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"ABSTRACTLung cancer is a devastating disease with a high incidence, mortality and morbidity rate, especially in developing countries. Conventional treatment with cytotoxic chemotherapy has some limitations attributed to chemoresistance and toxicity. Recent advances have shown that first generation Tyrosine Kinase Inhibitor (TKI), Gefitinib and Erlotinib, and the newest available second generation Tyrosine Kinase Inhibitor (TKI), Afatinib, have the potential to be an option in the management of patients with epidermal growth factor receptor/ EGFR mutation positive advanced/ metastatic non-small cell lung cancer. Afatinib works by binding to EGFR irreversibly, thus inactivating the tyrosine kinase receptor. Some studies demostrated that Afatinib first-line may result in longer progression free survival (PFS) and better disease control, and as an alternative for patients who intolerance to Gefitinib or Erlotinib. In Indonesia, the era of National Health Insurance has been implemented and National Health Insurance has covered treatment for cancer, including first generation TKIs, Gefitinib dan erlotinib, for patients with EGFR mutation positive advanced/ metastatic non-small cell lung cancer at Cipto Mangunkusumo National Hospital. Afatinib, as one of the newest available second generation TKI, may be given free of charge too as an alternative if the National Health Insurance will be covered in the future. Further research is needed to know the efficacy and adverse effects that may occur in patients from developing countries."

"ABSTRACTStage I non-small cell lung cancer (NSCLC) is a localized disease without metastasis; therefore, it can be treated effectively with local therapies. Pulmonary resection is the most frequent treatment, performed as pulmonary wedge resection, segmentectomy, lobectomy, or pneumonectomy. Some retrospective clinical studies of pulmonary wedge resection suggest that its outcome may be inferior to that of anatomical pulmonary resection, whereas other recent studies, which assess surgical margin status, leveled acceptable outcomes. Since the outcome of pulmonary wedge resection for lung cancer may depend on tumor size, distance from the surgical margin to the tumor, tumor size/margin distance ratio, and margin cytology results, a prospective study assessing these parameters is ongoing. This will allow us to identify the clinical implications of these factors and predict which patients are likely to have a good outcome."

"Latar Belakang: Cytomegalovirus (CMV) adalah virus yang dapat menginfeksi manusia dengan prevalens di populasi yang tinggi. Bukti terbaru menunjukkan bahwa CMV terkait dengan berbagai jenis kanker, termasuk kanker paru. Penelitian ini bertujuan untuk mengetahui kaitan antara CMV dengan kanker paru karsinoma bukan sel kecil (KPKBSK). Data dari penelitian ini diharapkan dapat berguna untuk penelitian lebih lanjut mengenai kaitan antara CMV dan kanker paru di masa depan. Metode: Penelitian ini adalah suatu penelitian observasional dengan metode potong lintang untuk mengetahui proporsi DNA cytomegalovirus pada sampel jaringan KPKBSK. Sampel jaringan merupakan sampel formalin-fixed paraffin-embedded (FFPE) yang diambil disimpan di RSUP Persahabatan pada 2017-2023. Deteksi DNA CMV dilakukan menggunakan polymerase chain reaction (PCR) dan elektroforesis. Data penyerta diambil dari rekam medis. Hasil: Sebanyak 87 sampel jaringan dari 87 subjek penelitian yang berbeda diikutkan dalam penelitian ini. Sebagian besar subjek penelitian adalah laki-laki perokok, memiliki indeks Brinkman berat dengan rerata usia 59,1 tahun. Proporsi DNA CMV yang terdeteksi pada sampel FFPE adalah 21%. Proporsi DNA CMV lebih tinggi pada sampel jaringan dengan mutasi EGFR positif meskipun tidak bermakna secara statistik (OR 2,63 (IK 95% 0,45 – 15,16)). Proporsi DNA CMV tidak berhubungan dengan status merokok, indeks Brinkman, metode pengambilan sampel jaringan, dan jenis KPKBSK. Proporsi DNA CMV lebih tinggi pada sampel jaringan dengan tanggal pengambilan yang lebih baru. Kesimpulan: Asam deoksiribonukleat CMV dapat ditemukan pada sampel FFPE KPKBSK dengan proporsi 21%. Proporsi DNA CMV lebih tinggi pada KPKBSK dengan mutasi EGFR.

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Background: Cytomegalovirus (CMV) is a virus with high seroprevalence in general population. Recent evidence shows that CMV is linked to various types of cancer, including lung cancer. This study aims to determine the relationship between CMV and non-small cell lung carcinoma (NSCLC). We hoped that the data from this study will be useful for further research in elucidating the link between CMV and lung cancer. Method: This research is an observational study using a cross-sectional method to determine the proportion of CMV DNA in NSCLC tissue samples. Tissue samples are formalin-fixed paraffin-embedded (FFPE) samples taken and stored at Persahabatan Hospital on 2017-2023. The detection of CMV was carried out using polymerase chain reaction (PCR) and electrophoresis. Accompanying data was taken from medical records. Results: A total of 87 tissue samples from 87 different research subjects were included in this study. Most of the research subjects were male smokers, had a heavy Brinkman index with an average age of 59.1 years. The proportion of CMV DNA detected in FFPE samples was 21%. The proportion of CMV DNA was higher in tissue samples with positive EGFR mutations although not statistically significant (OR 2.63 (95% CI 0.45 – 15.16)). The proportion of CMV DNA was not related to smoking status, Brinkman index, tissue sampling method, and NSCLC subtype. The proportion of CMV DNA was higher in tissue samples with more recent collection dates. Conclusion:Cytomegalovirus DNA were detected in NSCLC FFPE samples with a proportion of 21%. The proportion of CMV DNA was higher in NSCLC with EGFR mutations."

"ABSTRAKKanker Paru Karsinoma Bukan Sel Kecil KPKBSK memiliki prevalensi yang terus meningkat dibandingkan dengan Kanker Paru Karsinoma Sel Kecil KPKSK . Klien dengan KPKBSK kebanyakan memiliki tingkat kecemasan sedang sampai berat dan penurunan pada kualitas hidup. Penelitian ini bertujuan untuk melihat hubungan antara tingkat kecemasan dengan kualitas hidup pada klien KPKBSK. Penelitian ini menggunakan metode dan desain deskriptif korelatif pada 103 klien KPKBSK di RSUP Persahabatan Jakarta timur. Pengambilan sampel menggunakan metode consecutive sampling. Tingkat kecemasan di ukur dengan menggunakan instrument Zung self rating anxiety scale dan kualitas hidup di ukur dengan menggunakan instrumen EORTC QLQ C-30 Versi 3.0. Hasil analisis menunjukan bahwa terdapat hubungan antara tingkat kecemasan dengan kualitas hidup pada klien KPKBSK di RSUP Persahabatan Jakarta timur p value < 0.05. Rekomendasi dari penelitian ini adalah diperlukan pelayanan kesehatan jiwa yang terintegrasi dalam pelayanan keperawatan pada klien KPKBSK yang mengalami masalah psikososial khusunya kecemasan, dengan memberikan pendidikan kesehatan dan konseling mengontrol kecemasan.

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ABSTRACTLung cancer type Non Small Cell Lung Cancer NSCLC has an significant incidence rate compared with Small Cell Lung Cancer SCLC. Clients with NSCLC have a moderate to severe anxiety levels and decreased Quality of life. This is study aims to analyses the relationship between anxiety level with quality of life in NSCLC rsquo S clients. This study used correlative descriptive method and design on 103 NSCLC clients in Persahabatan Hospital East Jakarta. Samples recruited using consecutive sampling. The levels of anxiety was measured with zung self rating anxiety scale and the quality of life was measured using EORTC QLQ C 30 Versi 3.0. The result of this study shows that there is relationship between anxiety levels with quality of life on NSCLCs clients in Persahabatan Hospital p value 0,05 . The recommendation of this study is, NSCLC clients need an integrated mental health services, especially to clients who have a psychosocial problems such as anxiety, by giving health education and counseling to control anxiety."

"Latar Belakang: Jumlah kasus KPKBSK diperkirakan 85% dari seluruh kasus kanker paru dan 40% diantaranya adalah jenis adenokarsinoma. Sebanyak 10%-30% pasien adenokarsinoma mengalami mutasi EGFR dan mendapatkan terapi EGFR-TKI. Mayoritas pasien KPKBSK memiliki respons dan toleransi baik terhadap terapi EGFR- TKI tetapi sebagian kecil pasien mengalami penyakit paru interstisial akibat EGFR- TKI. Penelitian ini bertujuan untuk mengetahui proporsi gambaran penyakit paru interstisial pada pasien KPKBSK dengan terapi EGFR-TKI di RSUP Persahabatan.Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendeketan kohort retrospektif yang dilakukan bulan Januari 2021 hingga Juni 2022. Subjek penelitian adalah pasien KPKBSK yang mendapatkan terapi EGFR-TKI. Subjek penelitian dipilih sesuai kriteria inklusi dan eksklusi. Pengambilan data melalu data sekunder berupa rekam medis dan hasil CT scan toraks pasien yang kontrol di poliklinik onkologi RSUP Persahabatan.Hasil: Pada penelitian ini diperoleh 73 subjek penelitian, pasien KPKBSK dengan mutasi EGFR yang mendapatkan terapi EGFR-TKI di RSUP Persahabatan. Sebanyak 12 dari 73 subjek penelitian mengalami gambaran ILD yang dievaluasi berdasarkan CT scan toraks RECIST I dan II dengan karakteristik jenis kelamin laki-laki (22,2%), kelompok usia 40-59 tahun (19,4%), perokok (24,1%), indeks brinkman berat (42,9%) dan mendapatkan terapi afatinib (26,1%). Proporsi gambaran ILD pada pasien KBPKBSK dengan terapi EGFR-TKI adalah opasitas retikular (58,3%), parenchymal band (33,3%), ground-glass opacities (25%), traction bronchiectasis (25%) dan crazy paving pattern (8,3%). Hasil analisis bivariat dan multivariat menunjukkan tidak terdapat perbedaan antara faktor-faktor seperti jenis kelamin, usia, jenis EGFR-TKI, riwayat merokok, indeks brinkman, riwayat penyakit paru dan tampilan status terhadap gambaran ILD.Kesimpulan: Gambaran ILD pada pasien KPKBSK dengan terapi EGFR-TKI meliputi opasitas retikular, parenchymal band, ground-glass opacities, traction bronchiectasis dan crazy paving pattern. Tidak terdapat perbedaan bermakna secara statistik antara faktor-faktor yang memengaruhi terhadap gambaran ILD.

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Background: The number of cases of NSCLC is estimated around 85% of all lung cancer cases and 40% among them are adenocarcinoma. Approximately 10%-30% of adenocarcinoma patients have EGFR mutations and receive EGFR-TKI therapy. The majority of NSCLC patients have a good response and tolerance to EGFR-TKI therapy, but a small group of patients experience EGFR-TKI induced interstitial lung disease. This study aims to determine the proportion of features of interstitial lung disease ini NSCLC patients treated with EGFR-TKI at Persahabatan Hospital.

Methods: This study was an analytic observational with a retrospective cohort approach that was conducted from January 2021 until June 2022. The subject were NSCLC patients who received EGFR-TKI treatment. The inclusion and exclusion criteria were used to determine which subjects will be included in the study. Data collection through secondary data from medical record and chest CT scan results of patients controlled at oncology polyclinic at Persahabatan Hospital.

Result : In this study, there were 73 subjects of NSCLC with EGFR mutations and received EGFR-TKI therapy at Persahabatan Hospital. There were 12 out of 73 subjects had ILD features which were evaluated based on RECIST I and II chest CT scan with predominant of male (22.2%), age group 40-59 years old (19.4%), smokers (24.1%), severe Brinkman index (42.9%) and received afatinib (26.1%). The proportion of ILD features in NSCLC patients with EGFR-TKI therapy are reticular opacities (58.3%), parenchymal bands (33.3%), ground-glass opacities (25%), traction bronchiectasis (25%) and crazy paving pattern (8.3%). The results of bivariate and multivariate analyzes showed that there was no differences between factors such as sex, age, type of GEFR-TKI, smoking history, Brinkman index, history of lung disease and performance status with features of ILD.

Conclusion: Features of ILD in NSCLC patients with EGFR-TKI therapy include reticular opacities, parenchymal bands, ground-glass opacities, traction bronchiectasis and crazy paving pattern. There is no statistically significa"