Tesis

Perbedaan Hasil Terapi Antara Dua Pola Layanan Brakhiterapi Pasien Kanker Serviks Pasca Radiasi Eksterna dalam Masa Pandemi COVID-19 di Instalasi Pela yananTerpadu Onkologi RSCM = Differences in Therapeutic Results Between Two Patterns of Brachytherapy Services in Post External Radiation Cervical Cancer Patients during the COVID-19 Pandemic Radiation Oncology Department, Ciptomangunkusumo Hospital.

Latar Belakang: Terapi kanker serviks stadium lokal lanjut ialah dengan radiasi eksterna dilanjutkan dengan brakhiterapi. Brakhiterapi yang diberikan memiliki beragam skema fraksinasi. Brakhiterapi tiga fraksi merupakan skema yang rutin dilakukan. Pada masa pandemi Covid-19, salah satu alternatif untuk mengurangi risiko penularan ialah dengan mengurangi kunjungan ke rumah sakit dengan cara pemberian brakhiterapi dengan dua fraksi. Tujuan: Untuk mengetahui perbedaan respons terapi dan efek samping akut gastrointestinal dan genitourinaria pada pasien kanker serviks stadium II-III pasca radiasi eksterna yang menjalani brakhiterapi dua fraksi dan tiga fraksi. Metode : Penelitian kohort retrospektif dilakukan pada pasien kanker serviks stadium IIIII di Instalasi Pelayanan Terpadu Onkologi Radiasi RSCM yang memenuhi kriteria inklusi dan eksklusi pada periode Januari-Desember 2020. Analisis dilakukan dengan menilai perbedaan respons terapi dan efek samping pada pasien yang menerima brakhiterapi dua dan tiga fraksi. Hasil : Respons baik pada brakhiterapi dua dibandingkan dengan tiga fraksi adalah 85,7% vs 89,3% p=0,752. Efek samping akut GI derajat 1 pada brakhiterapi dua fraksi dibandingkan tiga fraksi adalah 8,5% vs 10,6% p=1,000. Efek samping akut GU derajat 1 pada brakhiterapi dua fraksi dibandingkan tiga fraksi adalah 5,7% vs 6,7% p=1,000. Kesimpulan: Penelitian ini menunjukan tidak ada perbedaaan antara respons terapi dan efek samping akut antara pemberian brakhiterapi dua fraksi dan tiga fraksi.
Kata Kunci : Kanker serviks, brakhiterapi, respons terapi, efek samping


Background: Treatment for locally advanced cervical cancer is external radiation followed by brachytherapy. The brachytherapy has a variety of fractionation schemes. Three-fraction brachytherapy is a routinely performed scheme. During the Covid-19 pandemic, one alternative to reduce the risk of transmission is to reduce hospital visits by giving brachytherapy in two fractions. Aim: To determine differences in therapeutic response and acute gastrointestinal and genitourinary side effects in cervical cancer patients stage II-III after external radiation who underwent two fractions and three fractions of brachytherapy. Methods: A retrospective cohort study was conducted on stage II-III cervical cancer patients at the Radiation Oncology Integrated Service Installation of RSCM who met the inclusion and exclusion criteria in the period January-December 2020. The analysis was carried out by assessing differences in therapeutic response and side effects in patients receiving dual brachytherapy. and three fractions. Results: Good response to brachytherapy two compared to three fractions was 85.7% vs. 89.3% p=0.752. Acute grade 1 GI adverse events in two-fraction versus three-fraction brachytherapy were 8.5% vs. 10.6% p=1,000. The acute side effect of grade 1 GU in twofraction versus three-fraction brachytherapy was 5.7% vs. 6.7% p=1,000. Conclusion: This study showed that there was no difference between the response to therapy and acute side effects between two and three fractions of brachytherapy.
Keywords: Cervical cancer, brachytherapy, response to therapy, side effects