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"ABSTRAKLatar 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

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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 ."

"Kanker paru jenis karsinoma bukan sel kecil (KPKBSK) merupakan kanker dengan tingkat kematian tertinggi dan merokok merupakan faktor risiko utama dari kanker ini. Diketahui bahwa selain memicu terjadinya karsinogenesis, merokok juga berpotensi meningkatkan keganasan dari KPKBSK. Berdasarkan penelitian terdahulu diketahui bahwa terdapat dua jenis mikro-RNA (miRNA) yang berasosiasi dengan keganasan KPKBSK yaitu miR-10b-5p dan miR-320b. Penelitian ini bertujuan untuk mengeanalisis ekspresi miR-10b-5p dan miR-320b pada vesikel ekstraseluler (VE) dari pasien KPKBSK terkait dengan kebiasaan riwayat merokok dari pasien. Sampel yang dianalisis adalah sampel jaringan dan darah dari pasien KPKBSK (n=21) dengan riwayat merokok dan tidak merokok. VE diisolasi dari plasma dan berikutnya dilakukan isolasi miRNA dari VE yang diperoleh. Ekspresi relatif miRNA dianalisis dan kemudian dibandingkan. Hasil penelitian menunjukkan bahwa miR-10b-5p dan miR-320b pada VE dapat membedakan pasien KPKBSK dengan riwayat merokok dan tidak merokok. Ditemukan bahwa miR-10b-5p pada VE memiliki tingkat ekspresi lebih tinggi pada perokok, sementara tingkat ekspresi miR-320b ditemukan lebih rendah pada pasien KPKBSK perokok. Di samping itu, analisis ROC juga menunjukkan bahwa VE (AUC 0,878; 0,739) merupakan sumber miR-10b-5p dan miR-320b yang lebih baik untuk digunakan dalam analisis dibanding plasma (AUC 0,629; 0,559). Hasil yang diperoleh juga menunjukkan bahwa miR-10b-5p dan miR-320b pada VE adalah memiliki potensi untuk digunakan sebagai biomarker prognosis untuk pasien KPKBSK dengan riwayat merokok.

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Non-small cell lung cancer (NSCLC) is the cancer with highest mortality and smoking is a well-known risk factor of this cancer. This study aimed to evaluate the potential of extracellular vesicles (EVs) miRNAs to be utilized in liquid biopsy for diagnosing NSCLC in smokers. It has been reported that other than inducing carcinogenesis, smoking could also contribute to induce the malignancy of NSCLC. Previous study has found 2 micro-RNAs (miRNAs), the miR-10b-5p and miR-320b which contribute to NSCLC malignancy. Therefore, this study aimed to analyze the expression of miR-10b-5p and miR-320b in EVs from NSCLC patients in relation to their smoking behavior.  Tissue and blood samples were collected from NSCLC patients (n=21) with smoking and non-smoking history. EV was isolated from plasma and miRNAs were extracted from the isolated EV. The miRNAs relative expression was analyzed and then compared. The results showed that plasma EV’s miR-10b-5p and miR-320b could differentiate the NSCLC patients with smoking and non-smoking history. EV’s miR-10b-5p was found overexpressed in smoker NSCLC patients, while miR-320b expression was lower in smoker NSCLC patients. Additionally, ROC analysis also showed that plasma EV (AUC 0,878; 0,739) was more suitable source of miR-10b-5p and miR-320b to be analyzed than plasma (AUC 0,629; 0,559). These results also suggest that EV’s miR-10b-5p and miR-320b are potential prognosis biomarker to be utilized for smoker NSCLC patients."

"[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.]"

"Latar Belakang: Tingginya angka kejadian kanker paru menyebabkan diperlukan pemanfaatan suatu penanda biologis spesifik kanker paru untuk menilai progresifitas penyakit. Transforming growth factor-β adalah protein yang disekresi untuk meregulasi proliferasi, diferensiasi dan kematian dari berbagai jenis sel. Semua jenis sel kekebalan termasuk sel B, sel T, sel dendritik dan makrofag mensekresi TGF-β. Jenis TGF-β yang terbanyak adalah TGF-β1. Diperlukan pengukuran kadar TGF-β1 serum darah tepi sebagai faktor prognostik pada kanker paru khususnya KPKBSK stage lanjutMetode: Penelitian ini merupakan studi perbandingan dengan disain potong lintang pada pasien kanker paru yang telah tegak diagnosis dan bersedia diambil serum darah tepi untuk pemeriksaan kadar TGF-β1 serum menggunakan Human TGF-β1 Quantikine ELISA kit dari R D. Kadar TGF-β1 serum diukur pada 68 subjek yang terdiri dari 30 subjek kelompok kanker paru dan 38 subjek kelompok bukan kanker paru.Hasil: Kadar TGF-β1 serum pada kelompok kanker paru meningkat signifikan lebih tinggi dibandingkan kelompok bukan kanker paru (median; min-max) (3601.85; 2006.87-14995.25 pg/mL vs 2510.11; 646.31-5584.07 pg/mL) (P = 0.000). Tidak ditemukan hubungan antara kadar TGF-β1 serum dengan jenis kelamin, umur, riwayat merokok, gejala klinis, gambaran bronkoskopi, jenis sitologi/histopatologi, KPKBSK stage lanjut, dan status tampilan umum. Median Survival Time (95% CI) TGF-β1 < 3601.85 pg/mL adalah 9.7 (2.4-16.9) bulan sedangkan TGF-β1 ≥ 3601.85 pg/mL adalah 16.7 (7.7-25.7) bulan. Over all survival TGF-β1 13.3 (5.8-20.8) bulanKesimpulan: Kadar TGF-β1 serum meningkat pada kelompok kanker paru dibandingkan kelompok bukan kanker paru. Kadar TGF-β1 serum belum dapat digunakan sebagai marker prognostik kanker paru.

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Beckground: The high incidence rate of lung cancer leads to the utilization of a specific biological marker of lung cancer to assess disease progression. Transforming growth factor-β is a secreted protein to regulate the proliferation, differentiation and death of different cell types. Types of immune cells are B cells, T cells, dendritic cells and macrophages secreting TGF-β. The most common type of TGF-β is TGF-β1. Therefore, measurement of serum level of TGF-β1 as a prognostic factors in lung cancer, especially advanced stage NSCLC, to assess progressivity of lung cancer is needed. Method: This study is a comparative study with cross-sectional design in lung cancer patients who had been diagnosed and were willing to be taken for examination of peripheral blood serum levels of TGF-β1 using the Quantikine Human TGF-β1 ELISA kit from R&D system. TGF-β1 serum levels were measured in 68 subjects consisted of 30 subjects with lung cancer group and 38 subjects controlled group. Result: Serum level of TGF-β1 in lung cancer group increased significantly higher than control group (median; min-max) (3601.85; 2006.87-14995.25 pg/mL vs. 2510.11; 646.31-5584.07 pg/mL) (P = 0.000). There was no association between serum level of TGF-β1 with gender, age, smoking history, clinical symptoms, bronchoscopy, cytology/histopathology, advanced stage of NSCLC, and performance status. Median Survival Time (95% CI) TGF-β1 <3601.85 pg/mL was 9.7 (2.4-16.9) months while TGF-β1 ≥ 3601.85 pg/mL was 16.7 (7.7-25.7) months. Over all survival TGF-β1 13.3 (5.8-20.8) months. Conclusion: Serum level of TGF-β1 is higher in the lung cancer group compared to controlled group. Serum TGF-β1 levels can not be used as a prognostic markers of lung cancer."

"Latar belakang : Toksisitas hematologi sering terjadi pada pasien dengan Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) yang diobati dengan kemoterapi berbasis platinum. Data sebelumnya menunjukkan bahwa trombositopenia karena kemoterapi berbasis karboplatin adalah rendah tetapi tidak ada data lokal yang menjelaskan angka kejadian trombositopenia pada KPKBSK yang diterapi dengan regimen karboplatin+gemsitabin. Tujuan dari penelitian ini adalah untuk melihat dan membandingkan angka kejadian toksisitas hematologi seperti trombositopenia, anemia, leucopenia, neutropenia dan perdarahan yang disebabkan kemoterapi karboplatin+gemsitabin dengan karboplatin+paklitaksel dan karboplatin+etoposid pada pasien KPKBSK. Dan juga membandingkan respons objektif dari ketiga regimen tersebut. Metode:. Penelitian ini kohort retrospektif pada pada pasien KPKBSK yang menerima 1.250 mg/m2 gemsitabin pada hari ke-1 dan hari ke-8 dan karboplatin AUC-5(Area under curve) hari pertama. Pasien yang menerima ≥ 2 siklus ikut dalam penelitian ini. Kami menilai dan membandingkan toksisitas hematologi tiap siklus seperti trombositopenia, anemia, leucopenia, neutropenia dan perdarahan serta respons objektif dari ketiga regimen berbasis karboplatin selama kemoterapi. Hasil: Pada penelitian ini didapatkan total 115 pasien (rerata umur 55.6±10, rerata jumlah siklus adalah 4, jenis histologi adenokarsinoma 91%, stage III or IV) Pasien KPKBSK yang menerima regimen karboplatin+gemsitabine (n=38), karboplatin+paklitaksel (n=39) dan karboplatin+etoposid (n=38). Angka kejadian trombositopenia regimen karboplatin+gemsitabin adalah 34.2%, karboplatin+paklitaksel 5.1%, dan karboplatin+etoposid 5.3%. Waktu terjadinya trrombositopenia pada regimen karboplatin+gemsitabin 2 siklus lebih cepat dari regimen lain. Toksisiti hematologi trombositopenia regimen karboplatin+gemsitabin sebesar 15,8% dengan grade 3-4, leukopenia 18,4% dengan grade 3- 4 dan anemia 5,3% grade 3-4. Overall respons rate dan time to progression dengan regimen karboplatin+gemsitabin lebih baik dari regimen lainnya. Kesimpulan : Angka kejadian dan waktu terjadinya toksisitas hematologi pada regimen karboplatin+gemsitabin lebih tinggi daripada regimen karboplatin+paklitaksel dan karboplatin+etoposid.. Tetapi Overall respons rate dan time to progression pada karboplatin+gemsitabin lebih baik daripada regimen lain. Background : Hematological toxicities often occur in patients with non-small-cell lung cancer (NSCLC) who are treated with chemotherapy. In our data had shown that thrombocytopenia due to carboplatin based chemotherapy was low but there was not any local data about carboplatin - gemcitabine regimen. The aim of this study is to investigate and to compare the frequency of hematologic events, such as thrombocytopenia, anemia, leucopenia, neutropenia, and hemorrhage due to combination of gemcitabine-carboplatin with carboplatin-paclitaxel, and carboplatin-etoposide in non-small cell lung cancer patients. And also to compare objective response of the three platinum based regimens. Methods : We conducted a retrospective cohort study that enrolled all non-small-cell lung cancer patients who received 1.250 mg/m2 gemcitabine on day 1,8 and AUC-5 carboplatin on day one. Patients who received 2 cycles or more are included in this study. We investigated and compared objective response of the three platinum based regimens and the frequency of thrombocytopenia, anemia, leucopenia, neutropenia, hemorrhage, during chemotherapy period. Results : A total 115 patients (mean age 55.6±10, median number of cycle of chemotherapy was 4, histological findings were adenocarcinoma 91%) with stage III or IV NSCLC received chemotherapy carboplatin-gemcitabine (n=38), carboplatin-paclitaxel (n=39) and carboplatin-etoposide (n=38). Frequency of thrombocytopenia in patients with NSCLC treated with combination of carboplatin-gemcitabin regimen was 34.2%, carboplatin-paclitaxel 5.1%, and carboplatin-etoposide 5.3%. The Carbo-gemcitabine group developed thrombocytopenia 1 or 2 cycles earlier than other group . The hematological toxicities data with carbo-gemcitabine regimen have shown that thrombocytopenia was 15,8% patient with grade 3 or 4, leucopenia 18,4% patients with grade 3 or 4 and 5,3% grade 3 or 4 anemia. Overall respons rate and time to progression with carboplatin-gemcitabine regimen were better than the other regimens Conclusion : Thrombocytopenia was found in gemcitabine and carboplatin regimen but lower than other published data. Overall respons rate and time to progression with carboplatin-gemcitabine regimen were better than the other regimens."