Tesis

Karakteristik, Angka Tahan Hidup dan faktor Prognostik Pasien Kanker Paru Jenis Karsinoma = Characteristics, Survival rate and Prognostic Factor of Small Cell Lung Cancer Patients

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


Background: Small cell lung cancer (SCLC) are generally aggressive than other subtypes of lung cancer. Small cell lung cancer has a rapid doubling time, rapid growth fraction and could metastasize rapidly and widely compared to non-small cell lung cancer (NSCLC). Small cell lung cancer is chemosensitive and radiosensitive although 95% of patients eventually died after underwent therapy. This study aims to determine the characteristics, survival rate and factors which influenced SCLC patients. Method: The study was conducted by using retrospective cohort of SCLC patients medical records in Persahabatan Hospital, Jakarta, Indonesia from January 1, 2008 until December 31, 2012. Data obtained were tested by Kaplan Meier analysis of survival. Result : Subjects in this study were 34 SCLC patients, with majority of male 32 subjects (94.1%), mean age of 59 years old and all of the subjects (100%) were smokers. The majority chief complaint was shortness of breath, the additional complaint was weight loss and most of the subjects did not receive either chemotherapy or radiotherapy treatment (38.2%). The majority of tumor characteristics were extensive disease in 32 subjects (94.1%), performance status ≤ 2 in 30 subjects (88.2%) and the most common metastatic was pleural effusion in 23 subjects (67.6%). Median survival time of SCLC patients were 78.75 days (2.5 months). Median survival time of SCLC patients with limited disease were 365 days (12 months) and extensive disease were 61 days (2 months). Median survival time of SCLC patients treated were 182 days (6 months) and not treated were 27 days (1 month). Factors which influenced median survival time were performance status and treatment. Conclusion : The 1-year survival rate of SCLC patients was 11.8 % and median survival time was 78.75 days. Factors which influenced the median survival rate of SCLC patients were performance status and treatment.
Keyword: Small cell lung cancer, survival rate, characteristics.