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Ina Ariani Kirana Masna

Pengaruh penggunaan filter udara Anion-Kation seimbang (Plasmacluster Air Purifier) terhadap gejala klinis, Faal Paru dan inflamasi saluran napas pasien Asma Alergi = The effects of balanced Anion-Cation Air filter (Plasmacluster Air Purifier) usage on clinical symptoms airway inflammation Asthma control and lung function test of allergic Asthma patients / Ina Ariani Kirana Masna

"ABSTRAK

Pendahuluan: Faktor lingkungan seperti alergen dan polusi udara dapat memicu ataupun memperberat gejala asma akut serta menyebabkan persitens gejala asma terutama asma alergi. Telah banyak usaha dilakukan untuk mengurangi kadar alergen dalam udara. Salah satu caranya adalah dengan mempertahankan keseimbangan anion-kation sehingga terjadi denaturasi protein tungau debu rumah yang merupakan alergen utama. Kondisi keseimbangan anion-kation dalam udara ini serupa dengan kondisi alamiah hutan. Lingkungan yang serupa dapat dicapai menggunakan filter udara dengan ioniser sehingga tercapai keseimbangan anion-kation dalam udara. Apakah kondisi ini akan mempengaruhi kondisi inflamasi saluran napas dan fungsi paru pasien asma alergi belum pernah dibuktikan sebelumnya.

Metode penelitian: Penelitian ini dilakukan dengan uji klinis silang (cross-over), terbuka, pada pasien-pasien asma alergi. Data subjek diambil secara mandiri oleh pasien dan pemeriksaan berkala di Poli Asma. PPOK RS Persahabatan sejak Desember 2011 sampai September 2012. Pemeriksaan FeNO menggunakan NIOX mino, uji fungsi paru (spirometri), serta penilaian ACT dilakukan setiap bulan di RS Persahabatan.

Hasil Penelitian: Terdapat 36 pasien yang berhasil mengikuti penelitian sampai selesai, selebihnya mengundurkan diri. Terdapat enam subjek laki-laki dan 30 perempuan, rerata usia 42,72 tahun (18-63). Klasifikasi terbanyak adalah asma persisten ringan (19) diikuti dengan asma persisten sedang dan berat (10 dan 7). Perbandingan selisih nilai ACT akhir dengan nilai awal antara kelompok kontrol dengan perlakuan berbeda bermakna secara statistik (p=0,008) maupun secara klinis (rerata kenaikan 3,31 poin). Tidak didapatkan perbedaan yang bermakna secara statistik dalam nilai FeNO dan uji fungsi paru antara kedua kelompok pengamatan.

Kesimpulan: Pada penelitian ini didapatkan peningkatan nilai asthma control test setelah penggunaan filter udara dengan ioniser namun tidak didapatkan perbedaan inflamasi saluran napas dan nilai faal paru. Penggunaan filter udara anion-kation seimbang dapat direkomendasikan pada pasien asma alergi.

ABSTRACT

Introduction: Many attempts have been tried to reduce concentration of allergens which may precipitate acute asthma or cause persistence of symptoms especially in allergic asthma patients. One of the techniques used is air filter and ionizer which creates a balance anion-cation ambiance. Studies have showed that its use can reduce airborne allergen concentration. Indoor ionised air has been proven to cause protein denaturation of house dust mite allergen, one of the most prominent indoor allergen. Ionised air has been proved to cause protein denaturation of mite allergens. This condition is similar to the natural condition existing in uncontaminated natural forests. This condition may be achieved by using a commercially available air purifier and ionizer. Whether this condition affects airway inflammation and lung function test in allergic asthma patients is yet to be proven.

Methods: This is a cross-over, unblinded, clinical trial, conducted in allergic asthma patients. Serial spirometry and FeNO measurements are performed monthly. Subjects are also asked to fill ACT for assement of asthma control. Subjects is observed for two months without using air filter in their bedrooms and two months using air filter in their bedrooms with a two weeks interval in between observation.

Results: There were 50 patients enrolled in the beginning of this study but 14 dropped out while 36 completed the study. There were six male subjects and 30 female, averaging 42,72 (min 18, max 63). Most patients were mild persistent (n=30), followed by moderate ande severe persistent asthma (10 and 7, respectively). The difference between baseline and end of two months observation in control and treatment group was statistically and clinically significant (paired t-test, p=0,008, 3 points ACT increase). Although there was a trend of decreased FeNO and increased FEV1/predicted ratio, time series and multivariate analysis in both was not statistically significant.

Conclusion: There was an increase of ACT score after air filter with ionizer usage but the change in FeNO and lung function test was not statistically significant. Air purifier can be recommended in allergic asthma patients to increase asthma control."

Fakultas Kedokteran Universitas Indonesia, 2013

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Cut Yulia Indah Sari

Proporsi penderita kanker paru dengan riwayat keterlambatan diagnosis akibat didiagnosis sebagai tuberkulosis paru = The diagnosis delay of lung cancer patient who were initially diagnosed as pulmonary tuberculosis

"Latar belakang: Di negara endemik TB, kanker paru seringkali terlambat didiagnosis akibat sebelumnya didiagnosis sebagai TB paru. Hal ini menjadi perhatian besar karena diagnosis dini kanker paru dapat meningkatkan ketahanan hidup dan kualitas hidup pasien dengan peluang pembedahan yang lebih besar atau pun modalitas kemo-radioterapi yang dapat dipilih. Penelitian inibertujuan untuk mengetahui proporsi pasien kanker paru yang mengalami keterlambatan diagnosis karena sebelumnya didiagnosis sebagai tuberkulosis paru.

Metode: Penelitian potong lintang ini dilakukan di RS Persahabatan dengan subjek penelitian adalah semua pasien kanker paru yang telah tegak didiagnosis secara histopatologi dari bulan September 2012 hingga Februari 2013 dengan jumlah total 100 pasien. Keterlambatan diagnosis ditetapkan apabila pasien didiagnosis sebagai TB paru dan mendapat Obat Anti Tuberkulosis (OAT) lebih dari 1 bulan sejak awal gejala ditemukan. Dilakukan anamnesis pada semua pasien dengan foto toraks yang didokumentasikan serta pengambilan data-data dari status pasien.

Hasil: Sebanyak 41 dari 100 pasien kanker paru didiagnosis sebagai TB paru dan riwayat mendapat OAT. Dua puluh sembilan dari 41 subjek mendapat OAT lebih dari 1 bulan. Dua puluh sembilan kasus yang terlambat diagnosis tersebut tersebut terdiri dari 21 laki-laki dan 8 perempuan dengan rerata usia 51,5 tahun dan dengan hasil PA yaitu Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) sebanyak 28 kasus dan Kanker Paru Karsinoma Sel Kecil (KPKSK) sebanyak 1 kasus serta dengan stage III sebanyak 6 kasus, stage IV sebanyak 22 kasus. Pemeriksaan sputum BTA hanya dilakukan pada 9 kasus. Rerata lama pemberian OAT adalah 4,5±0,4 bulan. Tenaga kesehatan yang memberikan OAT adalah dokter umum sebanyak 12 orang, dokter spesialis paru sebanyak 12 orang dan dokter spesialis penyakit dalam sebanyak 4 orang.

Diskusi : Hasil temuan gambaran foto toraks yang menyerupai TB paru di negara endemik TB dapat menyebabkan keterlambatan diagnosis kanker paru karena awalnya didiagnosis sebagai TB paru. Pemberian OAT tanpa evaluasi yang adekuat terlebih lagi tidak mengacu pada International Standard of TB Care (ISTC) akan memicu keterlambatan diagnosis serta progresivitas penyakit pada pasien kanker paru.

Introduction: In endemic countries, the diagnosis delay of lung cancer is due to initially misdiagnosed as pulmonary tuberculosis. The major concern rise since early diagnosis of lung cancer could improve survival and quality of life by tumor resectability chance and chemo-radiotherapy modality options. This study objective is to find out the proportion of lung cancer diagnosis delay due to misdiagnosed as pulmonary TB initially.
Method: The cross sectional study held in Persahabatan Hospital with the subjects were histopatologically proven lung cancer patients between September 2012 to February 2013 involving totally 100 patients. The diagnosis delay were determined whether the patients had diagnosed as pulmonary tuberculosis and received anti tuberculosis treatment (ATT) more than 1 month since current symptoms onset. All patients were interviewed, all chest X-rays were documented and data from medical records were collected.
Results: Fourty one of 100 patients were diagnosed as pulmonary TB and 29 of 41 patients received ATT more than 1 months. It consist of 21 men and 8 women with mean age 51.5 years old and the histopatological biopsy are 28 Non Small Cell Lung Cancer (NSCLC) cases, and 1 Small Cell Lung Cancer (SCLC) case with mostly end stage such as 6 cases are stage III and 22 cases are stage IV. Pre-referral sputum Acid Fast Bacilli (AFB) was conducted in only 9 cases with the results were negative. Mean duration of ATT taken was 4.5±0.4 months. The ATT were given by 13 general practitioners, 12 pulmonologists and 4 internists.
Discussion: Since similar radiological findings in highly incidence of pulmonary TB, a large number of lung cancer have diagnosis delay due to initially diagnosed as pulmonary tuberculosis. Without proper investigation based on International Standard of TB Care, starting ATT with inadequate evaluation leads to diagnosis delay and lung cancer progression."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

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UI - Tesis Membership Universitas Indonesia Library

Wily Pandu Ariawan

Laju Penurunan Nilai VEP1 dan VEP1/KVP dengan Spirometri pada Pasien PPOK Setelah Pengobatan selama Satu Tahun di Rumah Sakit Umum Pusat Persahabatan = Rate of FEV1 and FEV1/FVC Decline with Spirometry in COPD Patients After One Year Treatment in Persahabatan Hospital Jakarta

"Latar belakang: Laju penurunan VEP1 dan VEP1/KVP pada pasien PPOK dari beberapa data yang ada menunjukkan penurunan yang lebih tajam dibandingkan normal, namun untuk penelitian yang dilakukan selama 1 tahun belum pernah diperbarui di RSUP Persahabatan. Penelitian ini mencoba untuk mengetahui laju penurunan nilai VEP1, VEP1/KVP pada pasien PPOK setelah 1 tahun pengobatan.

Metode: Penelitian kohort retrospektif ini dilakukan untuk mengukur laju penurunan nilai VEP1, VEP1/KVP pasien PPOK di klinik Asma PPOK RSUP Persahabatan setelah pengobatan selama 1 tahun.

Hasil: Laju penurunan nilai VEP1 setelah 1 tahun pengobatan adalah sebesar 121,53 120ml/tahun sedangkan laju penurunan nilai VEP1/KVP setelah 1 tahun pengobatan adalah sebesar 2,75 0,47 p10 80,6, derajat GOLD 2 64,5 , mengkonsumsi LABACs 64,5 dan usia terdiagnosis ≥60 tahun 64,5 . Laju penurunan VEP1 lebih banyak terjadi pada kelompok D 110ml/tahun sedangkan laju penurunan VEP1/KVP lebih banyak terjadi pada kelompok B 3,29.

Kesimpulan: Pada penelitian ini diketahui sebagian besar pasien mengalami laju penurunan VEP1 dan VEP1/KVP yang bermakna secara statistik dan sebagian kecil yang mengalami kenaikan meskipun tidak bermakna secara statistik. Tidak didapatkan hubungan yang berbeda bermakna baik antara jenis kelamin, usia, keluhan respirasi, riwayat merokok, IB, jenis rokok, komorbid, tingkat pendidikan, usia terdiagnosis, IMT, kelompok A-B dan C-D, kelompok A-C dan B-D, riwayat eksaserbasi, CAT, derajat obstruksi dan pemberian terapi LABACs dengan laju penurunan nilai VEP1 dan VEP1/KVP. Kata kunci: Penurunan fungsi paru, PPOK.

Background: The rate of decline in FEV1 and FEV1/FVC in COPD patients from some of the available data shows more decline than normal, but for a 1 year study has not been updated in Persahabatan Hospital. This study attempted to determine the rate of FEV1 and FEV1/FVC decline in COPD patients after 1 year treatment.
Methods: This retrospective cohort study was conducted to measure the rate of FEV1 and FEV1/FVC decline in COPD patients at Asthma COPD Clinic Persahabatan Hospital after 1 year treatment.
Results: The rate of decline in FEV1 after 1 year treatment was 121.53 120ml/year while the rate of decline in FEV1/FVC after 1 year treatment was 2.75 0.47 p 10 80.6 , GOLD 2 64.5 , with LABACs treatment 64.5 and diagnosed ge;60 years 64.5 . The rate of decline in FEV1 was more prevalent in group D 110ml/year while the rate of decline in FEV1/FVC was more prevalent in group B 3.29.
Conclusions: In this study most patients have a statistically significant rate of decline in FEV1 and FEV1/FVC, however a small proportion of patients experienced increases in FEV1 and FEV1/FVC although it does not reach statistical treshhold. No significant differences are found between sex, age, respiratory complaints, smoking history, BI, type of cigarette, comorbid, educational level, diagnosed age, BMI, AB and CD group, AC and BD group, history of exacerbations, CAT, obstruction and treatment of LABACs with rate of decline in VEP1 and VEP1 / KVP. "

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018

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UI - Tugas Akhir Universitas Indonesia Library

Ginting, Martinus

Faal Paru pada polisi lalulintas Jakarta Pusat dan faktor-faktor yang mempengaruhi = Lung functions and their influencing factors on traffic policemen in Central Jakarta / Martinus Ginting

"ABSTRAK

Pendahuluan: Polusi udara akibat kepadatan kendaraan merupakan bahaya serius bagi kesehatan sehingga orang yang terpajan polutan terus menerus mengalami peningkatan risiko terjadinya penurunan faal paru. Polisi lalulintas merupakan subjek yang terus menerus terpajan dengan emisi gas buang kendaraan sebagai risiko dari pekerjaannya.Gas buang kendaraan terdiri dari nitrogen oksida, karbon monoksida, bahan partikel dan lainnya yang dapat menyebabkan kerusakan bronkiolus terminal dan menurunnya kompains serta kapasitas vital paru. Penelitian ini bertujuan menilai status faal paru polisi lalulintas Jakarta Pusat dan apakah terdapat hubungan antara pajanan terhadap polusi gas buang kendaraan dengan penurunan faal paru. Disamping itu juga dilakukan analisis hubungan antara penurunan faal paru dengan berbagai faktor yang mempengaruhinya.

Metode: Penelitian potong lintang ini melibatkan 170 polisi lalulintas di polres Jakarta Pusat, usia 20-55 tahun, masa kerja minimal 2 tahun. Data kesehatan secara keseluruhan diamati menggunakan Kuesioner Proyek Pneumomobile Indonesia dan pemeriksaan fisis dan status kesehatan paru secara khusus diamati menggunakan foto toraks dan spirometri. Kadar CO-ekshalasi juga dianalisis. Analisis statistik dikerjakan menggunakan SPSS versi 17.

Hasil: Dalam penelitian ini didapatkan sampel total adalah 130 subjek tetapi 9 subjek dropout karena tidak menyelesaikan pemeriksaan secara lengkap dan benar. Data subjek yang dilakukan analisis adalah sebanyak 121 dengan karakteristik 33,9% memiliki usia antara 41-50 tahun dengan rerata usia 37,0 tahun (SD 8,8); 57,9% memiliki berat badan lebih; 55,4% merupakan perokok aktif; 64,5% menggunakan alat pelindung diri secara buruk; 47,9% memiliki masa kerja >10 tahun; 100% bekerja 56 jam seminggu.Rerata kadar CO-ekshalasi adalah 8,7 (SD 5,0). 9,9% subjects memiliki foto toraks normal,hanya 16,7% yang merupakan kelainan paru dan 83,3% merupakan kelainan nonparu. 19% subjek memiliki kelainan faal paru yaitu 60,9% kelainan restriksi ringan dan 39,1% kelainan obstruksi ringan dan sedang. Tidak terdapat hubungan bermakna secara statistik antara variabel independen usia, status nutrisi, riwayat merokok, penggunaan alat pelindung diri, durasi kerja terhadap variabel dependen pemeriksaan spirometri.Hanya variabel masa kerja subjek yang semakin lama memiliki hubungan bermakna secara statistik terhadap penurunan hasil pemeriksaan spirometri dengan p=0,0014.

Kesimpulan: Penelitian ini menunjukkan lamanya masa kerja polisi lalulintas berhubungan bermakna secara statistik dengan penurunan faal paru.

ABSTRACT

Introduction: Air pollution due to road traffic is a serious health hazard and thus the persons who are continuously pollutant exposed, may be at an increased risk. In this respect, traffic policemen are at a risk, since they are continuously exposed to emissions from vehicles, due to the nature of their job. Automobile exhaust consists of oxides of nitrogen, carbon monoxide, particulate matter, and others, which cause injury to the terminal bronchioles and a decrease in the pulmonary compliance and vital capacity. The present study was aimed at assessing the pulmonary function status in traffic policemen in Central Jakarta whether prolonged exposure to vehicular exhausts had any detrimental effect on their lung functions. The relationship between decrements of lung function and various influencing factors also analyzed.

Methods: Across-sectional study was conducted in 170 traffic policemen in Central Jakarta, age 20-55 years, working periods at least 2 years. The data of overall health status was observed using Indonesia Pneumomobile Project Questioner and physical examinations and lung health status was observed using thorax X-ray and spirometry. Level of CO-exhalation was also analyzed. The statistical analysis was carried out with SPSS PC software version 17.

Results: Total samples included in this study were 130 subjects, 9 subjects were dropped out because uncompleted study’s tests. Analyzed subjects were 121 whose characteristics were 33,9% were in age classifications 41-50 years and mean age was 37,0 (SD 8,8); 57,9% overweight; 55,4% active smokers; 64,5% bad masker application; 47,9% in working periods >10 years; 100% had 56 working hours in a week. Mean CO-exhalation level was 8,7 (SD 5,0). 9,9% subjects had abnormal thorax X-ray that16,7% were lung abnormality and 83,3% were nonlung abnormality. 19% subjects recorded lung function decreased included 60,9% mild restriction and 39,1% mild and moderate obstruction. There were no statistical significant between age, nutrition’s classifications, smoking history, protective mask applications, working duration as independent variables and spirometry parameters as dependent variables. Longer working periods were the only dependent variable had statistical significant with decreasing spirometry results with p=0,0014.

Conclusion: This study showed that working periods had statistical significant with lung function decrement."

Fakultas Kedokteran Universitas Indonesia, 2012

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UI - Tesis Membership Universitas Indonesia Library

I Putu Gede Panca Wiadnyana

Prevalensi kemungkinan obstructive sleep apnea dan faktor-faktor yang berhubungan pada pengemudi taksi X di Jakarta = The prevalence of suspected obstructive sleep apnea and related factors on taxi drivers X in Jakarta

"Latar belakang: Profesi pengemudi taksi merupakan profesi yang unik, lingkungan kerja luas, jam kerja panjang, sistem pcnggajian yang fluktuatif, dan risiko kecelakaan di jalan raya. Pada PT X 60% kccelakaan dikarenakan mengantuk. Salah satu penyebab kondisi mengantuk adalah adanya kemungkinan obstructive sleep apnea (OSA). Bcbcrapa faktor risiko kemungkinan OSA seperti kegemukan dan hipertensi dijumpai pada pengemudi PT X.

Metode: Penelitian ini menggunakan desain cross sectional pada pengemudi taksi X Mampang Jakana Selatan, pada bulan November»Desember 2008. Pengumpulan dilakukan dengan pengisian Kuesioner Berlin, dan pemeriksaan fisik (tekanan darah, bcrat, badan, tinggi badan, dan lingkar leher) pada 280 orang pengemudi.

Hasil: Jumlah responden sebanyak 280 orang, didapatkan 70 orang (25%) kemungkinan OSA. Kemungkinan OSA pada pengemudi dipcngaruhi olch bcbcrapa faktor yaitu: IMT 325 (acyusred OR 4.29, p <0.001, 95% Cl 2.04 - 9.05) riwayat keluarga mendengkur (aafiusled OR 2,34, p <0.00l, 95% Cl 1.45 - 3.78), lingkar leher 3 40 cm (afyusred OR 3.37, p 0.002, 95% Cl 1.58 - 7.19), umur 3 36 tahun (argusted OR 2.47, p 0.027, 95% CI I.ll - 5.48) dan jadwal keija tinggi (ac§usted OR 3.07, p 0.0l6, 95% Cl L23 - 7.66).

Kesimpulan: Didapat prevalensi kemungkinan OSA pada pengemudi Taksi X sebesar 25%. Kemungkinan OSA pada pcngcmudi Taksi X dipengaruhi oleh faktor indeks massa tubuh 325, riwayat keluarga mendengkur, Iingkar leher 540 cm, umur 336 tahun serta jadwal kerjatinggi.

Background: Taxi Driver is an unique profession because of the wide environment, the long hours working duration, the fluctuation wages, and the accidental risks. About 60% taxi's accidents in Company X were caused by sleepy conditions. Sleepy conditions may be caused by obstructive sleep apnea (OSA). Some factors that increase the prevalence of suspected OSA, like obesity and hypertension were founded among the taxi drivers in this company.
Method: This study was conducted with cross sectional design. The data was collected from November until December 2008 in Mampang, Jakarta Selatan. Data collection used Berlin's Questionnaire and Physical examinations (blood pressure, weight, height, neck circumference) to 280 drivers.
Result: This research showed that there are 25%, it?s mean 70 respondents from 280 respondents have OSA prevalence. Prevalence of OSA among taxi?s drivers is caused by several factors. The factors are Body Mass index (BMI) 3 25 (adjusted OR 4.29, p < 0.00l, 95% Cl 2.04 - 9.05), snoring historical in family (adjusted OR 2.34, p < 0.001 , 95% CI 1.45 - 3.78), neck circumference 3 40 cm (adjusted OR 3.37, p 0.002, 95% CI 1.58 - 7.l9), age 2 36 years old (adjusted OR 2.47, p 0.027, 95% Cl 1.ll - 5.48) and high work schedule (adjusted OR 3.07, p 0.0l6, 95% Cl 1.23 - 7.66).
Conclusion: This research has founded that there are 25%, it?s mean 70 respondents from 280 respondents have suspected OSA. Prevalence of suspected OSA among taxi?s drivers is caused by BMI 2 25, snoring historical in family, neck circumference 5 40 cm, age 3 36 years old and high work schedule."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2008

T32302

UI - Tesis Open Universitas Indonesia Library

Gatot Sudiro Hendarto

Keterkontrolan pasien asma di RSUP Persahabatan berdasarkan asthma control test beserta hubungannya dengan kualitas hidup dan compliance terhadap terapi = Asthma control level of asthma patients according to asthma control test and its relationship to quality of life and medication compliance in Persahabatan Hospital Jakarta

"Tujuan penelitian potong lintang ini adalah menggambarkan tingkat keterkontrolan asma, kualitas hidup, dan kepatuhan pengobatan serta melihat hubungan antara keterkontrolan asma dengan kualitas hidup dan kepatuhan pengobatan. Sebanyak 132 pasien asma poli rawat jalan RSUP Persahabatan menyatakan kesediaan dan mengikuti penelitian ini dengan lengkap. Data diambil melalui wawancara dan pengamatan cara pakai obat. Sebesar 64 pasien (48,5%) menderita asma yang tidak terkontrol dan 68 pasien (51,5%) termasuk dalam asma yang terkontrol. Gambaran kualitas hidup menunjukkan nilai rerata domain gejala sebesar 4,83 (±1,49), domain keterbatasan aktivitas sebesar 5,99 (±0,86), domain fungsi emosi sebesar 5,13 (±1,63), dan domain pajanan lingkungan sebesar 3,89 (±1,88).

Gambaran kepatuhan pengobatan pada penelitian ini sebesar 45,5% pasien minum obat sesuai anjuran dokter, 38,6% pasien rutin kontrol ke petugas kesehatan, dan 45,5% menggunakan obat inhalasi dengan benar. Domain pajanan lingkungan berdampak lebih besar terhadap gangguan kualitas hidup dibandingkan dengan domain lainnya. Terdapat hubungan antara keterkontrolan asma dengan kualitas hidup (r=0,307, p<0,05) dan hubungan antara keterkontrolan asma dengan kepatuhan pengobatan (penggunaan dosis obat, rutin kontrol, dan penggunaan obat inhalasi) (p<0.05).

The aim of this cross-sectional study was to describe the level of asthma control, quality of life, medication compliance, and assess correlation between the level of asthma control, quality of life, and compliance with treatment. A hundred and thirty two patients with asthma in outpatient ward of RSUP Persahabatan hospital have provided consent and completed study. Data collection were conducted from interviews and observation how to use the drug. Sixty four patients (48.5%) had uncontrolled asthma and 68 patients (51.5 %) included in the controlled asthma. The mini asthma quality of life questionaire showed the mean symptom domains score of 4.83 (±1.49), activity limitations domain score of 5.99 (± 0.86), emotional function domain score of 5.13 (±1.63 ), and the environmental stimuli domain of 3.89 (±1.88).
Medication compliance revealed that 45,5% used medication dose as recommended by physician, 38,6% visited the physician for routine follow up, and 45,5% used the inhaled medication correctly. Environmental stimuli had more impact in quality of life compared to symptoms, activity limitation and emotional function. There is a relationship between the domain of quality of life with asthma control level (r=0,307, p<0,05) and there is a relationship between medication dose as recommended by physician, visiting the physician for routine follow up and using the inhaled medication correctly with asthma control level (p <0.05)."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

T39286

UI - Tesis Membership Universitas Indonesia Library

Rita Novariani

Proporsi kanker paru dengan riwayat kanker pada keluarga = The proportion of lung cancer with a history of cancer in the family

"[ABSTRAK

Latar belakang: Kasus baru dan kematian kanker paru semakin meningkat. Rokok tembakau sangat berperan tetapi hanya 15% yang menderita kanker paru. Oleh karena itu faktor genetik diduga berperan pada kanker paru. Penelitian-penelitian kohort selama ini menunjukan hubungan bermakna risiko kanker paru dengan riwayat kanker di keluarga.

Tujuan: Tujuan utama dari penelitian ini adalah untuk menentukan proporsi subjek kanker paru dengan riwayat kanker pada keluarga.

Metode: Penelitian ini adalah studi observasi deskriptif potong lintang dengan subjek kanker paru yang berobat jalan maupun inap di RSUP Persahabatan Jakarta 1 Januari 2013 sampai 31 Mei 2015.

Hasil: Subjek penelitian 380 dengan komposisi laki-laki lebih banyak dibandingkan perempuan (72,9% banding 27,1%) dengan median 56 tahun dan nilai minimum dan maksimum 20-86 (66) tahun. Sebanyak 65.3% subjek adalah perokok. Dari total subjek yang merokok, 33,2% termasuk perokok dengan Indeks Brickman (IB) sedang. Jenis sel kanker terbanyak adalah masuk kelompok Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) yaitu adenokarsinoma 73,4%. Sebagian besar subjek terdiagnosis pada stage lanjut baik pada kelompok KPKBSK maupun Kanker Paru Karsinoma Sel Kecil (KPKSK). Proporsi subjek dengan riwayat kanker keluarga sebesar 8,2% dengan subjek laki-laki lebih besar dibandingkan perempuan (5,8% dibandingkan 2,4%). Nilai minimum-maksimum usia 35-72 tahun, median 55 tahun. Subjek yang merokok hanya ditemukan pada laki-laki sebanyak 71% dan jenis kanker terbanyak adenokarsinoma 71%. Hubungan keluarga 1 orang lebih banyak ditemukan dibandingkan lebih 1 orang (64,4% banding 35,6%) dengan dominasi ayah (25,8%). Jenis kanker keluarga paling banyak bukan kanker paru dibandingkan kanker paru (85,4% banding 14,6%).

Kesimpulan: Proporsi subjek kanker paru dengan riwayat kanker pada keluarga adalah 8,2%. Subjek dengan 1 anggota keluarga yang memiliki kanker paling banyak 64,4% dengan dominasi ayah 25,8%. Jenis kanker paru dengan riwayat kanker keluarga terbanyak adenokarsinoma 71%. Jenis kanker keluarga lebih banyak adalah bukan kanker paru 85,4%.

ABSTRACT

Background: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer.

Objective: To determine the proportion of lung cancer?s subjects with a cancer history in the family.

Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer?s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.

Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject?s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).

Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%.;Background: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer.

Objective: To determine the proportion of lung cancer?s subjects with a cancer history in the family.

Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%., Background: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer.

Objective: To determine the proportion of lung cancer’s subjects with a cancer history in the family.

Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer’s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.

Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject’s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).

Fakultas Kedokteran Universitas Indonesia, 2015

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UI - Tugas Akhir Universitas Indonesia Library

Herman Suryatama

Kadar kotinin urin dan CO ekspirasi pada perempuan dewasa yang terapajan asap rokok di lingkungan rumah = Urinary cotinine concentrations and CO expiration in women exposed to environmental tobacco smoke at home

"[ABSTRAK

Latar Belakang: Penelitian mengenai dampak kesehatan dari pajanan asap rokok lingkungan dengan menggunakan kotinin, yaitu suatu hasil metabolisme nikotin yang terdeteksi dalam urin, telah direkomendasikan sebagai pengukuran kuantitatif nikotin dalam tubuh dan biomarker pajanan asap rokok lingkungan. Tujuan: Tujuan penelitian ini untuk melihat hubungan pajanan asap rokok di rumah pada perempuan dewasa bukan perokok, dengan mengukur kadar kotinin urin, CO ekspirasi dan melihat dampak kesehatannya.

Metode: Penelitian ini berjenis potong lintang terhadap 60 orang perempuan dewasa bukan perokok terpajan dan 58 orang tidak terpajan asap rokok di rumahnya dalam wilayah Pasar Rebo, Jakarta. Kadar kotinin urin diukur menggunakan metode pemeriksaan ELISA. Sebagai informasi tambahan, kami mengumpulkan data kadar CO ekspirasi, kuesioner kebiasaan merokok anggota keluarga di rumah dan dampak kesehatan respirasi subyek penelitian.

Hasil: Nilai median kadar kotinin urin yang didapat adalah 24,65 ng/ml pada kelompok terpajan dan 7,30 ng/ml pada kelompok tidak terpajan (p=0.000). Nilai median kadar CO ekspirasi adalah 5,00 ppm pada kelompok terpajan dan 3,00 ppm pada kelompok tidak terpajan (p=0.000). Durasi terpajan asap rokok (jumlah jam/hari) pada perempuan perokok pasif memiliki hubungan signifikan dengan tinggi rendahnya kadar kotinin urin(p=0.037). Gejala sesak napas yang muncul berhubungan signifikan dengan status pajanan asap rokok subjek (p=0.01). Faktor lama pajanan asap rokok terakhir memiliki hubungan signifikan dengan kadar CO ekspirasi (p=0,004). Nilai titik potong kotinin urin antara kelompok terpajan dan tidak terpajan asap rokok adalah 14,4 ng/ml (sensitifitas 75,0 %, spesifisitas 74,0 %, p=0.000). Nilai titik potong CO ekspirasi adalah 3,5 ppm (sensitifitas 75,0 %, spesifisitas 81,0 %, p=0.000).Terdapat korelasi yang cukup kuat dan signifikan antara kadar CO ekspirasi dan kotinin urin (r=0,641, p=0,000).

Kesimpulan: Kadar kotinin urin dan CO ekspirasi pada perempuan dewasa yang terpajan asap rokok lebih tinggi dibandingkan perempuan yang tidak terpajan asap rokok di rumah. Pengukuran kotinin urin adalah metode pengukuran pajanan asap rokok lingkungan dalam tubuh yang sensitif, non-invasif dan efektif.;Introduction :Studies of environmental tobacco smoke (ETS) health effects using cotinine, a nicotine metabolite detected in urine, has been recommended as a quantitative measurement of nicotine intake and as biomarker for ETS exposure in humans.

ABSTRACT

Objective: The aim of this study is to correlate dailyindoor ETS exposure in non-smokers (adult women) by measuring urinary cotinine levels, CO expiration and it`s health effects.

Method: We performed a cross-sectional study to 60 ETS-exposed and 58 non ETS exposed adult women in Pasar Rebo area, Jakarta. The urinary cotinine concentrations were measured and analyzed using ELISA method. In addition, CO expiration data and other information were collected through questionnaire regarding smoking habits of the subjects family members at home and respiratory health effects occured to subjects.

Results: Significant median urinary cotinine concentrations were found; 24,65 ng/ml in ETS-exposed group and 7,30 ng/ml in non-exposed to ETS group(p=0,000). Significant median CO expirationalso were found; 5,00 ppm in ETS exposed group and 3,00 ppm in non-exposed to ETS group (p=0.000). Total ammount of time (hours/day) women exposed to ETS in their house was significantly correlated to urinary cotinine concentrations result (p=0,037). The respiratory symptoms (dyspnea) occured to subjects showed significant relation with ETS exposure status (p=0,01). Time duration of last exposed to ETS had significant relation with CO expiration (p=0.004).The urinary cotinine concentrations cut-off point to differentiate ETS exposed and non-ETS exposed group in adult women was 14,4 ng/ml (sensitivity 75%,specificity 74%,p=0.000). The CO expiration cut-off point was 3,5 ppm (sensitivity 75%, specificity 81%, p=0.000). Strong and significant correlation was found between CO expiration and urinary cotinine value (r=0,641, p=0,000).

Conclusion: The urinary cotinine concentration and CO expiration are significantly higher in women exposed to tobacco smoke at home group than the non-exposed group. Urinary cotinine measurement is a sensitive, noninvasive and effective method to correlate with ETS exposure.;Introduction :Studies of environmental tobacco smoke (ETS) health effects using cotinine, a nicotine metabolite detected in urine, has been recommended as a quantitative measurement of nicotine intake and as biomarker for ETS exposure in humans.

Objective:The aim of this study is to correlate dailyindoor ETS exposure in non-smokers (adult women) by measuring urinary cotinine levels, CO expiration and it`s health effects.

Method :We performed a cross-sectional study to 60 ETS-exposed and 58 non ETS exposed adult women in Pasar Rebo area, Jakarta. The urinary cotinine concentrations were measured and analyzed using ELISA method. In addition, CO expiration data and other information were collected through questionnaire regarding smoking habits of the subjects family members at home and respiratory health effects occured to subjects.

Results :. Significant median urinary cotinine concentrations were found; 24,65 ng/ml in ETS-exposed group and 7,30 ng/ml in non-exposed to ETS group(p=0,000). Significant median CO expirationalso were found; 5,00 ppm in ETS exposed group and 3,00 ppm in non-exposed to ETS group (p=0.000). Total ammount of time (hours/day) women exposed to ETS in their house was significantly correlated to urinary cotinine concentrations result (p=0,037). The respiratory symptoms (dyspnea) occured to subjects showed significant relation with ETS exposure status (p=0,01). Time duration of last exposed to ETS had significant relation with CO expiration (p=0.004).The urinary cotinine concentrations cut-off point to differentiate ETS exposed and non-ETS exposed group in adult women was 14,4 ng/ml (sensitivity 75%,specificity 74%,p=0.000). The CO expiration cut-off point was 3,5 ppm (sensitivity 75%, specificity 81%, p=0.000). Strong and significant correlation was found between CO expiration and urinary cotinine value (r=0,641, p=0,000)

Conclusion :The urinary cotinine concentration and CO expiration are significantly higher in women exposed to tobacco smoke at home group than the non-exposed group. Urinary cotinine measurement is a sensitive, noninvasive and effective method to correlate with ETS exposure., Introduction :Studies of environmental tobacco smoke (ETS) health effects using cotinine, a nicotine metabolite detected in urine, has been recommended as a quantitative measurement of nicotine intake and as biomarker for ETS exposure in humans.

Objective:The aim of this study is to correlate dailyindoor ETS exposure in non-smokers (adult women) by measuring urinary cotinine levels, CO expiration and it`s health effects.

Method :We performed a cross-sectional study to 60 ETS-exposed and 58 non ETS exposed adult women in Pasar Rebo area, Jakarta. The urinary cotinine concentrations were measured and analyzed using ELISA method. In addition, CO expiration data and other information were collected through questionnaire regarding smoking habits of the subjects family members at home and respiratory health effects occured to subjects.

Fakultas Kedokteran Universitas Indonesia, 2015

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UI - Tugas Akhir Universitas Indonesia Library

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

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.

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.

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014

T58765

UI - Tesis Membership Universitas Indonesia Library

Putu Ayu Diah P S

Efikasi dan toksisiti kemoterapi karboplatin-vinorelbin pada pasien kanker paru jenis karsinoma bukan sel kecil (KPKBSK) stage lanjut di RSUP Persahabatan = Efficacy and toxicity of carboplatin vinorelbine chemotherapy in advanced non small cell lung cancer (NSCLC) patients at Persahabatan Hospital

"ABSTRAK

Latar Belakang : Paduan kemoterapi berbasis platinum dengan generasi ketiga khususnya karboplatin-vinorelbin sudah sering digunakan sebagai kemoterapi paliatif pada pasien KPKBSK stage lanjut di Indonesia khususnya Rumah Sakit Umum Pusat RSUP Persahabatan namun sampai saat ini belum terdapat data mengenai efikasi dan toksisiti paduan kemoterapi ini di RSUP Persahabatan.Metode : Desain penelitian ini adalah survey observasional retrospektif pada pasien KPKBSK stage lanjut IIIB dan IV yang menjalani kemoterapi lini I di RSUP Persahabatan dengan paduan kemoterapi karboplatin-vinorelbin sejak 1 Januari 2015 sampai 30 Maret 2017.Hasil : Total subjek dalam penelitian ini adalah 38 pasien yang mendapatkan paduan kemoterapi Karboplatin AUC-5 pada hari ke-1 dan vinorelbin 30 mg/m2 pada hari ke1 dan ke-8. Paduan kemoterapi karboplatin-vinorelbin mempunyai efikasi yang baik dengan Objective overall response rate ORR 12,5 dan clinical benefit rate CBR 87,5 . Overall survival OS pada penelitian ini adalah 34,2 dengan masa tengah tahan hidup 387 hari 12,9 bulan dan progression free survival 323 hari 10,7 bulan. Toksisiti hematologi dan nonhematologi yang paling sering terjadi adalah anemia derajat 1 38,4 dan keluhan mual, muntah derajat 2 57,9 . Pada penelitian ini terdapat 2 kasus perdarahan saluran cerna derajat 2 namun pasien masih dapat melanjutkan kemoterapi. Kami juga mendapatkan komplikasi tindakan kemoterapi berupa phlebitis ringan pada 24 pasien 65,7 dan phlebitis sedang pada 1pasien 2,6 .Kesimpulan: Paduan karboplatin-vinorelbin sebagai kemoterapi lini I memiliki efikasi yang baik serta efek toksisiti yang masih dapat ditoleransi sehingga aman diberikan pada pasien KPKBSK stage lanjut. Kata kunci: efikasi, toksisiti, hematologi, nonhematologi, objective overall response rate, clinical benefit rate, overall survival, MTTH, TTP, PFS

ABSTRAK

Background Combination of platinum base and third generation drugs Carboplatin and vinorelbine chemotherapy are frequently used as paliative chemotherapy for Non small cell lung cancer NSCLC patients in Indonesia especially in Persahabatan Hospital. But there are still no data about the activity and tolerability of this regiment in Persahabatan Hospital. This study is conducted to evaluate the efficacy and toxicity of this regiment as first line chemotherapy for advanced NSCLC patients in Persahabatan Hospital.Method This study is an observational survey retrospective study for advanced NSCLC patientswho receive carboplatin vinorelbine regiment as fisrt line chemotherapy since 1st January 2015 to 30th March 2017.Result We observea total of 38 patients who receive carboplatin 5 AUC on day 1 and vinorelbine 30mg m2 on day 1 and 8. This regiment has a good efficacy with overall response rate ORR 12,5 and clinical benefit rate CBR 87,5 . The overall survival OS is 34,2 with median of survival time 387 days 12,9 moths and PFS 323 days 10,7 moths . We found grade 1 anemia 38,4 and grade 2 nausea vomiting 57,9 as hematological and non hematological toxicity that frequently occur in this study. We found 2 cases of grade 2 gastrointestinal bleeding but the patients are still able to continue the chemotherapy after doing some correction for the haemoglobin Hb . We also found mild phlebitis in 24 patients 65,7 and 1 moderate phlebitis in 1 patient 2,6 as procedural complication of this chemotherapyConclusion Combination ofcarboplatin and vinorelbine as first line chemotherapy has a good efficacy and tolerability for advanced NSCLC patients. Key word efficacy, toxicity, haematological, non hematological, overall objective response rate ORR , clinical benefit rate CBR , overall survival OS , median time of survival, time to progression TTP and progression free survival PFS ."

2017

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UI - Tugas Akhir Universitas Indonesia Library

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