Tesis

Efektivitas Bevacizumab sebagai kemoterapi paliatif kanker kolorektal stadium lanjut pada protokol XELOX dan protokol mFOLFOX6 = Effectiveness of Bevacizumab as palliative chemotherapy for late-stage colorectal cancer on XELOX protocol and mFOLFOX6 protocol.

Latar Belakang: Dalam beberapa dekade terakhir telah dikembangkan terapi paliatif yang bertujuan untuk mengeliminasi metastasis. Kemoterapi paliatif banyak dipilih menjadi terapi standar pada tatalaksana kanker kolorektal stadium lanjut. Pemberian 5-fluorouracil (5-FU) intravena ditambah dengan leucovorin (LV) dan targeted therapy (bevacizumab) telah menjadi terapi paliatif standar dalam beberapa tahun terakhir. Di Indonesia, belum ada penelitian yang membandingkan efektifitas pemberian regimen kemoterapi Bevacizumab mFOLFOX6 dan Bevacizumab XELOX. Metode: Penelitian ini menggunakan desain potong lintang pada 15 pasien karsinoma kolorektal dengan metastasis hati dengan 11 pasien menjalani protokol Bevacizumab mFOLFOX6 dan 4 pasien menjalani protokol Bevacizumab XELOX. Efektifitas respons dilihat dengan menggunakan kadar CEA dan hasil CT scan. Hasil: Dengan menggunakan protokol kemoterapi Bevacizumab mFOLFOX6 81,8 % subjek memberikan respons stable disease dan 54,5 % subjek memberikan respons progressive disease. Sementara itu, dengan menggunakan protokol kemoterapi Bevacizumab XELOX 75,0 % subjek memberikan respons stable disease dan 50,0 % subjek memberikan respons partial response. Efektivitas kemoterapi tidak memiliki hubungan yang bermakna dengan regimen/protokol kemoterapi yang digunakan Bevacizumab mFOLFOX6 dan Bevacizumab XELOX, baik berdasarkan respon CT Scan (p = 0,993) maupun kadar CEA (0,774). Tidak terdapat pula hubungan antara variabel faktor dengan efektivitas kemoterapi. Kesimpulan: Efektivitas kemoterapi tidak memiliki hubungan yang bermakna dengan regimen/protokol kemoterapi yang digunakan. Selain itu, variabel usia, jenis kelamin, IMT, SGA, skor Karnofsky, lokasi tumor primer, jenis operasi, waktu kemoterapi dan tipe histopatologi tidak memiliki hubungan yang bermakna dengan efektivitas kemoterapi.
Kata kunci: Bevacizumab, kanker kolorektal stadium lanjut, kemoterapi paliatif, protokol XELOX, protokol mFOLFOX6



Background: In the last few decades, palliative therapy has been developed to eliminate metastasis. Palliative chemotherapy has become a standard therapy in the treatment of late-stage colorectal cancer. Treatment with 5-fluorouracil (5FU) plus leucovorin intravenous (LV) and targeted therapies (bevacizumab) has become a standard palliative therapy in recent years. In Indonesia, there were no study comparing the effectiveness of Bevacizumab mFOLFOX6 and Bevacizumab XELOX chemotherapy regimens. Method: This study used a cross-sectional design in 15 patients with liver metastatic colorectal carcinoma which 11 patients were treated with Bevacizumab mFOLFOX6 protocol and 4 patients were treated with Bevacizumab XELOX protocol. The effectiveness of the response were measured using CEA concentration and CT scan result. Results: With the Bevacizumab mFOLFOX6 protocol 81.8% of the subjects responded as stable disease and 54.5% responded as progressive disease. Meanwhile, with the Bevacizumab XELOX protocols 75.0% of the subjects responded as stable disease and 50.0% responded as partial response. Effectiveness of chemotherapy did not have a relationship with the chemotherapy protocols used Bevacizumab (mFOLFOX6 and XELOX), based on CT scans (p = 0.993) and CEA levels (0.774). In addition, there is no relationship between variable factors and the effectiveness of chemotherapy. Conclusions: Effectiveness of chemotherapy did not have a relationship with the chemotherapy protocols used. In addition, the variables of age, sex, BMI, SGA, score Karnofsky, primary tumor site, type of surgery, chemotherapy and histopathology type of time did not have a relationship with the effectiveness of chemotherapy.
Keywords: Bevacizumab, late-stage colorectal cancer, mFOLFOX6 protocol, palliative chemotherapy, XELOX protocol