Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Pasien kanker serviks di Indonesia 70 % datang pada stadium lanjut, 45,2% dengan stadium IIIB dan radiasi menjadi terapi utama. Radioresistensi menjadi masalah utama saat ini, namun radiosensitizer yang tersedia memiliki efek toksisitas tinggi. Curcumin sebagai fitofarmaka bisa menjadi alternatif radiosensitizer dengan cara menekan aktivitas enzim antioksidan thioredoxin reductase-1 dan memicu terjadinya proses apoptosis. Tujuan: Menilai efikasi Biocurcumin dalam menekan aktifitas thioredoxin reductase-1 dan pengaruhnya terhadap indeks apoptosis Metode: Penelitian payung uji klinis ini dilakukan di Divisi Ginekologi Onkologi Departemen OBGYN FKUI serta Departemen Biokimia FKUI. Dilakukan penelusuran archived data jaringan dari penelitian uji klinis utama. Pemeriksaan aktifitas thioredoxin reductase-1 pre dan pasca radiasi dilakukan pada 18 sampel yang diberi terapi radiasi dan BCM-95 serta 19 sampel dengan radiasi dan plasebo. Metode McCord dan Fridovich dipakai menggunakan kit human TrxR1(Thioredoxin Reductase-1) Elabscience. Dilakukan analisis perbedaaan kadar thioredoxin reductase-1 sebelum dan sesudah radiasi serta hubungan antara perubahan kadar thioredoxin reductase-1 dengan indeks apoptosis pada kedua kelompok. Hasil: Terdapat perbedaan bermakna perubahan rerata kadar thioreduxin reductase-1 pada kelompok yang mendapat terapi radiasi dan Biocurcumin dibandingkan kelompok yang mendapat terapi radiasi dan plasebo, nilai p = 0,02 (p < 0,05). Namun, tidak terdapat hubungan yang bermakna antara perubahan rerata Indeks Apoptosis pada kedua kelompok (nilai p>0,05). Selain itu juga tidak ada perbedaan nilai median pada perubahan kadar thioredoxin reductase-1 maupun perbedaan nilai rerata pada perubahan Indeks Apoptosis sebelum dan sesudah radiasi diantara keduanya (p > 0,05). Kesimpulan: BCM-95 efektif menurunkan rerata kadar thioredoxin reductase-1, namun tidak terdapat perbedaan indeks apoptosis pada kedua kelompok.

---

Background: Cervical cancer patients in Indonesia 70% come at an advanced stage, 45.2% with stage IIIB and radiation being the main therapy. Radioresistence is a major problem nowadays, but available radiosensitizers have a high toxicity effect. Curcumin as phytopharmaceuticals can be an alternative radiosensitizer by suppressing the activity of antioxidant enzyme thioredoxin reductase-1 and triggering the occurrence of apoptosis process. Objective: Assessing the efficacy of Biocurcumin in suppressing thioredoxin reductase-1 activity and its effect on apoptosis index Method: This clinical trial umbrella research was conducted in the Division of Oncology Gynaecology, OBGYN Department FMUI as well as the Department of Biochemistry FMUI. Archived network data from major clinical trial research. Examination of thioredoxin reductase-1 pre and post radiation activity was conducted on 18 samples given radiation therapy and BCM-95 and 19 samples with radiation and placebo. The McCord and Fridovich methods were used using the Human TrxR1(Thioredoxin Reductase-1) Elabscience kit. An analysis of the difference in thioredoxin reductase-1 levels before and after radiation and the relationship between changes in thioredoxin reductase-1 levels and apoptosis index in both groups. Results: There was a meaningful difference in the average level of thioreduxin reductase-1 in the group that received radiation therapy and Biocurcumin compared to the group that received radiation therapy and placebo, the value p = 0.02 (p < 0.05). However, there is no meaningful relationship between the changes in the average of Apoptosis Index in both groups (p>0.05). In addition, there was no difference in the median value in the change in thioredoxin reductase-1 levels or the difference in average value in the changes in the Apoptosis Index before and after radiation between the two (p > 0.05). Conclusion: BCM-95 effectively lowered average levels of thioredoxin reduxtase-1, but there was no difference in apoptosis index in both groups."

"Latar Belakang : Pasien kanker serviks di Indonesia terbanyak dalam stadium lanjut. Terapi standarnya adalah radiasi. Respons terapi radiasi tidak selalu komplet. MnSOD merupakan garda terdepan melawan radikal bebas yang dihasilkan radiasi. Aktifitas MnSOD dipikirkan dapat digunakan sebagai prediktor respons terapi radiasi. Diperkirakan semakin tinggi aktifitas MnSOD akan semakin buruk respons radiasinya. Tujuan : Menilai aktifitas MnSOD pada biopsi KSS serviks stadium IIIB sebagai prediktor keberhasilan terapi radiasi. Metode : Penelitian potong lintang komparatif ini dilakukan di Divisi Onkologi Ginekologi, Departemen Obstetri dan Ginekologi FKUI, RSCM Jakarta dan Departemen Biokimia dan Biologi Molekuler FKUI. Dilakukan penelusuran data base penelitian sebelumnya untuk mengindentifikasi sampel respons positif dan negatif, dilanjutkan pemeriksaan aktifitas MnSOD dengan sprektrofotometri metode McCord dan Fridovich menggunakan kit RanSOD . Data komparatif yang didapat kemudian di analisis. Hasil : Didapatkan 76 sampel yang memenuhi kriteria inklusi terdiri dari respons positif 47 61,8 negatif 29 38,2 . Dilakukan kategorisasi aktifitas MnSOD dengan titik potong pada nilai 13,126 U/mL. Dengan uji chi-square didapat hubungan bermakna secara statistik antara aktifitas MnSOD pada pasien kanker stadium IIIB dengan respons terapi radiasi. Nilai RR sebesar 1,849 1.075-3.178, IK 95 . Kesintasan dengan analisis bivariat memakai metode Kaplan-Meier: pasien dengan aktifitas MnSOD cutoff < 13,126 U/mL memiliki tingkat kesintasan 1 tahun yang lebih baik 63 dibandingkan dengan pasien kanker serviks IIIB dengan nilai aktifitas MnSOD ge; 14 . Risiko kematian dengan pengujian bivariat metode regresi cox: pasien dengan aktifitas MnSOD cutoff 13,126 U/mL memiliki risiko kematian 1,055 kali IK 95 : 1,003-1,110 dibanding pasien dengan aktifitas MnSOD dibawah nilai cutoff. Dari analisis multivariat terlihat aktifitas MnSOD semakin kuat sebagai prediktor respons terapi radiasi. Kesimpulan : Aktifitas MnSOD tinggi pada jaringan KSS serviks stadium IIIB menghasilkan respons negatif dari terapi radiasi.

---

Background: Most of the cervical cancer patients in Indonesia came with advanced stage. Therefore, the choice of treatment is radiotherapy. Although, radiotherapy does not always result in complete response. MnSOD is considered to be one the antioxidant enzyme which has the ability to work against free radicals. Its activity is expected to be acted as response predictor to radiotherapy treatment. It is hypothesized that high MNSOD activity tend to predict poor response of radiotherapy on advanced cervical cancer patients.

Objective : To investigate MnSOD activity on cervical SCC stage IIIB as a predictor of radiotherapy response.

Methods : It is a comparative cross sectional study conducted in the Gynecology Oncology Division, Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo Hospital Faculty of Medicine, University of Indonesia. Samples were collected from the tissue bank and research database. They were identified and divided into having positive or negative response to radiotherapy. In vitro experiment was conducted to measure the activity of MnSOD. Manganese superoxide dismutase was isolated using McCord and Fridovich method using RanSOD and the activity was analyzed using spectrophotometry. Data was then analyzed using SPSS.20 for comparative study.

Results : Seventy six samples were included in the study 47 61.8 with positive response and 29 38.2 with negative response on radiotherapy. Samples were then divided into having MnSOD activity of 13.126 U mL or 13.126 U mL. Univariate analysis chi square showed that there was statistically significant correlation between MnSOD activity and radiotherapy response in patients with cervical SCC stage IIIB RR 1.849 95 CI 1.075 3.178 . Survival analysis on the first year showed that patients with MnSOD activity 13.126 U mL had better survival than patients with MnSOD activity 13.126 U mL 63 vs 14 , Kaplan Meier study . Hazard ratio for overall survival was 1.055 95 CI 1.003 ndash 1.110 for patients with MnSOD activity of 13.126 U mL. Multivariate analysis showed that MnSOD activity was a strong predictor of radiotherapy response in this study.

Conclusion : This in vitro study showed that high activity of MnSOD was associated with poor response of radiotherapy for patients with cervical squamous carcinoma stage IIIB. "

"Latar belakang : Kanker serviks merupakan penyebab ketiga kematian dan morbiditas tertinggi pada wanita di seluruh dunia. Morbiditas dan mortalitas pasien dengan kanker serviks meningkat seiring dengan peningkatan usia dan stadium klinis. Metastasis menuju kelenjar getah bening (KGB) paraaorta merupakan salah satu bentuk metastasis pada kanker serviks stadium lanjut. Tujuan : Mengetahui adakah perbedaan respon klinis pasca radioterapi dan kesintasan 1 tahun pada pasien kanker serviks stadium lanjut dengan pembesaran KGB paraaorta dibandingkan pasien tanpa pembesaran KGB paraaorta.Metode : Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode kohort retrospektif. Pengambilan sampel dilakukan dengan cara conse cutive sampling. Subyek penelitian ini adalah semua wanita dengan diagnosis primer kanker serviks stadium IIB hingga IVB yang datang ke poliklinik Onkologi Ginekologi RSUPN dr. Cipto Mangunkusumo dan menjalani pemeriksaan MRI sebelum dilakukan terapi pada bulan Januari 2016 hingga Mei 2017.Hasil : Dari 76 subjek yang diteliti, didapatkan sebanyak 4 (5,1%) subyek yang mengalami pembesaran KGB paraaorta. Tidak didapatkan perbedaan yang bermakna antara status pembesaran KGB paraaorta dan usia (p = 0,829), usia hubungan seksual pertama (p = 0,333), paritas (p = 0,642), dan diameter massa (p = 0,777). Diferensiasi buruk memiliki risiko 3,89 lipat (p < 0,0001, IK95% 2,64-5,74) memiliki respon terapi negatif. Pasien dengan pembesaran KGB paraaorta memiliki risiko 2,13 kali lipat (p = 0,02, OR 2,13, IK95% 1,12-4,07) memiliki risiko respon terapi negatif. Tidak terdapat perbedaan kesintasan 1 tahun antara pembesaran KGB paraaorta dan tidak (median 201 vs. 293, p = 0,072.Kesimpulan : Tidak terdapat perbedaan karakteristik sosiodemografis, dan kesintasan 1 tahun antara pasien kanker serviks stadium lanjut dengan pembesaran KGB dan tanpa pembesaran KGB. Pasien dengan diferensiasi kanker buruk dan pembesaran KGB paraaorta memiliki risiko lebih tinggi mengalami respon radioterapi negatif. (p < 0,05).

---

Background : Cervical cancer is the third leading cause of death and highest morbidity in women worldwide. Morbidity and mortality of patients with cervical cancer increases along with age and clinical stage. Metastasis to the paraaortic lymph node (PALN) is a form of metastasis in advanced cervical cancer.

Objective : To determine whether there are differences in clinical response after radiotherapy and 1 year survival in patients with advanced cervical cancer with enlargement of PALN compared to patients without enlargement of PALN.

Method : This study was an observational analytic study using a retrospective cohort method. Sampling was done by consecutive sampling. The subjects of this study were all women with a primary diagnosis of stages IIB to IVB cervical caner who came to the gynecological oncology clinic of Dr. Cipto Mangunkusumo National General Hospital and underwent MRI examination before being treated in January 2016 to May 2017.

Result : From 76 subjects studied, there were 4 (5.1%) subjects who had enlarged PALN. There were no significant differences between the enlargement status of PALN and age (p = 0.829), age of first sexual intercourse (p = 0.33), parity (p = 0.642), mass diameter (p = 0.777). Badly differentiated mass has 3.89 times risk of having negative radiotherapy outcome (p < 0.0001, CI95% 2.64-5.74). Patients with PALN enlargement have 2.13 times risk of having negative radiotherapy outcome (p = 0.02, OR 2.13, CI95% 1.12 – 4.07). There was no difference in 1-year survival between patients with and without enlargement of PALN (median 201 vs. 293, p = 0.072).

Conclusion : There were no differences in sociodemographic characteristics and 1 year survival between patients with advanced cervical cancer with enlargement PALN. Patients with badly differentiated mass and PALN enlargement have increased risk of having negative radiotherapy outcome (p < 0.05)."