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Barus, Frans Abednego
Perbandingan keberhasilan pleurodesis povidon iodine dengan doksisiklin pada efusi plura ganas
Abstrak :
Efusi pleura ganas adalah masalah klinis yang sering terjadi pada kasus kanker. Sebuah penelitian menemukan kasus efusi pleura ganas sebesar 16% pada otopsi pasien yang meninggal karena kanker. Di Amerika Serikat diperkirakan lebih dari 150.000 kasus per tahun dan sekitar 42 - 77% efusi eksudatif adalah sekunder keganasan. Penelitian di Rumah Sakit Persahabatan pada bulan Juli 1994 - Juni 1997 didapatkan kasus efusi pleura ganas sebanyak 120 dari 229 kasus efusi pleura (52,4%). Efusi pleura ganas sering ditemukan pada kanker paru jenis adenokarsinoma (40%), sel skuamosa (23%) dan karsinoma sel kecil (17,5%). Penatalaksanaan efusi pleura ganas adalah mengeluarkan cairan pleura (torakosentesis) sekaligus pemeriksaan cairan pleura untuk mencari penyebab efusi. Light mengemukakan bahwa indikasi torakosentesis adalah efusi pleura dengan ketebalan lebih dari 10 mm pada pencitraan ultrasonografi tanpa disertai penyakit gagal jantung. Pada kasus efusi pleura ganas berulang dapat dilakukan pleurodesis dengan melakukan instilasi bahan kimia tertentu ke dalam rongga pleura melalui selang-water sealed drainage (WSD). Bahan kimia yang sering digunakan bervariasi misalnya talk, kuinakrin, tetrasiklin dan derivatnya (minosiklin dan doksisiklin), bleomisin dan agen kemoterapi lain yang berfungsi sebagai bahan sklerosan. Talk adalah bahan yang paling sering digunakan dan efektif, murah walaupun beberapa peneliti meragukan keamanannya. Komptikasi tersering yang pernah dilaporkan adalah embolisasi sistemik dan acute respiratory distress syndrome (ARDS). Povidon - iodin (dengan nama dagang Isocline atau Betadine) yang dikenal sebagai antiseptik topikal dapat dipakai sebagai bahan sklerosan yang efektif dan telah digunakan untuk mengatasi efusi pleura ganas. Penatalaksanaan bedah untuk kasus efusi pleura ganas bersifat paliatif dan dilakukan bila ditemukan terjadi kegagalan pleurodesis. Prosedur bedah yang sering dilakukan adalah pintas pleuroperitoneal atau pleuroektomi.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2004
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Koko Harnoko
Efektiviti megetrol asetat untuk pengobatan anoreksia dan penurunan berat badan penderita kanker paru jenis karsinoma bukan sel kecil
Abstrak :
Jumlah penderita kanker paru di dunia terus meningkat dan menjadi masalah kesehatan yang penting. Menurut International Journal of Cancer 1999, terdapat 8,1 juta penderita seluruh jenis kanker di dunia dan lebih dari separuhnya berada di negara berkembang. Kanker paru adalah jenis kanker yang paling sering ditemukan, yaitu 18% dari seluruh kanker di negara maju dan 21% dari seluruh kanker di negara berkembang. Di Indonesia, kanker paru menduduki peringkat ketiga di antara tumor ganas yang paling sering ditemukan. Data dari Rumah Sakit Persahabatan Jakarta menunjukkan peningkatan jumlah penderita kanker paru setiap tahunnya. Tabun 1970-1976 ada 382 kasus, tahun 1984-1988 ada 666 kasus dan tahun 1993-1998 didapatkan 1285 kasus. Anoreksia pada penderita kanker seringkali merupakan proses awal dalam suatu tahapan menuju berkurangnya asupan makanan yang kronik, malnutrisi dan akhirnya kakeksia. Kakeksia atau penurunan berat badan pada beberapa penelitian klinis berhubungan dengan berkurangnya angka tahan hidup, menurunnya respons terhadap kemoterapi dan penurunan tampilan klinis. Di antara faktor-faktor prognostik utama penderita kanker yaitu jenis tumor, stage, tampilan klinis dan penurunan berat badan, yang secara potensial paling respons terhadap intervensi pengobatan adalah penurunan berat badan. Dampak panting anoreksia dan penurunan berat badan ini biasanya tampak pada bentuk fisik dan konsekuensi psikososial. Anoreksia dapat mempengaruhi kondisi klinis dan emosional penderita seperti bentuk badan, massa lemak tubuh, energi, status fungsional, kemampuan bersosialisasi dan perasaan. Sitokin mempunyai peranan kunci sebagai faktor humoral utama pada kakeksia akibat kanker. Beberapa penelitian menunjukkan bahwa sitokin dapat menginduksi penurunan berat badan. Sitokin dapat mengatur ambilan energi (nafsu makan) dan pengeluaran energi (metabolic rate). Pemberian tumor necrosis factor (TNF) pada tikus dan manusia akan menurunkan asupan makanan, tetapi efeknya hanya terlihat jangka pendek. Darling dkk. membuktikan bahwa jika TNF diberikan melalui infus terus menerus akan menimbulkan efek anoreksik, sedangkan efek anoreksik tidak terjadi dengan pemberian secara bolus. TNF jugs berperan pada katabolisme protein dan mekanisme proteolitik dan apoptosis otot. Tidak ada pengobatan efektif yang telah terbukti sebelumnya untuk menyembuhkan anoreksia dan penurunan berat badan pada penderita kanker stage lanjut. Beberapa obat (kortikosteroid, siproheptadin, hidralazin sulfat dan dronabinol) yang telah diuji untuk mengatasi anoreksia ternyata kurang berhasil. Pemberian nutrisi enteral dan parenteral akan meningkatkan asupan kalori, tetapi cara ini dinilai tidak praktis, mahal dan tidak nyaman. Suatu obat praktis yang nontoksik untuk mengatasi anoreksia dan kakeksia akan lebih menguntungkan dalam penatalaksanaan simtomatik dan suportif penderita kanker.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2005
T58466
UI - Tesis Membership  Universitas Indonesia Library
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Priska Duana Putri
Kadar kotinin urin pada anak yang terpajan asap rokok di lingkungan rumah = The urinary cotinine concentration in children exposed to environmental tobacco smoke at home
Abstrak :
ABSTRAK
Latar Belakang : Kotinin merupakan hasil metabolit utama nikotin dan kadarnya pada urin merupakan indikator pajanan asap rokok. Penlitian ini untuk mengetahui kadar kotinin urin pada anak yang terpajan dan tidak terpajan asap rokok di lingkungan rumah. Metode : Penelitian potong lintang pada anak usia sekolah dasar yang tidak merokok. Subjek dikelompokkan menjadi kelompok terpajan dan tidak terpajan berdasarkan status pajanannya. Data yang diperoleh dari kuesioner dan sampel urin sewaktu yang diukur dengan metode ELISA. Hasil : Total subjek 128 anak usia 6-12 tahun yang terdiri dari 64 anak pada kelompok terpajan dan 64 anak yang tidak terpajan. Kadar kotinin urin pada kelompok terpajan lebih tinggi dibandingkan kelompok tidak terpajan (median 30,1 vs 8,45 ng/ml; p<0.05). Terdapat perbedaan kadar kotinin pada anak yang terpajan asap rokok dengan jumlah batang rokok yang dihisap oleh perokok di rumah (p<0.05). Status pajanan asap rokok berhubungan dengan keluhan batuk, infeksi saluran napas atas dan rawat inap karena keluhan respirasi pada anak. Nilai titik potong optimal kadar kotinin urin pada anak untuk menilai pajanan asap rokok yaitu 17,95 ng/ml (sensitifitas 81%, spesifisitas 81%, AUC 91,2%, p<0.05). Kesimpulan: Kadar kotinin urin dapat digunakan sebagai biomarker yang tidak invasif untuk evaluasi pajanan asap rokok pada anak. ABSTRACT
Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level of urinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smoke at home. Method : A Cross sectional study that enrolled elementary school nonsmokers children classified into exposed group and unexposed group based on tobacco smoke sexposure status. The questionnaire and spot urinary samples were collected and urinary cotinine levels were measured by ELISA. Results : A total 128 nonsmokers children age 6-12 years divided into 64 children in exposed group and 64 children in unexposed group. The urinary cotinine levels in exposed group significantly higher than unexposed group (median 30,1 ng/m; vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine level in exposed group with number of cigarettes (p<0.05). Tobacco smoke exposure status associated with frequent cough symptom, upper respiratory infection and hospitalization because of respiratory symptoms in subjects. The optimal cut off point urinary cotinine in children to distinguish unexposed children with exposed to tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%, p<0.05). Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children.
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Jamaluddin M
Efikasi dan toksisiti erlotinib/gefitinib sebagai terapi lini kedua pada pasien kanker paru jenis karsinoma bukan sel kecil = Efficacy and toxicity erlotinib/gefitinib as second line therapi in non small cell lung cancer patients
Abstrak :
ABSTRAK
Tesis ini menilai efikasi dan toksisiti Erlotinib/Gefitinib sebagai terapi lini kedua pada pasien KPKBSK yang mengalami progresifitas. Ini adalah sebuah penelitian kohor retrospektif antara tahun 2009 sampai 2013 dari rekam medis pasien KPKBSK yang mengalami progresifitas. Respons (subjektif, semisubjektif dan objektif) dievaluasi setiap bulan. Toksisiti dinilai setiap minggu sejak pemberian Erlotinib/Gefitinib berdasarkan kriteria WHO. Hasil evaluasi respons objektif, tidak ada pasien yang memberikan respons komplit. Best overall response rate dari 31 pasien, 48,8% menetap, 22,6% perburukan,12,9% respons sebagian dan 6,5% tidak dinilai/inevaluable. Pada penilaian respons semisubjektif didapatkan 19.4% peningkatan berat badan, 51,6% penurunan berat badan dan 29,0% menetap. Waktu tengah tahan hidup mencapai 18 bulan, rerata masa tahan hidup 1 tahunan 80,6% dan masa tahan hidup keseluruhan 6,50%. Data menunjukkan tidak ada timbul toksisiti hematologi berat (grade ¾) dan data penilaian toksisiti non hematologi sangat jarang timbul toksisiti berat (grade ¾). Efikasi monoterapi EGFR-TKI (Erlotinib/Gefitinib) cukup tinggi dengan toksisiti yang ditimbulkan tidak berat. Dengan demikian Erlotinib/Gefitinib sebagai terapi lini kedua cukup baik.ABSTRACT This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second line therapy in NSCLC patients. This is a retrospective cohort study between 2009 and 2013 from the medical records of patients who experienced progression NSCLC. Therapeutic response was evaluated every month. Toxicity assessed every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results of objective response evaluation none of the patients complete response. Best overall response rate of 31 patients with the most stable response are 48.8%. Most semisubjective response obtained are 51.6% weight loss. The middle survival time reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall survival. The data showed no hematologic toxicity arise severe (grade ¾) and non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good. ;This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second line therapy in NSCLC patients. This is a retrospective cohort study between 2009 and 2013 from the medical records of patients who experienced progression NSCLC. Therapeutic response was evaluated every month. Toxicity assessed every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results of objective response evaluation none of the patients complete response. Best overall response rate of 31 patients with the most stable response are 48.8%. Most semisubjective response obtained are 51.6% weight loss. The middle survival time reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall survival. The data showed no hematologic toxicity arise severe (grade ¾) and non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good.
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Kasum Supriadi
Angka tahan hidup pasien kanker paru kelompok bukan sel kecil non skuamosa yang mendapat terapi target Epidermal Growth Factor Receptor-Tyrosin Kinase Inhibitor dan yang mendapat kemoterapi lini pertama di Rumah Sakit Persahabatan = The survival rate of non squamous by non small cell lung carcinoma patiens who are given by target therapy Epidermal Growth Facttor Receptor-Tyrosin Kinase Inhibitors and those given by first line kemotheraphy treatment at Persahabatan Hospital
Abstrak :
[ABSTRAK
Pendahuluan. 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.
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.]
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T58765
UI - Tesis Membership  Universitas Indonesia Library
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Mia Elhidsi
Profil mutasi epidermal growth factor receptor dan angka tahan hidup pasien adenokarsinoma paru usia muda = Profile of epidermal growth factor receptor mutation and survival in young patients with lung adenocarcinoma
Abstrak :
Latar Belakang : Mutasi pada gen Epidermal Growth Factor Receptor (EGFR) berhubungan dengan karsinogenesis Adenokarsinoma paru terutama pada usia muda yang tidak terpajan cukup lama oleh rokok sebagai karsinogen. Penelitian ini untuk mengetahui profil mutasi gen EGFR dan angka tahan hidup pasien adenokarsinoma paru usia muda. Metode: Penelitian observasional kohort retrospektif dan prospektif pada Adenokarsinoma paru usia muda yakni usia <45 tahun dibandingkan dengan usia yang lebih tua. Data diambil dari catatan medis rumah sakit umum pusat Persahabatan Jakarta 2012-2013 dan dilakukan observasi progresivitas dan kematian selama 2 tahun pasca tegak diagnosis. Hasil: Total pasien Adenokarsinoma paru adalah 218 orang terdiri dari 65 orang usia muda dan 153 orang usia tua. Karakteristik Adenokasrsinoma paru usia muda adalah perempuan (58,3%), bukan perokok (66,7%), stage lanjut (98,5%), status tampilan WHO ≤2, metastasis ke luar rongga toraks (43,1%). Proporsi mutasi EGFR positif pada usia muda lebih tinggi dibandingkan usia tua (70,8%vs51%; p=0,007). Mutasi gen EGFR usia muda terdiri dari 36,9% delesi ekson 19; 30,8% mutasi ekson 21 L858R; 3,1% mutasi ekson 21 L861Q dan 29,2% wild type. Masa tengah tahan hidup Adenokarsinoma paru usia muda dengan EGFR positif yang diberikan EGFR tyrosine kinase inhibitor adalah 652 hari (590-713 hari, IK 95%) dengan angka tahan hidup 1 tahun adalah 87,5% dan masa bebas penyakit adalah 345 hari (IK 95%, 323-366 hari). Delesi ekson 19 memberikan masa bebas penyakit yang lebih baik dibandingkan dengan mutasi ekson 21 (RR 2,361; IK 95% 1,126-4,952; p=0,023). Masa tengah tahan hidup Adenokarsinoma paru usia muda dengan mutasi EGFR wild type yang mendapat kemo/kemoradioterapi adalah 515 hari (IK 95%, 487-542) dengan angka tahan hidup 1 tahun adalah 70,7% dan masa bebas penyakit adalah 202 hari (IK 95%, 137-266 hari). Kesimpulan: Profil mutasi gen EGFR pada Adenokarsinoma paru usia muda sangat penting dalam pemilihan terapi lini pertama sehingga dapat meningkatkan angka tahan hidup.
Introduction: Epidermal Growth Factor Receptor (EGFR) mutation is associated with Lung Adebocarcinoma carcinogenesis particularly in young patients which don?t have long exposure to smoke as carcinogen. This study investigate Profile of Epidermal Growth Factor Receptor Mutation and Survival in Young Patients with lung Adenocarcinoma. Method: Retrospective and prospective observational cohort study in lung Adenocarcinoma <45 years old compare with olders. Data are taken from medical record Persahabatan hospital Jakarta 2012-2013 and we observed for progressivity and mortality in 2 years since diagnosis. Results: A total 218 lung Adenocarcinoma consists of 65 young patients and 153 olders. Young lung Adenocarcinomas are female (58,3%), nonsmokers (66,7%), advanced stage (98,5%), performance status WHO ≤2, extrathoracic metastatics (43,1%). EGFR mutation in youngers are higher than olders (70,8%vs51%; p=0,007). Mutation in young patients consists are 36,9% exon 19 deletion; 30,8% exon 21 L858R mutation; 3,1% exon 21 L861Q mutation and 29,2% wild type. Overall survival (OS) young patients with EGFR mutation positive treated with EGFR tyrosine kinase inhibitor are 652 days (95% CI, 590-713 days), 1 year survival is 87,5% and progression free survival (PFS) are 345 days (95% CI, 323-366 days). Exon 19 deletion give higher PFS than exon 21 (RR 2,361; IK 95% 1,126-4,952; p=0,023). Overall survival young patients with EGFR wild type treated with conventional chemotherapy are 515 days (487-542 days, 95%), 1 year survival is 70,7% and their PFS are 202 days (137-266 days, 95% CI). Conclusion: EGFR mutation profile in young lung Adenocarcinoma is important to choose first line therapy so that can increase their survival.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
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