Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang: Insidens metastasis otak lebih tinggi dibanding tumor primer otak dan berisiko menimbulkan kematian dengan penyebab terbanyak berasal dari kanker paru (36,5%) di RSUPN Cipto Mangunkusumo (RSCM). Keterlambatan diagnosis berisiko menyebabkan herniasi otak, sehingga terjadi kecacatan dan kematian. Dibutuhkan data mengenai durasi penegakan diagnosis di RSCM.Metode penelitian: Penelitian ini merupakan studi deskriptif analitik dengan rancangan kohort retrospktif untuk mengetahui kesesuaian antara durasi penegakan diagnosis tumor otak metastasis akibat kanker paru dengan pedoman praktik klinis (durasi ≤2 minggu). Subjek merupakan pasien rawat inap di RSCM pada Januari 2019 s/d Desember 2021.Hasil: Terdapat 12 subjek (30%) dapat ditegakkan dalam waktu ≤2 minggu dengan  median durasi 18,5 hari (IQR (12-34 hari). Selain itu didapatkan durasi 7 hari (IQR 4-11 hari) untuk sampai didapatkannya massa di paru,  durasi 8 hari (IQR 4.5-13 hari) sampai dilakukannya biopsi, dan 6 hari (IQR 3.5-7 hari) sampai keluarnya hasil patologi anatomi. Tidak terdapat hubungan yang bermakna secara statistik antara variabel yang dinilai dengan durasi penegakan diagnosis ≤2 minggu (14 hari).Kesimpulan: Hanya 30% subjek dengan durasi yang sesuai dengan panduan praktik klinis di RSCM. Dibutuhkan diseminasi hasil dan kolaborasi antar bagian agar penegakan diagnosis lebih cepat.

---

Background: Incidence of brain metastases is higher than primary brain tumors, with lung cancer as common etiology (36.5%) at Cipto Mangunkusumo General Hospital (RSCM). Delay in diagnosis can cause brain herniation, resulting in disability and death. Data is needed regarding the duration of diagnosis in RSCM.

Method: This is a descriptive analytic study with a retrospective cohort design to determine the conformity between the duration of diagnosis of metastatic brain tumors due to lung cancer in daily clinical practice with clinical practice guidelines (duration 2 weeks). Subjects were inpatients at RSCM from January 2019 to December 2021

Results: There were 12 subjects (30%) who could be diagnosed within 2 weeks with a median duration of 18.5 days (IQR (12-34 days). Duration of 7 days (IQR 4-11 days) to obtain a lung mass, 8 days (IQR 4.5-13 days) until a biopsy was performed, and 6 days (IQR 3.5-7 days) until anatomic pathology results were released. There is no statistically significant relationship between the variables assessed and the duration of diagnosis 2 weeks.

Conclusion: Only 30% of subjects with the duration matched the clinical practice guidelines at RSCM. Dissemination of results and collaboration between departments is needed to make diagnosis faster."

"

Latar Belakang: WBRT adalah salah satu terapi utama pada tumor otak metastasis. Gangguan kognitif, terutama memori, adalah komplikasi yang umum terjadi pada WBRT. Preservasi memori merupakan hal yang penting diteliti karena memori memiliki banyak keterkaitan dengan domain kognitif lain, serta dengan kualitas hidup. WBRT dengan hippocampal sparing, dimana hipokampus dilindungi dari radiasi, telah menunjukkan efek protektif pada preservasi memori pada bukti-bukti ilmiah sebelumnya.

Metode: Dilakukan sebuah tinjauan sistematis untuk mengkaji apakah WBRT dengan hippocampal sparing bermanfaat dalam preservasi memori, dibandingkan dengan WBRT konvensional. Pencarian sistematis dilakukan untuk uji klinis dan studi observasional, dengan WBRT hippocampal sparing sebagai intervensi dan memori sebagai salah satu luaran pada basis data mayor, register uji klinis, dan basis data lokal serta gray literature. Penilaian risiko bias dilakukan menggunakan Risk of Bias-2 (RoB-2), Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I), dan Newcastle-Ottawa Scale (NOS), sesuai jenis studi. Data dipresentasikan menggunakan Harvest plot dan focused narrative synthesis.

Hasil: Kami menemukan 8 studi. Studi yang dirandomisasi memiliki risiko bias rendah dan studi yang tidak dirandomisasi memiliki risiko bias sedang. Distribusi Harvest plot menunjukkan gradien positif, yaitu efek protektif WBRT dengan hippocampal sparing.

Kesimpulan: WBRT dengan hippocampal sparing menujukkan efek protektif terhadap fungsi memori pasien tumor otak metastasis dan aplikabel untuk dilakukan di setting RSCM. Diperlukan penelitian lebih lanjut mengenai peran WBRT hippocampal sparing pada pasien di RSCM.

---

Background: Whole brain radiotherapy (WBRT) is the mainstay therapy for metastatic brain tumor. Cognitive dysfunction, particularly memory, is a common side effect of WBRT. Memory preservation has become increasingly popular, as memory is inter-related with other cognitive domains as well as with quality of life. WBRT with hippocampal sparing, where the hippocampus is avoided from radiation, has shown some protective effects in memory preservation in previous studies.

Methods: We conducted systematic review to determine whether WBRT with hippocampal sparing is beneficial in preserving memory compared to conventional WBRT. We systematically searched for clinical trials and observational studies with hippocampal sparing WBRT as the intervention and memory as one of the outcomes. Major databases, clinical trial registries, as well as local databases and gray literature were searched. Risk of bias assessment was performed using Risk of Bias-2 (RoB-2), Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I), and Newcastle-Ottawa Scale (NOS) tools, according to study type. Data were presented using Harvest plot and focused narrative synthesis.

Results: We identified 8 studies, which consisted of randomized and non-randomized studies. All randomized clinical trials showed overall low risk of bias, whereas nonrandomized trials and cohort studies showed moderate risk of bias. Harvest plot distribution showed a positive gradient. i.e. protective effect of hippocampal sparing WBRT.

Conclusions: WBRT with hippocampal sparing is effective in preserving memory in metastatic brain tumor patients. It is applicable to be performed in Cipto Mangukusumo Hospital. Further research is needed to assess its effectiveness in patients of Cipto Mangunkusumo Hospital.

"

"Latar belakang. Tumor otak metastasis berpotensi menyebabkan distres dan psikopatologi, serta menurunkan kualitas hidup pasien. Kerentanan ini terjadi karena beban gejala fisik dari tumor primer dan gejala dari metastasis otak yang dialami. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh psikoterapi suportif pada perbaikan distres, psikopatologi dan kualitas hidup pasien. Metode. Desain penelitian yang digunakan dalam penelitian ini adalah uji klinis randomisasi, tersamar tunggal, desain paralel tanpa matching, pragmatis. 15 pasien kelompok perlakuan adalah pasien tumor otak metastasis yang mendapatkan intervensi psikoterapi suportif sebanyak 6 sesi selama 30-45 menit pada setiap sesi dan perawatan standar dari dokter saraf, sedangkan 15 pasien kelompok kontrol mendapatkan terapi standar dari dokter spesialis saraf saja. Penelitian ini menggunakan kuesioner distress thermometer (DT) untuk menilai distres, Self-rating Questionnaire 20 (SRQ 20) untuk menilai psikopatologi dan World Health Organization Quality of life-Bref (WHOQOL-Bref) untuk menilai kualitas hidup pasien sebelum dan setelah intervensi. Sebelum dilakukan intervensi, dilakukan validasi isi pada modul psikoterapi suportif yang akan digunakan. Tidak ada subjek yang dropped out (lepas pantau) dan loss to followup dalam penelitian ini. Hasil. Hasil penelitian semua subjek kelompok perlakuan sebanyak 15 (100,0%) mengalami perbaikan skor distres, psikopatologi, dan kualitas hidup yang bermakna secara bermakna(P=0,00) sebelum dan sesudah psikoterapi suportif. Selain iut, didapatkan juga perbedaan yang bermakna secara bermaknadalam proporsi pasien yang mengalami masalah psikososial berupa masalah praktis sehari-hari, masalah emosional, dan masalah gejala tumor otak metastasis antara sebelum dan setelah intervensi (P<0,05). Ditemukan juga penurunan rata-rata skor variabel gejala tumor otak metastasis (p=0,00) berupa nyeri kepala (p=0,00), kelemahan (p=0,00), kejang dan penglihatan ganda antara sebelum dan sesudah intervensi psikoterapi suportif, pada kedua kelompok. Nilai keseluruhan validasi modul psikoterapi suportif 96,21% dan validasi isi setiap sesi lebih dari 90% sehingga menunjukkan hasil yang valid. Faktor demografi yang memengaruhi perbaikan skor psikopatologi adalah status ekonomi (p=0,03). Kesimpulan. Psikoterapi suportif berpengaruh secara bermaknadalam menurunkan distres dan psikopatologi, serta meningkatkan kualitas hidup pasien tumor otak metastasis.

---

Background. Patients with metastatic brain tumors are in risk of distress, psychopathology, and reduced quality of life. This vulnerability occurs because of the burden of physical symptoms from the primary tumor and symptoms of metastatic brain tumors experienced by the patients. The purpose of this study was to determine the effectiveness of supportive psychotherapy in alleviating distress, psychopathology, and quality of life of patients with metastatic brain tumors.

Method. This study is a randomized, single-blind, parallel design without matching, pragmatic clinical trial study. 15 patients in the treatment group were metastatic brain tumor patients who received 6 sessions of supportive psychotherapy (30-45 minutes each) and standard care from neurologists, while 15 patients in the control group received standard therapy from neurologists only. This study used distress thermometer (DT) to measure distress, Self-rating Questionnaire 20 (SRQ 20) to measure psychopathology, and World Health Organization Quality of life-Bref (WHOQOL-Bref) to measure quality of life before and after intervention. Prior to intervention, content validation was carried out on the supportive psychotherapy module. There were no dropped out and lost to follow-up subjects in this study.

Results. This study showed that all subjects in the treatment group (n=15; 100%) experienced significant improvements on distress, psychopathology, and quality of life scores (P=0.00) before and after supportive psychotherapy. The proportion of patients experiencing psychosocial problems including daily activities, emotional problems, and symptoms of metastatic brain tumor between before and after the intervention showed a significant difference (P<0.05). There was also a decrease in the average score for metastatic brain tumor symptoms (p=0.00) including headache (p=0.00), weakness (p=0.00), seizures and double vision between before and after supportive psychotherapy intervention. In both groups, the overall validation value of the supportive psychotherapy module is 96.21% and the content validation value of each session is more than 90%, which means that it shows valid results. The demographic factor that affects the improvement of psychopathology scores was economic status (p=0.03).

Conclusion. Supportive psychotherapy shows significant effects in alleviating distress, psychopathology, and quality of life of patients with metastatic brain tumors."