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Abstrak :
Latar Belakang: Karsinoma leher rahim (KLR) menduduki urutan pertama di antara semua penyakit kanker terbanyak di Indonesia. KLR menjadi penyebab mortalitas terbanyak akibat kanker pada wanita. Kemoradioterapi dalam pengobatan kanker, mempunyai efek samping yang bermakna. Penatalaksanaan yang efektif untuk kanker termasuk bertambahnya perhatian pada faktor psikologis dengan penilaian depresi yang tepat, dapat meningkatkan angka kesembuhan dan harapan hidup. Obyektif: Tujuan penelitian untuk mengetahui pengaruh kemoradioterapi terhadap peningkatan frekuensi dan derajat gangguan depresi pada pasien KLR yang menjalani kemoradioterapi, serta faktor-faktor yang berhubungan dengan terjadinya gangguan depresi. Penelitian dilaksanakan di RS Dr. Ciptomangunkusumo, antara bulan Desember 2005 - Juli 2006. Metode: Penelitian merupakan studi the one group pretest-posttest design. Pengambilan sampel dilakukan secara consecutive sampling. Instrumen yang digunakan SCID-1 (Structured Clinical Interview for DSM--IV Axis 1 disorders) versi bahasa Indonesia dan Hamilton Rating Scale for Depression (HRS-D). Analisis data statistik menggunakan program SPSS versi 11,5. Hasil: Derajat depresi dari rerata HRS-D 18,68 sebelum kemoradioterapi, meningkat menjadi rerata HRS-D 22,69 sesudah kemoradioterapi. Subyek yang bekerja mempunyai peluang menderita depresi 0,17 kali dibandingkan yang tidak bekerja pada saat sebelum kemoradioterapi. Gangguan depresi sebelum kemoradioterapi ditemukan pada 26 subyek (65%). Sesudah kemoradioterapi, subyek yang menderita gangguan depresi ada 26 subyek terdiri dari 19 subyek yang sebelumnya depresi dan 7 orang yang sebelumnya tidak depresi sedangkan 7 orang yang sebelumnya depresi menjadi tidak ditemukan depresi lagi. Simpulan: Berdasarkan hasil penelitian ini didapatkan peningkatan derajat gangguan depresi pada pasien karsinoma leher rahim yang sebelum kemoradioterapi telah menderita gangguan depresi. Hal menarik yang didapatkan dalam penelitian ini adalah ditemukannya 7 subyek yang menjadi tidak depresi setelah dilakukan kemoradioterapi. Penelitian lebih lanjut diperlukan untuk mengetahui respons tubuh subyek terhadap kemoradioterapi yang telah dilakukan. Diperlukan penelitian tentang dampak psikologis untuk pasien yang menjalani kemoradioterapi. Sampel yang lebih bervariasi dalam pendidikan dan penghasilan perlu dipertimbangkan.

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Background: Cervical cancer is the most common cancer in Indonesia. Cervical cancer is the most frequent cause of cancer mortality in women. Chemo radiotherapy of cancer treatment has significant adverse effect. Effective cancer management, including enhanced attention on psychological factors through appropriate evaluation of depression, may increase patients' cure and survival rate. Objectives: The objectives of this study are to know the effect of chemo radiotherapy on Increased depression frequency and severity in patients with cervical cancer who have been treated by chemo radiotherapy, and factors related to depression disorder. This study was conducted at Cipto Mangunkusumo Hospital in the period of December 2005 - July 2006. Methods: This study used one group pretest posttest design. The samples were taken by consecutive sampling. Instrument utilized was SCID-1 (Structured Clinical Interview for DSM 1V Axis 1 disorders) in Indonesian language version and Hamilton Rating Scale for Depression (HRS-D). Analysis of statistic data was using SPSS program version 11.5. Results: Depression severity of HRS-D mean value was 18.68 before chemo radiotherapy, increased to HAS-D 22.69 after chemo radiotherapy. The working subjects have 0.17 times possibility to have depression compared to the non-working subjects before chemo radiotherapy period. Depression disorders before chemo radiotherapy were found in 26 subjects (65%). After chemo radiotherapy, there were 26 subjects with depression disorder, i.e. 19 subjects who had previous depression, and 7 subjects without any previous depression. There were 7 subjects who had previous depression and turned to have no depression anymore. Conclusions: Based on the result of this study, there is increased depression severity in patients with cervical cancer who already had depression disorder before chemo radiotherapy. It is interesting that in this study, there is 7 subjects who have not carried out depression after their chemo radiotherapy treatment. We need further study to recognize the subject's response to chemo radiotherapy and further study on psychological impact in patients who undertake chemo radiotherapy. Further sample with more variation in education and income should be considered.

Abstrak :
Tujuan penelitian adalah diketahuinya pengaruh pemberian suplementasi makanan cair 500 kalori per hari berturut-turut dari awal radiasi sampai radiasi ke 20 terhadap kadar albumin serum dan berat badan pasien kanker nasofaring yang menjalani kemoradioterapi. Penelitian ini merupakan uji klinis paralel, membandingkan kelompok yang mendapat suplementasi makanan cair disertai penyuluhan gizi dan diet sehari-hari (P) dengan kelompok yang hanya mendapat penyuluhan gizi dan diet sehari-hari saja (K). Sebanyak 18 pasien kanker nasofaring yang menjalani kemoradioterapi yang memenuhi kriteria dibagi dalam dua kelompok secara randomisasi blok. Data yang diambil meliputi usia, jenis kelamin, indeks massa tubuh, stadium penyakit, asupan energi dan protein dengan food recall 1 x 24 jam Serta kebutuhan energi dan protein dengan rumus Harris- Benedict. Pemeriksaan kadar albumin semm Serta berat badan dilalcukan pada awal dan akhir perlakuan. Analisis data menggunakan uji t tidak berpasangan dan berpasangan Serta uji Mann Whitney dengan batas kemaknaan 5%. Diperoleh 8 orang di kelompok P dan 8 orang di kelompok K dengan usia 18-59 tahun yang mengikuti penelitian secara lengkap. Tidak ada perbedaan data awal yang bermakna antara kelompok P dan kelompok K. Pcnurunan ltadar albumin serum pada kelompok P Iebih rendah daripada kelompok K. Diperoleh rerata persentase penurunan berat badan pada kelompok P yang kurang 2,24 % dari kelompok K, namun secara statistik tidak bermakna. Pemberian suplementasi makanan cair 500 kalori per hari berturut-turut dari awal radiasi sampai radiasi ke 20 tidak dapat mempertahankan kadar albumin serum dan mengurangi rerata persentase penurunan berat badan pada kelompok perlakuan. ......The aims of this study were to investigate the influence of 500 calorie per day liquid food supplementation from the first day of chemoradiotherapy until twenty times radiation therapy on serum albumin level and body weight in nasopharynx cancer patients undergoing chemoradiotherapy. The study was a parallel randomized clinical trial.` Eighteen subjects of nasopharynx cancer patients treated with a targeted chemoradiotherapy were selected using certain criteria. The randomly (block randomization) eighteen subject were divided into two group. The treatment group received 500 calorie per day liquid food supplementation from the first day of treatment until twenty times radiation therapy, nutrition counseling and daily diet; the control group received nutrition counseling and daily diet alone. This study was conducted at Dr. Cipto Mangunkusumo Hospital Department of Radiotherapy. Data collected included age, gender, body weight and tall, body mass index, intake of energy and protein, and using l x 24 hours food recall. Laboratory 'findings (serum albumin levels) were done before and after intervention. For statistical analysis, impaired t-test, paired t-test and Mann Whitney were used with the level of significance was 5%. Eight subjects in the treatment group and Eight subjects in the control group completed the study and analyzed. The characteristic data of the two groups at baseline were not significantly different, therefore they were closely matched at baseline. There were decrease of serum albumin in both group, but it was lower in the treatment group than the control group, although it is not statistically significant (p>0,05). There were a 23,24 % relative reduction in weight loss in the treatment group but it is not statistically significant. In conclusions, the influence of 500 calorie per day liquid -food supplementation from the first day of chemo radiotherapy until twenty times radiation' did not preserve serum albumin level and were not reduction in weight loss in the treatment group.