Tesis

Gambaran Transposisi Ovarium sebagai Upaya Proteksi Fungsi Ovarium pada Pasien Kanker Serviks yang Menjalani Radioterapi = The effect of ovarian transposition in protecting ovarian function in cervical cancer patients undergoing radiotherapy

Tujuan: Untuk mengetahui gambaran transposisi ovarium sebagai upaya proteksi
fungsi ovarium pada pasien kanker serviks yang menjalani radioterapi
Metode: Penelitian ini merupakan penelitian cohort, before–after study pada
pasien-pasien kanker serviks dan kanker vagina stadium IB, IIA, IIB, IIIA, dan
IIIB yang akan menjalankan radioterapi dan dilakukan transposisi ovarium.
Penelitian dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM) dan Rumah
Sakit Umum Persahabatan (RSUP) sejak 1 Januari 2011 sampai 31 Maret 2014.
Luaran yang diukur adalah perubahan kadar Anti Mullerian Hormone (AMH),
Follicle Stimulating Hormone (FSH), dan skor keluhan hidup terkait menopause.
Hasil: Terdapat 16 subyek penelitian, namun hanya 12 orang subyek yang
dilakukan transposisi ovarium dan menyelesaikan radioterapi. Efek proteksi
transposisi ovarium sangat rendah (8,3%) dimana hanya satu dari 12 orang yang
tidak mengalami penurunan kadar AMH setelah radioterapi. Sisanya mengalami
penurunan kadar AMH setelah radioterapi yang bermakna (T-test berpasangan
p=0,037). Kadar FSH meningkat sesudah radioterapi (T-test berpasangan p=
0,015). Skor keluhan hidup meningkat setelah dilakukan radioterapi (T-test
berpasangan p 0,3 ng/ml, dan kadar FSH≤ 12
mIU/ml.
Kesimpulan: Transposisi ovarium memiliki efek proteksi fungsi ovarium yang
rendah (8,3%). Hal itu dapat disebabkan karena sebagian besar subyek memiliki
kadar AMH yang rendah sebelum terapi.


Objective: To know the effect of ovarian transposition in protecting ovarian
function in cervical cancer patients undergoing radiotherapy
Methodology: This cohort study was before–after study in patients who had
cervical or vaginal cancer stage IB, IIA, IIB, IIIA, and IIIB who underwent
ovarian transposition before radiotherapy. This study was done in Cipto
Mangunkusumo Hospital and Persahabatan satellite hospital since 1 January 2011
until 31 March 2014. The level of Anti Mullerian Hormone (AMH), Follicle
Stimulating Hormone (FSH), and menopause symptom score were evaluated
before and after radiotherapy.
Result: There were 16 patients who underwent ovarian transposition but only 12
patients completed radiotherapy. The protective effect of ovarian transposition
was low, only one among 12 subjects (8.3%) did not experience decreased level
of AMH. Ten subjects had significantly decreased AMH level after radiotherapy
(paired T-test, p=0.037). FSH level was significantly increased after radiotherapy
(paired T-test p=0.015). Menopause symptoms scores were increased after
radiotherapy (paired T-test p 0,3 ng/ml, and FSH level≤ 12 mIU/ml.
Conclusion: Ovarian transposition had low protective effect (8.3%) and it might
be caused by the low level of AMH in most subjects before radiotherapy