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Abstrak :
Tujuan: Menilai kesintasan pasien Glioblastoma Multiform (GBM) di RSCM dan mengidentifikasi faktor-faktor yang dapat mempengaruhi kesintasan pasien dengan GBM. Metode: dilakukan studi retrospektif pada 55 pasien GBM yang terdiagnosa secara histopatologis dan menjalani radiasi/kemoradiasi di RSCM pada Januari 2015-Desember 2019. Hasil: Mayoritas pasien adalah laki-laki dengan rasio 1,3:1 dibandingkan perempuan, rerata usia 45 tahun. Lokasi tumor tersering di lobus frontal (31,5%), lobus pariteal (26,3%) dan lobus temporal (24,2%). Median ekstensi reseksi tumor (EOR) 77% dan median volume residu tumor 50cm3. Median interval operasi-radiasi 42 hari dengan median total dosis radiasi 60 Gy. 69,1% telah mendapatkan terapi sesuai dengan panduan penatalaksanaan kanker (PPK). Median kesintasan hidup keseluruhan (OS) 13 bulan dan median kesintasan bebas progresifitas (PFS) 9 bulan. Median OS pasien dengan RTOG RPA kelas III, kelas IV dan kelas V-VI adalah 18 bulan, 13 bulan dan 6,7 bulan (p<0,001). Faktor yang memperburuk OS adalah usia ≥50 tahun (p=0,02), KPS<70 (p<0,001), volume residu tumor >20,4cm3 (p=0,001), interval waktu operasi-radiasi <4minggu (p=0,01) dan letak tumor di lobus parietal (p=0,02) pada uji univariat. Faktor yang memperburuk PFS adalah KPS <70 (p=0,001), volume residu tumor>20,4cm3 (p=0,02), terapi yang tidak sesuai PPK (p=0,004) dan letak tumor di lobus parietal (p=0,03). KPS merupakan faktor independen yang mempengaruhi OS dan PFS pada uji multivariat. Kesimpulan: KPS merupakan faktor prognostik independen yang mempengaruhi kesintasan pasien GBM. ......Aims: This study was done to assess the survival of patients with glioblastoma multiform in RSCM and to identify factors that can affect patient survival. Materials and methods: From January 2015 to December 2019, 55 patients with histopathologically confirmed glioblastoma multiform and received adjuvant radiation/chemoradiation in our department were retrospectively analyzed. Results: Most of the patiens in this study were men 1,3 times compared to women. Mean ages was 45 years old. The most common tumors site was frontal lobe (31,5%) followed by parietal lobe (26,3%) and temporal lobe (24,2%). Median extend of resection (EOR) was 77% with median residual tumor volume was 50cm3. Most of the patients (69,1%) already treated according to practice guidelines. The median total radiation dose was 60Gy. Median time to initiate adjuvant radiotherapy was 42 days. Median overall survival (OS) was 13 months and median progression free survival (PFS) was 9 months. Median OS in patients with RTOG RPA class III, class IV and class V-VI were 18 months, 13 months and 6,7 months respectively (p<0,001). Age≥50 (p=0,02), KPS<70 (p<0,0001), residual tumor volume >20,4cm3 (p=0,001), time to initiate adjuvant radiotherapy <4 weeks (p=0,01) and parietal lobes tumor site (p=0,02) were significantly associated with unfavorable OS in univariate analysis. KPS<70 (p=0,001), residual tumor volume >20,4cm3 (p=0,02), treatment that not in accordance with practice guidelines (p=0,004) and parietal lobes tumor site (p=0,03) associated with unfavorable PFS in univariate analysis. KPS was found to be the only independent factor that affected OS and PFS in multivariate analysis. Conclusions: The only factor that independently affected OS and PFS was KPS.

Abstrak :
Tujuan: Penelitian ini bertujuan untuk mengetahui distribusi dan karakteristik kejadian COVID-19 pada pasien dan tenaga kesehatan/pekerja di IPTOR RSUPN dr. Cipto Mangunkusumo dan juga dampak COVID-19 terhadap luaran terapi berdasarkan kriteria RECIST dan toksisitas radiasi berdasarkan kriteria RTOG pada pasien kanker serviks yang menjalani radioterapi di IPTOR RSUPN dr. Cipto Mangunkusumo. Metode: Studi eksploratif retrospektif dari 835 pasien kanker serviks yang terdaftar di IPTOR RSUPN dr. Cipto Mangunkusumo, dari Juli 2020 hingga Maret 2022. Melalui analisis kriteria inklusi dan eksklusi, didapatkan sampel 506 pasien yang terdiri dari 77 pasien terkonfirmasi COVID-19 dan 429 pasien yang tidak terpapar COVID-19, serta data insidensi terkonfirmasi COVID-19 dari seluruh pasien kanker, insiden COVID-19 di poliklinik serta insiden terkonfirmasi COVID-19 tenaga kesehatan dan pekerja di IPTOR RSUPN dr. Cipto Mangunkusumo. Hasil: Diketahuinya gambaran infeksi COVID-19 pada pasien dan tenaga kesehatan serta pekerja di RSUPN dr. Cipto Mangunkusumo. Juga, telah dilakukan penilaian luaran terapi berdasakran kriteria RECIST terhadap pasien kanker serviks terkonfirmasi COVID-19 maupun yang tidak terkonfirmasi COVID-19 pada 2 minggu serta ≥ 3 bulan pasca radiasi. Ditemukan bahwa status COVID-19 pada pasien kanker serviks tidak berpengaruh signifikan (p>0,05) terhadap luaran terapi 2 minggu setelah radiasi, namun meningkatkan peluang CR sebesar 1,120 OR (95% CI: 0,645-1,943). Lebih lanjut, pada luaran ≥ 3 bulan pasca radiasi, status COVID-19 berpengaruh signifikan (p<0,05) dan meningkatkan peluang CR sebesar 1,157 OR (95% CI: 1,09-1,223) Sementara itu, juga telah dilakukan penilaian antara toksisitas radiasi terhadap pasien kanker serviks terkonfirmasi COVID-19 maupun yang tidak COVID-19, di mana ditemukan bahwa status COVID-19 tidak berpengatuh signifikan (p>0,05) terhadap toksisitas radiasi, namun status COVID-19 positif ditemukan dapat meningkatkan peluang terjadinya toksisitas radiasi sebesar 1,348 (0,78-2,30) OR (95% CI). Kesimpulan: Berdasarkan pengumpulan dan analisis data dari penelitian ini, ditemukan bahwa infeksi COVID-19 memiliki pengaruh untuk tercapainya luaran terapi yang lebih baik pada pasien kanker serviks yang mendapatkan radioterapi. ......Objective: This study aims to determine the distribution and characteristics of COVID-19 incident in patients and clinicians/workers at IPTOR RSUPN dr. Cipto Mangunkusumo. Also, this study aims to investigate the impact of COVID-19 on radiotherapy outcome based on RECIST criteria and radiation toxicity based on RTOG criteria in cervical cancer patients undergoing radiotherapy at IPTOR RSUPN dr. Cipto Mangunkusumo. Method: An exploratory retrospective study of 835 cervical cancer patients registered at IPTOR RSCM, from July 2020 to March 2022. Through analysis of inclusion and exclusion criteria, a sample of 506 patients was obtained, consisting of 77 COVID-19 confirmed patients and 429 non-exposed COVID-19 patients, as well as data on the incidence of COVID-19 confirmed cases among cervical cancer patients, outpatients, and healthcare workers and staff at IPTOR RSCM. Results: This study showed an overview of COVID-19 infections in all patients and hospital staffs from Departement of Radiation Oncology Cipto Mangunkusumo Hospital. Also, in this study we assess the radiotherapy outcome according to RECIST criteria for cervical cancer patients with COVID-19 and those who were not confirmed with COVID-19 at 2 weeks and ≥ 3 months after radiation. We found that COVID-19 in patients with cervical cancer had no significant impact (p>0.05) on therapy outcomes 2 weeks after radiation, but it increased the chance of CR by 1.120 OR (95% CI: 0.645-1.943). For RECIST ≥ 3 months post-radiation, COVID-19 status had a significant impact (p<0.05) and increased the chance of CR by 1.157 OR (95% CI: 1.09-1.223). Meanwhile, an assessment was also carried regarding radiation toxicity in cervical cancer patients confirmed with COVID-19 and those without COVID-19, and it was found that COVID-19 status did not have a statistically significant impact (p>0.05) on RTOG toxicity but positive COVID-19 status increased the chance of radiation-related toxicity by 1.348 (0.78-2.30) OR (95% CI). Conclusion: Based on the data from this study, COVID-19 infection has an impact on the outcomes of cervical cancer patients who receive radiation therapy.