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"Latar Belakang: Gangguan pada aksis hipotalamus hipofisis merupakan salah satu efek samping lanjut akibat radiasi yang dapat menyebabkan terjadinya hipogonadism. Namun sedikit diketahui tentang pengaruh dosis radiasi di hipofisis dengan risiko terjadinya hipogonadism.Tujuan: Untuk mengetahui adakah perubahan hormon FSH, LH dan testosteron pada pasien pasca radiasi serta mengetahui hubungan antara dosis radiasi di hipofisis dengan perubahan nilai hormon tersebut.Metode: Penelitian retrospektif pada pasien yang telah menjalani radiasi lebih dari 1 tahun yang lalu. Dosis radiasi di hipofisis didapatkan dari data pada Treatment Planning System (TPS) saat perencanaan radiasi dan nilai hormon FSH, LH, dan testosteron didapatkan dari pemeriksaan laboratorium.Hasil: Didapatkan 20 pasien yang masuk dalam kriteria inklusi dan eksklusi pada penelitian ini dengan rerata usia 40,2±6,66 tahun, median follow up 20,5 (13-66) bulan dan median Dmax hipofisis 49,81 (2,72-73,34) Gy. Tidak didapatkan kasus dengan defisiensi FSH dan LH, namun didapatkan 1 kasus (5%) dengan defisiensi testosteron. Rerata nilai hormon FSH adalah 10,65±5,42 mIU/mL, LH 6,25±2,51 mIU/mL, dan testosteron 4,83±1,40 ng/mL. Terdapat korelasi positif antara Dmax hipofisis dengan FSH (r 0,409) dan korelasi negatif antara Dmax hipofisis dengan LH (r -0,230) dan testosteron (r -0,302). Pada subgrup analisis didapatkan pada kelompok dengan Dmax hipofisis >60 Gy terdapat median nilai FSH yang lebih tinggi (p 0,015) serta median nilai LH dan testosteron yang lebih rendah dibandingkan pada kelompok dengan Dmax hipofisis ≤60 Gy.<Kesimpulan: Gangguan pada aksis hipotalamus hipofisis dapat menyebabkan perubahan nilai hormon FSH, LH, dan testosteron. Dosis radiasi di hipofisis berhubungan dengan perubahan nilai hormon tersebut.

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Background: Disruption of the hypothalamic-pituitary axis is one of the late side effects of radiation which can cause hypogonadism. However, little information about the influence of radiation dose in pituitary due to risk of hypogonadism.

Objectives: To determine changes of patient's FSH, LH, testosterone after radiation and relationship between radiation dose in pituitary.

Methods: Retrospective study of patients who underwent radiation more than 1 year ago. The radiation dose of pituitary is obtained from data in Treatment Planning System (TPS) and values ​​of the FSH, LH,

Results: There were 20 patients who met the inclusion and exclusion criteria in this study with mean age of 40.2 ± 6.66 years, median follow-up of 20.5 (13-66) months and median Dmax pituitary of 49.81 (2.72-73 .34) Gy. There were no cases with FSH and LH deficiency, but there was 1 case (5%) with testosterone deficiency. The mean FSH value was 10.65 ± 5.42 mIU/mL, LH 6.25 ± 2.51 mIU/mL, and testosterone 4.83 ± 1.40 ng/mL. There is positive correlation between pituitary Dmax and FSH (r 0.409) and negative correlation with LH (r -0.230) and testosterone (r -0.302). In the subgroup analysis, it was found that in the Dmax pituitary >60 Gy there was a higher median FSH value (p 0.015) and lower median LH and testosterone values ​​than in the Dmax pituitary ≤60 Gy.

Conclusion: Disorders of the hypothalamic-pituitary axis can cause changes in the values ​​of FSH, LH, testosterone. The radiation dose of pituitary is related to changes in hormone values."

"Radiotherapy is one of treatment's modalities for head and neck malignancies. Its successful rate in curing cancer is undeniable. However, the patient will suffer several side effects or oral complications due to the treatment. If this condition is not properly managed, it can lead to the decline of patient's quality of life. There are 4 aspects that can be used as indicators of quality of life for the case of head and neck that must be aware of which are: (1) disturbing pain, (2) problem in chewing and swallowing, (3) problem in oral communication, (4) patient's emotion. In order to maintain patient's quality of life, patients must have the willingness to recover and follow all instructions suggested by the medical staffs in charge and receive full support of the family and health personnel which include oncology radiotherapist, dentists, and all the paramedics involved."

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 362-367Information on reliable factors to predict patient outcome is important for deciding upon the best treatment to increase loco-regional control, overall survival and quality of life of patients with head and neck squamous cell carcinoma (HNSCC). The objective of this study was to investigate the role of clinico-pathological parameters as predictors of disease recurrence in patients with HNSCC. We studied fifty patients who were seeking treatment for primary HNSCC in Westmead Hospital between 2002-2004. Univariate analysis was used to identify any significant association between clinico-pathological parameters and disease recurrence. It was showed that age (p=0.008), cTNM stage (p=0.02), size of tumour (p=0.009) and positive tumour margin (p=0.002) predicted the risk of the development of disease recurrence. In agreement with other studies we found that some traditional factors influenced disease recurrence. A longer follow-up study should be performed to assess the significance of these factors on overall survival as well as separate studies on prognostic indicators for patients with histologically negative lymph node."

"Latar belakang: Risiko kaheksia pada pasien kanker kepala dan leher KKL meningkat akibat tumor itu sendiri, letak tumor, dan pemberian terapi medis. Penurunan berat badan akibat efek samping radioterapi atau kemoradioterapi dapat menurunkan angka kesintasan dan kualitas hidup, serta meningkatkan angka morbiditas dan mortalitas. Terapi medik gizi klinik bertujuan mencegah malnutrisi bertambah berat, memperbaiki kualitas hidup, dan mendukung outcome terapi yang baik. Terapi medik gizi klinik berupa konsultasi individu, meliputi pemberian nutrisi adekuat sesuai kebutuhan energi, makronutrien, mikronutrien, dan nutrien spesifik, serta terapi medikamentosa dan edukasi.Metode: Pasien pada serial kasus ini berjumlah empat orang, berusia 32 ndash;53 tahun. Satu orang pasien dengan diagnosis karsinoma lidah dan 3 orang dengan kanker nasofaring. Dua dari 4 pasien menjalani kemoradioterapi. Semua terdiagnosis kaheksia pada awal pemeriksaan. Kebutuhan energi total dihitung menggunakan persamaan Harris-Benedict untuk kebutuhan basal dikalikan faktor stres 1,5. Pemantauan meliputi keluhan subjektif dan pemeriksaan objektif tanda vital, kondisi klinis, antropometrik, massa otot, massa lemak, kekuatan genggam tangan, Karnofsky Performance Status, analisis asupan, dan laboratorium . Pemantauan dilakukan secara berkala setiap minggu untuk menilai pencapaian target pemberian nutrisi.Hasil: Terapi medik gizi klinik pada keempat pasien meningkatkan asupan energi, protein, dan nutrien spesifik asam amino rantai cabang dan eicosapentaenoic acid . Penurunan BB, massa otot, dan kapasitas fungsional yang terjadi pada pasien hanya minimal.Kesimpulan: Terapi medik gizi klinik pada pasien KKL dengan kaheksia dalam radioterapi atau kemoradioterapi dapat meningkatkan asupan nutrisi dan meminimalkan penurunan status gizi pasien lebih lanjut.

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Introduction: The risk of cachexia of head and neck cancer HNC is increased because of the tumor itself, site of the tumor, and side effects of cancer treatment. Weight loss during radiotherapy or chemoradiotherapy will decrease the survival rates and quality of life, and increase morbidity and mortality rates. The purpose of medical therapy in clinical nutrition is to prevent further malnutrition during therapy, improve quality of life, and support the good outcome of cancer treatment. Individual medical therapy in clinical nutrition include adequate energy, macro and micronutrient, and specific nutrients requirements, pharmacotherapy and education.

Methods: Four HNC patients in this case series aged between 32 and 53. One patient diagnosed squamous cell carcinoma of the tongue and 3 patients with nasopharyngeal cancer. Two of four patients received chemoradiotherapy. Total energy requirement was calculated using Harris Benedict equation for basal energy need multipled by stress factor of 1,5. Monitoring include subjective complaints and objective examination vital sign, physical examination, anthropometric, muscle mass, fat mass, handgrip strength, Karnofsky Performance Status, dietary analysis, and laboratory. Monitoring was performed routinely every week to assess achievement of the nutrition therapy target.

Results: Medical therapy in clinical nutrition to four patients can increase the intake of energy, protein, and specific nutrients branched chain amino acid and eicosapentaenoic acid. The decreased of weight, muscle mass, and functional capacity during radiotherapy or chemoradiotherapy were only minimal.

Conclusion: Medical therapy in clinical nutrition for HNC patients with cachexia on radiotherapy or chemoradiotherapy can increase nutrition intake and minimalized further malnutrition."

"Latar Belakang: Kanker kepala dan leher terdapat 10 dari keseluruhan kasus kanker di seluruh tubuh. Efek samping akibat terapi kanker berdampak signifikan pada kualitas hidup pasien. Instrumen yang sering digunakan untuk menilai kualitas hidup pasien kanker kepala dan leher salah satunya adalah University of Washington Quality of Life UW-QOL. Hingga saat ini belum pernah dilakukan adaptasi kuesioner UW-QOL ke bahasa Indonesia. Tujuan: Penelitian ini bertujuan mendapatkan instrumen UW-QOL adaptasi bahasa Indonesia yang valid dan reliabel untuk menilai kualitas hidup pasien kanker kepala dan leher. Metodologi: Penelitian ini berdesain potong lintang, dilakukan di poliklinik THT FKUI/RSCM dr. Cipto Mangunkusumo terhadap pasien kanker kepala dan leher usia dewasa. Hasil: Uji validitas menggunakan uji korelasi Spearman dengan korelasi bermakna pada seluruh butir pertanyaan di tingkat signifikansi p

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Background: Head and neck cancer accounts for 10 of all cancer cases throughout the body.. Side effects due to cancer therapy have a significant impact on patient quality of life. The University of Washington Quality of Life UW QOL is the most frequent intruments used to assess the quality of life of head and neck cancer patients. At present, the Indonesian version of UW QOL questionnaire is not available.

Objective: This study aims to obtain a valid and reliable Indonesian adaptation of UW QOL to assess the quality of life of head and neck cancer patients.

Method: Cross sectional study was conducted in ORL HNS Department outpatient clinic dr. Cipto Mangunkusumo hospital towards 41 adult patients with head and neck cancer.

Result: The validity test using Spearman correlation test with significant correlation in all questions items at the level of significance p"

"Pasien kanker kepala leher rentan mengalami malnutrisi akibat penurunan sensitivitas indera pengecap yang sudah terjadi sejak awal diagnosis dan akan diperberat oleh terapi. Seng merupakan salah satu zat gizi yang berperan dalam proses metabolisme utama seperti regulasi siklus sel dan pembelahan sel, sintesis protein dan penyembuhan luka termasuk di antaranya sel-sel taste bud pada indera pengecap. Penelitian ini bertujuan untuk melihat hubungan antara asupan seng dengan kepekaan indera pengecap pada pasien kanker kepala leher sebelum menjalani kemoradiasi. Penelitian menggunakan desain potong lintang pada subyek dewasa dengan kanker kepala leher sebelum kemoradiasi di RSCM. Asupan seng dinilai menggunakan FFQ semi kuantitatif. Kepekaan indera pengecap dinilai dengan menggunakan 3-stimulus drop technique yang dikembangkan oleh Mossman dan Henkin untuk 4 kualitas rasa (asin, manis, asam, dan pahit). Sebanyak 85 subyek penelitian dengan median usia 54 tahun, mayoritas laki-laki, terdiagnosis kanker nasofaring dengan jenis karsinoma sel skuamosa dan stadium IV. Rerata subyek memiliki status gizi normal, dengan median asupan energi 28 (15-58) kkal/kgBB dan protein 1 (0-3) g/kgBB. Median asupan seng pada subyek sebesar 8 (3-24) gram dengan FFQ semi kuantitatif. Kepekaan indera pengecap subyek didapatkan paling tinggi berturut-turut adalah untuk rasa asam, pahit, asin, dan manis. Dilakukan uji korelasi antara asupan seng dengan kepekaan indera pengecap. Tidak ditemukan adanya korelasi bermakna antara asupan seng dengan kepekaan indera pengecap pada pasien kanker kepala leher praradiasi baik rasa manis (r= -0,170, p= 0,120), asin (r= -0,085, p= 0,442), asam (r= 0,080, p= 0,467), ataupun pahit (r= -0,131, p= 0,233).

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Head and neck cancer patients are susceptible to malnutrition due to decreased taste sensitivity that has occurred since first diagnosed and worsened by therapy. Zinc is a nutrient that plays a role in major metabolic processes such as regulation of the cell cycle dan cell proliferation, protein synthesis and wound healing, including taste bud cells. This study aims to examine the relationship between zinc intake and taste sensitivity in head and neck cancer patients before undergoing chemoradiation. The study used a cross-sectional design on adult head and neck cancer subjects who have not been undergone chemoradiation at RSCM. Zinc intake was assessed using a semi-quantitative food frequency questionnaire. Taste sensitivity was assessed using the 3-stimulus drop technique developed by Mossman and Henkin for 4 taste qualities (salty, sweet, sour, and bitter). A total of 85 subjects with a median age of 54 years, most of them are male, diagnosed with nasopharyngeal cancer and already at stage IV. On average, the subjects had normal nutritional status, median energy intake was 28 (15-58) kcal/kgBW and protein 1 (0-3) g/kgBW. The median zinc intake in subjects was 8 (3-24) grams assessed with a semi-quantitative FFQ. The highest taste sensitivity of the subjects was sour, bitter, salty, and sweet, respectively. A correlation test was conducted between zinc intake and taste sensitivity. There was no significant correlation between zinc intake and taste sensitivity in head and neck cancer patients before chemoradiation, either sweet (r= -0.170, p= 0.120), salty (r= -0.085, p= 0.442), sour (r= 0.080), p= 0.467), or bitter (r= -0.131, p= 0.233)."

"Imaging is crucial in the multidisciplinary approach to head and neck cancer management. The rapid technological development of recent years makes it necessary for all members of the multidisciplinary team to understand the potential applications, limitations, and advantages of existing and evolving imaging technologies. It is equally important that the radiologist has sufficient clinical background knowledge to understand the clinical significance of imaging findings. This book provides an overview of the findings obtained using different imaging techniques during the evaluation of head and neck neoplasms, both before and after therapy. All anatomic areas in the head and neck are covered, and the impact of imaging on patient management is discussed in detail. The authors are recognized experts in the field, and numerous high-quality images are included. This second edition provides information on the latest imaging developments in this area, including the application of PET-CT and diffusion-weighted magnetic resonance imaging."

"Head and Neck Surgery and Oncology, by Drs. Jatin P. Shah Snehal G. Patel, and Bhuvanesh Singh, offers you authoritative, multidisciplinary guidance on the latest diagnostic and multidisciplinary therapeutic approaches for head and neck cancer. With this medical reference book, you'll have all the help you need to offer your patients the best possible prognoses and to optimally preserve and restore form and function. Overcome any challenge in head and neck surgery with comprehensive coverage of the scalp, skull base, paranasal sinuses, oral cavity, pharynx, larynx, cervical lymph"