is one of the nutritional status examination. Hypoxia caused radioresistance to irradiation. The purpose of this study was to evaluate the correlation of albumin, hypoxia towards radiation response in locally advanced nasopharyngeal carcinoma.

Methods: This is a retrospective cohort study using secondary data from Departement of Radiotheraphy and Departement of Pathology Cipto Mangunkusomo hospital of 40 patients locally advanced nasopharyngeal cancer who meet the inclusion criteria from December 2012 to August 2013. Albumin preirradiation, body weight and CT scan before and after radiation were recorded. We examined the expression of HIF1 α by immunohistochemistry staining. Hypoxia cell was asessed by cell counting. Radiation response was determined by Recist criteria.

Results: The mean of serum albumin is 3.9 + / - 0.5 g /dL, and the median percentage of hypoxia was 24,7(1-100)%. There was no statistically significant relationship between albumin and radiation response (p≥0.05). There was a statistically significant relationship between hypoxia and radiation response (p<0,05). There were no correlation between albumin and hypoxia (r=-0,24, p=0,324).

Conclusion: This study showed that there was no correlation between albumin preirradiation and response in locally advanced nasopharyngeal cancer. It was proven that hypoxia increased radioresistance in locally advanced nasopharyngeal cancer. There was no correlation between albumin preirradiation and hypoxia."

"[ABSTRAKPendahuluan : Kanker kolorektal termasuk salah satu morbiditas terbanyak di Indonesia dengan hasil terapi yang cenderung memprihatinkan untuk stadium lanjut lokal. Oleh karena itu diperlukan kemoradiasi neoajuvan yang merupakan terapi standar sesuai guideline untuk kanker rektum stadium lanjut lokal, meskipun demikian espons yang dihasilkan sangat bervariasi dan dipengaruhi oleh berbagai faktor, termasuk hipoksia jaringan. Osteopontin adalah penanda hipoksia endogen yang berkorelasi signifikan dengan tekanan oksigen tumor. Osteopontin juga merupakan penanda hipoksia kronis yang lebih akurat dibandingkan Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), dan Lactate Dehydrogenase A (LDH A) tetapi belum pernah dilakukan penelitian yang mengukur kadar OPN secara kuantitatif pada jaringan kanker rektum serta mengkorelasikannya dengan respons pengecilan tumor pada kemoradiasi neoajuvan.Metode dan Materi: Dilakukan skrining data pasien dari Rekam Medis Departemen Radioterapi. Empat belas pasien yang memenuhi kriteria inklusi dan eksklusi dianalisis retrospektif dari bulan Februari sampai dengan bulan Mei 2015. Pencitraan radiologi pasca kemoradiasi dibandingkan dengan sebelum kemoradiasi, sementara jaringan rectum didapatkan dari blok parafin yang didapatkan dari biopsi sebelum kemoradiasi. Evaluasi radiologi diukur menggunakan kriteria RECIST 1.1. Kadar OPN diperiksa menggunakan metode ELISA dan diukur menggunakan spektrofometer.Hasil : Rerata kadar OPN adalah 0.5678 ± 0.26 ng/mL. Terdapat korelasi berbanding terbalik yang kuat (r= -0.630, p= 0.016) antara kadar OPN dan pengecilan tumor. Nilai ambang batas OPN ≥0.538 ng/mL memprediksikan ketidakresponsifan terhadap kemoradiasi neoajuvan dengan tingkat sensitivitas 100% dan spesifisitas 81,8%. Meskipun demikian, tidak terdapat korelasi antara kadar OPN dengan Hemoglobin.Kesimpulan : Penelitian ini menunjukkan bahwa hipoksia terdapat pada pasien dengan kanker rektum stadium lanjut lokal dan merupakan karakter yang menandai turunnya respons pengecilan tumor terhadap kemoradiasi neoajuvan. Kadar OPN yang makin tinggi menunjukkan kondisi hipoksia yang lebih buruk dan respons yang lebih buruk untuk pengecilan tumor.

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ABSTRACTIntroduction: Colorectal carcinoma is one of the common cancer in Indonesia with concerned clinical outcome for locally advanced stage, therefore neoadjuvant chemoradiation (CRT) is needed. Neoadjuvant CRT is the mainstay treatment for locally advanced rectal carcinoma, however the response is varied due to many factors, including tissue hypoxia. Osteopontin (OPN) is an emerging endogen hypoxic marker with significant correlation with tumor pO2, also more accurate chronic hypoxic marker compared to Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), and Lactate Dehydrogenase A (LDH A) but there's no research that measured OPN quantity in rectal cancer tissue and correlate it with tumor shrinkage response in neoadjuvant CRT.Methods and Materials: Patients? data was screened from Radiotherapy Department Medical Record Archieves. Fourteen patients that meet the inclusion and exclusion criteria were analyzed retrospectively from February to May 2015. Radiology imaging post CRT compared to the imaging pre CRT, while the rectum tissue obtained from Formalin-Fixed Paraffin Embedded (FFPE) tissue from biopsy sampling before CRT. Radiology evaluation was measured using RECIST 1.1. OPN level was conducted using ELISA method and measured with spectrophotometry.Results: The mean OPN concentration is 0.5678 ± 0.26 ng/mL. There was a significant strong negative correlation (r = -0.630, p= 0.016) between the OPN level and tumor shrinkage. OPN cut off value ≥0.538 ng/ml predicts non-responsiveness of neoadjuvant CRT with 100% sensitivity and 81.8% specificity. However, there is no correlation between OPN concentration and Hemoglobin concentration.Conclusion: This study showed that hypoxia occurs in patients with locally advanced rectal carcinoma, and characterizes decreasing tumor shrinkage response in neoadjuvant CRT. Higher level of OPN suggests worse level of hypoxic condition and worse response of tumor shrinkage., Introduction: Colorectal carcinoma is one of the common cancer in Indonesia with concerned clinical outcome for locally advanced stage, therefore neoadjuvant chemoradiation (CRT) is needed. Neoadjuvant CRT is the mainstay treatment for locally advanced rectal carcinoma, however the response is varied due to many factors, including tissue hypoxia. Osteopontin (OPN) is an emerging endogen hypoxic marker with significant correlation with tumor pO2, also more accurate chronic hypoxic marker compared to Carbonic Anhydrase IX (CAIX), Glucose Transporter 1 (GLUT1), and Lactate Dehydrogenase A (LDH A) but there’s no research that measured OPN quantity in rectal cancer tissue and correlate it with tumor shrinkage response in neoadjuvant CRT. Methods and Materials: Patients’ data was screened from Radiotherapy Department Medical Record Archieves. Fourteen patients that meet the inclusion and exclusion criteria were analyzed retrospectively from February to May 2015. Radiology imaging post CRT compared to the imaging pre CRT, while the rectum tissue obtained from Formalin-Fixed Paraffin Embedded (FFPE) tissue from biopsy sampling before CRT. Radiology evaluation was measured using RECIST 1.1. OPN level was conducted using ELISA method and measured with spectrophotometry. Results: The mean OPN concentration is 0.5678 ± 0.26 ng/mL. There was a significant strong negative correlation (r = -0.630, p= 0.016) between the OPN level and tumor shrinkage. OPN cut off value ≥0.538 ng/ml predicts non-responsiveness of neoadjuvant CRT with 100% sensitivity and 81.8% specificity. However, there is no correlation between OPN concentration and Hemoglobin concentration. Conclusion: This study showed that hypoxia occurs in patients with locally advanced rectal carcinoma, and characterizes decreasing tumor shrinkage response in neoadjuvant CRT. Higher level of OPN suggests worse level of hypoxic condition and worse response of tumor shrinkage.]"

"[Tujuan: Untuk mengetahui profil pasien kanker rektum di Departemen Radioterapi RSCM. Metode: Dilakukan penelitian restrospektif deskriptif analitik terhadap 144 pasien kankerrektum yang menjalani radiasi di Departemen Radioterapi RSCM periode Januari 2009Januari2014, dilihat karakteristik pasien dan tumor. Respons radiasi dinilai menggunakanmetode RECIST 1.1. Hubungan antara OTT dan DTT dengan respons radiasi dinilai dengankorelasi Spearman dan analisis kesintasan dihitung dengan kurva Kaplan Meier. Hasil: Pasien laki-laki sebesar 65.9%, median usia 53 (23-81) tahun dengan mayoritas beradapada kelompok usia 50-59 tahun. Tipe histopatologi terbanyak adalah adenokarsinoma(88.8%) dan pasien paling banyak datang dengan stadium IIIB (25.0%). Kemoradiasidilakukan pada 29.8% pasien, dengan toksisitas radiasi akut terbanyak adalah pada kulit(derajat I) sebesar 20.1%. Respons radiasi yang dinilai dengan metode RECIST 1.1menunjukkan respons terbanyak adalah stabil (71.4%). Tidak ditemukan korelasi antara OTTdan DTT dengan respons radiasi. Dari 118 pasien, didapatkan analisis kesintasan keseluruhan3 dan 5 tahun masing-masing adalah 65% dan 45% dengan median survival 59 bulan. Padakelompok pasien yang menjalani radiasi panjang, analisis kesintasan keseluruhan 3 dan 5tahun masing-masing adalah masing-masing 91% dan 78%. Kesimpulan: Karakteristik pasien rektum di Departemen Radioterapi RSCM yang berbedadengan berbagai studi sebelumnya hanya usia. Respons radiasi yang paling banyak dijumpai adalah stabil. Tidak ditemukan korelasi antara OTT dan DTT dengan respons radiasi.;Purpose: To obtain the profile of rectal cancer patients in Department of Radiotherapy, National General Hospital of Cipto Mangunkusumo.Method: A restrospective study was conducted over 144 rectal cancer patients undergone radiation therapy in Department of Radiotherapy, National General Hospital of CiptoMangunkusumo during period of January 2009 to January 2014. The characteristics ofpatients and tumour were assessed. The radiation response was evaluated with the RECIST1.1 method. The correlation between OTT and DTT with radiation response was analyzedwith Spearman?s correlation and the survival analysis was determined using Kaplan-Meiercurve. Result: The majority of patients were male (65.9%), with median age of 53 (23-81) years oldwhere most patients belonged to age group of 50-59 years old. The most frequenthistopathologic type found was adenocarcinoma (88.8%) with most patients were in stageIIIB (25.0%). Chemoradiation was performed in 29.8% of patients, and grade I skin toxicitywas the most frequent acute side effect of radiation found (20.1%). Radiation responseassessed with the RECIST 1.1 method showed stable disease as the mostly seen response(71.4%). There was no correlation found between OTT and DTT with radiation response.Overall survival from 118 patients for 3 and 5 years were 65% and 45%, respectively, withmedian survival of 59 months. In the group of patients underwent long-course radiotherapy,the overall survival for 3 and 5 years were 91% and 78%, respectively. Conclusion: The sole characteristic of rectal cancer patients in Department of Radiotherapy atCipto Mangunkusumo Hospital that is different from previous studies is the age group wheremost patients were in. Stable disease is the most frequent radiation response. There was no correlation found between OTT and DTT with radiation response., Purpose: To obtain the profile of rectal cancer patients in Department of Radiotherapy, National General Hospital of Cipto Mangunkusumo.Method: A restrospective study was conducted over 144 rectal cancer patients undergone radiation therapy in Department of Radiotherapy, National General Hospital of CiptoMangunkusumo during period of January 2009 to January 2014. The characteristics ofpatients and tumour were assessed. The radiation response was evaluated with the RECIST1.1 method. The correlation between OTT and DTT with radiation response was analyzedwith Spearman’s correlation and the survival analysis was determined using Kaplan-Meiercurve. Result: The majority of patients were male (65.9%), with median age of 53 (23-81) years oldwhere most patients belonged to age group of 50-59 years old. The most frequenthistopathologic type found was adenocarcinoma (88.8%) with most patients were in stageIIIB (25.0%). Chemoradiation was performed in 29.8% of patients, and grade I skin toxicitywas the most frequent acute side effect of radiation found (20.1%). Radiation responseassessed with the RECIST 1.1 method showed stable disease as the mostly seen response(71.4%). There was no correlation found between OTT and DTT with radiation response.Overall survival from 118 patients for 3 and 5 years were 65% and 45%, respectively, withmedian survival of 59 months. In the group of patients underwent long-course radiotherapy,the overall survival for 3 and 5 years were 91% and 78%, respectively. Conclusion: The sole characteristic of rectal cancer patients in Department of Radiotherapy atCipto Mangunkusumo Hospital that is different from previous studies is the age group wheremost patients were in. Stable disease is the most frequent radiation response. There was no correlation found between OTT and DTT with radiation response.]"

"ABSTRAK Peningkatan angka morbiditas dan mortalitas akibat penyakit kanker di Indonesia menunjukkan bahwa permasalahan kanker ini semakin besar dan kompleks Salah satunya adalah adanya keterlambatan pasien kanker untuk mendapatkan terapi definitif yang disebabkan oleh faktor faktor yang berasal dari pasien sendiri Penelitian ini merupakan studi analisis deskriptif menggunakan metode campuran kuantitatif dan kualitatif untuk mengetahui data insidens keterlambatan terapi karena keterlambatan pasien pada pasien kanker yang dirujuk ke Departemen Radioterapi RSUPN Dr Cipto Mangunkusmo pada bulan Mei Agustus 2015 serta mengevaluasi faktor faktor apa saja yang mempengaruhi keterlambatan pasien tersebut Terdapat 294 orang pasien yang diikutsertakan dalam penelitian ini setelah mendapatkan persetujuan tertulis Sebagian besar pasien 71 4 adalah perempuan dan 141 orang 48 bekerja sebagai ibu rumah tangga Rentang umur terbanyak adalah 36 50 tahun yaitu sebanyak 132 pasien 44 9 dan hampir seluruh pasien 91 8 telah menikah Keterlambatan terapi didapatkan pada 153 orang pasien 52 dan 67 orang di antaranya 43 8 memiliki riwayat pengobatan alternatif yang dilakukan dalam interval waktu setelah timbul keluhan pertama kali dan atau setelah pasien melakukan konsultasi medis pertama kali Analisis statistik menunjukkan adanya hubungan yang signifikan antara faktor usia p 0 047 pendidikan p 0 047 dan riwayat pengobatan alternatif p 0 0001 dengan keterlambatan terapi Adanya rasa takut untuk berobat secara medis atau menjalani tindakan medis menjadi alasan 51 orang pasien untuk memilih pengobatan alternatif Oleh karena itu diperlukan pengawasan dan evaluasi terhadap pengobatan alternatif terutama yang menyangkut kualitas efikasi dan keamanannya ABSTRACT Increased morbidity and mortality due to cancer in Indonesia showed that this problem has become more complex and significant One of the problems pointed out is regarding a delay in cancer patients to receive definitive therapy caused by factors derived from the patients themselves This study is a descriptive analysis using combination of quantitative and qualitative methods to determine the incidence of treatment delay due to patient delay in cancer patients who were referred to Radiotherapy Department Dr Cipto Mangunkusmo hospital during May August 2015 and to evaluate factors that influence the patient delay There are 294 patients enrolled in this study after obtaining a written consent Most of the patients 71 4 were women and 141 48 work as a housewife The largest age range was 36 50 years with 132 patients 44 9 and almost all patients 91 8 were married Delay in treatment obtained in 153 patients 52 and 67 of them 43 8 had a history of alternative medicine that is performed in a time interval after the patients experienced first complaints and or after patients had their first medical consultation Statistical analysis showed a significant relationship between age p 0 047 educational level p 0 047 and history of alternative medicine p 0 0001 with the treatment delay The fear of being treated medically or undergo a medical procedure has become the major reasons found in 51 patients to choose the alternative treatment Therefore it is necessary to conduct monitoring and evaluation of alternative medicine especially concerning the quality efficacy and its safety ;Increased morbidity and mortality due to cancer in Indonesia showed that this problem has become more complex and significant One of the problems pointed out is regarding a delay in cancer patients to receive definitive therapy caused by factors derived from the patients themselves This study is a descriptive analysis using combination of quantitative and qualitative methods to determine the incidence of treatment delay due to patient delay in cancer patients who were referred to Radiotherapy Department Dr Cipto Mangunkusmo hospital during May August 2015 and to evaluate factors that influence the patient delay There are 294 patients enrolled in this study after obtaining a written consent Most of the patients 71 4 were women and 141 48 work as a housewife The largest age range was 36 50 years with 132 patients 44 9 and almost all patients 91 8 were married Delay in treatment obtained in 153 patients 52 and 67 of them 43 8 had a history of alternative medicine that is performed in a time interval after the patients experienced first complaints and or after patients had their first medical consultation Statistical analysis showed a significant relationship between age p 0 047 educational level p 0 047 and history of alternative medicine p 0 0001 with the treatment delay The fear of being treated medically or undergo a medical procedure has become the major reasons found in 51 patients to choose the alternative treatment Therefore it is necessary to conduct monitoring and evaluation of alternative medicine especially concerning the quality efficacy and its safety ;Increased morbidity and mortality due to cancer in Indonesia showed that this problem has become more complex and significant One of the problems pointed out is regarding a delay in cancer patients to receive definitive therapy caused by factors derived from the patients themselves This study is a descriptive analysis using combination of quantitative and qualitative methods to determine the incidence of treatment delay due to patient delay in cancer patients who were referred to Radiotherapy Department Dr Cipto Mangunkusmo hospital during May August 2015 and to evaluate factors that influence the patient delay There are 294 patients enrolled in this study after obtaining a written consent Most of the patients 71 4 were women and 141 48 work as a housewife The largest age range was 36 50 years with 132 patients 44 9 and almost all patients 91 8 were married Delay in treatment obtained in 153 patients 52 and 67 of them 43 8 had a history of alternative medicine that is performed in a time interval after the patients experienced first complaints and or after patients had their first medical consultation Statistical analysis showed a significant relationship between age p 0 047 educational level p 0 047 and history of alternative medicine p 0 0001 with the treatment delay The fear of being treated medically or undergo a medical procedure has become the major reasons found in 51 patients to choose the alternative treatment Therefore it is necessary to conduct monitoring and evaluation of alternative medicine especially concerning the quality efficacy and its safety "

"Kanker merupakan salah satu beban bagi pemerintah dari segi pelayanan dan pembiayaan kesehatan. Berbeda dengan Indonesia, di beberapa negara, informasi tentang kanker dijalankan melalui program yang bernama National Program of Cancer Registries (NPCR) yang dikelola oleh Centers for Disease Control and Prevention (CDC). Penelitian ini dilakukan untuk melaporkan tentang profil kanker wilayah Jakarta Barat tahun 2008-2012, karena belum adanya data yang tepat dari pemerintah. Penelitian ini merupakan studi deskriptif dengan desain studi cross sectional terhadap seluruh pasien kanker yang berdomisili di Jakarta Barat berdasarkan data yang tercatat di RS Cipto Mangunkusumo, sebagai pusat pengendali registrasi kanker DKI Jakarta. Sebagai hasil didapatkan kasus kanker berjumlah 4057 kasus, dan jenis lima kasus kanker terbanyak. Lima kasus kanker paling banyak berlokasi di payudara (22,5%), serviks uteri (10,3%), paru dan bronkus 7,5%), nasofaring (5,3%), sistem hematopoietik dan retikuloendotelial (5,3%). Sebagian besar kasus ditemukan pada stadium lanjut (III dan IV), dan dominan pada jenis kelamin wanita dengan usia antara 45-54 tahun. Karsinoma intraduktal merupakan tipe morfologi terbanyak pada kasus kanker payudara.

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Cancer is one of the government burdens in terms of health service and financing. Different from Indonesia, in several countries, the data about cancer profile were collected by National Program of Cancer Registries (NPCR) and administered by the Centers for Disease Control and Prevention (CDC) . The main objective of this study is to describe the cancer profile in the West Jakarta region, from the year of 2008 to 2012, since there was no proper data about cancer profile provided by government. By using descriptive study with a cross sectional study design, the data from all cancer patients living in the region of West Jakarta who were registered in Cipto Mangunkusumo Hospital, a cancer control and registration center in the region of DKI Jakarta, were collected. As a result, from a total number of 4057 cancer patients found in the area, there were five most common locations recorded. Those five most common locations affected by cancer were breast (22.5%), cervical (10.3%), lung and bronchus (7.5%), nasopharynx (5.3%), hematopoietic and reticuloendothelial systems (5.3%). Unfortunately, most of those cases were found at latter stages (III and IV), and were between 45-54 years old with female predominant. Breast Carcinoma was the most common among all with Intra Ductal Carcinoma as its most common morphology type. "

"Latar Belakang: Kanker Nasofaring (KNF) merupakan keganasan yang sering di Indonesia. Molekul terkait imun yang banyak diteliti adalah Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1). Penelitian ini bertujuan untuk mengetahui profil PD-L1 dari spesimen KNF di Indonesia. Metode: Spesimen biopsi massa nasofaring diambil untuk pemeriksaan konsentrasi protein PD-L1 dengan metode Enzyme-Linked Immunosorbent Assay (ELISA). Pada spesimen yang terbukti secara histologis KNF dilakukan pemeriksaan Imunohistokimia (IHK) untuk mengetahui ekspresi PD-L1. Hasil: Lima puluh empat spesimen biopsi nasofaring diperoleh. Tiga puluh lima dari 54 spesimen dikonfirmasi secara histologis KNF yang tidak berdiferensiasi dengan usia rerata 51 tahun. Selebihnya, 19 spesimen lainnya secara histologis bukan KNF dengan usia rerata 37 tahun. Pada pemeriksaan ELISA, median konsentrasi PD-L1 dari spesimen KNF adalah 2100,73 ± 3689,52 pg/mg protein, dan spesimen bukan KNF adalah 1010,88 ± 1082,37 pg/mg protein. Pada pemeriksaan IHK 30 sampel KNF untuk pemeriksaan ekspresi PD-L1, semuanya mengekspresikan PD-L1 positif, dengan rincian; skor 1 sebanyak 7%, skor 2 sebanyak 30%, dan skor 3 sebanyak 63%. Kesimpulan: Protein PD-L1 dari spesimen KNF dengan pemeriksaan ELISA signifikan meningkat dibandingkan dengan bukan KNF. Semua spesimen KNF dengan pemeriksaan IHK mengeskspresikan PD-L1 positif dengan mayoritas skor 3.

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Background: Nasopharyngeal Carcinoma (NPC) is a common malignancy in Indonesia. Immune-related molecules that have been studied are Programmed Death-1 (PD-1)/Programmed Death-Ligand 1 (PD-L1). This study aims to determine the profile of PD-L1 from NPC specimens in Indonesia.

Method: A nasopharyngeal biopsy specimen was taken to examine the concentration of PD-L1 protein by the Enzyme-Linked Immunosorbent Assay (ELISA). Immunohistochemistry (IHC) examinations were conducted to determine the PD-L1 expression.

Results: Fifty-four nasopharyngeal biopsy specimens were obtained. Thirty-five of 54 specimens were confirmed histologically for undifferentiated NPC with an average age of 51 years. The rest, 19 other specimens are histologically non NPC with an average age of 37 years. On ELISA examination, the median PD-L1 concentration of the NPC specimen was 2100.73 ± 3689.52 pg/mg protein, and the non-KNF specimen was 1010.88 ± 1082.37 pg/mg protein. At the IHC examination of 30 NPC samples for PD-L1 expression examination, all of them expressed PD-L1 positive, with details; score 1 is 7%, score 2 is 30%, and score 3 is 63%.

Conclusion: PD-L1 protein from NPC specimens by ELISA examination was significantly increased compared to non-NPC. All NPC specimens with IHC examination expressed PD-L1 positive with a majority score of 3."

"Tujuan : Pembangunan pusat pelayanan radioterapi sampai saat ini belum menjadi prioritas utama khususnya di negara berkembang. Tingginya biaya yang dihabiskan untuk pusat pelayanan merupakan salah satu alasannya. Biaya terkait sumber daya manusia (SDM) berhubungan erat dengan biaya operasional yang dikeluarkan. Pengetahuan terkait produktivitas yang mencakup beban SDM dan penggunaan pesawat radiasi merupakan dasar untuk terciptanya pelayanan radioterapi dengan biaya efektif. Oleh karena itu, digagaslah penelitian tentang produktivitas SDM dan penggunaan pesawat radiasi di pusat pelayanan Onkologi Radiasi di Indonesia sebagai bagian dari penelitian terkait biaya radioterapi. Metode : studi deskriptif cross sectional. Subjek penelitian merupakan seluruh pusat pelayanan Onkologi Radiasi di Indonesia yang telah melakukan pelayanan selama setahun. Subjek diberikan kuesioner secara digital yang berisikan pertanyaan terkait ketersediaan SDM dan pesawat radiasi. Data yang didapat kemudian dimasukkan ke dalam Radiotherapy Resources and Cost Calculator (RRCC) v.20 serta dilakukan penghitungan dengan asumsi aktual sesuai kondisi di Indonesia. Hasil : beban kerja Dokter Spesialis, Fisika Medis, dan RTT di Indonesia bervariasi dengan rerata beban kerja secara berurutan sebesar 92,5% (asumsi aktual), 97,7%, 107,6%, dan 80,8%. Beban kerja SDM secara statistik lebih tinggi pada pusat pelayanan dengan brakhiterapi dan pusat pelayanan dengan jumlah pasien yang tinggi. Rerata penggunaan pesawat radiasi sebesar 104,1% dan 138% secara statistik signifikan lebih tinggi pada rumah sakit pemerintah dan jumlah pasien tinggi. Jumlah pasien memiliki korelasi kuat dengan jumlah kebutuhan dokter spesialis (r=0,927), fisika medis (r=0,838) dan RTT (r=0,886). Jumlah pasien dapat menjadi prediktor untuk menentukan kebutuhan Dokter Spesialis dengan adjusted R2 = 72,1% dan 80%, kebutuhan fisika medis adjusted R2 = 69,3%, dan kebutuhan RTT dengan adjusted R2 = 83,3%.Kesimpulan : produktivitas SDM dan penggunaan pesawat radiasi pada pusat pelayanan Onkologi Radiasi di Indonesia bervariasi. Penghitungan produktivitas dengan RRCC v.20 dapat diaplikasikan pada pusat pelayanan Onkologi Radiasi di Indonesia.

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Objective: The development of a radiotherapy center has not been a top priority, especially in developing countries. The high cost spent on service centers is one of the reasons. Human resource costs are inextricably linked to operational expenses. Knowledge related to productivity, which includes the workload of human resources and the use of radiation equipment, is the basis for creating cost-effective services. Therefore, research was initiated on human resource productivity and the use of radiation equipment at radiotherapy centers in Indonesia as part of research related to radiotherapy costs. Method: descriptive cross-sectional study. The research subjects were all radiotherapy centers in Indonesia that had been running for a year. Subjects were given a digital questionnaire containing questions related to the availability of human resources and radiation equipment. The data obtained is then entered into the Radiotherapy Resources and Cost Calculator (RRCC) v.20, and calculations are carried out with actual assumptions according to conditions in Indonesia. Results: The workload of specialists, medical physicists, and RTTs in Indonesia varies, with an average workload of 92.5% (actual assumption), 97.7%, 107.6%, and 80.8%, respectively. HR workload is statistically higher in centers with brachytherapy and in centers with a high number of patients. The mean use of radiation equipment was 104.1% and 138%, respectively, statistically significantly higher in government hospitals, and centers with a high number of patients. The number of patients has a strong correlation with the number of specialists (r = 0.927), medical physics (r = 0.838), and RTT (r = 0.886). The number of patients can be a predictor for determining the need for specialist doctors with adjusted R2 values of 72.1% and 80%, medical physics needs with adjusted R2 values of 69.3%, and RTT needs with adjusted R2 values of 83.3%. Conclusion: HR productivity and the use of radiation equipment at radiation oncology service centers in Indonesia vary. The calculation of productivity with RRCC v.20 can be applied to radiotherapy centers in Indonesia."