Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar belakang: Trombosis vena dalam merupakan komplikasi tersering yang dijumpai pada keganasan. Insidens trombosis vena dalam pada kanker paru sangatlah tinggi bila dibandingkan dengan populasi umum. Saat ini belum ada pedoman alur diagnosis yang dapat menegakkan diagnosis trombosis vena dalam pada kanker paru. Selain itu, penelitian serupa juga belum pernah dilakukan di Indonesia sehingga hasil penelitian ini dapat menjadi penelitian pendahuluan yang menitikberatkan pada trombosis vena dalam pada kanker paru. Tujuan: Tujuan penelitian ini adalah untuk menilai proporsi trombosis vena dalam menggunakan kriteria klinis yaitu skor Wells’ pada pasien kanker paru yang dirawat di RS Persahabatan. Metode: Desan penelitian ini menggunakan metode potong lintang. Kami melakukan pemeriksaan pada pasien kanker paru yang dirawat sejak September 2012 hingga Februari 2013. Kami menyingkirkan pasien kanker paru dengan penyakit infeksi serta pasien kanker paru dengan sediaan histopatologi yang belum tegak. Pemeriksaan fungsi hemostasis seperti PT, APTT dan D-dimer tetap dilakukan bersama dengan penggunaan kriteria klnis skor Wells’. Diagnosis trombosis vena dalam ditentukan apabila skor Wells berat. Hasil: Subjek dalam penelitian ini terbanyak adalah laki-laki (69,2%) dengan kelompok usia terbanyak yaitu kelompok usia 51-60 tahun (33,3%). Jenis histopatologi yang terbamyak ditemukan adalah jenis adenokarsinoma (57,7%). Hampir sebagian besar pasien yaitu 64 pasien (82,1%) memiliki D-dimer >500 dan hanya 14 pasien (17,9%) dengan D-dimer normal. Penelitian ini mengungkapkan proporsi trombosis vena dalam menggunakan skor Wells adalah 23,1%.%. Faktor-faktor seperti jenis kelamin, usia, riwayat merokok, jenis tumor, stadium tumor, status penampilan, serta fungsi hemostasis tidak berpengaruh terhadap trombosis vena dalam namun nilai D-dimer >500 berpengaruh terhadap trombosis vena dalam. Kesimpulan: Proporsi trombosis vena dalam pada pasien kanker paru di RS Persahabatan hampir sama jumlahnya dengan penelitian-penelitian di negara lain yaitu sekitar 21%. Penelitian ini menunjukkan bahwa skor Wells masih mempunyai peran penting dalam menentukan trombosis vena dalam mengingat penggunaannya mudah dan praktis. Penelitian selanjutnya diperlukan untuk menilai metode yang mudah dan sederhana digunakan dalam praktek sehari-hari bersama dengan skor Wells dalam menentukan trombosis vena dalam pada kanker paru. ......Background: Deep vein trombosis (DVT) is the common complication found in malignancy. Its incidence in lung cancer is much higher than in general population. Since there were no current diagnosis guideline which could help identify DVT in lung cancer and there were no similar study conducted before in Indonesia, thus this study could be a pilot study for further research focusing DVT in lung cancer. Objective: The objective of this study is to find deep vein trombosis proportion among lung cancer patients which is determined by clinical criteria such as Wells’ score in Persahabatan Hospital. Method: The study design is using a cross-sectional method. We examined the lung cancer patients who were hospitalized within September 2012 to Februari 2013. We excluded the lung cancer patients with infection comorbidity or who had not yet had histopathological confirmation. The hemostatis work up included PT, APTT, and D-dimer were conducted along with clinical Wells’ score criteria. Deep vein trombosis among the patients is determined by severe Wells’ score. Results: Subjects in this study were mostly male (69,2%) with predominant age group of 51-60 years old (33,3%). Predominant histopathologic sub type was adenocarcinoma (57,7%). Mostly, 64 patients (82,1%) had D-dimer >500 and only 14 patients (17,9%) with normal D-dimer. This study found that deep vein trombosis proportion is 23,1% using Wells’ score. Clinical characteristics such as sex, age, smoking history, tumor cell type, tumor staging, performance status and hemostasis function does not have correlation with DVT but score of D-dimer >500 have correlation with DVT. Conclusion: The DVT proportion among lung cancer patients in Persahabatan Hospital is similar found in some studies in other countries which is approximately 21%. This study revealed that the simple and practical application of Wells’ score in determining DVT is still have valueable role. Further study is needed to find the best simple and easy methods along with Wells’ score in determining DVT in daily practice.

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.]

Abstrak :
Homeostasis protein berperan penting dalam memperlambat proses malnutrisi dan dalam mempertahankan massa bebas lemak pasien kanker. Kehilangan signifikan massa bebas lemak terutama massa otot skelet akan mengurangi mobilitas fisik, kapasitas fungsional, dan skor kualitas hidup pasien kanker. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui korelasi antara asupan protein dengan massa bebas lemak dan kapasitas fungsional pada pasien kanker paru di poli onkologi RS Persahabatan Jakarta. Didapatkan 52 subjek laki-laki dengan rerata usia 55,63 6,77 tahun. Jenis dan stadium kanker yang terbanyak ditemukan adalah adenokarsinoma 63,5, stadium IV 65,4. Status nutrisi kurang berdasarkan IMT ditemui pada 21,2 subjek, dan berdasarkan kadar albumin serum didapatkan 30,8 subjek dengan hipoalbuminemia. Lebih dari 50 subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Pada pemeriksaan komposisi tubuh didapatkan rerata massa bebas lemak 47,20 6,28 kg, dengan 48,1 indeks massa bebas lemak rendah, massa otot rerata 44,74 5,98 kg dengan 40,4 massa otot tergolong kurang. Nilai kapasitas fungsional skala Karnofsky. ......The homeostasis of protein plays an important role in decreasing the process of malnutrition and in maintaining fat free mass in cancer patients. The significant loss of fat free mass, especially skeletal muscle mass could decrease physical activity, functional capacity, and quality of life of cancer patients. This was a cross sectional study aimed to investigate the correlation of protein intake, fat free mass and functional capacity in lung cancer patients in the Oncology Unit of Persahabatan Hospital Jakarta. Obtained 52 male subjects with a mean age of 55,63 6,77 years old. The most cancers type were adenocarcinoma 63,5 and most of subjects were at stage IV 65,4 . Nutritional status of the subjects 21,2 were in undernutrition based on body mass index parameter, and 30,8 of the subjects were in hypoalbuminemia. More than 50 of the subjects had low energy and protein intake. The mean of fat free mass was at 47,20 6,28 kg, that 48,1 of fat free mass index were in low categorized, and 40,4 of muscle mass were also in small categorized, that the mean was at 44,74 5,98 kg. Functional capacity Karnofsky scale of the subjects 26,9 showed less than 70. The data showed that the subjects had nutrition problems. This study showed positive and significant correlations between protein intake with fat free mass index r 0,379, p

Abstrak :
Latar belakang: Efusi pleura tuberkulosis (TB) adalah bentuk umum dari TB ekstra paru. Proporsi efusi pleura pada kasus TB adalah terbesar kedua setelah keganasan di RSUP Persahabatan. Diagnosis definitif ditegakan dengan menemukan basil Mycobacterium tuberculosis (M.tb) dari cairan pleura mapun jaringan pleura walaupun kurang sensitif. Analisis cairan pleura dan pemeriksaan kadar adenosine deaminase (ADA) dapat membantu dalam mendiagnosis efusi pleura pada kasus TB terutama pada negara dengan insidens TB menengah hingga tinggi. Tujuan: Tujuan penelitian ini adalah membandingkan profil efusi pleura pada kelompok TB dan non-TB. Metode: Penelitian potong lintang dilakukan terhadap 411 catatan medis subjek dengan efusi pleura yang menjalani prosedur diagnostik di RSUP Persahabatan dari bulan Januari 2013 hingga 31 December 2015 secara retrospektif. Semua jaringan dan cairan diperiksa untuk pemeriksaan mikrobiologi, histopatologi, analisis cairan pleura dan ADA. Total 273 subjek dieksklusikan dan 138 subjek memenuhi kriteria inklusi untuk TB (n=65) dan non-TB (n=73). Hasil: Nilai tengah usia pada kelompok TB adalah 27 (15-69) tahun dengan proporsi 34 (75%) laki-laki berbeda bermakna dengan nilai tengah usia pada kelompok non TB yaitu 51 (16-75) tahun yang terdiri atas 38 (52%) perempuan. Pada kelompok TB rentang nilai ADA adalah 5,9 hingga 437,6 U/L dengan nilai tengah 103 U/L sedangkan pada kelompok non TB rentang 3,4 hingga 155 U/L dengan nilai tengah 19,9 U/L. Protein cairan pleura pada kelompok TB memiliki rerata 5,6 (SD 1,1) mg/dL berbeda bermakna dibandingkan pada rerata kelompok non TB yaitu 4,9 (SD 1,6) mg/dL. Sensitivitas ADA dengan titik potong 60 IU/dL adalah 89% dengan spesifitas 77% untuk kepositifan TB. Protein cairan pleura dengan titik potong 5 g/dL memberikan sensitivitas dan spesifitas sebesar 60% dan 52%. Pada penelitian ini kombinasi titik potong ADA dengan kadar 60 IU/L dan protein dengan kadar 5 g/dL meningkatkan spesifisitas menjadi 78% dan sensitivitas menjadi 66%. Kesimpulan: Hasil ADA dan protein cairan pleura harus diintepretasikan bersama temuan klinis dan hasil uji konfirmasi lain. ...... Background: Pleural effusion is a common form of extra pulmonary tuberculosis (TB). Effusion due to pleural TB is second biggest proportion after malignancy in Persahabatan Hospital. The definitive diagnosis was established by determining the basil of Mycobacterium tuberculosis (M.tb) in the pleural fluid or pleural tissue but less sensitive. Pleural fluid analysis and adenosine deaminase (ADA) level can aid in the diagnosis of TB pleural effusions commonly used in the countries with a moderate to high incidence of TB. Objectives: The aim of the study is comparing the profile of pleural effusion in TB and non-TB group. Methods: This is retrospective cross sectional study on 411 subjects with pleural effusions who underwent diagnostic procedure at Persahabatan Hospital by January 1st 2013 to December 31th 2015. All data from tissue and fluid sample of microbiological, histopathological, pleural fluid and ADA examinations were taken from medical records. Total 138 patients met our inclusion criteria for TB (n=65) and non-TB (n=73) and 273 patients were excluded. Results: Median of age in tuberculosis group age median was 27 (15-69) years old and consisted of 34 male (75%). Median of age in non-TB group was 51 (16.75) years old and consisted of 38 female (52%). In TB groups ADA range from 5.9 to 437.6 U/L with median ADA level 103 and in non TB groups ADA level range from 3.4 to 155 U/L with median 19.9 U/L. In TB groups protein level mean 5.6 (SD 1.1) mg/dL non TB 4.9 (SD 1.6) mg/dL. By using cut off the sensitivity of ADA level 60 IU/dL were 89% with specifity 77%. Protein level cutoff at 5 g/dL the sensitivity and specifity were 60% and 52%. This study showed a combination of ADA and protein as a cut off increasing specifity up to 78% and sensitivity 66%. Conclusion: The results of ADA and protein of pleural fluid should be interpreted in parallel with clinical findings and the results of comfirmation tests.

Abstrak :
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 .

Abstrak :
Latar Belakang: Kanker paru merupakan kanker terbanyak kedua yang terdiagnosis dan menjadi penyebab terbanyak kematian akibat kanker. Pemberian afatinb sebagai terapi target Epidermal Growth Factor Receptor (EGFR)-Tyrosine Kinase Inhibitor (TKI saat ini telah menjadi terapi standar untuk pasien adenokarsinoma paru dengan mutasi EGFR di Indonesia, termasuk di RSUP Persahabatan. Penelitian ini dilakukan untuk menganalisis pemberian terapi afatinib pada pasien adenokarsinoma paru dengan mutasi EGFR di RSUP Persahabatan. Metode: Desain penelitian ini adalah kohort retrospektif menggunakan data rekam medis fisik dan elektronik, dilakukan di Poli Onkologi RSUP Persahabatan, dengan teknik total sampling. Subjek penelitian adalah pasien adenokarsinoma paru dengan mutasi EGFR yang mendapatkan afatinib pada Januari 2018-Desember 2021 di Poli Onkologi RSUP Persahabatan yang memenuhi kriteria penelitian. Hasil: Didapatkan 116 subjek penelitian, pasien adenokarsinoma paru dengan mutasi EGFR yang mendapatkan afatinib di RSUP Persahabatan dengan karakteristik lebih banyak laki-laki (52,6%), kelompok usia <65 tahun (80,2%), suku Jawa (81,9%), tanpa faktor risiko keganasan di keluarga (82,8%). Saat terdiagnosis subjek penelitian lebih banyak dengan stage IVA (75%), metastasis pleura (59,5%), mutasi EGFR delesi ekson 19 (53,4%) status tampilan 0-1 (75,9%) dan metastasis otak didapatkan pada 19% subjek. Nilai median progression free survivival (PFS) subjek penelitian yang mendapat afatinib adalah 13 bulan (95%IK 10,5-15,5 bulan), dan nilai median overall survival (OS) adalah 17 bulan (95%IK 14,9-19,1 bulan). Angka tahan hidup satu tahun yang didapat 65,1% dan Objective Respons Rate (ORR) adalah 36,1%. Sebanyak 35,3% subjek mendapatkan penurunan dosis afatinib 20 mg atau 30 mg. Toksisitas nonhematologi tersering pada pada penelitian ini adalah diare (74,1%), diikuti oleh stomatitis (61,2%), ruam kulit (59,5%) dan paronikia (49,1%). Kesimpulan: Afatinib sebagai terapi lini pertama memberikan luaran yang cukup baik untuk pasien adenokarsinoma paru dengan mutasi EGFR di RSUP Persahabatan dengan efek samping samping nonhematologi yang dapat dikelola. Riwayat penurunan dosis afatinib tidak memengaruhi angka kesintasan. ......Background: Lung cancer is the second most diagnosed cancer and the most common cause of death from cancer. Afatinib as targeted therapy with Epidermal Growth Factor Receptor (EGFR)-Tyrosine Kinase Inhibitor (TKI) has now become standard therapy for lung adenocarcinoma patients with EGFR mutations in Indonesia, including at RSUP Persahabatan. This study was conducted to analyze the administration of afatinib therapy in lung adenocarcinoma patients with EGFR mutations at Persahabatan General Hospital. Metode: Design of the study was retrospective cohort using secondary data, physical and electronic medical records at Oncology Clinic Persahabatan Hospital with total sampling technique. Subject of this study were medical records of lung adenocarcinoma patients with EGFR mutation and received afatinib therapy by January 2018- December 2021 which met the inclusion criteria. Results: There were 116 subjects of lung adenocarcinoma with EGFR mutation and received afatinib at Persahabatan Hospital, with predominant of male (52,6%), age <65 years old (80,2%), Javanese (81,9%), without history of cancer in family (82,8%). Most of subjects are diagnosed as lung adenocarcinoma at stage IVA (75%), with most of them have pleural metastases (59,5%), EGFR mutation with exon 19 deletion (53,4%), performa status 0-1 (75,9%), and brain metastases were found in 19% of subject. The median progression free survival (PFS) of subjects was 13 months (95% CI 10.5-15.5 months), and the median overall survival (OS)was 17 months (95% CI 14.9- 19.1 months). The one-year survival rate was 65.1% and the Objective Response Rate (ORR) was 36,1%. As many as 35.3% of subjects had adjustment dose of afatinib to 20 mg or 30 mg The most common non-hematological toxicity found was diarrhea (74.1%), followed by stomatitis (61.2%), skin rash (59.5%) and paronychia (49.1%). Conclusion: Afatinib as a first-line therapy provides a good outcome for lung adenocarcinoma patients with EGFR mutations at Persahabatan General Hospital with manageable non-hematological adverse events. History of adjustment dose of afatinib did not affect survival rate.

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.