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"Therapy of radiation is chosen therapy for oral cancer especially Carcinoma Nasopharynx, however, often caused changes in normal tissue in the oral cavity. Based on the anamnese of the patient, they have dry mouth since the disturbance of the function of Parotid salivary gland has causing the saliva amount became lower. This condition can encourage the caries process. From all of the five cases occured after the radiation between one mouth until six year the time, extended damage is seen, demineralization with a small cavity and discoloring teeth color into brown."

"Planning Target Volume (PTV) adalah konsep geometris dan ditentukan untuk memilih pengaturan sinar yang sesuai, dengan mempertimbangkan efek dari semua variasi geometris yang memungkinkan, untuk memastikan bahwa dosis yang ditentukan benar-benar diserap pada Clinical Target Volume (CTV). Penambahan margin diperlukan untuk mendapatkan PTV dari CTV yang telah ditentukan. Margin tersebut bisa berdasarkan hitungan manual maupun referensi penelitian yang sudah tersedia sebelumnya. Margin CTV-ke-PTV dapat dihitung menggunakan rumus Van Herk yang membutuhkan nilai kesalahan sistematik dan acak dari nilai pergeseran pasien. Pada penelitian ini, data pergeseran pasien yang digunakan adalah sejumlah 21 pasien kanker nasofaring di RSUPN Dr. Cipto Mangunkusumo. Pergeseran dilihat dari berbagai arah, yaitu laterolateral (LL), kraniokaudal (KK), dan anteriorposterior (AP), sehingga margin PTV yang didapatkan juga dari masing-masing arah. Margin yang digunakan secara klinis di RSUPN Dr. Cipto Mangunkusumo adalah 0,5 cm dari semua arah, sedangkan margin yang didapat dengan rumus Van Herk adalah 0,4 cm pada sumbu LL, 0,5 cm pada sumbu KK, dan 0,2 cm pada AP. Hal tersebut berpengaruh pada organ at risk (OAR) yang akan menerima lebih sedikit dosis dari margin yang biasanya diterapkan karena pada sumbu LL dan AP nilai margin lebih kecil. 

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Planning Target Volume (PTV) is a geometric concept and it is determined to select an appropriate beam setting, by considering the effects of all possible geometric variations. This volume aims to ensure that the specified dose is absorbed at the CTV. Additional margin is required to generate PTV from delineated CTV. The margin can be based on manual calculations or research references that have been previously available. The CTV-to-PTV margin can be calculated using the Van Herk formula which requires the systematic and random error values of the patient shift. In this study, the patient shift data were 21 patients with nasopharyngeal cancer at Dr. RSUPN. Cipto Mangunkusumo. The shift can be seen from various directions, anterior-posterior (AP), cranial-caudal (CC), left-right (LR) so that the PTV margin obtained is also from each direction. In the clinical routine of Dr. RSUPN. Cipto Mangunkusumo, PTV margin for NPC cases was 0.5 cm from all directions. However, the margin obtained by the Van Herk formula were 0.4 cm on the LR axis, 0.5 cm on the CC axis, and 0.2 cm on the AP. This affects the organ at risk (OAR) which received fewer doses than the standard margin because on the LR and AP axes the margin values are smaller."

"Kanker masih menjadi penyakit yang menakutkan bagi masyarakat. Kanker merupakan penyebab ke dua kematian utama setelah penyakit jantung di dunia. Salah satu kanker ganas karsinoma nasofaring KNF merupakan jenis kanker ke empat terbanyak di Indonesia. Massa yang mendesak jaringan sekitar akan menyebabkan rasa nyeri bagi pasien yang mengalami penyakit kanker. Karya ilmiah akhir ini bertujuan menganalisis praktik asuhan keperawatan pada anak dengan KNF yang mengalami nyeri kronik. Evaluasi hasil intervensi yang dilakukan didapatkan data bahwa masalah nyeri kronik, kekurangan nutrisi kurang dari kebutuhan tubuh, resiko perdarahan teratasi sebagian. Tindakan teknik distraksi berupa permainan games dan penatalaksaan nyeri menggunakan farmakologi mampu mengurangi skala Children rsquo;s Hospital of Eastern Ontario Pain Scale CHEOPS dengan KNF.

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Cancer is still a frightening disease for people. Cancer is the second leading cause of death after heart disease in the world. One of the most severe cancers of nasopharyngeal carcinoma KNF is the fourth most common cancer in Indonesia. The urgent mass of surrounding tissue will cause pain for patients with cancer. This final paper aims to analyze the practice of nursing care in children with KNF who experience chronic pain. Evaluation of intervention result done got data that problem of chronic pain, lack of nutrition less than requirement of body, risk of bleeding partially resolved. The technique of distraction such as playing games and pain management using pharmacology can reduce the scale Children rsquo s Hospital of Eastern Ontario Pain Scale CHEOPS with KNF. "

"Kanker nasofaring (KNF) merupakan kanker leher kepala terbanyak di Indonesia (28,4%) dan sebagian besar terdiagnosis pada stadium lanjut. Modalitas pengobatan pada kasus KNF stadium lanjut adalah kemoterapi dan radioterapi. Namun, pada stadium sama, respon terhadap pengobatan memiliki hasil berbeda dikarenakan adanya perbedaan karakteristik biologi molekular. Cyclin D1 adalah protein yang berperan dalam siklus sel. Peningkatan ekspresi cyclin D1 akan mempercepat proliferasi. Penelitian ini ingin mengetaui tingkat ekspresi cyclin D1 terhadap respons kemoterapi. Hal tersebut berdasarkan perbedaan hasil penelitian terdahulu. Data ekspresi cyclin D1 pada KNF di Indonesia belum ada, sehingga perlu penelitian ekspresi cyclin D1 pada KNF serta hubungannya berdasarkan respons pengobatan. Metode: Penelitian ini menggunakan studi kohort retrospektif dengan subjek merupakan pasien KNF yang berobat di RSCM pada kurun waktu 2015-2018. Gambaran radiologi sebelum dan sesudah pengobatan ditinjau ulang berdasarkan kriteria RECIST. Pewarnaan imunohistokimmia cyclin D1 menggunakan antibodi monoklonal cyclin D1 NovocastraTM dengan teknik pengambilan antigen suhu tinggi dan intensitasnya dinilai dengan H-skor menurut kriteria Allred. Hasil: Terdapat 16 subjek (51,6%) dengan ekspresi cyclin D1 positif dan 15 subjek (48,4%) dengan ekspresi negatif. Peneliti menemukan bahwa ekspresi cyclin memiliki perbedaan rerata yang bermakna antara kelompok subjek yang respons (rerata 116,24 ± 57,80) dan tidak respons (rerata 77,97 ± 45,27) terhadap pengobatan (p = 0,048). Simpulan: Penelitian ini menunjukkan ekspresi cyclin D1 yang kuat pada kelompok dengan respons pengobatan yang baik.

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Nasopharyngeal cancer (NPC) is the most type of head and neck cancer in Indonesia (28.4%) and mostly diagnosed at advanced stage. Treatment of this stage is chemotherapy and radiotherapy. However, patients with the same stage of disease had different treatment response probably due to different characteristics of molecular biology. Cyclin D1 is a protein involved in cell cycle, which the overexpression of it will fasten proliferation. Studies regarding the association of cyclin D1 expression and chemotherapy response have shown a different result. In Indonesia, data of cyclin D1 expression of NPC do not yet exist. This study aimed to examine the proportion of cyclin D1 in NPC and its association with treatment response. Methods: A retrospective cohort study was conducted using subjects of NPC patients at Cipto Mangunkusumo Hospital from 2015 until 2018. The response of treatment was reviewed based on RECIST criteria. The technique used for cyclin D1 immunohistochemistry staining was antigen retrieval methods, using cyclin D1 NovocastraTM monoclonal antibody and the intensity was assessed based on Allred criteria. Results: Sixteen subjects (51.6%) had positive expression of cyclin D1 and 15 subjects (48.4%) had negative expression. The researchers found that cyclin D1 expression had significant mean differences between groups of subjects who responded (mean ± SD = 116.24 ± 57.80) and did not respond (mean ± SD = 77.97 ± 45.27) to treatment (p = 0.048). Conclusion: This study suggests that higher expression of cyclin D1 is associated with a good treatment response in NPC patients."

"Malnutrisi pada kanker nasofaring (KNF) disebabkan oleh peradangan, sel tumor dan efek kemoradioterapi. Malnutrisi dikaitkan dengan penurunan kualitas hidup, fungsi fisik, dan kelangsungan hidup. Pemberian nutrisi pasien KNF yang menjalani radioterapi (RT) memperbaiki status gizi, kapasitas fungsional, dan prognosis keseluruhan. Pasien KNF dengan kaheksia, usia 29 - 67 tahun, tiga pria dan satu wanita yang menjalani kemoradioterapi. Diberikan nutrisi sesuai kebutuhan energi, makronutrien, mikronutrien, dan nutrien spesifik. Pemantauan pasien di awal, hingga RT selesai, pada keluhan terkait terapi, analisis asupan, antropometri, komposisi tubuh, kapasitas fungsional, dan pemeriksaan CRP. Didapatkan penurunan asupan pada empat pasien saat RT, tetapi meningkat lagi pada tiga pasien setelah pemasangan NGT. Satu pasien dengan peningkatan berat badan (BB), sedangkan 3 pasien lainnya BB menurun 2,2-13% pasca RT. Tiga pasien dengan CRP meningkat pada awal RT, tetapi hanya 1 pasien dengan CRP kembali normal. Massa otot meningkat pada 3 pasien setelah RT. Tiga pasien mengalami perbaikan skor ECOG pasca RT, dan satu pasien dengan skor ECOG tetap stabil. Pemasangan NGT dapat mempertahankan asupan pasien. Terapi nutrisi memperbaiki penurunan BB, tetapi tidak terlihat kaitan dengan CRP, massa otot dan kapasitas fungsional karena faktor lain.

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Malnutrition in nasopharyngeal carcinoma (NPC) is induced by inflammation, tumor cells and the effects of chemoradiotherapy. Malnutrition is associated with decrease in quality of life, physical function and survival. Nutritional therapy to NPC who underwent radiotherapy (RT) improves nutritional status, functional capacity, and prognosis. NPC cachexic patients, ages 29 - 67 years, three male and one female, all underwent chemoradiotherapy. Nutrition therapy start with planning of energy, macronutrient, micronutrient and specific nutrients needs. Patients monitoring start from the the beginning, until completed RT, related to therapy, intake analysis, anthropometry, body composition, functional capacity, and C-Reactive Protein (CRP) examination. Decrease intake in four patients during RT, but it increased in three patients after NGT insertion. One patient increase body weight (BW), while other 3 patients dropped BW 2.2-13% post-RT. Three patients increase in CRP at the start of RT, but only 1 CRP patient returned to normal. Muscle mass increased in 3 patients after RT. Three patients had improved ECOG scores after RT, and one patient with ECOG scores remained stable. Insertion of NGT can maintain patient intake. Nutritional therapy maintains BW, but does not appear to be related to CRP, muscle mass and functional capacity due to other factors."

"Protein sel merupakan makromolekul yang terdiri dari satu atau beberapa polipeptida yang tersusun dari rangkaian asam amino yang saling berikatan. Terdapat perbedaan profil protein antara sel normal dengan sel kanker.Tujuan : Melihat ekspresi protein pada KSSRM dan mukosa mulut normal.Metode : Sel galur HSC-3 dan HSC-4 dikultur hingga confluent. Sel skuamosa mukosa normal diambil dari jaringan gingiva pasien odontektomi. Semua sampel dilakukan prosedur ekstraksi protein, Bradford protein assay, dan SDS PAGE.Hasil : KSSRM mengekspresikan protein dengan level cukup tinggi pada berat molekul 31-78 kDa. Namun, pada mukosa normal, kebanyakan mengekspresikan protein pada berat molekul antara 39 - 172 kDa.Kesimpulan : Terdapat perbedaan ekspresi protein pada sel galur KSSRM dibandingkan dengan mukosa mulut normal.

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Cells Proteins are macro molecules consist of one or several polypeptides which formed from amine acid chain that bound one another. There is a different of protein profile between normal and cancer cells.Objective : To observe the protein expression in OSCC and normal oral mucous.Method : Cell lines HSC-3 and HSC-4 were cultured until confluent. Normal squamous mucosa was taken from gingival tissues patient who had odontectomy procedure. Protein extraction, Bradford protein assay, and SDS PAGE procedure were performed for all samples.Results : Oral squamous cells carcinoma expressed rather high level of protein which have molecular weight of 31-78 kDa compared to normal gingival which express protein molecular weight ranging between 39 - 172 kDa.Conclusion : There are different protein expression between oral squamous cells carcinoma and normal oral mucous."

"Latar Belakang: p73, homolog p53, diketahui memiliki kemampuan serupa dalam menekan pertumbuhan tumor. Protein p73 diekspresikan dalam berbagai level pada sel kanker dan jaringan normal yang berbeda. Belum diketahui bagaimana pola ekspresi protein p73 pada KSSRM dan pada jaringan mukosa mulut normal.Tujuan: Mengetahui profil protein p73 pada KSSRM tipe mutant p53 dan jaringan mukosa mulut normal berdasarkan berat molekul protein.Metode: Ekstrak protein dari HSC-3 dan HSC-4 serta jaringan mukosa normal dianalisa dengan teknik SDS PAGE untuk mendeteksi protein p73 berdasarkanberat molekulnya.Hasil:. pita protein p73 pada HSC-3 lebih tebal daripada HSC- 4. Terdapat variasi profil protein p73 pada mukosa mulut normal dengan pita protein tebal (8/17) dan sedang (5/17).Simpulan: Terdapat perbedaan profil protein p73 antara HSC-3 dan HSC-4 berkaitan dengan tingkat protein p53 dan SNP pada kodon 72. Kebanyakan sampel jaringan mukosa memperlihatkan ketebalan pita protein p73 yang cukup tinggi.

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Backround: p73, the homolog of p53, has a similar ability in tumor suppression. p73 protein expressed at a different level in various cancer cells and normal tissues. Profile of p73 protein in mutant p53 OSCC cell line and normal human oral mucosa have not been known.

Objectives: To observe p73 protein profile in mutant p53 OSCC cell lines and normal human oral mucosa.

Methods: The extracted protein of HSC-3 and HSC-4 cell lines and normal mucosal tissues were analyzed with SDS PAGE to detect p73 protein based on the molecular weight.

Results:. The band of p73 protein in HSC-3 shows a higher density compared to its density of HSC-4. A thick p73 protein band was shown on 8/17 of normal mucosal tissues while medium level of p73 protein band was shown on 5/17.

Conclusion: The protein profile between HSC-3 and HSC-4 were different related with p53 protein and SNP on codon 72 of each samples. Most of mucosal tissues shows a quite high density of p73 protein bands."

"Studi retrospektif ini bertujuan untuk mengetahui perbandingan respon terapi radiasi antara teknik konvensional 2D dengan pengecilan lapangan radiasi teknik 2D, 3DCRT atau brakiterapi pada pasien kanker nasofaring stadium dini (stadium I – IIa). Dari 20 sampel didapatkan respon komplit pada 17 pasien (85%) dan respon parsial pada 3 pasien (15%) (p=0.219). Efek samping akut yaitu dermatitis radiasi grade 3-4 adalah 5% (p=0.435), mukositis grade 3-4 adalah 15% (p=0.510) dan xerostomia grade 3-4 adalah 0% (p=0.517). Secara statistik tidak didapatkan perbedaan bermakna tetapi secara klinis mempunyai kesan ada kecenderungan bahwa dengan pengecilan lapangan radiasi teknik brakiterapi dan 3DCRT lebih baik dalam hal efek samping akut mukositis dibanding teknik 2D.

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This retrospective study aimed to compare the response of radiation therapy between 2D conventional technique with the booster of 2D, 3DCRT or brachytherapy techniques in patients with early-stage nasopharyngeal cancer (stage I - IIa). From 20 sample, obtained complete response in 17 patients (85%) and partial response in 3 patients (15%) (p = 0.219). Side effects of acute radiation dermatitis grade 3-4 is 5% (p=0.435) , mucositis grade 3-4 is 15% (p=0.510) and xerostomia grade 3-4 is 0% (p=0.517). The result showed no satistically significant but clinically there is a tendency that with the booster of brachytherapy and 3DCRT techniques, are better compared with 2D technique in terms of acute mucositis side effects."

"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.

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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. "