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Abstrak :
Insidens kanker paru terus meningkat baik di negara maju maupun negara berkembang. Saat ini berkembang berbagai modaliti gabungan yang dianggap berperan dalam menurunkan morbiditi dan memperpanjang usia. Terapi pilihan kanker paru jenis karsinoma bukan sel kecil (KPKBSK) bila masih memungkinkan adalah pembedahan. Dua puluh lima persen sampai 45% dari seluruh kasus KPKBSK yang dilaporkan, dapat menjalani pembedahan. Pembedahan pada stage yang tepat akan memberikan masa tahan hidup yang lebih panjang terutama bagi penderita KPKBK. Di Rumah Sakit Persahabatan, pembedahan dilakukan terhadap 10% kasus kanker paru. Kasus dengan stage yang rendah mempunyai angka tahan hidup 5 tahun atau 5 year survival rate yang baik. Pembedahan pada stage yang tepat mempunyai angka tahan hidup 5 tahun yang meningkat pada KPKBSK. Kemoterapi dan radioterapi dianjurkan pada kasus yang tidak mungkin dibedah. Angka tahan hidup penderita pascabedah dipengaruhi oleh berbagai faktor di antaranya stage, jenis histologis, usia, jenis pembedahan dan jenis kelamin serta penggunaan, terapi neoadjuvan I adjuvan. Angka tahan hidup secara sederhana dapat dihitung memakai metoda life table. Radiasi atau kemoterapi saja dapat memperbaiki kualiti hidup penderita tetapi tidak meningkatkan angka tahan hidup 5 tahun. Jenis histologis juga merupakan faktor yang berpengaruh terhadap angka tahan hidup penderita. Faktor lain yang berperan dalam prognosis KPKBSK adalah usia dan jenis kelamin dan jenis reseksi. Terapi neoadjuvan ditujukan bagi kasus stage IIIA yang akan dibedah. Multimodaliti ini meningkatkan angka tahan hidup secara bermakna.

Abstrak :
ABSTRAK
Latar 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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ABSTRACT
Introduction: 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.

Abstrak :
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.

Abstrak :
[ABSTRAK
Pendahuluan. Kanker paru jenis karsinoma bukan sel kecil (KPKBSK) terdiri dari nonskuamosa dan skuamosa. Kanker paru jenis karsinoma bukan sel kecil nonskuamosa adalah adenokarsinoma dan karsinoma sel besar. Saat ini terapi kanker paru sangat berkembang dari agen kemoterapi sampai terapi target terutama EGFR-TKI. Penelitian ini bertujuan untuk menilai angka tahan hidup pasien KPKSBK nonskuamosa yang mendapat kemoterapi lini pertama dibandingkan terapi EGFR-TKI di RSUP Persahabatan. Metode. Penelitian ini adalah penelitian retrospektif antara tahun 2010 sampai 2013 dari rekam medis pasien KPKBSK non skumosa yang mendapatkan kemoterapi lini pertama dan EGFR-TKI. Pasien dikemoterapi dengan platinum baseddan EGFR-TKI diterapi gefitinib 1x250 mg/hari atau erlotinib 1x150 mg/hari. Angka tahan hidup dinilai dari mulai tegak diagnosis sampai pasien meninggal atau saat penelitian dihentikan. Hasil. Dari 96 sampel KPKBSK non skuamosa terdiri dari 48 pasien yang mendapat kemoterapi lini pertama dan 48 pasien yang diterapi EGFR-TKI. Berdasarkan karakteristik pasien, usia terbanyak adalah 40-60 tahun (kemoterapi 32 (66,7%) dan EGFR-TKI 31 (64,6%) dengan jenis kelamin laki-laki yang mendominasi (kemoterapi 25(52,1%), EGFR-TKI 27 (56,2%). Pasien merokok yang mendapat kemoterapi lini pertama 41,7% dan EGFR-TKI 56,3% dengan IB terbanyak untuk kemoterapi (IB ringan 27,1%) dan untuk EGFR-TKI (IB sedang 22,9%). Jenis histologi adenokarsinoma 95,8% dengan dominasi stage IV 89,6% (kemoterapi 91,7% dan EGFR-TKI 87,5%) disertai tampilan status 2 59,4%. Angka tahan hidup pasien (ATH) 6 bulan 74%, ATH 1 tahun 22,90% dan ATH 2 tahun 6,20%. Masa tengah tahan hidup (MTTH) pasien yang mendapat EGFR-TKI lebih lama sedikit dibandingkan yang mendapat kemoterapi lini pertama (263 hari versus 260 hari. Kesimpulan. Masa tahan hidup 1 tahun pasien KPKBSK non skuamosa yang diterapi EGFR-TKI sedikit lebih lama dibandingkan kemoterapi lini pertama (263 hari vs 260 hari). Sedangkan ATH 1 tahun pasien kemoterapi lini pertama lebih besar dibandingkan EGFR-TKI (25% vs 20,8%). Faktor yang paling mempengaruhi angka tahan hidup adalah stage dengan nilai p<0,05.

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ABSTRACT
Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05., Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital. Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days). Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.]

Abstrak :
ABSTRAK
Pasien kanker paru stadium lanjut bergantung pada pasangannya terkait cepatnya penurunan fisik, beban gejala yang berat dan depresi yang dialami. Pasangan dari pasien seringkali tidak siap untuk menjalankan peran caregiver yang mempengaruhi kualitas perawatan dan dukungan yang diberikan. Tujuan penelitian ini adalah menggali pengalaman pasangan dari pasien kanker paru stadium lanjut berperan sebagai caregiver pasien yang sedang menjalani perawatan di rumah sakit. Metode penelitian menggunakan pendekatan studi fenomenologi. Pengumpulan data dilakukan dengan wawancara dan analisis data mengggunakan Metode Collaizi. Penelitian melibatkan sembilan partisipan yang termasuk kelompok rentan caregiver yakni wanita, pria dan usia lanjut. Hasil penelitian menemukan tiga tema: 1 perubahan peran dalam rumah tangga, 2 keikhlasan dalam merawat pasangannya yang sakit, dan 3 perubahan kedekatan dengan pasangan yang sakit. Kesimpulan penelitian ini adalah pasangan dari pasien kanker paru stadium lanjut yang berperan sebagai caregiver berperan penting dalam perawatan pasien sehingga perlu diintervensi untuk meningkatkan kesiapan dan proses adaptasi dalam menjalankan peran caregiver.

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ABSTRACT
Advanced lung cancer patients experienced rapid physical deteriorations, burdened and depression that contributed to high dependency to caregiver. Caregiver rsquo s role was frequently applied by spouse of patient with lack of experience that influenced quality of care and support given to patient. The aim of this study is to gain deep understanding about the experience of spouse having role as spousal caregiver of advanced lung cancer patients during treatment in hospital. Qualitative descriptive phenomenology approach was applied to nine participants which were chosen based on vulnerable group of caregivers female, male and elderly caregivers. Data collection was done using in depth interview. Collaizi rsquo s method was appllied in data analysis. The findings revealed three themes 1 changing roles in family, 2 acceptance of the roles as caregiver to ill spouse, and 3 changes in spousal closeness. The conclusion of this study is spousal caregivers have important role in treatment and need interventions to enable them performing and adjusting caregiver rsquo s role.

Abstrak :
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. ......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.

Abstrak :
ABSTRAK
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.ABSTRACT 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. ;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.