Tesis

Perbandingan Efikasi Dan Toksisitas Hematologi Kemoterapi Lini I Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) Jenis Karsinoma Sel Skuamosa (KSS) Dengan Adenokarsinoma EGFR wild typeDi RSUP Persahabatan = The Efficacy and Hematological Toxicity of First-line Chemotherapy of Non-small Cell Lung Cancer (NSCLC) Patients Treated at Persahabatan Hospital Jakarta, Indonesia .

Latar belakang: Meningkatnya insidens kesakitan dan kematian akibat keganasan alternatif terapi dengan kemoterapi. Rejimen kemoterapi menggunakan obat sitotoksik yang mempunyai batas terapi sangat sempit sehingga memberi efek samping lebih besar dibandingkan manfaat dan angka harapan hidup. Kedua hal ini terjadi pada pasien KPKBSK jenis KSS dan adenokarsinoma EGFR wild type. Metode: Desain penelitian ini dilakukan dengan metode Survey retrospektif dan studi analitik terhadap faktor yang mempengaruhi prognosis. Data diambil dari Rekam Medis RSUP Persahabatan dengan total sampling pada periode 2011 sampai 2016 Hasil: Sampel penelitian teridiri dari 30 subjek kelompok KSS dan 30 subjek kelompok adenokarsinoma dengan karakteristik subjek laki-laki 86,7% dan subjek perempuan 13,3% dengan usia (median 57, range 36-66). Mendapatkan median TTP pada kelompok KSS yaitu 150 Hari (IK 95% 123,401-176,599) dan adenokarsinoma memiliki TTP 150 Hari (IK 95% 134,818-165,182).Mendapatkan KSS memiliki median PFS 150 Hari (IK 95% 99,790-200,210) dan adenokarsinoma memiliki PFS 150 Hari (IK 95% 121,597-178,403). Mendapatkan median KSS memiliki median OS 330 Hari (IK 95% 265,558-349,412) dan adenokarsinoma memiliki OS 341 Hari (IK 95% 227,930-404,070). Subjek dengan one year survival rate pada kedua kelompok sama banyak yaitu 47%. Kejadian anemia terbanyak yaitu grade 2 pada kelompok KSS sebanyak 8 subjek dan kelompok adenokarsinoma EGFR wild type sebanyak 5 subjek. Kesimpulan:Perbandingan Efikasi dan toksisitas hematologi kemoterapi lini I kanker paru karsinoma bukan sel kecil (KPKBSK) jenis karsinoma sel skumosa (KSS) dengan adenokarsinoma EGFR wild typetidak mengalami perbedaan yang signifikan.
Kata kunci: Efikasi, Tosisitas Hematologi, Kemoterapi


Background: Cancer chemotherapy have narrow margin of safety which results in greater side effects and decreasing chance of survival as seen in the case ofnon-small cell lung cancer (NSCLC). Hematological toxicity is the most common side effect of platinum-based lung cancer chemotherapy which serves as the first-line options particularly in Indonesia. This study characterizes the efficacy and hematological toxicity of first line chemotherapy observed in NSCLC cases, of which are squamous cell lung carcinoma (SCC) and wild-type EGFR lung adenocarcinoma. Methods: This is a retrospective survey involving 60 NSCLC patients, grouped into SCC and wild-type EGFR lung adenocarcinoma, treated at Persahabatan Hospital Jakarta, Indonesia, between 2011 – 2016. Clinical data, which includes clinical course, treatment course and treatment outcome, was obtained through medical records. Results: The subjects, 30 were SCC and 30 were adenocarcinoma, were predominantly males (86.7%). Median age of the subject was 57 (range 36 – 66). Median time to progression (TTP) in SCC was 150 days (CI 95% 123.401 – 176.599) and in adenocarcinoma was 150 days (CI 95% 134.818 – 165.182). Progression free survival in SCC was 150 days (CI 95% 99,790 – 200.210) and in adenocarcinoma was 150 days (CI 95% 121.597 – 178.403). Median OS of SCC was 330 days (CI 95% 265.558 – 349.412) and adenocarcinoma was 341 days (CI 95% 227.930 – 404.070). One-year survival rate between groups were similar (47%). Grade 2 anemia was found in 8 SCC subjects and in 5 adenocarcinoma subjects. Conclusion: First-line chemotherapy has similar efficacy and has similar toxicity between NSCLC-SCC and NSCLC-wild type EGFR adenocarcinoma.
Keywords: first-line chemotherapy efficacy, first-line chemotherapy hematological toxicity, NSCLC survival rate