Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Cisplatin merupakan kemoterapi efektif dengan spektrum luas. Efek terapeutiknya bertambah bermakna pada peningkatan dosis. Namun aplikasi dosis tinggi (>50 mg/m2) dibatasi nefrotoksisitasnya yang berat.Tujuan: Mempelajari efek cisplatin terhadap aktivitas eritropoiesis, kadar eritropoietin dan fungsi ginjal pasien tumor padat ganas.Metode dan Cara : Studi pre & post sejak Nopember 2004 sampai Januari 2005 dilakukan pada 14 pasien kanker tumor solid (KNF, Osteosarkoma, Ca paru) yang mendapat rejimen kemoterapi mengandung cisplatin dosis 70-100 mg/m2. Pengambilan sampel dilakukan pra, pasta kemoterapi 1 dan II, dengan rentang 21 hari. Analisis univariat dilakukan terhadap usia, Janis kelamin, Janis tumor dan stadium klini.k Dilakukan analisis bivariat pads komponen eritropoiesis, kadar EPO dan TKK hitung..Hasil : Didapatkan tumor solid berupa karsinoma nasofaring (88,24%), osteosarkoma (5,88%) dan adenokarsinoma pare (5,88%). Di mana stadium III (70,6%) dan stadium IV (29,4%). Didapatkan penurunan nilai Hb bermakna pasca siklus 110,74% (p = 0, 029)_ Pasca siklus H, Hb turun 1% (p = 0,37). Evaluasi pasca 2 siklus, lib turun 7,7% (p 0, 035). Hasil yang sama didapatkan pada nilai Ht, pasca kemoterapi siklus I (p = 0,03) dan pasca 2 siklus (p = 0, 008). Sedangkan pasca siklus II tidak bermakna (p = 0,594). Jumlah eritrosit pasca siklus I turun 13% (p = 0,00) dan pasca siklus II turun 8,7% (p = 0,00). Jumlah eritrosit turun 20,8% pasca 2 siklus (p = 0,00). Pasca 2 siklus, indeks retikulosit turun 1,59% (p = 0,975). Kadar eritropoietin pasca siklus I turun 12,7% (p = 0,73), pasta siklus II turun 20% (p = 0,03). Pasca 2 siklus didapatkan penurunan eritropoietin 30% (p = 0,925). TKK hitung mengalami penurunan pasta siklus 112,65% (p = 0,052) dan Il 0,4% (p = 0,157). Pasca 2 siklus TKK hitung turun sebesar 13% (p = 0,052). Terdapat korelasi lemah antara eritropoietin dan jumlah eritrosit pasca siklus H. Tidak didapatkan korelasi antara eritropoietin dengan Hb, indeks retikulosit dan TKK hitung.Kesimpulan: Pemberian cisplatin dosis tinggi (70-100 mg/m2) menyebabkan penurunan eritropoiesis, TKK hitung. Penurunan kadar eritrbpoietin tidak berkorelasi gagal ginjal akut Penurunan jumlah eritrosit disebabkan pula oleh rendahnya nilai eritropoeitin.

---

Background: Cisplatin (Cis diaminodichloro Platinum II) is known as an effective broad spectrum anti tumor. Even though, the nephrotoxicity is one of serious side effects. The accumulation of toxic effects against to tubules area, where erythropoietin is produced, causes acute renal failure and anemia.Purpose: To study the effect of 2 cycles cisplatin against erythropoiesis, erythropoietin level and creatinine clearance at patients with solid tumor cancer.Methods: Pre and post study was done to 14 solid tumor cancer patients that receive high dose cisplatin regiment (70-100 mglm2). Hb, Ht, erythrocyte count, erythropoietin level and calculated creatinin clearance test were determined before each cycle. Age, sex, tumor type, clinical stages were evaluated Statistical analysis was done with student T and Wilcoxon Rank and Pearson correlation.Results: Tumors were NPC 88.24%, Adeno Ca 5.88% and Osteosarcoma 5.88%. Clinical stage Ili 70.6% and IV 29.4%. There were decline level among groups after 1" cycle in Hb (10.74%, p=O.029), Ht (7.6%, p=0.03), erythrocyte count (13%, p=0.OO), erythropoietin level (12.7%, p=4.73) and creatinin clearance (12.65%, p4'.1052). After 2°d cycle, there were decline in Hb (1%, pl.37), Ht (1.46%, p 4l.59), erythrocyte count (8.7%, p=0.00), erythropoietin level (20%, p.03) and creatinin clearance (0.4%, p 0.15).Reticulocyte index was not reduce after 1" and 2"d cycle. After 2 cycles assessment, there were decline level in Hb (7.7%, p=0.035), Ht (48.7%, p=0.008), erythrocyte count (20.8%, p=0.00), erythropoietin level (30%, p4.).92) and creatinin clearance (13%, p=0.022).There is a low correlation between erythropoietin level and erythrocyte count after 1 s` (r-0,397, p=0,159) and 2nd cycle (r x.46, p l.09). Variable's correlation between erythropoietin level and Hb, reticulocyte index, erythrocyte count did not reach statistical significance.Conclusion: High dose cisplatin (70-100 mglm2) cause decrease in eritropoiesis process and creatinin clearance. Decreasing erythropoietin level is not affected by acute renal failure. Low erythrocyte count is also caused by low level of erythropoietin."

"ABSTRAKLatar Belakang: Salah satu modalitas terapi untuk kanker paru stadium lanjut jenis Non-Small Cell (NSC) adalah kemoterapi. Jenis kemoterapi yang sering digunakan di Indonesia adalah Cisplatin-Etoposide (EC) dan Cisplatin-Docexatel (DC). Tolak ukur keberhasilan pengobatan adalah kesintasan dan Progression Free Survival (PFS). Keberhasilan kemoterapi dipengaruhi oleh banyak faktor seperti dosis obat, intensitas pemberian, jenis kemoterapi, jenis histologi, stadium, perfoma status, komorbiditas dan sosial ekonomi. Di Indonesia pendanaan dan jenis rejimen kemoterapi masih merupakan masalah terdahap keberhasilan terapi. Tujuan: Mengetahui perbedaan kesintasan 2 tahun dan PFS antara pasien kanker paru jenis NSC yang diterapi menggunakan EC dibandingkan dengan DC.Metode: Penelitian desain kohort retrospektif dengan analisis kesintasan. Pasien yang dimasukkan dalam penelitian ini adalah pasien kanker paru stadium lanjut (minimal stadium IIIa) jenis NSC, yang datang ke RSKD dan RSCM pada Januari 2006 – Desember 2010 yang baru pertama kali dikemoterapi sampai selesai, sebanyak 6 kali dan dilakukan pengamatan 2 tahun. Data dianalisis dengan program SPSS 16.0, dilakukan analisis cox regression dan ditampilkan dalam kurva Kaplan Meier.Hasil: Didapatkan hasil 55 pasien diberikan cisplatin-etoposide dan 55 pasien diberikan cisplatin-docexatel. Kesintasan 1 tahun EC sebesar 30,9% dan DC sebesar 47,3%, (p=0.030). Kesintasan 2 tahun EC sebesar 0% dan DC sebesar 5,5%, (p 0.003). Median time survival antara EC selama 27 minggu dengan DC selama 38 minggu (p< 0,016). Dibandingkan DC, kemoterapi EC dapat meningkatkan risiko kematian dengan HR 1,684 (IK95% 1,010-2,810). Kelompok subyek yang menggunakan rejimen kemoterapi DC memiliki PFS 20,1 minggu, sedangkan kelompok subyek yang menggunakan rejimen kemoterapi EC memiliki PFS 16,8 minggu (p=0,022).Kesimpulan: Kesintasan cisplatin-docexatel lebih baik bila dibandingkan dengan cisplatin-etoposide, demikian juga dengan progression free survivail.

---

ABSTRACTBackground: One of the therapy for the advanced Non-Small Cell Lung Cancer (NSCLC) is chemotherapy. The most frequent regiment used in Indonesia is Cisplatin-Etoposide (EC) and Cisplatin-Docetaxel (DC). The success of chemotherapy is measured with the 1-year survival, 2-year survival, and the Progression Free Survival (PFS) rate. The success is influenced by many factors, such as the dosage, administer intensity, chemotherapy regiment, type of histology, stage, performance status, comorbidity, and social economic. In Indonesia, funding and chemotherapy regiment are the common problems for the success of chemotherapy.Goal: To determine the 2-year survival rate and PFS rate differences between EC against DC of advanced NSCLC patients.Method: The study is a retrospective Cohort study with survival analysis. The Patients included to this study were the advanced NSCLC (At least Stadium IIIa) who came to RSKD and RSCM during January 2006 – December 2010 for their first chemotherapy until finished the cycle (6 times) and had 2-year monitoring. Data was analyzed by SPSS 16.0 by cox regression analysis, and featured on the Kaplan Meier Curve.Result: Fifty five patients were given EC and the other 55 patients were given DC. One year survival rate of EC was 30,9% and DC was 47,3%, (p=0.030). Two year survival rate of EC was 0% and DC was 5.5% (p 0.003). The median time survival of EC was 27 weeks and DC was 38 weeks (p<0.016). Compared to DC, EC chemotherapy increased the death risk by HR 1,684 (CI 95% 1,010-2,810). The PFS rate of the subjects who were given EC chemotherapy regimen was 20.1 weeks, while the patients who were given DC chemotherapy regimen was 16.8 weeks (p=0.022).Conclusions: The survival with cisplatin-docexatel was better compared to cisplatin-etoposide, this applies to PFS as well."

"Penggunaan cisplatin sebagai agen kemoterapi menyebabkan efek samping berupa nefrotoksisitas yang perlu mendapatkan perhatian serta penanganan khusus. Nefrotoksisitas akan memengaruhi fungsi ginjal pasien yang ditandai dengan adanya penurunan Laju Filtrasi Glomerulus. Penelitian ini bertujuan untuk mengevaluasi penurunan fungsi ginjal pasien yang mendapatkan kemoterapi cisplatin di Rumah Sakit Kanker Dharmais Jakarta periode Juli – Desember 2012. Desain penelitian ini adalah cross-sectional dan pengambilan data retrospektif dilakukan dengan menggunakan rekam medik pasien. Sampel adalah pasien kanker yang mendapatkan kemoterapi cisplatin di Rumah Sakit Dharmais Jakarta periode Juli - Desember 2012. Pengambilan sampel sebanyak 53 pasien dilakukan secara consecutive sampling. Berdasarkan perhitungan klirens kreatinin pasien, persentase penurunan fungsi ginjal pasien yang mendapatkan kemoterapi cisplatin di Rumah Sakit Kanker Dharmais Jakarta periode Juli-Desember 2012 pasca kemoterapi siklus pertama sebesar 17,96%, pasca kemoterapi siklus kedua sebesar 18,29%, dan pasca kemoterapi siklus ketiga sebesar 21,11%.

---

Use of cisplatin as chemotherapeutic agent cause side effect such as nephrotoxicity that need attention and special handling. Nephrotoxicity will affect renal function characterized by impairment in glomerular filtration rate. This research aimed to evaluate the decrease in patient’s renal function who got chemotherapy cisplatin at Dharmais Cancer Hospital. The research design was cross-sectional and retrospective by using the patient's medical record. Samples were cancer patients who got chemotherapy cisplatin in Dharmais Cancer Hospital period July to December 2012. Sampling was carried out as many as 53 patients with consecutive sampling. Based on the calculation of patient's creatinine clearance, percentage of decline in renal function of patients treated with Cisplatin Chemotherapy in Dharmais Cancer Hospital Jakarta Period July – December 2012 after the first chemotherapy was 17,96%, after the second chemotherapy was 18,29%, and after the third chemotherapy was 21,11%."

"Kemoterapi dengan cisplatin merupakan modalitas utama pada terapi pada kanker ovarium, walaupun telah diketahui toksisitasnya pada berbagai organ termasuk ginjal. Kurkumin, senyawa fenolik yang diperoleh dari Curcuma longa, diketahui memiliki efek proteksi pada ginjal akibat cisplatin pada berbagai model toksisitas in vivo. Namun, efek kurkumin pada ginjal dibatasi oleh bioavailabilitasnya yang rendah. Kelompok penelitian kami telah berhasil mengembangkan formulasi kurkumin nanopartikel baru yang telah terbukti memperbaiki efikasi cisplatin pada model kanker ovarium. Namun, belum diketahui apakah formulasi kurkumin nanopartikel ini juga dapat memperbaiki fungsi dan kondisi inflamasi pada ginjal yang disebabkan oleh cisplatin.Metode Sebanyak 24 ekor tikus Wistar betina dibagi menjadi: 6 ekor tikus normal (sham treatment) dan 18 ekor tikus yang diinduksi menjadi kanker ovarium dengan DMBA. Tikus kanker ovarium dibagi menjadi 3 kelompok masing-masing 6 ekor yang menerima cisplatin 4 mg/kgBB/minggu atau cisplatin 4 mg/kgBB/minggu +kurkumin 100 mg/kgBB/hari atau cisplatin 4 mg/kgBB/minggu + nanokurkumin 100 mg/kgBB/hari. Terapi diberikan selama 4 minggu, kemudian dilakukan terminasi dan diambil darah dan organ ginjal untuk analisis penanda fungsi ginjal dan inflamasi.Hasil Nanokurkumin dapat menurunkan kadar ureum serum signifikan dibandingkan kelompok cisplatin, namun tidak mempengaruhi kadar kreatinin dan sedikit menurunkan kadar neutrophil gelatinase-associated lipocalin (NGAL). Nanokurkumin tidak berhasil menurunkan kadar penanda inflamasi: TNF-, IL-1β dan IL-6.KesimpulanNanokurkumin memiliki kecenderungan untuk memperbaiki beberapa penanda fungsi ginjal dalam darah pada model kanker ovarium yang diberikan cisplatin, namun tidak mempengaruhi kadar penanda inflamasi di ginjal.

---

The effects of nanocurcumin on kidney function and inflammatory

markers in rat model of ovarian cancer treated with cisplatin

Cisplatin remains the main modality of treatment for ovarian cancer, despite its known toxic effects to various organs, including the kidney. Curcumin, a phenolic compound derived from Curcuma longa, was known to have a renoprotective effect on cisplatin- induced in vivo models. However, the beneficial effect of curcumin on the kidney is limited by its low bioavailability. Our research group has successfully developed a novel curcumin nanoparticle formulation that has been shown to improve the efficacy of cisplatin in ovarian cancer models. However, it is not yet known whether this curcumin nanoparticle formulation can also improve kidney function and inflammatory conditions caused by cisplatin in ovarian cancer models.

Method

A total of 24 female Wistar rats were divided into: 6 normal rats (sham treatment) and 18 rats induced to develop ovarian cancer with DMBA. Ovarian cancer rats were divided into 3 groups of 6 each receiving cisplatin 4 mg/kgBW/week or cisplatin 4 mg/kgBW/week + curcumin 100 mg/kgBW/day or cisplatin 4 mg/kgBW/week + nanocurcumin 100 mg/day. kgBB/day. Therapy was given for 4 weeks, then terminated and blood and kidney were taken for analysis of markers of kidney function and inflammation.

Results

Nanocurcumin lowered serum urea levels significantly compared to the cisplatin group. However, nanocurcumin did not alter creatinine levels and slightly reduced serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations. Nanocurcumin was did not affect the inflammatory markers studied: TNF-, IL-1β and IL-6.

Conclusion

Nanocurcumin has a tendency to improve several markers of kidney function in cisplatin- treated ovarian cancer models. However, the effect was not associated by the alteration of inflammatory cytokines in the kidney."

"Penggunaan cisplatin masih merupakan lini pertama penanganan tumor padat walaupun dapat menyebabkan penurunan fungsi ginjal. Salah satu penanganan nefrotoksisitas cisplatin adalah pemberian hidrasi. Penelitian ini bertujuan untuk memperoleh faktor-faktor yang mempengaruhi penurunan fungsi ginjal serta mengevaluasi penggunaan volume hidrasi pada pasien yang mendapatkan regimen cisplatin di RS Dharmais. Desain penelitian adalah potong lintang dengan menggunakan data rekam medik pasien. Sampel adalah seluruh pasien kanker dewasa yang mendapatkan cisplatin dosis 60mg/m2 minimal selama empat siklus periode Agustus 2011-November 2013. Klirens kreatinin digunakan sebagai parameter penurunan fungsi ginjal. Pasien yang mendapatkan cisplatin selama empat siklus sebanyak 88 orang, sedangkan pasien yang mendapatkan cisplatin selama enam siklus sebanyak 56 orang. Hasil penelitian menunjukkan bahwa prevalensi nefrotoksisitas cisplatin setelah enam siklus kemoterapi sebesar 92,90% dengan rata-rata persentase penurunan fungsi ginjal sebesar 40,97±17,34% (n=56). Prevalensi nefrotoksisitas cisplatin setelah empat siklus kemoterapi sebesar 75,00% dengan rata-rata persentase penurunan fungsi ginjal sebesar 26,52±19,43% (n=88). Volume hidrasi rata-rata per siklus selama enam siklus kemoterapi cisplatin adalah 6168,46±2866,84 ml tapi ternyata tidak mempengaruhi penurunan fungsi ginjal. Faktor yang mempengaruhi penurunan fungsi ginjal pasien dalam penelitian ini adalah usia (p<0,05). Nefrotoksisitas cisplatin terjadi sejak siklus pertama kemoterapi. Tingkat kerusakan ginjal semakin tinggi seiring dengan penggunaan berulang cisplatin pada siklus-siklus berikutnya.

---

Cisplatin had been using as the first line for solid tumor although its nephrotocixity. Hydration is one of strategies to handle cisplatin nephrotoxicity. The goals of this research were to evaluate the factors that affect the decrease of renal function and to evaluate hydration volume on patients treated with cisplatin in Dharmais Cancer Hospital. The design was cross-sectional by using patients medical record. Subjects were all adult cancer patients who treated with cisplatindose 60mg/m2 minimum for four chemotherapy cycles from August 2011 to November 2013. Creatinine clearance was used as a renal function parameter. Patients who treated with cisplatin for four chemotherapy cycles were 88 persons and for six cycles were 56 persons. The prevalence of cisplatin nephrotoxicity after six cycles of chemotherapy was 92.90% with average decrease of renal function was 40.97±17.34 % (n=56). The prevalence of cisplatin nephrotoxicity after four cycles of chemotherapy was 75.00% with average decrease of renal function was 26.52 ± 19.43% (n=88). The average of hydration volume per cycle after six chemotherapy cycles was 6168.46 ± 2866.84 ml but it did not affect cisplatin nephrotoxicity. The only factor that affects this toxicity was patient?s age (p<0.05). Nephrotoxicity could be observed after the first cycle of chemotherapy. The degree of nephrotoxicity was higher after repeated use of cisplatin in the next cycles."

"Latar Belakang: Periostin memainkan peran sebagai mediator proses inflamasi termasuk inflamasi dan fibrosis ginjal. Namun, data signifikansi periostin pada acute kidney injury terbatas. Kami meneliti korelasi kadar periostin urin dengan fungsi ginjal pada pasien keganasan yang mendapat terapi cisplatin dosis tinggi. Metode: Penelitian kohort prospektif ini dilakukan di n ruang rawat HOM lantai 8 gedung A, di RSCM dari November 2019 hingga jumlah sampel minimal terpenuhi dengan cara consecutive sampling. Data dianalisis menggunakan SPSS versi 23.0 sesuai tujuan penelitian. Hasil: Dari 37 responden diketahui 70,3% laki-laki, 29,7% berusia 41-50 tahun, 59,5% menderita KNF, serta 64,9% memiliki Skor Karnofsky 80. Kadar ureum dan kreatinin darah responden meningkat dari pra kemoterapi hingga 1 minggu paska kemoterapi I. Begitu juga dengan nilai eGFR yang makin menurun. Perubahan kadar periostin menurun selama kemoterapi I dan II, naik kembali 1 minggu paska kemoterapi III dengan nilai p>0,05. Pada uji korelasi kadar periostin urin dengan variabel fungsi ginjal lainnya tidak didapatkan domain yang signifikan bermakna (p>0,05) dengan nilai koefisien korelasi lemah (r = 0,017-0,254) dan beberapa domain memiliki arah korelasi negatif.Simpulan: Tidak didapatkan korelasi bermakna kadar periostin urin dengan kadar ureum darah, kreatinin darah serta laju filtrasi glomerulus pasien keganasan dengan terapi cisplatin dosis tinggi.

---

Background: Periostin plays role as mediator of inflammatory processes including inflammation and kidney fibrosis. However, data on the significance of periostin in acute kidney injury are limited. We investigated the correlation of urine periostin levels with kidney function in malignant patients receiving high-dose cisplatin therapy. Methods: This prospective cohort study was conducted in the 8th floor HOM care room in building A, in the RSCM from November 2019 until the minimum sample size was fulfilled by consecutive sampling. Data were analyzed using SPSS version 23.0 according to the purpose of study. Results: Of the 37 respondents known to be 70.3% male, 29.7% aged 41-50 years, 59.5% suffer from NPC, and 64.9% have Karnofsky score of 80. Urea levels and blood creatinine of respondents increased from pre-chemotherapy to 1 week after chemotherapy I. Likewise, the eGFR value decreases. Changes in periostin levels decreased during chemotherapy I and II, rising again 1 week after chemotherapy III with a p value> 0.05. In the correlation test of urinary periostin levels with other kidney function variables, no significant domain was found (p> 0.05) with a weak correlation coefficient (r = 0.017-0.254) and some domains had a negative correlation direction.

Conclusion: No significant correlation was found in urine periostin levels with blood urea levels, blood creatinine and glomerular filtration rates of malignant patients with high-dose cisplatin therapy."

"Latar Belakang: Periostin memainkan peran sebagai mediator proses inflamasi termasuk inflamasi dan fibrosis ginjal. Namun, data signifikansi periostin pada acute kidney injury terbatas. Kami meneliti korelasi kadar periostin urin dengan fungsi ginjal pada pasien keganasan yang mendapat terapi cisplatin dosis tinggi. Metode: Penelitian kohort prospektif ini dilakukan di n ruang rawat HOM lantai 8 gedung A, di RSCM dari November 2019 hingga jumlah sampel minimal terpenuhi dengan cara consecutive sampling. Data dianalisis menggunakan SPSS versi 23.0 sesuai tujuan penelitian. Hasil: Dari 37 responden diketahui 70,3% laki-laki, 29,7% berusia 41-50 tahun, 59,5% menderita KNF, serta 64,9% memiliki Skor Karnofsky 80. Kadar ureum dan kreatinin darah responden meningkat dari pra kemoterapi hingga 1 minggu paska kemoterapi I. Begitu juga dengan nilai eGFR yang makin menurun. Perubahan kadar periostin menurun selama kemoterapi I dan II, naik kembali 1 minggu paska kemoterapi III dengan nilai p>0,05. Pada uji korelasi kadar periostin urin dengan variabel fungsi ginjal lainnya tidak didapatkan domain yang signifikan bermakna (p>0,05) dengan nilai koefisien korelasi lemah (r = 0,017-0,254) dan beberapa domain memiliki arah korelasi negatif. Simpulan: Tidak didapatkan korelasi bermakna kadar periostin urin dengan kadar ureum darah, kreatinin darah serta laju filtrasi glomerulus pasien keganasan dengan terapi cisplatin dosis tinggi.

---

Background: Periostin plays role as mediator of inflammatory processes including inflammation and kidney fibrosis. However, data on the significance of periostin in acute kidney injury are limited. We investigated the correlation of urine periostin levels with kidney function in malignant patients receiving high-dose cisplatin therapy.

Methods: This prospective cohort study was conducted in the 8th floor HOM care room in building A, in the RSCM from November 2019 until the minimum sample size was fulfilled by consecutive sampling. Data were analyzed using SPSS version 23.0 according to the purpose of study.

Results: Of the 37 respondents known to be 70.3% male, 29.7% aged 41-50 years, 59.5% suffer from NPC, and 64.9% have Karnofsky score of 80. Urea levels and blood creatinine of respondents increased from pre-chemotherapy to 1 week after chemotherapy I. Likewise, the eGFR value decreases. Changes in periostin levels decreased during chemotherapy I and II, rising again 1 week after chemotherapy III with a p value> 0.05. In the correlation test of urinary periostin levels with other kidney function variables, no significant domain was found (p> 0.05) with a weak correlation coefficient (r = 0.017-0.254) and some domains had a negative correlation direction.

Conclusion: No significant correlation was found in urine periostin levels with blood urea levels, blood creatinine and glomerular filtration rates of malignant patients with high-dose cisplatin therapy."

"Latar Belakang. Sebagian besar pasien kanker akan mengalami neuropati. Gejalaneuropatik yang muncul akibat kemoterapi dapat menghambat proses terapi.Cisplatin merupakan kemoterapi yang paling banyak digunakan dalam terapikanker nasofaring (KNF) dan banyak menyebabkan neuropati perifer. Penelitianini bertujuan untuk mengetahui gambaran neuropati pada pasien KNF yangmendapat kemoterapi di RSUPN Cipto Mangunkusumo serta faktor-faktor yangmempengaruhinya.Metode. Subyek penelitian ini adalah pasien KNF yang dikemoterapi dengancisplatin kurang dari 6 bulan sebelum pemeriksaan, baik tunggal, sebagaikemoadjuvant maupun kombinasi dengan kemoterapi lain yang tidakmenyebabkan neuropati perifer. Pasien Diabetes Mellitus serta gangguanneurologis sebelumnya disingkirkan dari penelitian. Dilakukan anamnesis,pemeriksaan fisik neurologis, dan elektroneurografi (ENG). Penelitian dilakukandengan menggunakan desain potong lintang. Pengumpulan data dilakukan padabulan Februari hingga Mei 2013.Hasil. Sebanyak 100 subyek penelitian yang terdiri dari 81 subjek laki-laki dan 19subyek perempuan diikutsertakan dalam penelitian ini. Usia dari subjek penelitianberkisar antara 30-60 tahun. Didapatkan 76% subjek mengalami neuropati, 51subjek diantaranya mengalami neuropati ENG, 25 subjek mengalami neuropatisecara klinis dan ENG. Didapatkan neuropati sensorik 82.89%, neuropati motorik80,26%, dan 51,32% mengalami neuropati otonom. Berdsarkan tipenya 89,47%mengalami degenerasi aksonal dan tidak satupun mengalami yang mengalamidemielinisasi murni. Secara statistik terdapat hubungan yang bermakna antara usiadan dosis dengan kejadia neuropati secara klinis (masing-masing p < 0,05).Kesimpulan. Telah didapatkan yang mendapat kemoterapi cisplatin di RSUPNCipto Mangunkusumo termasuk tinggi yaitu sebesar 76%, dan hanya 25% yangmengalami gejala neuropati secara klinis. Lebih dari setengah (51%) pasienmengalami neuropati subklinis prevalensi neuropati perifer. Neuropati sensorikmerupakan neropati paling banyak terjadi. Hampir semua pasien yang mendapatkemoterapi cisplatin mengalami neuropati aksonal. Usia lebih tua dan dosis totalyang lebih besar merupakan faktor-faktor yang mempengaruhi neuropati padapasien KNF yang mendapat kemoterapi cisplatin

---

Background. The majority of cancer patients will experience neuropathy.

Neuropathic symptoms arising from chemotherapy can inhibit the therapeutic

process. Cisplatin is the most widely used chemotherapy in the treatment of

nasopharyngeal cancer (NPC) and the many causes of peripheral neuropathy. This

study aims to describe the neuropathy in NPC patients who received

chemotherapy in Cipto Mangunkusumo and the factors that influence it.

Method. The study subjects were NPC patients whose chemotherapy with

cisplatin less than 6 months before the examination, whether single, as

kemoadjuvant or in combination with other chemotherapy that does not cause

peripheral neuropathy. Diabetes Mellitus and patients with neurological disorders

previously excluded from the study. Anamnesis, neurological physical

examination, and elektroneurografi (ENG) were done. The study was conducted

using a cross-sectional design. The data was collected between February and May

2013.

Results. A total of 100 study subjects consisted of 81 male subjects and 19 female

subjects were included in this study. Age of study subjects ranged from 30-60

years. There were 76% of the subjects had neuropathy, 51 subjects had

neuropathy based on ENG only, 25 subjects based on clinical and ENG. There

were 82.89% had sensory neuropathy, 80.26% had motor neuropathy, and 51.32%

had autonomic neuropathy. Most (89.47%) had axonal degeneration and none had

the experience of pure demyelination. There is a statistically significant

relationship between age and dose with the incidence of clinical neuropathy (each

p <0,05).

Conclusion. The prevalence of neuropathy in cisplatin chemotherapy in NPC

patients in Cipto Mangunkusumo was as high as 76%, and only 25% who

experienced clinical symptoms. More than half (51%) patients had subclinical

neuropathy of peripheral neuropathy. Older age and greater total doses are all

factors that influence the KNF neuropathy in patients receiving cisplatin

chemotherapy."

"Tujuan: Untuk melihat respon pemberian regimen kemoterapi paclitaxel, ifosfamide, dan cisplatin pada pasien dengan kanker penis. Metode Penelitian: Pasien SCC penis dengan pembesaran kelenjar getah bening di inguinal dan pelvik di RS. Haji Adam Malik dari tahun 2014 sampai 2016 diinklusikan. Kami menggunakan regimen kemoterapi TIP yaitu paclitaxel 175 mg/m2 pada hari 1, ifosfamide 1200 mg/m2 pada hari 1-3, dan cisplatin 25 mg/m2 pada hari 1-3 setiap 21-28 hari. Hasil Penelitian: Selama 2 tahun terdapat 17 pasien kanker penis dengan keterlibatan kelenjer getah bening yang mendapat regimen TIP dengan rata-rata umur pasien 44,18 11,13. Hanya 10 pasien yang menyelesaikan kemoterapi secara penuh. Dari 10 pasien, tidak ada yang menunjukkan komplit respon. Enam pasien menunjukkan parsial respon, 3 pasien stabil respon dan 1 pasien progresif. Kaplan-Meier overall survival rate OS adalah 6 bulan 95 CI: 4,4-7,6 bulan . Median waktu follow up adalah 7 bulan antara 1 sampai 11 bulan . Analisis subgrup, OS pasien yang memiliki respon lebih baik secara signifikan bila dibandingkan dengan yang tidak berespon log-rank test, p?0,004 . Kesimpulan: Kemoterapi TIP memberikan manfaat klinik pada pasien kanker penis dengan penyebaran kelenjer getah bening.

---

Aim This study was conducted to evaluate the response of penile cancer patients who were in TIP Paclitaxel, Ifosfamide, Cisplatin regimen. Method We included all medical records of penile squamous cell carcinoma patients associated with nodal involvement who acquired TIP regimen in Adam Malik Hospital between 2014 and 2016. We administered 175 mg m2 of Paclitaxel on day 1, 1200 mg m2 of Ifosfamide on day 1 3, and 25 mg m2 of Cisplatin on day 1 3 every 21 28 days. Results We extracted data from 17 patients of penile cancer with nodal involvement who acquired TIP regimen with mean age of 44.18 11.13 years old from our medical records. Only 10 patients completed 4 cycles of the regimen. There was no complete respond noted. Six patients were noted as partial respond and 1 patient was noted as progressive disease. The Kaplan Meier curve shows an overall 6 months 95 CI 4.4 7.6 months of survival with median of follow up time was 7 1 11 months. In subgroup analysis, we found that the responder group have significantly better overall survival than the non responder group log rank test, p 0.004 . Conclusion TIP regimen gives significant clinical benefit in penile cancer with nodal involvement. "

"Latar belakang Sisplatin merupakan pengobatan utama untuk karsinoma nasofaring KNF , tetapi berpotensi menimbulkan nefrotoksisitas. Selain kadar BUN dan kreatinin serum, KIM-1 dan NGAL diduga cukup sensitif untuk mendeteksi nefrotoksisitas. Penelitian ini bertujuan untuk mengevaluasi kadar KIM-1 dan NGAL dalam urin untuk mendeteksi gangguan fungsi ginjal pada pasien KNF stadium lanjut yang mendapatkan kemoterapi berbasis sisplatin.Metode: Penelitian ini merupakan penelitian kohort prospektif. Subyek penelitian dibagi dalam 3 kelompok: pasien yang belum pernah terpapar dan yang sudah pernah mendapatkan kemoterapi berbasis sisplatin 75-100 mg/m serta pasien yang belum pernah mendapatkan kemoterapi sisplatin dan kemudian diberi sisplatin 40 mg/m 2 . Kadar KIM-1, NGAL dalam urin serta kadar BUN dan kreatinin dalam serum diukur pada saat sebelum dan sesudah mendapatkan sisplatin pada ketiga kelompok. Analisis statistik yang digunakan adalah uji ANOVA, uji Pearson, Spearman, Kolmogorov-Smirnov dan SPSS versi 22,0.Hasil: Terdapat perbedaan selisih kadar BUN yang bermakna antara sebelum dan sesudah diterapi pada ketiga kelompok p=0.0001 . Perbedaan selisih kadar NGAL dalam urin pada penelitian ini juga berbeda bermakna antara sebelum dan sesudah diterapi terhadap ketiga kelompok p=0,025 , tetapi ada perbedaan rerata pada sepasang kelompok yang bermakna hanya didapatkan pada kelompok yang belum pernah dikemoterapi 40 mg/m 2 dan kelompok yang sudah pernah diberi kemoterapi 75-100 mg/m 2 p=0,02. Perbedaan selisih kadar KIM-1 tidak bermakna pada ketiga kelompok p=0,275.Kesimpulan: Sisplatin menunjukkan akumulasi nefrotoksisitas yang tergantung pada dosis dose-dependent manner . Pengukuran kadar NGAL dalam urin dapat mendeteksi nefrotoksisitas tahap dini, tetapi belum bisa menggantikan peran BUN. Pengukuran kadar KIM-1 dalam urin tidak dapat mendeteksi gangguan fungsi ginjal.

---

Background: Cisplatin is the main treatment for nasopharyngeal carcinoma NPC with a potency of causing nephrotoxicity. In addition to serum BUN and creatinine levels, KIM 1 and NGAL levels is assumed to be quite sensitive in detecting nephrotoxicity. The study was aimed to evaluate urinary KIM 1 and NGAL level to detect kidney dysfunction in patients with advanced stage NPC who received cisplatin based chemotherapy.

Method: The study was a cohort prospective study. Subjects were categorized into 3 groups, i.e. patients who had never received and who had received 75 100 mg m2 cisplatin based chemotherapy as well as those who had never received any cisplatin based chemotherapy and were subsequently received 40 mg m cisplatin. The levels of urinary KIM 1, NGAL and serum level of BUN and creatinine were measured before and after receiving cisplatin in the three groups. Statistical analysis used in our study were ANOVA, Pearson, Spearman, KolmogorovSmirnov test and SPSS version 22.0.

Results: There was a significant difference of delta BUN level before and after treatment in all three groups p 0.0001 . Delta urinary NGAL level was also significantly different between before and after treatment in all groups p 0.025 however, a significant mean difference of a pair group was only found between those who never had 40 mg m 2 chemotherapy and those who had received 75 100 mg m 2 chemotherapy p 0.02 while delta KIM 1 level showed no significant difference in all three groups p 0.275.

Conclusion: Cisplatin may cause accumulated nephrotoxicity, which has dosedependent manner. Measuring urinary NGAL level can detect an early stage of kidney dysfunction however, it still cannot replace the role of BUN. Measurement of urinary KIM 1 level cannot detect kidney dysfunction."