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Latar Belakang: Kanker ovarium merupakan salah satu kanker yang menyebabkan kematian paling tinggi pada wanita. Tujuh puluh persen saat didiagnosis ditemukan pada stadium lanjut, dengan angka kesintsan dalam 5 tahun hanya 46 . Modalitas terapi saat ini adalah sitoreduksi dengan kemotterapi adjuvant platinum based sebagai lini pertama. Efektivitas kemoterapi hanya 60 pada stadium lanjut, untuk selanjutnya berkembang menjadi rekuren. Oleh karena itu dibutuhkan jenis terapi tambahan berdasarkan jenis atau agen yang bekerja spesifik di sel kanker dan dapat bersinergi dengan pengobatan standar saat ini. Kurkumin sebagai salah satu agen yang banyak diuji memiliki efek anti-kanker. Kurkumin berpotensi sebagai anti kanker dan bekerja pada semua multistep karsinogenesis. Kurkumin dapat bekerja sebagai antiproliferasi dan meningkatkan apoptosis.Tujuan: untuk mengetahui antiproliferasi ekspresi Ki67 dan apoptosis caspase 3 dan caspase 8 kombinasi cisplatin dengan nanokurkumin pada sel hayati SKOV3.Metode: Penelitian ini dilakukan uji eksperimental in vitro dengan menggunakan sel hayati SKOV3 untuk mengetahui antiproliferasi ekspresi Ki67 dan apoptosis caspase 3 dan caspase 8 kombinasi cisplatin dengan nanokurkumin pada sel tersebut. Uji analisis data dengan T tidak berpasangan bila sebaran normal / uji Mann Whitney bila sebaran tidak normal serta menggunakan Graph Pad Prism.Hasil: Berdasarkan penelitian ini, didapatkan cc50 nanokurkumin 67 m dan cc50 cisplatin 54 m dengan menggunakan metode MTT Assay. Viabilitas sel pada penelitian ini menurun sesuai dengan dose dependent, dimana pada dosis kombinasi nanokurkumin 134 m dengan cisplatin 108 m ditemukan sel hidup yang paling rendah 24.3 p

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ABSTRACT
Background Ovarian cancer is one of the most leading cancers in women. Seventy percent at the time of diagnosis are found at an advanced stage, with a 5 year survival rate of only 46 . The current treatment modality is cytoreduction with platinum based adjuvant chemotherapy as first line. The effectiveness of chemotherapy is only 60 at an advanced stage, to further develop into recurrent. Therefore, additional types of therapy are required based on types or agents that work specifically in cancer cells and can synergize with current standard treatments. Curcumin as one of the many tested agents has anti cancer effects. Curcumin has the potential effect as an anti cancer and works on all multisteps of carcinogenesis. Curcumin can work as an antiproliferation and increase apoptosis.Objective to know antiproliferation effect expression Ki67 and apoptosis effect caspase 3 and caspase 8 of combination cisplatin with nanokurkumin on cell SKOV3.Methods This experimental study was conducted in vitro by using biological cell line SKOV3 to know antiproliferation effect expression Ki67 and apoptosis effect caspase 3 and caspase 8 of combination cisplatin with nanokurkumin on the cell. The data was analysed with unpaired T when normal distribution Mann Whitney test when distribution is not normal and also using Graph Pad Prism.Result Based on this result, cc50 of nanokurkumin is 67 m and cc50 of cisplatin is 54 m by using MTT Assay method. The viability of the cells in this study decreased according to the dose dependent, whereas in the combined dose of 134 m nanocurcumin with 108 m cisplatin found the lowest life cell 24.3 p

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[ABSTRAK
Penelitian ini bertujuan untuk mengetahui gambaran umum kanker ovarium di Rumah Sakit Ciptomangunkusumo (RSCM) 5 tahun terakhir beserta faktor-faktor yang berhubungan dengan kanker ovarium. Penelitan ini mengambil data pasien kanker ovarium selain tipe borderline yang terdapat di Cancer Registry divisi Ginekologi Onkologi dan masih memiliki rekam medis di RSCM pada periode Januari 2010 – Desember 2014, dilakukan follow up untuk mengetahui kesintasan hidup selama 4 tahun. Kami mendapatkan 98 subyek penelitian. Pada penelitian ini didapatkan insidensi kanker ovarium terbanyak pada usia 45-54 tahun (33,6%), insidensi kanker ovarium menurun dengan bertambahnya jumlah anak, sebagian besar kanker ovarium merupakan tipe epitelial (76,5%) dan sebagian besar pasien didiagnosa pada stadium lanjut (55.1%). Kesintasan hidup 4 pasien kanker ovarium tipe epitelial 77%; tipe germinal 83.3%; tipe stroma 100%. Kesintasan hidup 4 tahun dengan terapi pembedahan 84.1%; pembedahan disertai kemoterapi adjuvan 83.3%; kemoterapi neoadjuvan sebelum pembedahan 68.4%. Terdapat 63% respon komplit pada kelompok kemoterapi adjuvan; dan 41.2% pada kelompok kemoterapi neoadjuvan.

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ABSTRACT
The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy.;The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy.;The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy., The aim of this research is to describe the incidence of ovarian cancer and its characteristic in Ciptomangunkusumo Hospital in the last 5 year. The data was collected from Gynecology Oncology Division’s Cancer Registry and RSCM’s medical record from Januari 2010 – December 2014, follow up was performed to know the survival. There was 98 subject in this research. The result was : majority incidence of ovarian cancer was in the age 45-54 years old (33,6%); ovarian cancer incidence decrease in parity’s group; the majority histotype was epithelial (76.5%); and most of them were diagnosed on advanced stage (55.1%). The 4 year survival rate for epithelial was 77%; germinal was 83,3%; and stromal was 100%. Based on therapy the 4 year survival rate was 84.1%; 83.3% in adjuvant chemotherapy group; and 68.4% in neoadjuvan chemotherapy. In the group of adjuvant chemotherapy there was 63% complete respon and 41.2% in neoadjuvan chemotherapy.]

Abstrak :
Latar Belakang: Cisplatin, agen kemoterapi utama dalam terapi kanker ovarium, memiliki sifat hepatotoksik karena menginduksi stres oksidatif. Kurkumin dapat meningkatkan kadar atau aktivitas antioksidan endogen seperti enzim superoksida dismutase dan glutation. Formulasi nanopartikel kurkumin dapat meningkatkan bioavailabilitas kurkumin dan distribusinya pada organ target. Penelitian ini bertujuan untuk mengetahui pengaruh nanokurkumin terhadap hepatotoksisitas akibat cisplatin melalui regulasi antioksidan endogen SOD dan GSH. Metode: 25 ekor tikus galur Wistar betina dibagi ke dalam 1 kelompok sham dan 4 kelompok model kanker ovarium yang diinduksi DMBA pada penelitian in-vivo ini. Empat kelompok tersebut adalah kelompok tanpa terapi, cisplatin 4 mg/KgBB intraperitoneal, cisplatin dengan kurkumin konvensional 100 mg/KgBB per oral, atau cisplatin dengan nanopartikel kurkumin dalam kitosan 100 mg/KgBB per oral. Setelah perlakuan selama 1 bulan, hepar tikus diambil dan disimpan beku. Pengukuran aktivitas SOD, kadar GSH, dan kadar GSSG dilakukan dengan metode spektrofotometri. Hasil: Uji statistik pada kadar GSH, GSSG, dan aktivitas SOD menunjukkan peningkatan yang signifikan pada kelompok ko-kemoterapi kurkumin konvensional dibanding monoterapi cisplatin (p<0.05). Tidak ada perbedaan yang bermakna antarkelompok pada rasio GSH/GSSG (p>0.05) dan tidak ditemukan perbedaan bermakna antara kedua kelompok ko-kemoterapi pada semua variabel (p>0.05). Kesimpulan: Kurkumin konvensional dan nanokurkumin setara dalam meregulasi antioksidan endogen SOD dan GSH pada tikus model kanker ovarium yang mendapat cisplatin. ......Introduction: As the primary chemotherapeutic agent of choice for ovarian cancer, cisplatin has hepatotoxic properties via oxidative stress induction. Curcumin can increase the levels and activities of endogenous antioxidants like superoxide dismutase enzyme and glutathione. Formulation of curcumin nanoparticles increases its bioavailability and target organ distribution. This research aims to elucidate the effects of nanocurcumin on cisplatin-induced hepatotoxicity via regulation of endogenous antioxidants, SOD and GSH. Method: 25 Wistar female rats were grouped into 1 sham group and 4 DMBA-induced ovarian cancer model groups in this in-vivo study. Four cancer model groups were further divided into no-treatment, 100 mg/KgBW intraperitoneal cisplatin therapy, cisplatin with oral 100 mg/KgBW conventional curcumin, and cisplatin with oral 100 mg/KgBW curcumin nanoparticle in chitosan group. The liver of the rats were taken and frozen after one month of treatment. Spectrophotometry was used to measure the activities of SOD, levels of GSH, and levels of GSSG. Results: Statistic tests on levels of GSH, GSSG, and activity of SOD showed significant increase in the curcumin cochemotherapy against cisplatin monotherapy (p<0.05). There was no significant difference within the groups of GSH/GSSG ratio (p>0.05) and no significant difference was found between the curcumin co-chemotherapy and nanocurcumin co-chemotherapy groups in all the variables (p>0.05). Conclusion: Conventional curcumin and nanocurcumin administration are similar in regulating endogenous antioxidants SOD and GSH on rats with ovarian cancer model treated with cisplatin.

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Kanker ovarium masih menempati urutan kedua terbanyak dalam keganasan ginekologi dan merupakan penyebab utama kematian akibat kanker pada perempuan. Banyak bukti menunjukkan bahwa kanker ovarium umunya dalam pengaruh stress oksidatif. Dalam penelitian ini bertujuan untuk mengetahui aktivitas stress oksidatif melalui pengukuran enzim Superoxide Dismutase (SOD) dan kadar Malondialdehyde (MDA) pada penderita keganasan ovarium dibandingkan dengan penderita tumor jinak ovarium. Penelitian dilakukan dengan uji potong-lintang yang dilaksanalan di Ruang Rawat Kebidanan Ginekologi RSCM Jakarta, RS Persahabatan Jakarta dan RS Fatmawati Jakarta pada Juli hingga Desember 2018. Seluruh penderita keganasan ovarium dan penderita tumor jinak ovarium yang memenuhi kriteria diikutsertakan dalam penelitian ini. Darah penderita tumor ovarium diambil sebelum dilakukan operasi, lalu sampel dilakukan pengukuran kadar SOD dan MDA. Terdapat 35 penderita keganasan ovarium dan 43 penderita tumor jinak ovarium yang diikutsertakan dalam penelitian ini. Rerata atau median kadar SOD dan MDA pada penderita keganasan ovarium adalah 1,23 (0,24-5,709) dan 0,803 ± 0,316 , sementara rerata atau median kadar SOD dan MDA pada penderita tumor jinak ovarium adalah 0,488 (0,101-1,86) dan 0,634 ± 0,266. Terdapat perbedaan kadar SOD dan MDA yang bermakna antara kedua kelompok. Terdapat perbedaan kadar SOD yang bermakna antara penderita keganasan ovarium stadium awal dengan penderita keganasan ovarium stadium lanjut. Sementara pada pemeriksaan MDA tidak terdapat perbedaan bermakna antara penderita stadium awal dengan stadium lanjut. Kesimpullan pada penelitian ini terdapat perbedaan kadar SOD dan MDA yang bermakna antara penderita keganasan ovarium dengan penderita tumor jinak ovarium.

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Ovarian cancer is the leading cause of death due to gynecological malignancies among women. A lot of evidence shows that ovarian cancer is generally influenced by oxidative stress. In this study aims to determine the activity of SOD enzymes and MDA levels in patients with ovarian malignancies and patients with benign ovarian tumors. The study was conducted by cross-sectional tests carried out in the RSCM Jakarta Gynecology Obstetric Room and Persahabatan Hospital Jakarta and Fatmawati Hospital Jakarta in July to December 2018. All patients with ovarian malignancies and patients with benign ovarian tumors who met the criteria were included in this study. Blood from ovarian tumor patients taken before surgery, then the samples were measured for SOD and MDA levels. There were 35 ovarian malignancies and 43 patients with benign ovarian tumors included in the study. The mean or median level of SOD and MDA in patients with ovarian malignancy is 1.23 (0.24 - 5.709) and 0.803 ± 0.316, while the mean or median level of SOD and MDA in patients with benign ovarian tumors is 0.488 (0.101-1.86) and 0.634 ± 0.266. There were significant differences in SOD and MDA levels between the two groups. There were significant differences in SOD levels between patients with early-stage ovarian malignancies and those with advanced ovarian malignancies. While on MDA examination there were no significant differences between patients with early stages with advanced stages. Conclusion in this study were significant differences in SOD and MDA levels between ovarian malignancies and patients with benign ovarian tumors