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"Tujuan: membandingkan perbedaan luaran klinis antara pasien metastasis otak yang diberikan whole brain radiation therapy (WBRT) dan WBRT dengan simultaneous integrated boost (SIB) pada pasien metastasis otak. Metode: antara tahun Januari 2018 dan Januari 2023, 47 pasien metastasis otak diberikan radioterapi paliatif otak. Diantaranya, 30 pasien menjalani WBRT dan 17 pasien menjalani WBRT-SIB. Hasil akhir pada penelitian ini termasuk kontrol intrakranial, respons tumor dan kesintasan keseluruhan (OS). Hasil: median follow-up pada kelompok WBRT dan WBRT-SIB yaitu 5,4 bulan dan 7,1 bulan secara berurutan. Median kontrol intrakranial pada kelompok WBRT adalah 4,8 bulan dan 9 bulan pada kelompok WBRT-SIB. Kontrol intrakranial 6 bulan pada kelompok WBRT-SIB lebih tinggi dibandingkan kelompok WBRT (76,4% vs 30%, p=0,002). Tidak terdapat perbedaan signifikan pada kesintasan keseluruhan dan respons tumor. Analisis multivariat menunjukkan Penyakit primer terkontrol, kemoterapi pasca RT dan metode WBRT-SIB dapat meningkatkan angka kontrol intrakranial pada pasien metastasis otak. Tidak dijumpai toksisitas radiasi derajat 3 atau lebih pada kedua kelompok. Tidak terdapat perbedaan signifkan penurunan fungsi kognitif pada kedua kelompok. Kesimpulan: WBRT-SIB dapat meningkatkan kontrol intrakranial dibandingkan WBRT saja pada pasien metastasis otak. Namun, tidak dijumpai perbedaan signifikan OS dan respons tumor pada kedua kelompok.

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Purpose: To compare the differences in clinical outcomes between brain metastasis patients treated with Whole Brain Radiation Therapy (WBRT) alone and WBRT with Simultaneous Integrated Boost (SIB). Method: Between January 2018 and January 2023, 47 brain metastasis patients received palliative brain radiotherapy. Among them, 30 patients underwent WBRT, and 17 patients underwent WBRT-SIB. The primary outcomes assessed in this study included intracranial control, tumor response, and overall survival (OS). Results: The median follow-up in the WBRT and WBRT-SIB groups was 5.4 months and 7.1 months, respectively. The median intracranial control in the WBRT group was 4.8 months, while in the WBRT-SIB group was 9 months. The 6-month intracranial control in the WBRT-SIB group was significantly higher compared to the WBRT group (76.4% vs. 30%, p=0.002). There were no significant differences in overall survival and tumor response between the two groups. Multivariate analysis showed that controlled primary disease, post-RT chemotherapy, and WBRT-SIB method could improve intracranial control rates in brain metastasis patients. No grade 3 or higher radiation toxicity was observed in both groups. There were no significant differences in cognitive function decline between the two groups. Conclusion: WBRT-SIB can improve intracranial control compared to WBRT alone in brain metastasis patients. However, there were no significant differences in overall survival and tumor response between the two groups."

"ABSTRAKLatar Belakang Peningkatan insidensi tumor metastasis intrakranial setiap tahunnya, juga diikuti oleh meningkatnya angka disabilitas dan mortalitas pada pasien. Terapi standar pada tumor metastasis otak adalah WBRT, SRS, operasi atau kombinasi dari ketiganya. Dengan semua pilihan terapi yang ada, sangat penting untuk memerhatikan prognosis pasien dengan tumor metastasis otak untuk menentukan jenis terapi yang sesuai, salah satunya dengan menggunakan indeks prognosis. Belum terdapat data yang menggambarkan profil demografis dan kesintasan pasien tumor metastasis otak di Indonesia dengan menerapkan indeks prognosis yang sudah ada.Tujuan dan Metode Penelitian ini merupakan studi cohort retrospektif untuk melihat kesesuaian hasil analisis kesintasan pasien tumor metastasis otak di Departemen Radioterapi RSUPN Dr. Cipto Mangunkusumo tahun 2012-2014 dengan data acuan indeks RPA, GPA, dan BSBM.Hasil Terdapat 62 subyek yang diikutsertakan dalam penelitian ini setelah mendapat persetujuan. Median kesintasan keseluruhan mencapai 9,16 bulan. Hasil analisis kesintasan berdasarkan indeks RPA memperlihatkan median kesintasan Kelas I, Kelas II dan Kelas III, secara berurutan 16.3 bulan, 11.2 bulan, dan 4.7 bulan. Karakteristik dan median kesintasan subyek pengamatan berdasarkan indeks GPA, secara berurutan mulai dari GPA 0-1 sampai GPA 3,5-4 adalah 4.3, 10.4, 12.4, dan 16.3 bulan. Hasil penerapan kedua indeks tersebut terlihat sesuai dengan data acuan penelitian pendahulunya. Namun indeks BSBM tidak mampu memperlihatkan hasil yang sesuai saat diterapkan pada populasi sampel penelitian.Kesimpulan Indeks RPA dan GPA dapat digunakan untuk memprediksi prognosis pasien tumor metastasis otak di RSUPN-CM karena memberikan karakterisitik yang sesuai dengan data acuan. Indeks GPA dianggap lebih baik karena menggunakan variabel yang lebih objektif.

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ABSTRACTBackground The incidence of intracranial metastasis has increased annually, which also followed by the increased number of patient rsquo s disability and mortality. Standard therapy in brain metastasis are Whole Brain Radiotherapy WBRT , Stereotactic Radio Surgery SRS , surgery, or combination of all. With all these treatment options available, it is very important to consider the prognosis in order to decide which therapy is appropriate. One of the methods that can be used to determine the prognosis is by using the prognostic indices. Currently, there has been no data or report about the demographic and survival profile of patients with brain metastastis in Indonesia using the available index prognosis.Methods This is a retrospective cohort study to evaluate the survival analysis in patients with brain metastasis that are undergoing treatment in Radiotherapy Department, RSUPN Dr. Cipto Mangunkusumo in 2012 2014 based on RPA, GPA, and BSBM index.Results Sixty two patients are included in this study after obtaining the approved consent. The median of survival rate is 9.16 months. Survival analysis based on RPA index showed median class I, II, and III are 16.3, 11.2, and 4.7 months, respectively. Characteristics and median observer based on GPA, from GPA 0 1 to GPA 3.5 4 are 4.3, 10.4, 12.4, and 16.3 months, respectively. These findings are similar with the previous studies. However, BSBM index does not able to illustrate the result that is appropriate when it is being applied to the subjects of this study.Conclusions RPA and GPA index can be used to predict the prognosis in patients with brain metastasis that are undergoing treatment in RSUPN Dr. Cipto Mangunkusumo because it provides characteristics, which correspond to the reference data. GPA index is considered better because it uses more objective variables."

"Tujuan: Menilai kesintasan pasien metastasis otak yang menjalani radioterapi di RSUPN Dr. Cipto Mangunkusumo dan kesesuaian terhadap stratifikasi prognostik indeks Recursive Partitioning Analysis (RPA) dan Diagnosis-Specific Graded Prognostic Assessment (DS-GPA). Metode: Dilakukan studi retrospektif pada 51 pasien metastasis otak yang menjalani radiasi whole brain di RSCM pada Januari 2017-Desember 2019. Data klinis dikumpulkan melalui rekam medis. Stratifikasi pasien dilakukan berdasarkan indeks RPA dan DS-GPA. Kesintasan keseluruhan (OS) diukur sejak pasien menyelesaikan radioterapi hingga meninggal dunia atau follow-up terakhir. Kinerja indeks RPA dan DS-GPA dibandingkan menggunakan model regresi Cox. Kesintasan dinilai dengan uji Kaplan-Meier dan analisis model Cox proportional hazard. Hasil: Median kesintasan keseluruhan subyek adalah 5,3 bulan. Indeks RPA menunjukkan stratifikasi yang signifikan pada primer kanker paru dan kelompok adenokarsinoma paru. Stratifikasi DS-GPA signifikan pada primer kanker payudara dan kanker paru. Stratifikasi RPA lebih unggul dibandingkan DS-GPA pada primer kanker paru (5,752; IK95% 1,523- 21,723; p=0,004 vs 3,231; IK95% 1,008-10,350; p=0,039). Jenis kelamin (p=0,009), KPS (p=0,030), dan jumlah lesi intrakranial (p=0,023) merupakan faktor prognostik yang mempengaruhi kesintasan hidup pasien metastasis otak. Kesimpulan: Dalam populasi studi ini, stratifikasi prognostik indeks DS-GPA sesuai untuk diterapkan pada pasien metastasis otak dengan primer kanker payudara dan kanker paru. Stratifikasi indeks RPA pada kelompok primer kanker paru lebih baik dibandingkan DS-GPA.

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Aims: This study was aimed to assess survival of patients with brain metastases after radiotherapy in RSCM and to confirm the validation of Recursive Partitioning Analysis (RPA) and Diagnosis-Specific Graded Prognostic Assessment (DS-GPA). Materials and methods: This retrospective study included 51 patients treated with whole brain radiation between 2017 and 2019. Clinical data collected from hospital medical records were reviewed. Patients were classified by RPA and DS-GPA. Overall survival (OS) was calculated from last day of radiotherapy to death or last follow-up. The performances of RPA and DS-GPA were compared using Cox regression model. Survival was determined using the Kaplan-Meier curves and Cox proportional hazards model. Results: Median OS in this population study was 5.3 months. RPA provided significant stratification in lung cancer primary group and lung adenocarcinoma subgroup. Prognostic stratification of DS-GPA was valid in breast cancer and lung cancer groups. RPA was superior to DS- GPA in patients with lung cancer primary (5.752; 95%CI 1.523-21.723; p=0.004 vs 3.231; 95%CI 1.008-10.350; p=0.039). Sex (p=0.009), KPS (p=0.03), and number of brain lesions (p=0.023) were significant independent prognostic factors for survival in brain metastatic patients. Conclusions: In this study population, prognostic stratification of DS-GPA was valid in brain metastatic patients with breast and lung cancer primaries. RPA was valid and performed better stratification than DS-GPA in patients with lung cancer primary."

"Latar belakang: Insidens metastasis otak lebih tinggi dibanding tumor primer otak dan berisiko menimbulkan kematian dengan penyebab terbanyak berasal dari kanker paru (36,5%) di RSUPN Cipto Mangunkusumo (RSCM). Keterlambatan diagnosis berisiko menyebabkan herniasi otak, sehingga terjadi kecacatan dan kematian. Dibutuhkan data mengenai durasi penegakan diagnosis di RSCM.Metode penelitian: Penelitian ini merupakan studi deskriptif analitik dengan rancangan kohort retrospktif untuk mengetahui kesesuaian antara durasi penegakan diagnosis tumor otak metastasis akibat kanker paru dengan pedoman praktik klinis (durasi ≤2 minggu). Subjek merupakan pasien rawat inap di RSCM pada Januari 2019 s/d Desember 2021.Hasil: Terdapat 12 subjek (30%) dapat ditegakkan dalam waktu ≤2 minggu dengan  median durasi 18,5 hari (IQR (12-34 hari). Selain itu didapatkan durasi 7 hari (IQR 4-11 hari) untuk sampai didapatkannya massa di paru,  durasi 8 hari (IQR 4.5-13 hari) sampai dilakukannya biopsi, dan 6 hari (IQR 3.5-7 hari) sampai keluarnya hasil patologi anatomi. Tidak terdapat hubungan yang bermakna secara statistik antara variabel yang dinilai dengan durasi penegakan diagnosis ≤2 minggu (14 hari).Kesimpulan: Hanya 30% subjek dengan durasi yang sesuai dengan panduan praktik klinis di RSCM. Dibutuhkan diseminasi hasil dan kolaborasi antar bagian agar penegakan diagnosis lebih cepat.

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Background: Incidence of brain metastases is higher than primary brain tumors, with lung cancer as common etiology (36.5%) at Cipto Mangunkusumo General Hospital (RSCM). Delay in diagnosis can cause brain herniation, resulting in disability and death. Data is needed regarding the duration of diagnosis in RSCM.

Method: This is a descriptive analytic study with a retrospective cohort design to determine the conformity between the duration of diagnosis of metastatic brain tumors due to lung cancer in daily clinical practice with clinical practice guidelines (duration 2 weeks). Subjects were inpatients at RSCM from January 2019 to December 2021

Results: There were 12 subjects (30%) who could be diagnosed within 2 weeks with a median duration of 18.5 days (IQR (12-34 days). Duration of 7 days (IQR 4-11 days) to obtain a lung mass, 8 days (IQR 4.5-13 days) until a biopsy was performed, and 6 days (IQR 3.5-7 days) until anatomic pathology results were released. There is no statistically significant relationship between the variables assessed and the duration of diagnosis 2 weeks.

Conclusion: Only 30% of subjects with the duration matched the clinical practice guidelines at RSCM. Dissemination of results and collaboration between departments is needed to make diagnosis faster."

"Tumor otak sekunder dapat menyebabkan masalah nutrisi. Manifestasi klinis penurunan selera makan, gangguan menelan, mual, muntah, hemiparesis, kejang, gangguan fungsional dan kognitif dapat menurunkan asupan makanan dan berat badan sehingga berisiko malnutrisi. Perubahan metabolisme makronutrien dan mikronutrien yang terjadi juga memengaruhi terjadinya malnutrisi. Tatalaksana terapi medik gizi yang diberikan bertujuan mempertahankan atau memperbaiki status gizi sehingga meningkatkan kualitas hidup dan memperlama harapan hidupnya. Terapi medik gizi yang sesuai rekomendasi European Society of Clinical Nutrition and Metabolism (ESPEN) adalah diet seimbang yang meliputi makronutrien, mikronutrien, nutrien spesifik, dan edukasi. Pasien serial kasus ini adalah perempuan, berusia antara 48 sampai 59 tahun dengan diagnosis tumor otak sekunder. Tiga pasien memiliki tumor primer kanker payudara, sedangkan satu pasien dengan kanker endometrium. Skrining menggunakan malnutrition screening tool (MST) dilanjutkan asesmen gizi. Terapi medik gizi diberikan sesuai rekomendasi ESPEN dan toleransi pasien. Pemantauan gizi meliputi pemeriksaan fisik, antropometri, komposisi tubuh, kapasitas fungsional dan analisis asupan. Hasil menunjukkan semua pasien mencapai asupan makan sesuai target pemberian makronutrien, mikronutrien, dan nutrien spesifik. Status gizi berhasil dipertahankan dengan tiga pasien mengalami peningkatan BB. Kapasitas fungsional keempat pasien menunjukkan perbaikan dengan menggunakan Karnofski dan Eastern Cooperative Oncology Group (ECOG). Pemeriksaan handgrip hanya dapat dilakukan pada 3 pasien menunjukkan perbaikan.

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A secondary brain tumor may cause nutritional problems. Clinical manifestations such as decreased appetite, swallowing disorders, nausea, vomiting, hemiparesis, seizures, functional and cognitive disorders may reduce food intake and increase malnutrition. Also changes in metabolism can affect the malnutrition. The aim of the medical nutrition therapy to maintain nutritional status to improve the quality of life and life expectancy. Balance diet were recommended by European Society of Clinical Nutrition and Metabolism (ESPEN) includes macronutrients, micronutrients, specific nutrients with continuing nutrition education. Patients are females, aged 48 to 59 years, with secondary brain tumor. The primary tumor of three patients were breast cancer and one patient was endometrial cancer. Screening was done using the malnutrition screening tool (MST) and followed with nutritional assessment. Medical nutrition therapy were given based on ESPEN recommendations and patient tolerance. Nutrition monitoring includes physical examination, anthropometry, body composition, functional capacity and intake analysis. Patient’s monitoring showed that all patients achieved their intake targets. The body weight of three patient increased showed that the nutrition status was maintained well enough. Patient’s functional capacity were improved according to Karnofsky and Eastern Cooperative Oncology Group (ECOG). Handgrip examination were also improve when it was assesed on three patients."

"Hipoksia merupakan keadaan dimana kadar oksigen berada dibawah kadar 20-21%. Otak merupakan salah satu organ yang rentan mengalami kematian sel akibat hipoksia disebabkan oleh kebutuhan energi yang lebih banyak untuk melakukan fungsinya. Aktivitas Enzim Laktat Dehidrogenase (LDH) memiliki peran dalam keadaan hipoksia untuk menghasilkan energi melalui reaksi glikolisis anaerob. Penelitian ini bertujuan untuk mengamati dan mempelajari adaptasi jaringan otak dengan melihat aktivitas enzim LDH di jaringan otak tikus normoksia dibandingkan dengan hipoksia.Penelitian ini merupakan studi eksperimental yang dilaksanakan sejak Maret 2011. Dilakukan pengkondisian hipoksia dalam hypoxic chamber (oksigen 10% dan nitrogen 90%) selama 1 hari, 3 hari, 7 hari, dan 14 hari kepada 20 tikus galur Sprague Dawley, sedangkan 5 ekor tikus akan berperan sebagai kontrol. Pasca perlakuan, otak tikus diambil melalui proses bedah dengan melakukan eutanasia dengan eter terlebih dahulu, otak ditimbang hingga batas 100 mg, dan diubah menjadi supernatan yang akan diperiksa absorbansinya dengan menggunakan elektrofotometer untuk menentukan aktivitas enzim LDH.Hasil menunujukkan peningkatan aktivitas pada 1 dan 3 hari hipoksia, dan menurun pada 7 dan 14 hari hipoksia. Analisis dengan uji nonparametrik Kruskal-Wallis didapatkan nilai p > 0.05 sehingga tidak ada perbedaan bermakna antara aktivitas LDH pada kelompok kontrol dengan kelompok yang diberi perlakuan hipoksia.

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Hypoxia is a term to a condition which oxygen level below 20-21%. The brain is an organ which is susceptible to cell death due to hypoxia caused by the need of more energy to perform its function. Lactate Dehydrogenase (LDH)?s activity has role in hypoxic condition to produce energy through anaerob glycolisis. This research aimed to observe and study about the adaptation of brain through LDH's activity in the tissue of normoxic rat brain compared to the hypoxic rat.

This is an experimental study which held from March 2011. 20 rats were placed in the hypoxic chamber (10% Oxygen, 90% Nitrogen) for 1, 3, 7, and 14 days; while 5 normoxic rats will be served as control. The brain were taken by a surgery with a process of eutanaschia before it. The brain weighed up to the limit of 100 mg, then converted to supernatant. Absorbance of the supernatant examined by electrophotometer as the activity of the enzymes.

There were increased activity in the 1, and 3-day hipoxia, and decreased in 7, and 14-day hipoxia. analyzed by Kruskal-Wallis nonparametric test obtained p > 0.05 which means there is no significant difference between LDH?s activity in the normoxic and hypoxic tissue."

"Latar belakang. Laktat awalnya dianggap sebagai produk berbahaya dari metabolisme anaerobik, namun bukti terbaru menunjukkan laktat dapat melindungi neuron dan memperbaiki luaran. Dalam studi ini, kami mencari korelasi antara kadar laktat darah dan luaran pascaoperasi pasien dengan cedera otak traumatika (traumatic brain injury, TBI). Metode. Studi kohort prospektif ini mengambil sampel dari pasien dengan TBI terisolasi yang menjalani operasi di Departemen Bedah Saraf RSUPN dr. Cipto Mangunkusumo dari April 2020 hingga Juni 2021. TBI dikategorikan menjadi ringan (GCS 13-15), sedang (GCS 9-12), dan berat (GCS 3-8). Kadar laktat darah diambil dari vena perifer sebelum dan pada hari ke-3 pascaoperasi. Luaran klinis dievaluasi berdasarkan perubahan (D) GCS pada hari ke-7 pascaoperasi dengan preoperasi, lalu dibagi menjadi 3 kelompok: membaik, tidak berubah, dan memburuk. Hasil. Dari 72 subjek dalam penelitian ini, ditemukan terdapat korelasi yang signifikan (p = 0,019, r = 0,275) antara kadar laktat preoperatif dengan D GCS, dimana semakin tinggi kadar laktat preoperatif maka D GCS akan semakin positif. Berdasarkan analisis dengan kurva receiver operating characteristics (ROC) dan Chi-square, ditemukan bahwa subjek dengan kadar laktat >=2,35 mmol/L memiliki kemungkinan 1,64 kali lebih besar untuk mengalami peningkatan GCS pascaoperasi. Kesimpulan. Laktat dapat dijadikan suatu faktor prognostik luaran baik pascaoperasi pasien TBI.

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Background. Lactate was initially thought to be a harmful product of anaerobic metabolism, but recent evidence suggests it can protect neurons and improve outcomes. Therefore, we sought a correlation between blood lactate levels and the postoperative outcome of patients with traumatic brain injury (TBI). Method. This prospective cohort study took samples from patients with isolated TBI who underwent surgery at the Department of Neurosurgery, Cipto Mangunkusumo National Hospital from April 2020 to June 2021. Blood lactate levels were taken from peripheral veins before surgery and on the 3rd postoperative day. The clinical outcome was evaluated based on the change (D) of GCS from before surgery and on the 7th postoperative day, then categorized into 3 groups: improved, unchanged, and worsen. Results. From 72 subjects in this study, significant correlation (p = 0.019, r = 0.275) was found between preoperative lactate levels and D GCS, where the higher preoperative lactate levels, the more positive D GCS would be. Based on the analysis using ROC curve and Chi-square, subjects with lactate levels >=2.35 mmol/L were 1.64 times more likely to experience an increase in postoperative GCS. Conclusion. Lactate can be used as a favorable prognostic factor in TBI patients."

"Penelitian ini bertujuan menganalisis ekspresi HIF-1? pada hati tikus yang diracuni CCl4 dalam kondisi normoksia, dengan atau tanpa perlindungan N-asetil sistein (NAC). Sebanyak 25 ekor tikus Sprague-Dawley jantan dibagi menjadi 5 grup: kontrol, diberikan minyak kelapa, diberikan CCl4, disuntik NAC lalu diberikan CCl4, diberikan CCl4 lalu disuntik NAC. Ekspresi mRNA HIF-1? dianalisis dengan real time RT-PCR dan dikuantifikasi menggunakan metode Livak. Ekspresi protein HIF-1? diukur menggunakan ELISA. Hasil ekspresi mRNA dan protein HIF-1? tertinggi terdapat pada grup tikus yang hanya diberi CCl4, lalu lebih rendah pada grup yang diberi NAC sebelum CCl4, grup yang diberi NAC setelah CCl4, grup kontrol, dan grup yang diberi minyak kelapa. Disimpulkan bahwa pemberian CCl4 pada kondisi normoksia menyebabkan peningkatan ekspresi HIF-1?, sedangkan pemberian NAC terbukti menurunkan ekspresi HIF-1a. Hal tersebut menunjukkan bahwa mekanisme perubahan ekspresi pada HIF-1a memang dipengaruhi oleh radikal bebas yang terbentuk akibat metabolisme CCl4.

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This study analyzed the expression of HIF-1? in liver rat tissue induced by CCl4 under normoxic conditions, with or without N-acetyl cysteine (NAC) protection. Twenty five male Sprague-Dawley rats were divided into 5 group: control rats, rats administered with coconut oil, rats administered with CCl4, rats injected with NAC then administered with CCl4, rats administered with CCl4 then injected with NAC. The expression of HIF-1? mRNA was measured by real time RT-PCR using Livak method, while the HIF-1? protein was measured by ELISA assay. Results showed that the highest HIF-1? mRNA and protein expression were found in the group treated by CCl4 and then was gradually lowered in the pre-NAC group, post-NAC group, control group, and coconut oil group. The overall result of this study show the effect of CCl4-treated rats under normoxic conditions increased the expression of HIF-1?, while NAC treatment decreased the expression of HIF-1?. These findings show that free radical formed by CCl4 metabolism play a role in the regulation of HIF-1"

"[ABSTRAKTumor otak (TO) merupakan penyebab kematian kedua darisemua kanker yang terjadi pada anak. TO memiliki gambaran klinis, radiologisdan histopatologis yang sangat bervariasi karena proses pengembangan sel-seljaringan otak masih berlanjut sampai usia 3 tahun. Data penelitian mengenai TOpada anak masih sedikit.Tujuan: Untuk mengetahui gambaran klinis, radiologis, histopatologis dan faktorprognostik TO di Departemen Ilmu Kesehatan Anak FKUI/ RS. Dr.Ciptomangunkusumo Jakarta periode tahun 2010 - 2015.Metode Penelitian: Kohort retrospektif dilakukan pada semua anak dengan TOprimer yang berobat/dirawat di Departemen Ilmu Kesehahatan Anak FKUI/RSDr. Ciptomangunkusumo Jakarta.Hasil: Didapatkan 88 pasien TO primer, terdiri dari 16 pasien berusia kurang dari3 tahun dan 72 pasien berusia lebih dari 3 tahun, laki-laki 53% dan perempuan47%. Anak usia kurang dari 3 tahun mengalami gejala sakit kepala (63%) dankejang (56%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebralventrikel (25%) dan cerebellum (24%), berdasarkan histopatologis jenis TO yangterbanyak adalah Astrositoma (31%) dan Medulloblastoma (25%). Anak usialebih dari 3 tahun mengalami gejala sakit kepala (81%) dan gangguan penglihatan(65%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebellum(24%) dan suprasellar (10 %), berdasarkan histopatologis jenis TO yangterbanyak adalah Medulloblastoma (21%), Astrositoma (18%) dan Glioma (17%).Angka kehidupan TO adalah 37 %. Tidak didapatkan faktor prognostik TO yangbermakna.Kesimpulan: Gejala TO tersering adalah sakit kepala, berdasarkan radiologisletak tumor terbanyak adalah di cerebellum serta berdasarkan histopatologis jenistumor terbanyak adalah Medulloblastoma dan Astrositoma. Tidak didapatkanfaktor prognostik TO pada anak.

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ABSTRACTPrimary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor., Background: Primary brain tumors rank second as the most frequent neoplasm inchildren. The lesions occurring in neonates or infants have been reported to differfrom those in older children in terms of their clinical presentation, radiology andhistopathology features.Objective To clarify the clinical presentation, radiology, histopathology features.and prognostic factor of primary brain tumors in Child DepartmentCiptomangunkusumo Hospital Jakarta in 2010 - 2015.Method: Retrospective cohort using medical records and neuroradiological danhistopathological studies, we analyzed each patient?s clinical presentation, tumorlocation, histopathological diagnosis and treatment then we compared betweenunder 3 years of age and more 3 years of age . The patients were followed untiltheir death or until the end of October 2015.Result: 88 patient of primer brain tumor that consist of 16 patients with under 3years of age and 72 patients with more 3 years of age. Boys are 53% and girlsare 47% . The most symptoms of children under 3 years of age is headache (63%)and seizure (56%), based on radiology the most location tumor is cerebralventrikel (25%) and cerebellum (24%), based on histopathology the predominanttumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptomsof children more 3 years of age is headache (81%) and visual difficulties (65%),based on radiology the most tumor location is cerebellum (24%) and suprasellar(10 %), based on histopathology the predominat tumor is Medulloblastoma(21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %.There is no prognostic factor of brain tumor.Conclusion: The most symptom of brain tumor is headache, based on radiologythe most tumor location is cerebellum, and based on histopathology thepredominant tumor is Medulloblastoma and Astrositoma. There is no prognosticfactor of brain tumor.]"