Hasil Pencarian  ::  Simpan CSV :: Kembali

"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."

"Although the most common cause of lung cancer is long-term exposure to tobacco smoke, the role of genetic factor for the cell defense mechanism, such as MnSOD, should also be considered. This study aims to analyze the expression and genotype of MnSOD in lung cancer cells of smoker patients. Samples were normal and lung cancer cells of patients operated in Persahabatan Hospital from May to December 2008, as well as lung cancer cells extracted from FFPE collection. Leukocyte cells of healthy smoker subjects were used as controls. The MnSOD mRNA expression was analyzed using Real Time RT-PCR and the specific activity using xantin oxidase inhibition assay. The genotyping was performed using PCR-RFLP.The result showed that the MnSOD specific activity in lung cancer of smoker patients is higher than in leukocyte cells of smoker controls. Compared to the expression of MnSOD in the normal lung cells of patients, in the lung cancer cells the level of MnSOD mRNA was lower, whereas its specific activity was higher (1.988 times). The samples from lung cancer patients have a Val/Val genotype frequency of 100%. In this study, we could conclude that MnSOD expression is altered in lung cancer cells."

"Tujuan Mendapatkan metode diagnostik kanker paru dengan cara tidak invasif dengan HRCT sistem skoring yang setara dengan pemeriksaa Patologi Anatomik. Metode Penelitian dilakukan dari Desember 2006 sampai dengan Maret 2008. Sebanyak 55 pasien, 40 laki-laki dan 15 perempuan yang diduga kanker paru diperiksa dengan CT-scan toraks teknik HRCT tanpa dan dengan kontras, dilanjutkan TTB dengan tuntunan CT untuk mendapatkan bahan sitologi. Hasil Pemeriksaan PA didapatkan 43 pasien (78%) kanker paru dan 12 pasien (22%) tidak terbukti ganas/jinak. Berdasarkan kecocokan gambaran HRCT dan PA dibuat skor untuk umur > 49 tahun, volume tumor lebih dari 68 cm3, HU lebih dari 21, spikula positif , dan angiogram + serta KGB + , dengan nilai masing?masing 20, 19, 10, 24, 18, dan 17 skor total 108. Kesimpulan Tehnik baru dalam mendiagnosis kanker paru dengan HRCT sistem skoring setara dengan pemeriksaan patologi anatomik dengan sensitivitas 97,7% dan spesifisitas 83,3% dengan nilai batas skor 35. Bila skor < 35 berarti lesi jinak dan bila skor >35 berarti ganas

---

AbstractAim To find a non-invasive diagnostic method for lung cancer with results almost as accurate as histopathological examinations with HRCT scoring system. Method This study was conducted from December 2006 until March 2008. A total number of 55 persons, comprised of 40 male and 15 female patients suspected of having lung cancer, underwent high resolution computed tomography with and without contrast as well as CT-guided transthoracic needle aspiration to obtain cytology specimens.. Results Histopathological examinations revealed the existence of lung cancer in 43 patients (78%) and benign lesions in 12 patients (22%). A scoring system was then made based on the similarities of findings from CT and findings from pathological examinations, where the age group of 49 years and above, tumor volume of more than 68 cm3, HU of more than 21, spicula positive, angiogram positive and lymph node positive had a value of respectively 20, 19, 10, 24, 18, and 17 (total score 108). Conclusion This new method to diagnose lung cancer using high resolution computed tomography converted into a scoring system is constantly as accurate as histological findings with a sensitivity of 97.7% and a specificity of 83,3% and a cut-off score of 35. According to this system, a score of less than 35 indicates that the lesions were benign while a score higher than 35 was considered an indication that the lesions were malignant."

"ABSTRAKLatar belakang: Penyebab kematian pada kanker paru seringkali tidak tergambarkan dengan jelas. Penelitian ini untuk mengetahui gambaran penyebab kematian pada kanker paru dan faktor-faktor yang mempengaruhinya di RS Persahabatan dan untuk mengetahui kesesuaian antara penyebab kematian yang terdapat dalam lembar kematian dengan penyebab kematian sesuai dengan audit kematian. Metode: Penelitian potong lintang ini dilakukan di RS Persahabatan dengan subjek penelitian adalah semua pasien kanker paru yang mengalami kematian pada Januari 2010 – Desember 2011. Penyebab kematian langsung dan tidak langsung pada pasien kanker paru dicatat dari rekam medis kemudian dilakukan audit kematian dan dinilai kesesuaian dengan penyebab kematian langsung dan tidak langsung yang tertulis di rekam medis dengan audit kematian. Hasil: Total data kematian dari 96 rekam medis. Penyebab kematian langsung berdasarkan rekam medis adalah efusi pleura masif 19 kematian (19,8%) sedangkan penyebab kematian tidak langsung menurut rekam medis adalah sepsis s 44 kematian (45,8%) Sementara itu, penyebab kematian langsung berdasarkan audit kematian terbanyak adalah efusi pleura masif 48 kematian (50%), penyebab kematian tidak langsung menurut audit kematian adalah sepsis 16 kematian (16,7%). Lembar kematian yang sesuai dengan rekam medis adalah 43 kasus (44,8%) dan yang tidak sesuai 53 kasus (55,2%) sedangkan SOP yang dijalankan adalah 37 kasus (38,5%) dan SOP yang tidak dijalankan 59 kasus (61,5%). Alasan mengapa SOP tidak dijalankan adalah karena keadaan umum pasien yaitu 12 kasus (20,3%) sedangkan karena biaya dan administrasi 47 kasus (79,6%). Dari hasil uji statistik yang menilai hubungan antara SOP yang dijalankan dengan faktor pembiayaan ternyata tidak didapatkan hubungan yang bermakna (p=0,48). Diskusi : Audit kematian memang bukan standar baku emas penentuan penyebab kematian melainkan dengan autopsi klinis. Dalam konteks sosial dan budaya di Indonesia, autopsi klinis tidak mudah dilakukan sebagai penentu penyebab kematian. Dalam penelitian ini audit kematian mempunyai peran jaminan dan kendali mutu layanan kesehatan. Ketidaksesuaian penyebab kematian antara rekam medis dan kematian, serta seberapa banyak SOP yang dijalankan dan mengapa SOP tidak dijalankan dapat diungkapkan. Walaupun dari penelitian ini menunjukkan tidak terdapat hubungan bermakna antara faktor pembiayaan dengan SOP yang dijalankan atau tidak..

---

ABSTRACTIntroduction: The causes of death for patients with lung cancer were inadequately described. This study objectives were to describe the causes of death in lung cancer and contributing factors in Persahabatan Hospital and to describe discrepancies between the causes of death from medical records and death audit. Method: A cross sectional study was held in PersahabatanHospital involving lung cancer patients who were died between January 2010 to December 2011. The immediate and indirect causes of death from medical records were assessed and compared with death audit. The discrepancies between were analysed. Result: A total of 96 cases were found from medical record, massive pleural effusion was found as the immediate causes in 19 cases (19.8%), while sepsis was found as the indirect causes 44 cases (45.8%). From the death audit, massive pleural effusion was found as immediate causes in 48 cases (50%), while sepsis was found asthe indirect causes 16 cases (16.7%). The discrepancies between both were found in 53 cases (55.2%). SOP was executed in 37 cases (38.5%) and unexecuted in 59 cases (61.5%). The reason of unexecuted SOP due to cost was found in 47 cases (79.6%). There is no significant correlation between the executed SOP with cost was found in factors (p=0.48). Discussion : The death audit is not the gold standard method in determining the causes of death but the clinical autopsy. This study reveals that death audit have roles inhealth care quality control and assurance. The causes of death discrepancies, the unexecueted SOP, and why SOP could not be executed could be revealed from this study."

"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.

---

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."

"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.

---

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."

"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.

---

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."

"Latar belakang : Terapi target baru golongan EGFR-TKi telah direkomendasikan sebagai terapi lini pertama untuk pasien KPKBSK non skuamosa dengan mutasi EGFR positif. Belum tersedia data di Indonesia tentang efikasi dan toksisitas terapi target baru EGFR-TKi pada pasien KPKBSK dengan mutasi EGFR positif dibandingkan dengan kemoradioterapi pada EGFR wild type di RSUP Persahabatan Jakarta.Metode : Disain penelitian ini kohort retrospektif melalui resume medis pasien KPKBSK non skuamosa di RSUP Persahabatan periode Januari 2010 sampai Juli 2014. Teknik pengambilan sampel adalah consequtive sampling. Jumlah sampel 61 pasien yang terdiri dari 31 pasien KPKBSK non skuamosa dengan mutasi EGFR positif yang diberikan terapi target baru EGFR-TKi dan 30 pasien dengan EGFR wild type yang diberikan kemoradioterapi.Hasil : Karakteristik pasien KPKBSK non skuamosa dengan mutasi EGFR yang positif adalah laki-laki sebanding dengan perempuan, bukan perokok, mutasi delesi di ekson 19 sebanding dengan mutasi L858R di ekson 21, angka tahan hidup 1 tahun 48,37%, rata-rata time to progression 284 hari sedangkan pasien EGFR wild type adalah laki-laki lebih dominan, perokok, angka tahan hidup 1 tahun 33,3% dan rata-rata time to progression 210 hari dan overall survival 293 hari. Uji T independen menunjukan terdapat hubungan yang bermakna antara terapi target baru EGFR-TKi dengan lama time to progression (p=0,028). Toksisitas yang sering ditemukan pada terapi target baru EGFR-TKi adalah mual- muntah (6,8%) diare (16,2%), alopesia (3,2%) dan kelainan kulit kemerahan (12,9%) sedangkan pada kelompok kemoradioterapi toksisitas yang ditemukan adalah anemia (13,3%), leukopenia (6,7%) dan trombositopenia (3,3%).Kesimpulan : Pasien KPKBSK non skuamosa dengan mutasi EGFR yang positif dan diberikan terapi target baru EGFR-TKi memiliki time to progression yang lebih lama dan toksisitas yang dapat ditoleransi.

---

Background: The new targeted therapy of EGFR-TKi has been recommended as first-line therapy for patients with NSCLCC non-squamous with mutated EGFR. There are no data about the efficacy and toxicity of the new targeted therapy of EGFR-TKi in NSCLC non-squamous with mutated EGFR compared with chemotradiotherapy in wild type at Persahabatan Hospital, Jakarta.

Methods: The design of study are retrospective cohort through medical records of NSCLC non-squamous patients in the Department of Pulmonology and Respiratory Persahabatan Hospital in January 2010 to July 2014. The sampling technique is consequtive sampling. The number of samples are 61 patients consisted of 31 patients with NSCLC non-squamous with mutated EGFR treated the new targeted therapy of EGFR-TKi and 30 patients with EGFR wild type treated chemoradiotherapy.

Results: The characteristics of NSCLC non-squamous patients with positive mutated EGFR are male compared to women, non-smokers, a deletion mutation in exon 19 L858R mutation comparable with in exon 21, 1-year survival 41,9%, mean time to progression is 284 days and patients of wild-type mutation are more dominant in males, smokers, 1-year survival 33,3% and mean time to progression is 210 days and overall survival is 293 days . The independent t test showed a significant relationship between the new targeted therapy with EGFR-TKi and TTP (p = 0.028). The most common adverse events in the EGFR-TKi group are nausea and vomitus 96,8%), diarrhea (16,2%), alopecia (3,2%) and rash (12,9%) and in the chemotherapy group, anemia (13,3%), leucopenia (6,7%) and thrombocytopenia (3,3%).

Conclusions: The EFGR-TKi for patients with advanced non small cell lung cancer who are selected on the basis of EGFR mutations improve time to progression with acceptable toxicity."

"Latar Belakang : Penelitian perbandingan kesintasan pasien karsinoma paru bukan sel kecil usia lanjut stadium IIIB/IV yang menjalani kemoterapi dan non-kemoterapi sudah pernah diteliti di negara lain sebelumnya, namun penelitian tersebut di Indonesia belum pernah dilakukan. Penelitian-penelitian terdahulu belum banyak yang memperhitungkan faktor perancu seperti komorbiditas, jenis histopatologi, indeks massa tubuh, stadium, usia dan status fungsional dalam meneliti pengaruh kemoterapi terhadap kesintasan karsinoma paru bukan sel kecil usia lanjut.Tujuan : Mengetahui adakah perbedaan kesintasan satu tahun antara pasien kanker paru karsinoma bukan sel kecil usia lanjut stadium IIIB/IV yang menjalani kemoterapi dan non-kemoterapi.Metode : Kohort retrospektif dengan analisis kesintasan terhadap 232 pasien kanker paru karsinoma bukan sel kecil stadium IIIB/IV dan status fungsional ECOG 0-2 yang berobat jalan maupun rawat inap di RS Cipto Mangunkusumo dan RS Kanker Dharmais Januari 2007-April 2013, terbagi menjadi dua kelompok yaitu yang menjalani kemoterapi dan non-kemoterapi. Kurva Kaplan-Meier digunakan untuk mengetahui kesintasan satu tahun masing-masing kelompok. Analisis bivariat menggunakan uji log-rank, analisis multivariat menggunakan cox proportional hazard regression. Besarnya hubungan variabel kemoterapi dengan kesintasan dinyatakan dengan crude HR dan IK 95% serta adjusted HR dan IK 95% setelah dimasukkan variabel perancu.Hasil : Terdapat 232 pasien kanker paru karsinoma bukan sel kecil yang dibagi menjadi dua kelompok yaitu kemoterapi (118 subyek) dan non-kemoterapi (114 subyek). Persentase mortalitas satu tahun adalah 93,9% pada kelompok non-kemoterapi dan 57,6% pada kelompok kemoterapi. Median kesintasan kelompok non-kemoterapi adalah 2 bulan, sedangkan kelompok kemoterapi 9,73 bulan, p<0,001, HR 3,447(IK 95% 2,522-4,711). Analisis bivariat menunjukkan hubungan bermakna antara kemoterapi dengan kesintasan satu tahun. Analisis multivariat menunjukkan stadium adalah perancu kemoterapi terhadap kesintasan.Simpulan : Kesintasan satu tahun pasien kanker paru bukan sel kecil usia lanjut stadium IIIB/IV yang menjalani kemoterapi lebih baik dibandingkan dengan non-kemoterapi.

---

Background : The effects of chemotherapy on survival in elderly with advanced non-small cell lung cancer has been studied in other country before, but in Indonesia this topic hasn?t been studied. The influence of confounding factors such as comorbidity, histopathology, body mass index, functional status, age and stage of cancer were seldom considered in the earlier studies.Objective : To determine whether there?s a difference in one year survival between elderly with advanced non-small cell lung cancer who received chemotherapy and those who received non-chemoterapeutic approaches.Methods : Retrospective cohort design and survival analysis were used to 232 elderly with advanced non-small cell lung cancer (IIIB/IV) and performance status of ECOG 0-2 who visited Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital between January 2007 and April 2013 that divided into 2 groups according to therapy that they received (chemotherapy and non-chemotherapy). 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 : There were 232 elderly advanced non-small cell lung cancer that divided into two groups ; chemotherapy (118 subjects) and non-chemotherapy (114 subjects). One year mortality percentage were 93,9% and 57,6% to non-chemotherapy and chemotherapy group. The survival median were 2 months in non-chemotherapy group and 9,73 months in chemotherapy group, with p< 0,001 and HR 3,447 (95% CI : 2,522-4,711). Bivariate analysis showed statistically significant relation between chemotherapy and one year survival. Multivariate analysis showed that stage of cancer was a confounder to chemotherapy relation to survival.Conclusion : One year survival in elderly with advanced non-small cell lung cancer who received chemotherapy were better compared to those who received non-chemotherapeutic approaches."

"[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%.

---

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%.]"