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"Latar belakang : Toksisitas hematologi sering terjadi pada pasien dengan Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) yang diobati dengan kemoterapi berbasis platinum. Data sebelumnya menunjukkan bahwa trombositopenia karena kemoterapi berbasis karboplatin adalah rendah tetapi tidak ada data lokal yang menjelaskan angka kejadian trombositopenia pada KPKBSK yang diterapi dengan regimen karboplatin+gemsitabin. Tujuan dari penelitian ini adalah untuk melihat dan membandingkan angka kejadian toksisitas hematologi seperti trombositopenia, anemia, leucopenia, neutropenia dan perdarahan yang disebabkan kemoterapi karboplatin+gemsitabin dengan karboplatin+paklitaksel dan karboplatin+etoposid pada pasien KPKBSK. Dan juga membandingkan respons objektif dari ketiga regimen tersebut. Metode:. Penelitian ini kohort retrospektif pada pada pasien KPKBSK yang menerima 1.250 mg/m2 gemsitabin pada hari ke-1 dan hari ke-8 dan karboplatin AUC-5(Area under curve) hari pertama. Pasien yang menerima ≥ 2 siklus ikut dalam penelitian ini. Kami menilai dan membandingkan toksisitas hematologi tiap siklus seperti trombositopenia, anemia, leucopenia, neutropenia dan perdarahan serta respons objektif dari ketiga regimen berbasis karboplatin selama kemoterapi. Hasil: Pada penelitian ini didapatkan total 115 pasien (rerata umur 55.6±10, rerata jumlah siklus adalah 4, jenis histologi adenokarsinoma 91%, stage III or IV) Pasien KPKBSK yang menerima regimen karboplatin+gemsitabine (n=38), karboplatin+paklitaksel (n=39) dan karboplatin+etoposid (n=38). Angka kejadian trombositopenia regimen karboplatin+gemsitabin adalah 34.2%, karboplatin+paklitaksel 5.1%, dan karboplatin+etoposid 5.3%. Waktu terjadinya trrombositopenia pada regimen karboplatin+gemsitabin 2 siklus lebih cepat dari regimen lain. Toksisiti hematologi trombositopenia regimen karboplatin+gemsitabin sebesar 15,8% dengan grade 3-4, leukopenia 18,4% dengan grade 3- 4 dan anemia 5,3% grade 3-4. Overall respons rate dan time to progression dengan regimen karboplatin+gemsitabin lebih baik dari regimen lainnya. Kesimpulan : Angka kejadian dan waktu terjadinya toksisitas hematologi pada regimen karboplatin+gemsitabin lebih tinggi daripada regimen karboplatin+paklitaksel dan karboplatin+etoposid.. Tetapi Overall respons rate dan time to progression pada karboplatin+gemsitabin lebih baik daripada regimen lain. Background : Hematological toxicities often occur in patients with non-small-cell lung cancer (NSCLC) who are treated with chemotherapy. In our data had shown that thrombocytopenia due to carboplatin based chemotherapy was low but there was not any local data about carboplatin - gemcitabine regimen. The aim of this study is to investigate and to compare the frequency of hematologic events, such as thrombocytopenia, anemia, leucopenia, neutropenia, and hemorrhage due to combination of gemcitabine-carboplatin with carboplatin-paclitaxel, and carboplatin-etoposide in non-small cell lung cancer patients. And also to compare objective response of the three platinum based regimens. Methods : We conducted a retrospective cohort study that enrolled all non-small-cell lung cancer patients who received 1.250 mg/m2 gemcitabine on day 1,8 and AUC-5 carboplatin on day one. Patients who received 2 cycles or more are included in this study. We investigated and compared objective response of the three platinum based regimens and the frequency of thrombocytopenia, anemia, leucopenia, neutropenia, hemorrhage, during chemotherapy period. Results : A total 115 patients (mean age 55.6±10, median number of cycle of chemotherapy was 4, histological findings were adenocarcinoma 91%) with stage III or IV NSCLC received chemotherapy carboplatin-gemcitabine (n=38), carboplatin-paclitaxel (n=39) and carboplatin-etoposide (n=38). Frequency of thrombocytopenia in patients with NSCLC treated with combination of carboplatin-gemcitabin regimen was 34.2%, carboplatin-paclitaxel 5.1%, and carboplatin-etoposide 5.3%. The Carbo-gemcitabine group developed thrombocytopenia 1 or 2 cycles earlier than other group . The hematological toxicities data with carbo-gemcitabine regimen have shown that thrombocytopenia was 15,8% patient with grade 3 or 4, leucopenia 18,4% patients with grade 3 or 4 and 5,3% grade 3 or 4 anemia. Overall respons rate and time to progression with carboplatin-gemcitabine regimen were better than the other regimens Conclusion : Thrombocytopenia was found in gemcitabine and carboplatin regimen but lower than other published data. Overall respons rate and time to progression with carboplatin-gemcitabine regimen were better than the other regimens."

"ABSTRAKLatar Belakang : Paduan kemoterapi berbasis platinum dengan generasi ketiga khususnya karboplatin-vinorelbin sudah sering digunakan sebagai kemoterapi paliatif pada pasien KPKBSK stage lanjut di Indonesia khususnya Rumah Sakit Umum Pusat RSUP Persahabatan namun sampai saat ini belum terdapat data mengenai efikasi dan toksisiti paduan kemoterapi ini di RSUP Persahabatan.Metode : Desain penelitian ini adalah survey observasional retrospektif pada pasien KPKBSK stage lanjut IIIB dan IV yang menjalani kemoterapi lini I di RSUP Persahabatan dengan paduan kemoterapi karboplatin-vinorelbin sejak 1 Januari 2015 sampai 30 Maret 2017.Hasil : Total subjek dalam penelitian ini adalah 38 pasien yang mendapatkan paduan kemoterapi Karboplatin AUC-5 pada hari ke-1 dan vinorelbin 30 mg/m2 pada hari ke1 dan ke-8. Paduan kemoterapi karboplatin-vinorelbin mempunyai efikasi yang baik dengan Objective overall response rate ORR 12,5 dan clinical benefit rate CBR 87,5 . Overall survival OS pada penelitian ini adalah 34,2 dengan masa tengah tahan hidup 387 hari 12,9 bulan dan progression free survival 323 hari 10,7 bulan. Toksisiti hematologi dan nonhematologi yang paling sering terjadi adalah anemia derajat 1 38,4 dan keluhan mual, muntah derajat 2 57,9 . Pada penelitian ini terdapat 2 kasus perdarahan saluran cerna derajat 2 namun pasien masih dapat melanjutkan kemoterapi. Kami juga mendapatkan komplikasi tindakan kemoterapi berupa phlebitis ringan pada 24 pasien 65,7 dan phlebitis sedang pada 1pasien 2,6 .Kesimpulan: Paduan karboplatin-vinorelbin sebagai kemoterapi lini I memiliki efikasi yang baik serta efek toksisiti yang masih dapat ditoleransi sehingga aman diberikan pada pasien KPKBSK stage lanjut. Kata kunci: efikasi, toksisiti, hematologi, nonhematologi, objective overall response rate, clinical benefit rate, overall survival, MTTH, TTP, PFS

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ABSTRAK Background Combination of platinum base and third generation drugs Carboplatin and vinorelbine chemotherapy are frequently used as paliative chemotherapy for Non small cell lung cancer NSCLC patients in Indonesia especially in Persahabatan Hospital. But there are still no data about the activity and tolerability of this regiment in Persahabatan Hospital. This study is conducted to evaluate the efficacy and toxicity of this regiment as first line chemotherapy for advanced NSCLC patients in Persahabatan Hospital.Method This study is an observational survey retrospective study for advanced NSCLC patientswho receive carboplatin vinorelbine regiment as fisrt line chemotherapy since 1st January 2015 to 30th March 2017.Result We observea total of 38 patients who receive carboplatin 5 AUC on day 1 and vinorelbine 30mg m2 on day 1 and 8. This regiment has a good efficacy with overall response rate ORR 12,5 and clinical benefit rate CBR 87,5 . The overall survival OS is 34,2 with median of survival time 387 days 12,9 moths and PFS 323 days 10,7 moths . We found grade 1 anemia 38,4 and grade 2 nausea vomiting 57,9 as hematological and non hematological toxicity that frequently occur in this study. We found 2 cases of grade 2 gastrointestinal bleeding but the patients are still able to continue the chemotherapy after doing some correction for the haemoglobin Hb . We also found mild phlebitis in 24 patients 65,7 and 1 moderate phlebitis in 1 patient 2,6 as procedural complication of this chemotherapyConclusion Combination ofcarboplatin and vinorelbine as first line chemotherapy has a good efficacy and tolerability for advanced NSCLC patients. Key word efficacy, toxicity, haematological, non hematological, overall objective response rate ORR , clinical benefit rate CBR , overall survival OS , median time of survival, time to progression TTP and progression free survival PFS ."

"Latar Belakang : Pasien kanker paru sering mengalami pneumonia, hal ini terjadikarena penurunan daya tahan tubuh. Pneumonia menyulitkan penanganan,memperburuk kualitas hidup, mengurangi survival dan seringkali merupakanpenyebab langsung kematian pasien kanker paru. Penangananan pneumonia padapasien NSCLC(non small cell lung cancer) dengan antimikroba yang terus menerustanpa memperhatikan kultur sensisitivitas akan menyebabkan resistensi dari kumanpenyebab pneumonia tersebut.Tujuan : Penelitian ini bertujuan untuk mengetahui, pola kuman penyebabpneumonia pada pasien NSCLC, dan membandingkan kesintasan pasien NSCLCyang menderita pneumonia yang disebabkan oleh bakteri MDR (multidrugresistance) dengan yang disebabkan oleh bakteri non-MDR.Metode : Penelitian ini merupakan kohort retrospektif dengan subjek penelitianadalah pasien NSCLC dengan pneumonia yang disebabkan oleh bakteri MDR dannon-MDR yang dirawat di Rumah Sakit Dr Cipto Mangunkusumo bulan Januari2013-Desember 2017. Analisis dilakukan dengan analisis multivariat regressi cox.Hasil: Setelah dilakukan pemeriksaan kultur BAL(Bronchoalveolar lavage), cairanpleura dan sputum, diperoleh 32 subjek hasil kulturnya hanya bakteri MDR, 14subjek tumbuh bakteri MDR dan non-MDR, dan 23 subjek hanya tumbuh bakterinon-MDR. Bakteri non-MDR terbanyak penyebab pneumonia pada pasienNSCLC adalah Klebsiella pneumoniae sebanyak 37,3%, sedangkan bakteri MDRyang terbanyak menyebabkan pneumonia pada pasien NSCLC adalahAcinetobacter baumannii sebanyak 23,2%. Median survival Pasien NSCLCdengan pneumonia yang disebabkan oleh bakteri MDR adalah 57 hari(43,707-70,293) sedangkan yang oleh bakteri non-MDR 92 hari(58,772-125,228).Simpulan : kesintasan pasien NSCLC dengan pneumonia yang disebabkan olehbakteri MDR lebih singkat daripada yang disebabkan oleh bakteri non-MDR.

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Back Ground: Lung cancer patients often experience pneumonia. This is due tothe decrease in body endurance of the patients. Pneumonia complicatestreatment, worsens the quality of life, reduces survival and is often a direct causeof death for lung cancer patients. Dealing with pneumonia in non-small cell lungcancer (NSCLC) patients with continuous antimicrobials treatment withoutregard to culture sensitivity will cause resistance of germs that cause pneumonia.Objectives: This study aims to study the pattern of germs that cause pneumoniain NSCLC patients, and to compare the survival of NSCLC patients sufferingfrom pneumonia caused by MDR (multidrug resistance) bacteria with thosecaused by non-MDR bacteria.Methods: This study was a retrospective cohort with research subjects wasNSCLC patients with pneumonia caused by MDR and non-MDR bacteria whowere treated at Dr. Cipto Mangunkusumo Hospital from January 2013 toDecember 2017. Analysis was performed with multivariate cox regressionanalysis.Results: The results of the culture examination of BAL(Bronchoalveolar lavage),pleural fluid and sputum showed that 32 subjects were infected only from MDRbacteria, 14 subjects infected by both MDR and non MDR bacteria, and 23subjects were infected by only non MDR bacteria. The most non-MDR bacteriathat cause pneumonia in NSCLC patients was Klebsiella pneumoniae as much as37,3%, while the most MDR bacteria that cause pneumonia in NSCLC patientswas Acinetobacter baumannii as much as 23,2%. Median survival of NSCLCpatients with pneumonia caused by MDR bacteria was 57 days(43,707-70,293)while those by non-MDR bacteria was 92 days (58,772-125,228).Conclusions: The survival of NSCLC patients with pneumonia caused by MDRbacteria is shorter than that caused by non-MDR bacteria."

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Latar Belakang : Pasien kanker paru sering mengalami pneumonia, hal ini terjadi karena penurunan daya tahan tubuh. Pneumonia menyulitkan penanganan, memperburuk kualitas hidup, mengurangi survival  dan seringkali merupakan penyebab  langsung kematian pasien kanker paru. Penangananan pneumonia pada pasien NSCLC(non small cell lung cancer) dengan antimikroba yang terus menerus tanpa memperhatikan kultur sensisitivitas akan menyebabkan resistensi dari kuman penyebab pneumonia tersebut.

Tujuan : Penelitian ini bertujuan untuk mengetahui karakteristik pasien NSCLC, pola kuman penyebab pneumonia pada pasien NSCLC, dan membandingkan kesintasan pasien NSCLC yang menderita pneumonia yang disebabkan oleh bakteri MDR (multidrug resistance) dengan yang disebabkan oleh bakteri non-MDR.

Metode : Penelitian ini merupakan kohort retrospektif dengan subjek penelitian adalah pasien NSCLC dengan pneumonia yang disebabkan oleh bakteri MDR dan non-MDR yang dirawat di Rumah Sakit Dr Cipto Mangunkusumo bulan Januari 2013–Desember 2017. Analisis dilakukan dengan analisis multivariat regressi cox.

Hasil: Setelah dilakukan pemeriksaan kultur BAL(Bronchoalveolar lavage), cairan pleura dan sputum, diperoleh 32 subjek hasil  kulturnya hanya bakteri MDR, 14 subjek  tumbuh bakteri MDR dan non-MDR, dan 23 subjek hanya tumbuh bakteri non-MDR.  Bakteri non- MDR terbanyak penyebab pneumonia pada pasien NSCLC adalah Klebsiella pneumoniae sebanyak 37,3%, sedangkan bakteri MDR yang terbanyak menyebabkan pneumonia pada pasien NSCLC adalah  Acinetobacter baumannii  sebanyak 23,2%. Median survival Pasien NSCLC dengan pneumonia yang disebabkan oleh bakteri MDR adalah 57 hari(43,707-70,293) sedangkan yang oleh bakteri non-MDR 92 hari(58,772-125,228). 

Simpulan : kesintasan pasien NSCLC dengan pneumonia yang disebabkan  oleh bakteri MDR lebih singkat daripada yang disebabkan oleh bakteri non-MDR.

 

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Back Ground: Lung cancer patients often experience pneumonia. This is due to the decrease in body endurance of the patients. Pneumonia complicates treatment, worsens the quality of life, reduces survival and is often a direct cause of death for lung cancer patients. Dealing with pneumonia in non-small cell lung cancer (NSCLC) patients with continuous antimicrobials treatment without regard to culture sensitivity will cause resistance of germs that cause pneumonia.

Objectives: This study aims to study the characteristics of NSCLC patients, the pattern of germs that cause pneumonia in NSCLC patients, and to compare the survival of NSCLC patients suffering from pneumonia caused by MDR (multidrug resistance) bacteria with those caused by non-MDR bacteria.

Methods: This study was a retrospective cohort with research subjects was NSCLC patients with pneumonia caused by MDR and non-MDR bacteria who were treated at Dr. Cipto Mangunkusumo Hospital from January 2013 to December 2017. Analysis was performed with multivariate cox regression analysis.

Results: The results of the culture examination of BAL(Bronchoalveolar lavage), pleural fluid and sputum showed that 32 subjects were infected only from MDR bacteria, 14 subjects infected by both MDR and non MDR bacteria, and 23 subjects were infected by only non MDR bacteria. The most non-MDR bacteria that cause pneumonia in NSCLC patients was Klebsiella pneumoniae as much as 37,3%, while the most MDR bacteria that cause pneumonia in NSCLC patients was Acinetobacter baumannii as much as 23,2%. Median survival of NSCLC patients with pneumonia caused by MDR bacteria was 57 days(43,707-70,293) while those by non-MDR bacteria was 92 days (58,772-125,228).

Conclusions: The survival of NSCLC patients with pneumonia caused by MDR bacteria is shorter than that caused by non-MDR bacteria.

 

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"ABSTRACTStage I non-small cell lung cancer (NSCLC) is a localized disease without metastasis; therefore, it can be treated effectively with local therapies. Pulmonary resection is the most frequent treatment, performed as pulmonary wedge resection, segmentectomy, lobectomy, or pneumonectomy. Some retrospective clinical studies of pulmonary wedge resection suggest that its outcome may be inferior to that of anatomical pulmonary resection, whereas other recent studies, which assess surgical margin status, leveled acceptable outcomes. Since the outcome of pulmonary wedge resection for lung cancer may depend on tumor size, distance from the surgical margin to the tumor, tumor size/margin distance ratio, and margin cytology results, a prospective study assessing these parameters is ongoing. This will allow us to identify the clinical implications of these factors and predict which patients are likely to have a good outcome."

"ABSTRACTLung cancer is a devastating disease with a high incidence, mortality and morbidity rate, especially in developing countries. Conventional treatment with cytotoxic chemotherapy has some limitations attributed to chemoresistance and toxicity. Recent advances have shown that first generation Tyrosine Kinase Inhibitor (TKI), Gefitinib and Erlotinib, and the newest available second generation Tyrosine Kinase Inhibitor (TKI), Afatinib, have the potential to be an option in the management of patients with epidermal growth factor receptor/ EGFR mutation positive advanced/ metastatic non-small cell lung cancer. Afatinib works by binding to EGFR irreversibly, thus inactivating the tyrosine kinase receptor. Some studies demostrated that Afatinib first-line may result in longer progression free survival (PFS) and better disease control, and as an alternative for patients who intolerance to Gefitinib or Erlotinib. In Indonesia, the era of National Health Insurance has been implemented and National Health Insurance has covered treatment for cancer, including first generation TKIs, Gefitinib dan erlotinib, for patients with EGFR mutation positive advanced/ metastatic non-small cell lung cancer at Cipto Mangunkusumo National Hospital. Afatinib, as one of the newest available second generation TKI, may be given free of charge too as an alternative if the National Health Insurance will be covered in the future. Further research is needed to know the efficacy and adverse effects that may occur in patients from developing countries."

"Latar Belakang: Kanker paru adalah penyakit dengan ancaman serius di Indonesia. Progresifitas massa tumor merupakan salah satu faktor yang mempengaruhi kesintasan hidup pasien kanker paru. Karsinoma sel kecil (KPKSK) menunjukkan progresifitas yang lebih tinggi daripada karsinoma bukan sel kecil (KPKBSK). Beberapa studi menunjukkan bahwa pasien KPKBSK memiliki tingkat kesintasan hidup yang lebih baik daripada pasien KPKSK. Penelitian ini bertujuan untuk menilai perbedaan kesintasan antara pasien KPKSK dan KPKBSK di Rumah Sakit Kanker "Dharmais" (RSKD) dengan mengontrol variabel umur, jenis kelamin, stadium klinis, dan penatalaksanaan.Metode: Studi kohort retrospektif ini melibatkan 949 partisipan (KPKSK dan KPKBSK) di RSKD dari tahun 2013 hingga 2017, dengan follow-up hingga tahun 2021. Tingkat kesintasan dianalisis menggunakan metode Kaplan-Meier, dan efek prediktor dinilai dengan model Cox proportional hazard.Hasil: Kesintasan pasien KPKSK di RSKD pada periode 2013-2017 lebih rendah dibandingkan dengan pasien KPKBSK. Kesintasan di tahun pertama pada pasien KPKSK adalah 31,21%, dan pada tahun ketiga, keseluruhan pasien KPKSK meninggal. Pada pasien KPKBSK, kesintasan di tahun pertama, ketiga, dan kelima berturut-turut adalah 45,19%, 23,62%, 15,92%. Median waktu kesintasan pasien KPKSK adalah hari ke-172, lebih pendek dibandingkan dengan pasien KPKBSK (hari ke-272). Setelah mengontrol variabel-variabel kovariat, tidak terdapat perbedaan kesintasan yang bermakna secara statistik antara pasien KPKSK dan KPKBSK (p > 0,05).Kesimpulan: Studi menunjukkan bahwa kesintasan pasien KPKSK lebih rendah dibandingkan dengan pasien KPKBSK di RSKD; namun secara statistik tidak menunjukkan perbedaan signifikan setelah mengontrol variabel umur, jenis kelamin, stadium klinis, dan penatalaksanaan.

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Background: Lung cancer is a disease with a serious threat in Indonesia. Tumor mass progression is one of the factors influencing the survival of lung cancer patients. Small cell carcinoma (SCLC) shows higher progression compared to non-small cell carcinoma (NSCLC). Several studies have shown that NSCLC patients have a better survival rate than SCLC patients. This study aims to assess the difference in survival rates between SCLC and NSCLC patients at Dharmais Cancer Hospital while controlling for age, gender, clinical stage, and management.

Method: This retrospective cohort study involved 949 participants (SCLC and NSCLC) from 2013 to 2017, with follow-up until 2021. Survival rates were analyzed using the Kaplan-Meier method, and the predictor effect was assessed using the Cox proportional hazard model.

Results: The survival rate of SCLC patients at Dharmais Cancer Hospital during the period 2013-2017 was lower compared to NSCLC patients. The survival rate in the first year for SCLC patients was 31.21%, and by the third year, all SCLC patients had passed away. For NSCLC patients, the survival rates in the first, third, and fifth years were 45.19%, 23.62%, and 15.92%, respectively. The median survival time for SCLC patients was day 172, which was shorter compared to NSCLC patients (day 272). After controlling for covariate variables, there was no statistically significant difference in survival between SCLC and NSCLC patients (p > 0.05).

Conclusion: The study shows that the survival rate of SCLC patients is lower than NSCLC patients at Dharmais Cancer Hospital , but statistically, there is no significant difference after controlling for age, gender, clinical stage, and management."

"ABSTRAKLatar Belakang: Salah satu modalitas terapi untuk kanker paru stadium lanjut jenis Non-Small Cell (NSC) adalah kemoterapi. Jenis kemoterapi yang sering digunakan di Indonesia adalah Cisplatin-Etoposide (EC) dan Cisplatin-Docexatel (DC). Tolak ukur keberhasilan pengobatan adalah kesintasan dan Progression Free Survival (PFS). Keberhasilan kemoterapi dipengaruhi oleh banyak faktor seperti dosis obat, intensitas pemberian, jenis kemoterapi, jenis histologi, stadium, perfoma status, komorbiditas dan sosial ekonomi. Di Indonesia pendanaan dan jenis rejimen kemoterapi masih merupakan masalah terdahap keberhasilan terapi. Tujuan: Mengetahui perbedaan kesintasan 2 tahun dan PFS antara pasien kanker paru jenis NSC yang diterapi menggunakan EC dibandingkan dengan DC.Metode: Penelitian desain kohort retrospektif dengan analisis kesintasan. Pasien yang dimasukkan dalam penelitian ini adalah pasien kanker paru stadium lanjut (minimal stadium IIIa) jenis NSC, yang datang ke RSKD dan RSCM pada Januari 2006 – Desember 2010 yang baru pertama kali dikemoterapi sampai selesai, sebanyak 6 kali dan dilakukan pengamatan 2 tahun. Data dianalisis dengan program SPSS 16.0, dilakukan analisis cox regression dan ditampilkan dalam kurva Kaplan Meier.Hasil: Didapatkan hasil 55 pasien diberikan cisplatin-etoposide dan 55 pasien diberikan cisplatin-docexatel. Kesintasan 1 tahun EC sebesar 30,9% dan DC sebesar 47,3%, (p=0.030). Kesintasan 2 tahun EC sebesar 0% dan DC sebesar 5,5%, (p 0.003). Median time survival antara EC selama 27 minggu dengan DC selama 38 minggu (p< 0,016). Dibandingkan DC, kemoterapi EC dapat meningkatkan risiko kematian dengan HR 1,684 (IK95% 1,010-2,810). Kelompok subyek yang menggunakan rejimen kemoterapi DC memiliki PFS 20,1 minggu, sedangkan kelompok subyek yang menggunakan rejimen kemoterapi EC memiliki PFS 16,8 minggu (p=0,022).Kesimpulan: Kesintasan cisplatin-docexatel lebih baik bila dibandingkan dengan cisplatin-etoposide, demikian juga dengan progression free survivail.

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ABSTRACTBackground: One of the therapy for the advanced Non-Small Cell Lung Cancer (NSCLC) is chemotherapy. The most frequent regiment used in Indonesia is Cisplatin-Etoposide (EC) and Cisplatin-Docetaxel (DC). The success of chemotherapy is measured with the 1-year survival, 2-year survival, and the Progression Free Survival (PFS) rate. The success is influenced by many factors, such as the dosage, administer intensity, chemotherapy regiment, type of histology, stage, performance status, comorbidity, and social economic. In Indonesia, funding and chemotherapy regiment are the common problems for the success of chemotherapy.Goal: To determine the 2-year survival rate and PFS rate differences between EC against DC of advanced NSCLC patients.Method: The study is a retrospective Cohort study with survival analysis. The Patients included to this study were the advanced NSCLC (At least Stadium IIIa) who came to RSKD and RSCM during January 2006 – December 2010 for their first chemotherapy until finished the cycle (6 times) and had 2-year monitoring. Data was analyzed by SPSS 16.0 by cox regression analysis, and featured on the Kaplan Meier Curve.Result: Fifty five patients were given EC and the other 55 patients were given DC. One year survival rate of EC was 30,9% and DC was 47,3%, (p=0.030). Two year survival rate of EC was 0% and DC was 5.5% (p 0.003). The median time survival of EC was 27 weeks and DC was 38 weeks (p<0.016). Compared to DC, EC chemotherapy increased the death risk by HR 1,684 (CI 95% 1,010-2,810). The PFS rate of the subjects who were given EC chemotherapy regimen was 20.1 weeks, while the patients who were given DC chemotherapy regimen was 16.8 weeks (p=0.022).Conclusions: The survival with cisplatin-docexatel was better compared to cisplatin-etoposide, this applies to PFS as well."