Ketahanan Hidup 1 Tahun dan Faktor Prognostik Pasien dengan Kanker Serviks Stadium Lanjut Terlokalisir (LACC) setelah Radiasi Eksterna tanpa Brakiterapi Intrakaviter.

Ramawati, Sherly (2014) Ketahanan Hidup 1 Tahun dan Faktor Prognostik Pasien dengan Kanker Serviks Stadium Lanjut Terlokalisir (LACC) setelah Radiasi Eksterna tanpa Brakiterapi Intrakaviter. Sarjana thesis, Universitas Brawijaya.

Abstract

Standar terapi Locally Advanced Cervical Cancer (LACC) adalah terapi radiasi eksterna whole pelvis, dilanjutkan dengan brakiterapi intrakaviter dan ditambah dengan kemoterapi konkuren. Namun, tidak semua rumah sakit di Indonesia memiliki fasilitas brakiterapi, salah satunya di RSU Dr Saiful Anwar Malang sebagai RS pendidikan Universitas Brawijaya. Sampai saat ini belum pernah dilaporkan bagaimana efektivitas terapi radiasi eksterna yang diberikan tanpa brakiterapi ini. Salah satu parameter yang sering digunakan untuk memonitoring keberhasilan suatu metode pengobatan adalah angka ketahanan hidup (AKH) dan angka bebas penyakit (DFS). Penelitian ini bertujuan untuk mengetahui AKH pasien LACC yang mendapat terapi radiasi definitif tanpa brakiterapi intrakaviter beserta faktor-faktor prognostik mana saja yang berpengaruh signifikan (p<0.05) terhadap AKH dan DFS pasien. Sampel yang digunakan adalah status penderita dengan stadium IIB, IIA, IIIB dan IVA saja (LACC). Penelitian dilakukan dengan metode kohort retrospektif dengan mengambil data rekam medis yang ada di RSU Dr Saiful Anwar Malang. Data kemudian dianalisis dengan analisis kesintasan uji Kaplan Meier dan faktor-faktor prognosis dianalisis dengan analisis univariat Logrank test. Hasil penelitian menunjukkan AKH pasien LACC yang mendapat terapi radiasi tanpa brakiterapi intrakaviter dalam setahun adalah sebesar 72%. Diantara faktor prognostik yang ada, hanya riwayat kemoterapi dan kadar hemoglobin (Hb) sebelum radiasi yang berpengaruh signifikan (p<0.05) terhadap AKH dan DFS. Pasien yang mendapatkan kemoterapi memiliki AKH dan DFS yang lebih rendah daripada pasien yang tidak mendapatkan kemoterapi (55.7 vs 88.9%, p=0.043 dan 38.4 vs 83.5%, p=0.008). Pasien dengan kadar Hb sebelum radiasi < 12 gr/dl memiliki DFS yang lebih rendah dibandingkan pasien dengan kadar Hb ≥ 12 gr/dl (40.1 vs 71.8%, p=0.029) Kesimpulan dari penelitian ini adalah AKH pasien LACC yang mendapat terapi radiasi tanpa brakiterapi relatif cukup tinggi. Faktor prognostik selain riwayat kemoterapi dan kadar hemoglobin sebelum radiasi, tidak berpengaruh signifikan terhadap AKH dan DFS pasien.

English Abstract

The standard treatment for Locally Advanced Cervical Cancer (LACC) is whole pelvis external radiation therapy, continued by intracavity brachytherapy, with the addition of concurrent chemotherapy. Nevertheless, facility for brachytherapy is unlikely available in every Indonesian hospital like Saiful Anwar Hospital as academic hospital for medical students from University of Brawijaya. Even, there is no study about effectivity of the external radiation therapy that given without brachytherapy in Indonesia has been reported. Most commonly used parameters for monitoring the success rate of a treatment method is overall survival (OS) and disease free survival rate (DFS). This study is aimed to know the survival rate of LACC patient who has got definitive radiation therapy without intracavity brachytherapy and which prognostic factors that contribute significantly (p<0,05) to the overall survival and disease free survival rate. The sample used was the LACC patient, limited to stage IIB, IIIA, IIIB, and IVA only. The method applied in this study was restrospective cohort using patient’s medical record which were taken from Saiful Anwar Hospital, Malang. The data had been collected was analized with Kaplan-Meier synthesis test and the prognostic factors was analized using univariate analysis Logrank test. The result of this study showed that the survival rate of the patients who underwent radiation therapy without brachytherapy was 72%. Among the various prognostic factors, only chemotherapy and hemoglobin pre treatment rate that contributed significantly toward OS and DFS. Patient who underwent chemotherapy had lower OS and DFS-rate than the patient who did not underwent chemotherapy (55.7 vs 88.9%, p=0.043 and 38.4 vs 83.5%, p=0.008). Patient with low Hb pre treatment rate (<12 gr/dl) had lower DFS rate compared to patient with Hb pre treatment rate >12 gr/dl (40.1 vs 71.8%, p=0.029). The conclusion of this study is survival rate of LACC patient who had gotten radiation therapy without intracavity brachytherapy was relatively high. The prognostic factors others chemotherapy history and hemoglobin pre treatment, did not have significant (p>0.05) influence to the OS-rate and patients DFS-rate.

Item Type: Thesis (Sarjana)
Identification Number: SKR/FK/2014/433/051403491
Subjects: 600 Technology (Applied sciences) > 610 Medicine and health > 610.7 Education, research, nursing, services of allied health personnel
Divisions: Fakultas Kedokteran > Pendidikan Dokter
Depositing User: Budi Wahyono Wahyono
Date Deposited: 26 Jun 2014 13:29
Last Modified: 21 Oct 2021 16:20
URI: http://repository.ub.ac.id/id/eprint/124427
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