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"ABSTRAKLatar belakang: Distribusi histologis kanker paru berbeda antara laki-laki dan perempuan. Perempuan perokok lebih sering terkena adenokarsinoma sedangkan laki-laki perokok lebih sering terkena karsinoma sel skuamosa. Insidens kanker paru perempuan di Asia Timur dinyatakan 2-3 kali lebih banyak dibandingkan perempuan negara barat dan sekitar 70% bukan perokok. Tujuan: Mengetahui angka tahan hidup pasien kanker paru pada perempuan, karakteristik dan faktor-faktor yang mempengaruhi ketahanan hidupnya. Metode: Penelitian dilakukan dengan metode cohort retrospektif dari rekam medis pasien kanker paru yang dirawat dan meninggal di RS Persahabatan dalam kurun waktu Januari 2008-Desember 2012. Hasil: Subjek dalam penelitian ini diperoleh 83 orang dengan rata-rata usia 53 tahun, pendidikan SLTA 49,4%, 86,7% bukan perokok, 71,1% belum pernah pengobatan tuberkulosis, keluhan utama terbanyak nyeri dada 28,9%, dan 57,8% tampilan pasien baik (PS≤2). Karakteristik tumor 81,9% adenokarsinoma, 100% stage IV, 71,1% metastasis di pleura dan masalah pasien terbanyak efusi pleura ganas 42,2%. Lima puluh tiga persen pasien tidak mendapatkan terapi tumor. Masa tengah tahan hidup pasien kanker paru perempuan 42 hari, dan angka tahan hidup (ATH) 1 bulan 59%, 6 bulan 18,1%, 1 tahun 6%, 2 tahun 1,2%. Faktor yang dianggap mempengaruhi ketahanan hidup pasien kanker paru perempuan adalah tampilan pasien dan pemberian terapi. Kesimpulan: Angka tahan hidup pasien kanker perempuan di RS Persahabatan lebih rendah daripada penelitian lain, hal ini dikarenakan semua subjek merupakan stage IV dan sebagian tampilannya buruk. Faktor tampilan yang bagus dan pemberian terapi dianggap meningkatkan ketahanan hidup pasien kanker paru perempuan.

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ABSTRACTIntroduction:Histological distribution of lung cancer is different between man and woman. Women smokers are more often exposed to adenocarsinoma, but men smokers are more often get squamous cell carsinoma. Incidence of lung cancer in East Asian women expressed 2-3 times more than the western countries and about 70% are non-smokers. Objective: To know the survival rate of lung cancer in women, the characteristics factors that’s influence the survival. Method: The study was conducted using a retrospective cohort of medical records of patients treated for lung cancer and died at RSUP Persahabatan during the period January 2008-December 2012. Results: Subjects in this study were obtained 83 men with an average age of 53 years, 49.4% high school education, 86.7% non-smokers, 71.1% had never been the treatment of tuberculosis, most major complaint of chest pain 28.9%, and 57 , 8% of patients look good (PS ≤ 2). Tumor characteristics adenocarcinoma 81.9%, 100% stage IV, 71.1% and pleural metastasis in most patients the problem 42.2% of malignant pleural effusions. Fifty-three percent of patients did not receive tumor therapy. Median survival of lung cancer in women 42 days, and the survival rate (SR) of 1 month 59%, 6 months 18.1%, 1-year 6%, 2 years 1.2%. Factors considered to affect the survival of lung cancer in this study are performance status and therapy. Conclusion: Therapy in patients with lung cancer can improve survival of lung cancer in women even though had advanced stage, especially if it has a good performance status."

"Insidens kanker paru terus meningkat baik di negara maju maupun negara berkembang. Saat ini berkembang berbagai modaliti gabungan yang dianggap berperan dalam menurunkan morbiditi dan memperpanjang usia. Terapi pilihan kanker paru jenis karsinoma bukan sel kecil (KPKBSK) bila masih memungkinkan adalah pembedahan. Dua puluh lima persen sampai 45% dari seluruh kasus KPKBSK yang dilaporkan, dapat menjalani pembedahan. Pembedahan pada stage yang tepat akan memberikan masa tahan hidup yang lebih panjang terutama bagi penderita KPKBK. Di Rumah Sakit Persahabatan, pembedahan dilakukan terhadap 10% kasus kanker paru. Kasus dengan stage yang rendah mempunyai angka tahan hidup 5 tahun atau 5 year survival rate yang baik. Pembedahan pada stage yang tepat mempunyai angka tahan hidup 5 tahun yang meningkat pada KPKBSK. Kemoterapi dan radioterapi dianjurkan pada kasus yang tidak mungkin dibedah. Angka tahan hidup penderita pascabedah dipengaruhi oleh berbagai faktor di antaranya stage, jenis histologis, usia, jenis pembedahan dan jenis kelamin serta penggunaan, terapi neoadjuvan I adjuvan. Angka tahan hidup secara sederhana dapat dihitung memakai metoda life table.Radiasi atau kemoterapi saja dapat memperbaiki kualiti hidup penderita tetapi tidak meningkatkan angka tahan hidup 5 tahun. Jenis histologis juga merupakan faktor yang berpengaruh terhadap angka tahan hidup penderita. Faktor lain yang berperan dalam prognosis KPKBSK adalah usia dan jenis kelamin dan jenis reseksi. Terapi neoadjuvan ditujukan bagi kasus stage IIIA yang akan dibedah. Multimodaliti ini meningkatkan angka tahan hidup secara bermakna."

"Kanker paru jenis karsinoma sel kecil (KPKSK) pada umumnya bersifat agresif dibandingkan subtipe kanker paru lainnya. Kanker paru jenis karsinoma sel kecil mempunyai doubling time cepat, fraksi pertumbuhan cepat dan bermetastasis dengan cepat dan luas dibandingkan kanker paru jenis karsinoma bukan sel kecil (KPKBSK). Kanker paru jenis karsinoma sel kecil bersifat kemosensitif dan radiosensitif meskipun 95% pasien akhirnya meninggal. Penelitian ini ingin melihat karakteristik, angka tahan hidup dan faktor yang mempengaruhi. Metode: Penelitian dilakukan dengan metode kohort retrospektif dari rekam medis pasien kanker paru jenis karsinoma sel kecil di RSUP Persahabatan periode 1 Januari 2008 hingga 31 Desember 2012. Data diuji dengan analisis kesintasan Kaplan Meier. Hasil: Subjek dalam penelitian ini diperoleh 34 orang dengan jenis kelamin laki-laki 32 subjek (94,1 %) dengan usia rata-rata 59 tahun, 34 subjek (100 %) perokok. Keluhan utama subjek paling banyak sesak napas dan keluhan tambahan paling dominan adalah berat badan turun dan sebagian besar subjek tidak mendapat terapi baik kemoterapi maupun radioterapi (38,2 %). Karakteristik tumor paling dominan stage ekstensif 32 subjek (94,1 %), status tampilan PS ≤ 2 pada 30 subjek (88,2 %) dan metastasis paling dominan adalah efusi pleura pada 23 subjek (67,6 %). Masa tengah tahan hidup pasien KPKSK adalah 78,75 hari (2,5 bulan) untuk stage terbatas adalah 365 hari (12 bulan) dan stage ekstensif adalah 61 hari (2 bulan). Masa tengah tahan hidup pasien KPKSK yang diterapi adalah 182 hari (6 bulan) dan yang tidak diterapi adalah 27 hari (1 bulan). Faktor yang mempengaruhi angka tahan hidup adalah tampilan dan terapi. Kesimpulan: Angka tahan hidup 1 tahun pasien KPKSK 11,8 % dan masa tengah tahan hidup 78,75 hari. Faktor yang mempengaruhi angka tahan hidup pasien KPKSK adalah tampilan dan terapi.

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Small cell lung cancer (SCLC) are generally aggressive than other subtypes of lung cancer. Small cell lung cancer has a rapid doubling time, rapid growth fraction and could metastasize rapidly and widely compared to non-small cell lung cancer (NSCLC). Small cell lung cancer is chemosensitive and radiosensitive although 95% of patients eventually died after underwent therapy. This study aims to determine the characteristics, survival rate and factors which influenced SCLC patients.

Method: The study was conducted by using retrospective cohort of SCLC patients medical records in Persahabatan Hospital, Jakarta, Indonesia from January 1, 2008 until December 31, 2012. Data obtained were tested by Kaplan Meier analysis of survival.

Results: Subjects in this study were 34 SCLC patients, with majority of male 32 subjects (94.1%), mean age of 59 years old and all of the subjects (100%) were smokers. The majority chief complaint was shortness of breath, the additional complaint was weight loss and most of the subjects did not receive either chemotherapy or radiotherapy treatment (38.2%). The majority of tumor characteristics were extensive disease in 32 subjects (94.1%), performance status ≤ 2 in 30 subjects (88.2%) and the most common metastatic was pleural effusion in 23 subjects (67.6%). Median survival time of SCLC patients were 78.75 days (2.5 months). Median survival time of SCLC patients with limited disease were 365 days (12 months) and extensive disease were 61 days (2 months). Median survival time of SCLC patients treated were 182 days (6 months) and not treated were 27 days (1 month). Factors which influenced median survival time were performance status and treatment.

Conclusion: The 1-year survival rate of SCLC patients was 11.8 % and median survival time was 78.75 days. Factors which influenced the median survival rate of SCLC patients were performance status and treatment."

"[ABSTRAKPendahuluan. 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.

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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.]"

"Efusi pleura ganas (EPG) sebagai bentuk perluasan dari keganasan sering muncul pada penderita kanker paru, mempersulit penatalaksanaan kanker paru, dan membuat prognosis pasien memburuk dengan rerata angka ketahanan hidup 6 bulan. Penelitian ini bertujuan untuk melihat karakteristik dan ketahanan hidup pasien kanker paru dengan EPG di RS Kanker Dharmais Jakarta tahun 2009-2013. Desain penelitian ini adalah kohort longitudinal dengan analisis univariat dan ketahanan hidup. Sampel penelitian ini adalah pasien kanker paru dengan EPG (stadium IIIB atau IV) dari metastasis kanker paru berdasarkan pemeriksaan sitologi atau biopsi dan memiliki rekam medik lengkap. Hasil penelitian menunjukkan bahwa rata-rata umur pasien adalah 58,73 tahun, berjenis kelamin laki-laki, tidak merokok, dan status pekerjaan terbanyak adalah pensiunan. Mayoritas pasien mengeluhkan gangguan respirasi saat pertama berobat, memiliki jenis sel kanker adenokarsinoma, sudah mencapai stadium IV, dan lokasi efusi berada di paru-paru kanan. Sekitar 68.5% pasien bertahan hidup 6 bulan setelah diagnosis dan median survival adalah 12,5 bulan. Diharapkan ada KIE bagi masyarakat, terutama terkait kebiasaan merokok dan ditujukan untuk populasi berisiko, mengenai kanker paru untuk mengurangi jumlah pasien yang baru berobat setelah kanker mencapai stadium lanjut.

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Malignant pleural effusion (MPE) often appears in patients with lung cancer and deteroriates prognosis of patients with mean survival rate of 6 months. This study aims to look at the characteristics and survival of lung cancer patients with MPE (stage IIIB or IV) at Dharmais Cancer Hospital Jakarta in 2009-2013. Study design was longitudinal cohort with univariate and survival analysis. Sample was lung cancer patients with metastatic MPE based on cytology test or biopsy with complete medical record.

Results showed average age of patients was 58.73; most were male, nonsmoker, and pensioner. Majority of patients had respiratory disorder, adenocarcinoma cancer type, reached stage IV, and effusion in the right lung. Approximately 68.5% of patients surviving 6 months after diagnosis and median survival were 12.5 months. IEC is needed for community; especially population with lung cancer risk, to help reducing number of new patients seeking treatment after cancer reaches advanced stage."

"[ABSTRAKLatar 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%.

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ABSTRACTBackground: 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.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. 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%.]"

"Latar Belakang: Usia lanjut dan hubungannya dengan kesintasan kanker paru karsinoma bukan sel kecil sudah diteliti sebelumnya, namun kesintasannya di rumah sakit di Indonesia belum diteliti. Belum banyak penelitian lain yang memperhitungkan faktor perancu antara lain derajat keparahan penyakit, status fungsional, komorbiditas, dan indeks massa tubuh dalam meneliti pengaruh pertambahan usia dengan kesintasan kanker paru karsinoma bukan sel kecil. Tujuan: Mengetahui adakah perbedaan kesintasan satu tahun pasien kanker paru karsinoma bukan sel kecil usia lanjut dan bukan usia lanjut yang diterapi di semua stadium dengan mempertimbangkan functional status, indeks massa tubuh, dan komorbiditas. Metode: Kohort retrospektif dengan pendekatan analisis kesintasan terhadap 227 pasien kanker paru karsinoma bukan sel kecil yang berobat jalan maupun rawat inap di RS Cipto Mangunkusumo dan RS Kanker Dharmais tahun 2002-2012, terbagi 2 kelompok berdasarkan usia saat diagnosis (<60 tahun dan >60 tahun). Kurva Kaplan-Meier digunakan untuk mengetahui kesintasan satu tahun masingmasing kelompok. Analisis bivariat menggunakan uji log-rank, analisis multivariat menggunakan cox proportional hazard regression. Besarnya hubungan variabel usia dengan kesintasan dinyatakan dengan crude HR dan IK 95% serta adjusted HR dan IK 95% setelah dimasukkan variabel perancu. Hasil dan Pembahasan: Terdapat 227 pasien adalah kanker paru karsinoma bukan sel kecil yang diterapi dimana karakteristik kedua kelompok (<60 tahun dan >60 tahun) sebanding kecuali jenis kelamin, merokok, ada tidaknya komorbiditas, dan jumlah komorbiditas. Persentase mortalitas satu tahun adalah 68,0% dan 61,9% untuk kelompok usia <60 dan >60 tahun dengan median kesintasan 8 dan 9 bulan bulan. Analisis bivariat tidak menunjukkan hubungan bermakna antara usia dengan kesintasan satu tahun. Simpulan: Tidak ada pengaruh usia terhadap kesintasan satu tahun pasien kanker paru karsinoma bukan sel kecil yang diterapi di RS Cipto Mangunkusumo dan RS Kanker Dharmais di semua stadium dengan mempertimbangkan functional status, indeks massa tubuh, dan komorbiditas.

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Background: Old age and its relations to non-small cell lung carcinoma survival has been studied before but its survival in Indonesia has not been studied before. Not many studies that have considered confounders, such as stage, functional status, comorbidities and body mass index, in the study between advancing age and non-small cell lung cancer carcinoma survival.

Aim: To evaluate differences of treated non-small cell lung carcinoma one year survival between non-elderly and elderly considering stages, functional status, body mass index and comorbidities.

Methods: Retrospective cohort design and survival analysis were used to 227 patients with non-small cell lung cancer that being treated at Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital between 2002 and 2012 that divided into 2 groups according to age at diagnosis (<60 years and >60 years). Kaplan-Meier curve was used to evaluate the one year survival of each group. Bivariate analysis was conducted using log-rank test, multivariate analysis was conducted using cox proportional hazard regression. The extend of relation between advancing age and survival was expressed with crude HR with 95% CI and adjusted HR with 95% CI after adjusting for confounders.

Results and Discussion: There were 227 non-small cell lung carcinoma being treated whereas the characteristics between two groups (<60 years and >60 years) were the same except for sex, smoking status, comorbidities and number of comorbidities. One year mortality percentage were 68.0% and 61.9% to <60 years and >60 years groups, respectively, with the survival median of 8 and 9 months. Bivariate analysis didn’t find statistically significant relation between age and one year survival.

Conclusion: Age didn’t influence one year survival of treated non-small cell lung carcinoma at Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital considering stage, functional status, comorbidities and body mass index."

"Gangguan yang paling sering dikeluhkan oleh pasien kanker paru adalah adanya kesulitan bernapas dan kecemasan yang menyebabkan pasien menjadi tidak relaks.Tujuan dari penelitian ini adalah untuk mengetahui pengaruh program latihan pursed lip breathing (PLB) dan Progressive Muscle Relaxation (PMR) terhadap peningkatan saturasi oksigenasi dan tingkat relaksasi pada pasien kanker paru. Metode penelitian yang digunakan adalah Quasi eksperiment dengan desain pre dan post test without control group. Jumlah sampel yang digunakan sebanyak 19 orang. Alat ukur yang digunakan yaitu oksimetri nadi untuk menilai saturasi oksigen dan lembar monitoring subjektif dan objektif untuk menilai tingkat relaksasi.Hasil penelitian menunjukkan bahwa ada perbedaan yang signifikan antara nilai saturasi oksigen sebelum dan sesudah latihan PLB dan PMR (p value < 0,05) dan ada perbedaan yang signifikan antara tingkat relaksasi sebelum dan sesudah latihan PLB dan PMR (p value < 0,05). Hasil analisis multivariate didapatkan bahwa usia menjadi prediktor terhadap peningkatan saturasi oksigen.Penelitian ini menyimpulkan bahwa latihan PLB dan PMR dapat meningkatkan saturasi oksigen dan tingkat relaksasi sebagai terapi komplementer pendamping terapi oksigen standar. Rekomendasi dari penelitian ini adalah perlunya terapi pengaturan napas dan teknik relaksasi untuk meningkatkan saturasi oksigen dan tingkat relaksasi pada pasien kanker paru stadium III dan IV.

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The most common symptoms in lung cancer are dyspnea and anxiety that cause patients restlessness.

This study aimed to find out the influence of PLB and PMR training program on the increase oxygen saturation and relaxation level in patients with lung cancer. This study employed a Quasy Experiment with pre test and post test without control group. There were 19 participants in this study. The instruments used were pulse oxymetry to measure oxygen saturation and monitoring form to measure subjective and objective relaxation level.

The results show that there is a significant difference on oxygen saturation before and after PLB and PMR training program (p value < 0,05) and a significant difference on relaxation level before and after PLB and PMR training program (p value < 0,05). A Multivariate analysis shows that age becomes a strong predictor of oxygen saturation.

This study concludes that PLB and PMR training program apllied to patient with lung cancer increases oxygen saturation and relaxation level as a complementary therapyalong with oxygen standart therapy. This study sugests breathing and relaxation training program to increase oxygen saturation and relaxation level for patient with lung cancer at grade III and IV."

"Data mengenai luluh paru LP sangat terbatas mencakup karakteristik demografi, status hipertensi pulmoner HP , fungsi paru, kapasitas latihan, akivitas fisis dan kejadian rawat inap berulang. Penelitian ini memiliki desain potong lintang dengan 54 subjek. Echokardiografi dilakukan untuk menyingkirkan terdapatnya kelainan jantung dan menentukan status HP. Subjek kemudian akan menjalani serangkaian prosedur antara lain wawancara, pemeriksaan fisis, uji jalan 6 menit 6MWT , uji fungsi paru dan pemeriksaan darah. Hipertensi pulmoner ditemukan pada 63 subjek dengan mPAP 29,13 13,07 sedangkan 55,9 diantaranya mengalami PH yang berat. Rawat inap berulang terjadi pada 44,4 , sesak napas mMRC >1 , aktivitas fisis, rawat inap berulang, luas lesi, CRP dan tekanan oksigen arteri memiliki hubungan bermakna terhadap status HP. Kadar CRP dan 6MWT merupakan variabel yang paling berhubungan dengan kejadian rawat inap berulang pada LP-HP yang dianalisis dengan analisis multivariat. Echokardiografi sebaiknya dilakukan pada pasien LP. Pasien LP-HP mengalami sesak yang lebih berat, rawat inap berulang, lesi yang lebih luas, kadar CRP lebih tinggi, aktivitas fisis, uji fungsi paru, PaO2 dan indeks massa tubuh yang lebih rendah. Hasil spirometri dan kadar CRPmerupakan faktor yang paling berpengaruh terhadap kejadian rawat inap berulang pada pasien LP-HP melalui analisis multivariat.

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We investigated and provided datas about demographyc and clinical characteristics. We also found out the influencing factors of re hospitalization in destroyed lung with pulmonary hypertension patients. This is a cross sectional study involving 54 DL subjects. Echocardiography was performed to rule out cardiac abnormality and to establish their PH status. Subjects performed several procedures such as interview, physical examination, 6 minutes walking test 6MWT , lung function test, and blood tests to obtain all the neede data. Pulmonary hypertension was found in 63 of subjects with mPAP was 29,13 13,07 while 55,9 of DL PH subjects had severe PH. Re hospitalization occured in 44,44 subjects. We analyzed using chi square for categorical data and student t test and found a significant association of PH status in DL subjects with breathlessness by mMRC scale 1, physical activity, re hospitalization, body mass index, FVC, FEV1, FEV1 FVC, spirometry result, extend of lesion, CRP and arterial oxygen pressure. Level of CRP, VEP1 dan 6MWT had the strongest association for DL having PH and rehospitalization by multivariate analysis. Echocardiography should be performed among DL patients. Patients DL who got PH have more breathlessness, re hospitalization and extend of lesion, higher CRP level, lower physical activity, worse lung function test, lower PaO2 and lower BMI. Spirometri result, and CRP level had the strongest association for DL having PH and rehospitalization by multivariate analysis."

"ABSTRAK Tesis ini menilai efikasi dan toksisiti Erlotinib/Gefitinib sebagai terapi lini kedua pada pasien KPKBSK yang mengalami progresifitas. Ini adalah sebuah penelitiankohor retrospektif antara tahun 2009 sampai 2013 dari rekam medis pasienKPKBSK yang mengalami progresifitas. Respons (subjektif, semisubjektif danobjektif) dievaluasi setiap bulan. Toksisiti dinilai setiap minggu sejak pemberianErlotinib/Gefitinib berdasarkan kriteria WHO. Hasil evaluasi respons objektif,tidak ada pasien yang memberikan respons komplit. Best overall response ratedari 31 pasien, 48,8% menetap, 22,6% perburukan,12,9% respons sebagian dan6,5% tidak dinilai/inevaluable. Pada penilaian respons semisubjektif didapatkan19.4% peningkatan berat badan, 51,6% penurunan berat badan dan 29,0%menetap. Waktu tengah tahan hidup mencapai 18 bulan, rerata masa tahan hidup1 tahunan 80,6% dan masa tahan hidup keseluruhan 6,50%. Data menunjukkantidak ada timbul toksisiti hematologi berat (grade ¾) dan data penilaian toksisitinon hematologi sangat jarang timbul toksisiti berat (grade ¾). Efikasi monoterapiEGFR-TKI (Erlotinib/Gefitinib) cukup tinggi dengan toksisiti yang ditimbulkantidak berat. Dengan demikian Erlotinib/Gefitinib sebagai terapi lini kedua cukupbaik.ABSTRACT This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second

line therapy in NSCLC patients. This is a retrospective cohort study between 2009

and 2013 from the medical records of patients who experienced progression

NSCLC. Therapeutic response was evaluated every month. Toxicity assessed

every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results

of objective response evaluation none of the patients complete response. Best

overall response rate of 31 patients with the most stable response are 48.8%. Most

semisubjective response obtained are 51.6% weight loss. The middle survival time

reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall

survival. The data showed no hematologic toxicity arise severe (grade ¾) and

non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR

TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not

severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good. ;This thesis assesses the efficacy and toxicity of Erlotinib/Gefitinib as a second

line therapy in NSCLC patients. This is a retrospective cohort study between 2009

and 2013 from the medical records of patients who experienced progression

NSCLC. Therapeutic response was evaluated every month. Toxicity assessed

every month since giving Erlotinib/Gefitinib according to WHO?s criteria. Results

of objective response evaluation none of the patients complete response. Best

overall response rate of 31 patients with the most stable response are 48.8%. Most

semisubjective response obtained are 51.6% weight loss. The middle survival time

reached 18 month, the mean 1 year survival time are 80.6% and a 6.50% overall

survival. The data showed no hematologic toxicity arise severe (grade ¾) and

non-hematological toxicity very rarely arise severe toxicity. The efficacy of EGFR

TKI monotherapy (Erlotinib/Gefitinib) is high enough with toxicity cause not

severe. Thus Erlotinib/Gefitinib as second-line therapy is quite good. "