Latar belakang: Argon Plasma Coagulation (APC) merupakan modalitas terapi yang
banyak digunakan untuk pengobatan kolitis radiasi pada pasien keganasan ginekologi,
kolorektal dan urologi yang mendapatkan radioterapi di RSUPN-CM.
Tujuan: Menilai hasil dari APC yang dilakukan pada penderita kolitis radiasi dan
faktor perancunya.
Metode: Penelitian deskriptif analitik dengan desain kohort retrospektif berdasarkan
data dari rekam medis RSUPN-CM antara bulan April 2012 sampai dengan Oktober
2019. Variabel yang dinilai meliputi umur, jenis kelamin, jenis keganasan, diabetes
melitus, hipertensi, dan status anemia, dengan luaran berupa keberhasilan APC.
Pengujian kemaknaan statistik dilakukan sesuai dengan karakteristik data serta tujuan
penelitian, dengan p <0,05 dianggap bermakna. Juga dilakukan analisis multivariat
untuk melihat variabel perancu yang paling memengaruhi keberhasilan APC.
Hasil: Sebanyak 180 pasien kolitis radiasi yang mendapatkan terapi APC memenuhi
kriteria penelitian dengan proporsi terbanyak berjenis kelamin perempuan sebesar
89,4%, dan berusia >50 tahun sebanyak 83,9%. Sedangkan jenis tumor terbanyak
adalah keganasan ginekologi sebanyak 88,9%. Sebanyak 81,3 % subyek mengalami
keberhasilan terapi APC. Nilai tengah frekuensi APC sebanyak 2 sesi dengan rentang
1 sampai 12 sesi. Terdapat 180 subyek (100%) menderita anemia sebelum menjalani
APC yang pertama. Kadar hemoglobin pada penderita APC meningkat dengan
median Hb sebelum APC pertama sebesar 8 g/dL (3-11 g/dL) menjadi 12 g/dL (10-14
g/dL) sebelum APC terakhir. Sebanyak 59,2% subyek yang mengalami keberhasilan
APC tidak lagi menderita anemia setelah terapi APC, dengan perbaikan status anemia
meningkat sebesar 1,628 kali lebih baik pada subyek yang mengalami keberhasilan
APC dibandingkan dengan subyek yang mengalami ketidakberhasilan terapi APC
(p=0,017). Usia, jenis kelamin, jenis keganasan, hipertensi dan diabetes melitus bukan
merupakan faktor perancu terhadap status anemia pada keberhasilan APC.
Kesimpulan: Terdapat perbaikan status anemia pada penderita kolitis radiasi yang
mendapatkan terapi APC di RSUPN-CM.
Background: Argon Plasma Coagulation (APC) is recently widely used in the
treatment of radiation colitis among patients with gynecology, colorectal and
urology malignancy.
Purpose: To measure the result of APC conducted on radiation colitis patients and its
counfounding factors.
Methods: An analytic descriptive study with retrospective cohort design based on
RSUPN-CM database between April 2012 until October 2019. Variables measured
were age, gender, tumor types, diabetes melitus, hypertension, and anaemia, with
efficacy of APC treatment as the outcome. Statistical tests conducted according to
characteristics and the purpose of the study, with p value <0.05 considered
significant. Multivariate analysis was also conducted to evaluate which factors
influenced to the efficacy of APC therapy.
Results: As much as 180 radiation colitis patients received APC treatment fulfilled
inclusion criteria with characteristics female patients (89.4%), and age >50 years old
(83.9%) were found in this study. Types of tumor were dominated by gynecology
malignancy (88.9%). As much as 81.3% subjects had successful APC treatment.
Median number of efficacy of APC treatment in this study was 2 sessions. All of the
subjects had anaemia before the first APC treatment. There was improvement in Hb
level, median Hb before the first APC treatment was 8 g/dL (3-11 g/dL) and median
Hb level before the last APC treatment was 12 g/dL (10-14 g/dL). As much as 59.2%
subjects who had successful APC treatment were no longer anaemia after APC
treatment, with improvement of anaemia status was 1.628 times more likely in
subjects who had successful APC treatment compared to subjects who did not have
successful APC treatment (p=0.017). Age, gender, malignancy types, hypertension
dan diabetes melitus were not confounding factors to anaemia status in successful
APC treatment.
Conclusion: There was improvement in anaemia status on radiation colitis patients
receiving APC treatment in RSUPN-CM.