Faturrohmaniah, Ari and dr. Irma Darinafitri, Sp.Rad(K) and dr. Rafiq Sulistyo Nugroho, Sp.Onk.Rad (2024) Perbedaan Kepadatan Mineral Tulang Menggunakan Nilai Hounsfield Unit Corpus Lumbalis Dan Collum Femur Pada Pasien Kanker Rektum Sebelum Dan Sesudah Kemoterapi Kemoradiasi. Magister thesis, Universitas Brawijaya.
Abstract
Kemoterapi dan kemoradiasi sebagai terapi pendamping pada kanker rektum, dapat menurunkan kepadatan mineral tulang yang beresiko terjadinya fraktur akibat kerapuhan. Penelitian ini bertujuan menilai penurunan kepadatan mineral tulang setelah terapi dengan menganalisis perbedaan kepadatan mineral tulang dengan pengukuran nilai hounsfield unit (HU) corpus L1-L5 dan collum femur pasien kanker rektum. Penelitian retrospektif cross sectional ini menggunakan data CT sebelum dan sesudah kemoterapi dan kemoradiasi di RSUD dr. Saiful Anwar Provinsi Jawa Timur. Pengukuran nilai HU dilakukan pada corpus lumbalis potongan axial (superior-mid-inferior corpus) dan collum femur tanpa menyentuh korteks tulang. Perbedaan rerata nilai HU dianalisis menggunakan tes T berpasangan dan ANOVA. Hasil analisa statistik dari total 47 pasien, 31 (66%) pasien mendapat kemoterapi dan 16 (34%) pasien mendapat kemoradiasi. Rerata usia 50 tahun dan jenis kelamin dominan laki-laki. 9 dari 16 pasien menggunakan dosis radiasi 59.4Gy. Penurunan HU pasien yang mendapat kemoterapi sebesar 16-18HU pada corpus L1-L5, collum femur dengan osteoporosis sebanyak 16.1% corpus lumbalis, 41.9% collum femur. Penurunan HU pasien yang mendapat kemoradiasi sebesar 26-43HU pada corpus L3, L4, L5, collum femur dengan 12.5% pasien kategori osteoporosis L4-L5, 37.5% collum femur. Terdapat perbedaan signifikan HU post radiasi L5 terkena radiasi dengan L1 tidak terkena radiasi. Dosis radiasi total, fraksinasi dosis, waktu evaluasi tidak mempengaruhi penurunan HU secara signifikan. Pemberian kemoterapi dan radioterapi pasien kanker rektum menyebabkan penurunan HU yang signifikan pada copus lumbalis dan collum femur dengan dominan osteoporosis terjadi pada collum femur
English Abstract
Chemotherapy and chemoradiation as adjuvant therapy for rectal cancer may reduce bone mineral density, increasing the risk of fragility fractures. This study aims to assess the decrease in bone mineral density post-therapy which analyzes differences in bone mineral density by measuring the HU values of the L1-L5 vertebral body and femoral neck in rectal cancer patients. This retrospective cross-section study analyzed CT data pre- and postchemoteraphy and chemoradiation at RSUD dr. Saiful Anwar, East Java Province. HU values were measured on axial section of lumbar vertebral body (upper-middlelower vertebral body) and femoral neck without touching the bone cortex. Mean HU values differences were assessed using paired T-test and ANOVA. The result of the statistical analysis shows the total 47 patients, 31 (66%) patients received chemotherapy and 16 (34%) patients underwent chemoradiation. The average age was 50 years with male being the dominant gender. Among the 16 patients receiving chemoradiation, 9 were administrated with a radiation dose of 59.4Gy. In patients who received chemotherapy, there was a decrease in HU of 16-18HU in the L1-L5, femoral neck with osteoporosis by 16.1% of the lumbar, 41.9% of the femoral neck. For patients who underwent chemoradiation, the decrease in HU ranged from 26-43HU in the L3, L4, L5 and femoral neck with 12.5% of patients in the L4-L5 osteoporosis category, 37.5% of the femoral neck. A significant difference in HU post-radiation was observed between L5 irradiation area and L1 non-irradiation area. However, the total radiation dose, dose fractionation, and evaluation time did not significantly affect the reduction in HU. Administering chemotherapy and radiotherapy to rectal cancer patients significantly decreases HU in the lumbar vertebral body and femoral neck with osteoporosis predominantly ccuring in the femoral neck
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 042407 |
| Uncontrolled Keywords: | hounsfield unit, kepadatan mineral tulang, kemoterapi, radioterapi |
| Divisions: | Profesi Kedokteran > Spesialis Radiologi, Fakultas Kedokteran |
| Depositing User: | Unnamed user with username nova |
| Date Deposited: | 01 Aug 2024 06:50 |
| Last Modified: | 01 Aug 2024 06:50 |
| URI: | http://repository.ub.ac.id/id/eprint/222267 |
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