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"Latar Belakang: Berdasarkan fitur radiologisnya seperti ukuran, lokasi, tepi nodul, serta adanya kavitas dan air bronchogram intratumoral, CT scan dapat membantu membedakan antara adenokarsinoma (AK) dan karsinoma sel skuamosa (KSS). CT scan merupakan modalitas non invasif. Tujuan: Mengetahui gambaran radiologi pada subtipe AK dan KSS paru menggunakan CT toraks sebagai alat bantu dalam mendiagnosis karsinoma paru. Metode: Dilakukan evaluasi CT scan berupa lokasi, kavitas dan airbronchogram intratumoral, tepi tumor dan densitas tumor pada 31 subjek AK dan 16 subjek KSS yang memenuhi kriteria penelitian. Analisis bivariat dilakukan dengan uji Chi Square atau Fisher. Analisis multivariat dilakukan dengan analisis regresi logistik. Hasil: Proporsi tumor AK lebih banyak berlokasi di perifer, sedangkan KSS lebih banyak di sentral. Kavitas intratumoral lebih sering bermanifestasi pada KSS dibandingkan AK. Tepi berspikulasi lebih banyak terlihat pada AK dibandingkan KSS. Air bronchogram dan lesi subsolid lebih sering bermanifestasi pada AK. Kesimpulan: Terdapat perbedaan yang signifikan pada variabel densitas tumor di mana lesi subsolid lebih sering bermanifestasi pada AK dibandingkan KSS.

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Background: Based on its radiological features such as size, location, nodule margins, as well as the presence of intratumoral cavities and air bronchograms, CT scans can aid in distinguishing between adenocarcinoma (AK) and squamous cell carcinoma (KSS). CT scans are a non-invasive modality. Objective: To assess the radiological characteristics of lung cancer subtypes AK and KSS using thoracic CT scans as a diagnostic tool. Methods: CT scans were evaluated for location, intratumoral cavities, air bronchograms, tumor margins, and tumor density in 31 AK subjects and 16 KSS subjects who met the study's criteria. Bivariate analysis was conducted using the Chi-Square or Fisher's test. Multivariate analysis was performed using logistic regression. Results: The proportion of AK tumors is more often located in the periphery, whereas KSS tumors tend to be more central. Intratumoral cavities are more frequent in KSS than AK. Spiculated margins are more common in AK than KSS. Air bronchograms and subsolid lesions are more frequent in AK. Conclusion: There is a significant difference in tumor density, with subsolid lesions being more common in AK than in KSS."

"ABSTRAKAdenocarcinoma paru merupakan salah satu jenis kanker paru yang sering ditemukan pada pasien. Pada pasien yang mengalami berupa efusi pleura dapat memperburuk prognosis dan mempersulit terapi pasien. Deteksi mutasi genetik penyebab timbulnya sel kanker dapat membantu menentukan terapi yang tepat bagi pasien dengan prognosis yang lebih baik. Metodi genotyping saat ini telah banyak dikembangkan dalam menentukan biormarker sel kanker, salah satunya adalah teknik RFLP Restriction Fragment Length Polymorphism . Penelitian ini bertujuan untuk mendeteksi adanya salah satu mutasi gen yaitu KRAS kodon 12 dan kodon 13 dengan metode RFLP yang relatif lebih sederhana dibanding metode lainnya. Partisipan pada penelitian potong lintang cross section adalah pasien adenocarcinoma paru stage 4 dengan komplikasi efusi pleura. Rentang usia partisipan adalah 28-71 tahun. Sampel yang digunakan pada studi ini berjumlah 28 dan berasal dari efusi pleura yang disimpan pada kertas saring. Hasilnya tidak ditemukan adanya mutasi KRAS kodon 12 dan kodon 13 pada seluruh sampel 0/28 .

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ABSTRACTPulmonary adenocarcinoma is one type of lung cancer that is often found in patients. In patients experiencing pleural effusion may aggravate prognosis and complicate patient therapy. Detection of genetic mutations causing cancer cells can help determine the right therapy for patients with a better prognosis. A current genotyping methodology has been widely developed in determining cancer cell biomarkers, one of which is the RFLP Restriction Fragment Length Polymorphism technique . This study aims to detect the presence of one of the gene mutations KRAS codon 12 and codon 13 with RFLP method is relatively more simple than other methods. Participants in cross sectional study were stage 4 adenocarcinoma patients with complications of pleural effusion. The age range of participants is 28 71 years. The sample used in this study amounted to 28 and came from pleural effusions stored on filter paper. The result was no mutation of KRAS codon 12 and codon 13 on all samples 0 28 ."

"Perawat residensi spesialis medikal bedah kekhususan respirasi yang melakukan praktik di RSUP Persahabatan Jakarta diharapkan dapat menerapkan proses asuhan keperawatan profesional dalam mengatasi masalah pernapasan yang dialami pasien untuk meningkatkan kualitas layanan kesehatan. Kompetensiyang harus dimiliki perawat spesialis diantaranya melakukan asuhan keperawatan profesional dan advokasi, berperan sebagai konsultan keperawatan Clinical Care Manajer (CCM ) bagi staf keperawatan dan pemberi terapi keperawatan kepada pasien. menjadi peneliti dan menerapkan evidence-based nursing practice (EBN), memimpin perubahan (inovator), Kompetensi tersebut sejalan dengan kompetensi yang telah dicapai pada praktik residensi ini. Peran pertama yaitu memberikan asuhan keperawatanprofesional pada pasien utama kanker paru dan 30 kasus resume menggunakan pendekatan teori Self Care Dorothea Orem. bertujuan untuk membantu individu kegiatan memenuhi kebutuhan dalam mempertahankan kehidupan, kesehatan dan kesejahteraan individu baik dalam keadaan sehat maupun sakit yang dilakukan oleh individu itu sendiri. Pasien dengan diagnosa kanker paru, untuk mengetahui stadium nodul kanker parunya. Maka dokter akan melakukan prosedur bronkoskopi. Pasien yang akan menjalani prosedur bronkoskopi, 57.2% pasien merasa takut/cemas. Pada penerapan Evidence Base Nursing (EBN), residen melakukan penerapan pemberian terapi musik binaural beat untuk mengurangi kecemasan pada pasien yang menjalani prosedur bronkoskopi. Hasil penerapan EBN menunjukan bahwa penerapan pemberian terapi musik binaural beat signifikan dalam menurunkan skor kecemasan pasien yang menjalani prosedur bronkoskopi. Implementasi proyek inovasi booklet bundle tracheostomy. Tujuan dari inovasi ini untuk meningkatkan kemampuan dan pengetahuan perawat dalam melakukan perawatan trakeostomi. serta perawat dapat memberikan edukasi terhadap pasien dalam melakukan perawatan trakeostomi secara mandiri.

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Competencies that are required with specialized nurse is to be able do professional nursing care plan, to advocate, to act as nursing consultant in Clinical Care Manager (CCM) for other nursing staff, to give therapy for patients, to be a a researcher and implement evidence-based nursing (EBN) practice, and to be an innovator. These competencies is in line with the competencies that was achieved during this residency practical. The first role is to give professional care plan for patients with primarily lung cancer and 30 case-resumes with the Dorothea Orem Self Care Theory approach, aiming to help individuals with life-sustaining needs, health care needs, and welfare needs during health condition or during illness of the individual. To know the stage of the lung cancer nodules for lung cancer diagnostics, the doctor is required to do bronchoscopy procedure. 57.2% of patients that will undergo bronchoscopy procedure felt scared or worried. In this implementation of Evidence-Based Nursing (EBN), binaural beat music therapy was given for the patients that will be having bronchoscopy procedure to help to reduce the patient's anxiety. The results of the EBN showed that giving binaural beat musical therapy significantly reduced the anxiety score for lung cancer patients that is undergoing bronchoscopy procedure. To implement the innovation project of Tracheostomy Bundle Booklet. The aim for this innovation is to increase the knowledge and ability for nurses to be able to do tracheostomy care. In addition, nurses will be able to educate patients and their families to do tracheostomy care independently if needed for home care."

"Latar Belakang: Beberapa bukti menunjukkan bahwa quiescent cancer stem cell (CSC) terlibat dalam resistans terhadap gefitinib pada adenokarsinoma paru sebagai mekanisme nonmutasi. Kami sebelumnya telah mempublikasikan bahwa gefitinib- resistant persister (GRP) mengekspresikan stemness factor dengan level yang tinggi dan memiliki ciri khas fenotip CSC. Studi terbaru menunjukkan bahwa FBXW7, merupakan jenis protein F-box, memainkan peran penting dalam pemeliharaan quiescent CSC dengan memediasi degradasi protein c-MYC melalui proses ubiquination. Tujuan dari penelitian ini adalah untuk mengetahui peran FBXW7 dalam resistans terhadap gefitinib pada adenokarsinoma paru dengan mutasi EGFR.Metode: Cell line dari sel adenokarsinoma paru, PC9, yang mengandung mutasi sensitif EGFR dipajankan pada gefitinib dengan konsentrasi tinggi untuk mengembangkan GRP. Kami mencoba melakukan abrogasi ekspresi gen FBXW7, dan mengevaluasi sensitivitasnya terhadap gefitinib dan populasi CD133-positive stem cell di GRP. Kami juga memasukkan plasmid FUCCI melalui proses infeksi lentiviral ke dalam sel dan kemudian menyelidiki siklus sel dan sel pada fase G0 dalam GRP. Selanjutnya, kami telah mengembangkan model gefitinib-resistant tumor (GRT) dengan menyuntikkan sel PC9 ke dalam mencit NOG diikuti dengan pemberian gefitinib setelah pertumbuhan tumor, dan mengevaluasi ekspresi mRNA dan ekspresi protein dari penanda terkait quiescence, FBXW7 in vivo.Hasil: GRP menunjukkan ekspresi yang tinggi dari penanda cancer stem cell, CD133 dan penanda terkait quiescence, FBXW7 dan ekspresi c-MYC yang rendah pada tingkat protein secara in vitro. Analisis siklus sel menunjukkan bahwa mayoritas GRP berada pada fase G0/G1. TIndakan abrogasi gen FBXW7 menurunkan populasi sel CD133-positive di GRPs. Abrogasi FBXW7 juga meningkatkan kerentanan sel terhadap gefitinib, membalikkan populasi sel fase G0/G1 menjadi sel S/G2/M, dan menurunkan jumlah sel GRP. Secara in vivo, pada GRT setelah pengobatan gefitinib menunjukkan ekspresi FBXW7 yang tinggi dan ekspresi c-MYC yang rendah. Kami juga menemukan bahwa ekspresi FBXW7 dalam sel CD133-positive meningkat dan ekspresi c-MYC menurun pada mencit dan pada 9 dari 14 spesimen tumor dari pasien adenokarsinoma paru dengan mutasi EGFR resistan terhadap gefitinib.Kesimpulan: Temuan ini menunjukkan bahwa FBXW7 dapat memainkan peran penting dalam pemeliharaan quiescence pada gefitinib-resistant lung CSC pada adenokarsinoma paru dengan mutasi positif EGFR

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Background: Accumulating evidence indicates that quiescent cancer stem cells (CSCs) are involved in the resistance to gefitinib in non-small cell lung cancer (NSCLC) as non-mutational mechanism. We have previously reported that gefitinib-resistant persisters (GRPs) highly expressed stemness factors and had characteristic features of the CSCs phenotype. Recent studies demonstrate that FBXW7, a type of F-box protein, plays an important role in the maintenance of quiescent CSC by mediating the degradation of c-MYC protein by ubiquination. The aim of this study is to figure out the role of FBXW7 in the resistance to gefitinib in lung adenocarcinoma with EGFR mutation.

Methods: lung adenocarcnoma cell lines, PC9, harboring sensitive-EGFR mutation were exposed to high concentration of gefitinib in order to develop GRPs. We tried to knockdown FBXW7 gene expression, and evaluated their sensitivity to gefitinib and CD133-positive stem cell population in GRPs. We also introduced FUCCI plasmid via lentiviral infection in the cells and then investigated the cell cycle and G0-phase cells in GRPs. Furthermore, we established gefitinib-resistant tumor (GRT) model by injecting PC9 cells into NOG-mice followed by gefitinib administration after tumor growth, and evaluated mRNA and protein expression of quiescence-related markers including FBXW7 in vivo.

Results: In vitro, GRPs showed high expression of stem cell marker CD133 and quiescence-related markers including FBXW7 and low expression of c-MYC at protein level. Cell cycle analysis revealed that majority of GRPs existed in G0/G1 phase. Silencing of FBXW7 gene reduced CD133-positive cell population in GRPs. Knockdown of FBXW7 also increased susceptibility of cells to gefitinib, reversed population of G0/G1 cells to G2/S/M cells, and decreased cell number of GRPs. In vivo, GRTs after gefitinib treatment revealed high expression of FBXW7 and low expression of c-MYC. We also found that FBXW7 expression in CD133-positive cells was increased and c-MYC expression was decreased in mice and in 9 out of

14 tumor specimens from EGFR-mutant lung adenocarcinoma patients with acquired resistance to gefitinib.

Conclusion: These findings suggest that FBXW7 plays a pivotal role in the maintenance of quiescence in gefitinib-resistant lung CSCs in EGFR mutation- positive lung adenocarcinoma."

" ABSTRAKAdenokarsinoma paru merupakan keganasan epitel paru yang paling seringdijumpai baik pada perokok aktif maupun pasif. Seiring bertambah majunyateknologi, sudah ditemukan beberapa terapi untuk adenokarsinoma paru, sepertikemoterapi dan farmakogenetik terhadap gen tertentu. Akan tetapi , efek sampingterapi tersebut cukup besar dan hanya ampuh untuk gen tertentu. Oleh karena itu,diperlukan penelitian baru untuk menemukan alternatif terapi adenokarsinoma paru.Asam galat telah lama dikenal memiliki aktivitas antikanker yang baik. Namun,kadar asam galat yang diperlukan untuk menghambat pertumbuhan sel A549 adenokarsinoma paru masih terhitung besar. Untuk memperbaiki farmakokinetikdan farmakodinamik asam galat, dibuatlah derivat-derivatnya melalui modifikasistruktur, dengan menambahkan gugus alkil ester dan alkil eter pada asam galat.Penelitian ini bertujuan untuk membandingkan dan menemukan IC50 asam galatbeserta derivatnya terhadap sel A549 berbasis konsentrasi. Peneliti menggunakandelapan variasi konsentrasi, berkisar antara 0,26 g/ml hingga 33,33 g/ml. Tiapsumur yang berisi sel A549 diinkubasi bersama asam galat dan derivatnya selama24 jam. Pembacaan absorbansi dilakukan menggunakan MTT assay. Hasilpengolahan data menunjukkan etil galat, isoamil galat, sekunder amil galat, heksilgalat, cis-2-heksenil galat, cis-2-oksi-heksenil galat, dan trans-heksenil galatmemiliki nilai IC50 yang lebih baik dari asam galat. Hasil tersebut menunjukkanbahwa modifikasi gugus karboksil pada asam galat dengan gugus alkil ester rantailurus, rantai bercabang, maupun alkil ester yang memiliki ikatan rangkap berisomergeomeri cis dan trans, dapat memperbaiki sitotoksisitas derivat asam galat terhadapsel adenokarsinoma paru A549.Kata kunci: Derivat asam galat, alkil galat, sel paru A549, sitotoksisitas.

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ABSTRAKLung adenocarcinoma is the most common lung epithelial malignancy found inboth active and passive smoker. Recently, chemotherapy and genetic therapy havebeen widely used to treat the lung cancer. Unfortunately, thechemotherapy has theside effects, and the gene therapy can be used only for certain gene involved in thepathogenesis. These facts indicated that the search for new anti lung cancer agentsis needed. Gallic acid has been known to have anticancer activities. However, ittakes a high concentration of gallic acid to inhibit lung adenocarcinoma A549 cells.Therefore, research and development of the new gallic acid derivatives that showhigher cytotoxicity in lower concentration is required. The purpose of this researchis to compare and to find the IC50 value of gallic acid and its derivatives againstlung A549 cells in eight variety of concentrations, ranging of 0,26 g ml to 33,33 g ml. Each lung A549 cells in well is incubated with gallic acid and its derivativesfor 24 hours. The absorbance was read by using MTT assay. The results showedthat ethyl gallate, isoamyl gallate, secondary amyl gallate, hexyl gallate, cis 2 hexenyl gallate, cis 2 oxy hexenyl gallate, and trans hexenyl gallate show lowerIC50 value than gallic acid. These results suggested Thar structure modification oncarboxyl group of gallic acid withalkyl ester group having linear chain andbranched chain, as well as having the double bond with cis or trans configuration,could improve the cytotoxicities of gallic acid derivatives against lung A549 cells.Keyword alkyl gallate, cytotoxicity, gallic acid derivatives, lung A549 cell."

"Latar belakang : Efek potensial EGFR-TKI terhadap fungsi paru belum diinvestigasi secara mendalam. Penelitian ini bertujuan untuk menilai efek pemberian EGFR TKI terhadap fungsi paru terutama nilai DLCO.Metode : Penelitian berlangsung secara prospektif dari September 2018 hingga Juni 2019 di Rumah Sakit Persahabatan Jakarta. Terdapat 20 subjek adenokarsinoma paru dengan mutasi tunggal di exon 19/21 yang dapat menyelesaikan pemeriksaan DLCO baik sebelum mendapat EGFR TKI dan setelah tiga bulan terapi.Hasil : Penelitian ini mendapatkan peningkatan bermakna nilai rerata KVP prediksi dari 60,6% menjadi 68,25% (p=0,03), nilai rerata VEP1 Prediksi dari 59,7% menjadi 67,05% (p=0,036), nilai rerata DLCO dari 11,55 ml/menit/mmHg menjadi 13,72 ml/menit/mmHg (p=0,004) dan DLCO prediksi dari 53,4% menjadi 63,85% (p=0,03). Peningkatan nilai rerata DLCO prediksi paling besar pada kelompok dengan hasil RECIST partial response yaitu sebesar 16,43% (p=0,056).Kesimpulan : Terapi EGFR TKI selama tiga bulan pada subyek adenokarsinoma paru dengan mutasi tunggal exon19/21 dapat meningkatkan fungsi paru secara bermakna baik nilai KVP prediksi, VEP1 prediksi, DLCO, dan DLCO prediksi.

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Background : The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are drugs of choice in non-small cell lung cancer possessing EGFR mutation. Its effect on the lung function is not well understood. This study aims to assess lung function using the lung diffusion capacity (DLCO) test in lung cancer patients treated with EGFR-TKIs. mingMethod :This prospective study included lung cancer patients treated with EGFR-TKIs at Persahabatan Hospital Jakarta, Indonesia, between September 2018 andGrowt June 2019. The study recruited 20 lung adenocarcinoma patients presented with a single mutation at exon 19 or 21 as subjects in the process. Their DLCO was examined before and three months after receiving EGFR-TKI. Subjects were grouped according to the Response Evaluation Criteria in Solid Tumors (RECIST) assessment.Results: There was an increase in predicted FVC from 60.60% to 68.25% (p=0.03), predicted FEV1 from 59.7% to 67.05% (p=0.036%), DLCO from 11.5 mL/minute/mmHg to 13.72 mL/minute/mmHg (p=0.004), and predicted DLCO from 53.4% to 63.85% (p=0.03) during the therapy. The largest increase of predicted DLCO was shown in RECIST group of partial response (16.43%, p=0.056) Conclusion: This study found an improvement in lung function (predicted FVC, predicted FEV1, DLCO, and predicted DLCO) among lung adenocarcinoma subjects exhibiting single mutation at exon 19 or 21 after three months of EGFR-TKIs treatment."

"[ABSTRAKPendahuluan. Kanker paru jenis karsinoma bukan sel kecil (KPKBSK) terdiri dari nonskuamosa dan skuamosa. Kanker paru jenis karsinoma bukan sel kecil nonskuamosa adalah adenokarsinoma dan karsinoma sel besar. Saat ini terapi kanker paru sangat berkembang dari agen kemoterapi sampai terapi target terutama EGFR-TKI. Penelitian ini bertujuan untuk menilai angka tahan hidup pasien KPKSBK nonskuamosa yang mendapat kemoterapi lini pertama dibandingkan terapi EGFR-TKI di RSUP Persahabatan.Metode. Penelitian ini adalah penelitian retrospektif antara tahun 2010 sampai 2013 dari rekam medis pasien KPKBSK non skumosa yang mendapatkan kemoterapi lini pertama dan EGFR-TKI. Pasien dikemoterapi dengan platinum baseddan EGFR-TKI diterapi gefitinib 1x250 mg/hari atau erlotinib 1x150 mg/hari. Angka tahan hidup dinilai dari mulai tegak diagnosis sampai pasien meninggal atau saat penelitian dihentikan.Hasil. Dari 96 sampel KPKBSK non skuamosa terdiri dari 48 pasien yang mendapat kemoterapi lini pertama dan 48 pasien yang diterapi EGFR-TKI. Berdasarkan karakteristik pasien, usia terbanyak adalah 40-60 tahun (kemoterapi 32 (66,7%) dan EGFR-TKI 31 (64,6%) dengan jenis kelamin laki-laki yang mendominasi (kemoterapi 25(52,1%), EGFR-TKI 27 (56,2%). Pasien merokok yang mendapat kemoterapi lini pertama 41,7% dan EGFR-TKI 56,3% dengan IB terbanyak untuk kemoterapi (IB ringan 27,1%) dan untuk EGFR-TKI (IB sedang 22,9%). Jenis histologi adenokarsinoma 95,8% dengan dominasi stage IV 89,6% (kemoterapi 91,7% dan EGFR-TKI 87,5%) disertai tampilan status 2 59,4%. Angka tahan hidup pasien (ATH) 6 bulan 74%, ATH 1 tahun 22,90% dan ATH 2 tahun 6,20%. Masa tengah tahan hidup (MTTH) pasien yang mendapat EGFR-TKI lebih lama sedikit dibandingkan yang mendapat kemoterapi lini pertama (263 hari versus 260 hari.Kesimpulan. Masa tahan hidup 1 tahun pasien KPKBSK non skuamosa yang diterapi EGFR-TKI sedikit lebih lama dibandingkan kemoterapi lini pertama (263 hari vs 260 hari). Sedangkan ATH 1 tahun pasien kemoterapi lini pertama lebih besar dibandingkan EGFR-TKI (25% vs 20,8%). Faktor yang paling mempengaruhi angka tahan hidup adalah stage dengan nilai p<0,05.

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ABSTRACT Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05., Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.]"

"Latar Belakang : Pasien kanker paru rentan terhadap infeksi jamur. Candida dan Aspergillus merupakan jenis jamur paling banyak yang menyebabkan infeksi jamur pada pasien kanker. Penelitian ini bertujuan untuk mengetahui profil klinis, spektrum jamur dan imunoglobulin G spesifik Aspergillus pada pasien kanker paru yang belum dikemoterapi di RSUP Persahabatan.Metode : Penelitian ini berdesain potong lintang. Subjek penelitian adalah pasien KPKBSK yang sudah tegak jenis dan belum dikemoterapi yang berobat di RSUP Persahabatan. Dahak dan serum diperiksakan biakan jamur dan IgG spesifik Aspergillus di Departemen Parasitologi Fakultas Kedokteran Universitas Indonesia. Hasil biakan jamur dan IgG spesifif Aspergillus dianalisis untuk mengetahui hubungannya dengan demografi.Hasil : Subjek penelitian sebanyak 77 pasien. Hasil biakan dahak yang tumbuh jamur sebanyak 76 subjek (98,7%). Jumlah isolat jamur yang tumbuh ≥ dua spesies sebanyak 35 pasien (45,5%). Isolat jamur yang paling banyak tumbuh adalah Candida albicans (72,3%) dan Aspergillus niger (33,8%). Hasil IgG spesifik Aspergillus pada subjek penelitian yang positif sebanyak 22,1%. Terdapat hubungan bermakna antara umur dan leukosit dengan IgG spesifik Aspergillus dan antara umur dan jenis kelamin dengan biakan Aspergillus.Kesimpulan : Isolat jamur yang ditemukan di antaranya adalah Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis dan Candida kruseii. Terdapat hasil IgG spesifik Aspergillus positif pada subjek penelitian sebanyak 22,1%. Umur dan nilai leukosit berhubungan dengan IgG spesifik Aspergillus dengan nilai (p = 0,048) dan (p = 0,014), sedangkan umur dan jenis kelamin berhubungan dengan biakan Aspergillus dengan nilai (p = 0,027) dan (p = 0,035).

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Background: Lung cancer patients are prone to fungal infections. Candida and Aspergillus are the most common cause of fungal infections in cancer patients. This study aimed to determine the clinical profile, fungal detection spectrum and level of Aspergillus specific immunoglobulin-G (igG) of new lung cancer patients prior to chemotherapy at Persahabatan Hospital.

Methods: We performed a cross-sectional study, involving NSCLC patients in Persahabatan Hospital whose type of cancer had been established and had not received chemotherapy as subjects. Sputum and serum of the patients was examined for fungus and Aspergillus specific IgG cultures in the Department of Parasitology Faculty of Medicine, Universitas Indonesia. The results of Aspergillus specific fungi and IgG were analyzed to determine their relationship with demographics.

Results: The study included 77 patients as subjects. Sputum culture detected fungi growth in 76 subjects (98.7%). Fungal isolates that grew ≥ 2 species were present in 35 patients (45.5%). Candida albicans (72.3%) and Aspergillus niger (33.8%) were found from the cultures. Positive Aspergillus specific IgG was present in 22.1% of the subjects. There was a significant relationship between age, leukocytes concentration, and level of Aspergillus specific IgG and between age, sex and Aspergillus culture.

Conclusion: The fungi isolates in this study were Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis and Candida kruseii. Aspergillus specific IgG results were positive in 22.1% of subjects. Age and leukocyte value are associated with Aspergillus specific IgG with (p=0.048) and (p=0.014), and age and sex are associated with Aspergillus culture with (p=0.027) and (p=0.035)."

"Penelitian ini bertujuan untuk mengevaluasi volume target dan akurasi dosis pada kasus intrafraksi menggunakan modalitas pencitraan 4 dimensi dan fantom toraks dinamis in-house. Gerakan intrafraksi dapat membuat kesalahan dalam definisi volume target, yang secara signifikan dapat mempengaruhi akurasi pemberian radiasi. Manajemen gerak menggunakan modalitas 4 dimensi diperlukan untuk mengurangi risiko tersebut. Ukuran target dengan diameter 2 cm dan 3 cm serta amplitudo pernapasan puncak-ke-puncak sebesar 5 mm dan 10 mm sesuai dengan pola sinusoidal diterapkan dalam penelitian ini. Dari variasi ini, ITV dari 10 fase citra 4D-CT (ITV10), proyeksi intensitas rata-rata (AIP), dan mid-ventilation (Mid-V) direkonstruksi dari semua set data 4D-CT sebagai citra referensi. Selain itu, pernapasan bebas (FB), augmentasi napas bebas (Aug-FB), dan citra statis diakuisisi menggunakan protokol 3D-CT untuk perbandingan. Dalam evaluasi dosis, modalitas 4D-CBCT diterapkan sebelum iradiasi untuk mendapatkan koreksi posisi. Kemudian, dosis dievaluasi dengan film Gafchromic EBT3. Hasil menunjukkan bahwa ITV10, AIP, dan Mid-V memberikan GTV yang cocok dengan GTV statis. Citra referensi AIP dan Mid-V memungkinkan pengurangan ITV dan PTV tanpa mengurangi jangkauan area pergerakan target dibandingkan dengan citra FB dan Aug-FB dengan persentase yang bervariasi dalam kisaran 29,17% hingga 52,60%. Dalam evaluasi dosis, nilai diskrepansi antara dosis pengukuran dan perencanaan pada pengiriman dosis dengan citra referensi 3D berada pada kisaran 2,77% hingga 10,29%, dengan nilai terbesar ditemukan pada citra referensi FB. Sedangkan nilai diskrepansi teramati lebih rendah pada citra referensi 4D, yakni berkisar antara 0,94% hingga 6,94%, dengan nilai terbesar ditemukan pada citra ITV10. Modalitas 4D-CT dapat memungkinkan definisi volume target yang akurat dan mengurangi PTV. Selain itu, 4D-CBCT menyediakan citra lokalisasi selama registrasi untuk memfasilitasi koreksi posisi sehingga dapat melakukan pengiriman dosis yang akurat.

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This study aimed to evaluate the target volume and dose accuracy in intrafraction cases using 4-dimensional imaging modalities and an in-house dynamic thorax phantom. Intrafraction motion can create errors in the definition of target volumes, which can significantly affect the accuracy of radiation delivery. Motion management using 4-dimensional modalities is required to reduce the risk. Two variations in both target sizes with diameters of 2-cm and 3-cm and peak-to-peak respiratory amplitudes of 5-mm and 10-mm according to the sinusoidal pattern were applied in this study. From these variations, ITVs countoured in 10 phases of 4D-CT (ITV10), average intensity projection (AIP), and mid-ventilation (Mid-V) images were reconstructed from all 4D-CT datasets as reference images. Free-breathing (FB), augmentation free-breathing (Aug-FB), and static images were also acquired using the 3D-CT protocol for comparisons. In dose evaluations, the 4D-CBCT modality was applied before irradiation to obtain position correction. Then, the dose was evaluated with Gafchromic film EBT3. The results showed ITV10, AIP, and Mid-V provide GTVs that match the static GTV. The AIP and Mid-V reference images allowed reductions in ITVs and PTVs without reducing the range of target movement areas compared to FB and Aug-FB images with varying percentages in the range of 29.17% to 52.60%. In the dose evaluation, the discrepancy of measured and planned doses in dose delivery using 3D reference images was in the range of 2.77% to 10.29%, with the largest value was found in the FB image. While the value of the observed discrepancy is lower in the 4D reference image, which ranges from 0.94% to 6.94%, with the largest value was discovered in the ITV10 image. The 4D-CT modality can enable accurate definition of the target volume and reduce the PTV. Furthermore, 4D-CBCT provides localization images during registration to facilitate position correction and accurate dose delivery."