Tesis

Tingkat Utilisasi Radioterapi dalam Tatalaksana Leukemia dan Limfoma di Indonesia = Radiotherapy Utilization Rate in the Treatment of Leukaemia and Lymphoma in Indonesia.

Latar belakang: Kanker merupakan salah satu penyebab kematian di dunia. Di Indonesia, limfoma dan leukemia termasuk dalam 10 besar kasus kanker baru di Indonesia pada tahun 2020. Radioterapi memiliki peranan dalam kedua kasus tersebut, sehingga utilitasnya perlu dievaluasi. Tingkat utilisasi radioterapi (TUR) didefinisikan sebagai proporsi dari populasi pasien kanker tertentu yang mendapatkan radioterapi selama kehidupannya. TUR optimal diperhitungkan dengan pertimbangan indikasi radioterapi sesuai pedoman tatalaksana kanker serta pertimbangan data epidemiologi kanker tersebut. Collaboration for Cancer Outcomes Research and Evaluation (CCORE) telah mengeluarkan decision tree yang digunakan untuk menghitung TUR optimal. Estimasi TUR optimal dan TUR aktual leukemia dan limfoma hingga saat ini belum ada di Indonesia, sehingga diperlukan adanya studi untuk memperhitungkan TUR untuk kedua kanker tersebut. Metode: Penelitian dilakukan dengan desain potong lintang. Data yang digunakan merupakan data sekunder dari cancer registry maupun rekam medis rumah sakit di Indonesia yang memiliki fasilitas radioterapi pada tahun 2019. Proporsi dan insiden kemudian dimasukkan ke decision tree untuk mendapatkan hasil TUR. Hasil: TURo leukemia didapatkan pada 92.76% (92.44-93.06%) dan limfoma 79.31% (53.75-87.15%). TURa leukemia 0.72% dan limfoma 12.65%, sehingga kebutuhan tidak terpenuhi pada leukemia sebesar 92.76% (92.44-93.06%) dan limfoma sebesar 84.05% (76.47-85.48%). Kesimpulan: Sebagian besar pasien leukemia dan limfoma di Indonesia yang membutuhkan radioterapi, masih belum terpenuhi kebutuhannya. Perlu adanya studi lebihi lanjut untuk mempelajari faktor-faktor yang memengaruhi hal tersebut.
Kata kunci: tingkat utilisasi radioterapi, TUR, leukemia, limfoma



Background: Cancer is one of the highest cause of death in the world. In Indonesia, lymphoma and leukaemia were included as 10 biggest new cancer cases in 2020. Radiotherapy have a role in the treatment of both type of cancers, and so its utlilization must be evaluated. Radiotherapy utilization rate (RTU) is defined as the proportion of a certain cancer population whom have radiotherapy as one of their therapy in their lifetime. Optimal RTU were calculated by considering the indications for radiotherapy according to guidelines, and also considering cancer epidemiology data. Collaboration for Cancer Outcomes Research and Evaluation (CCORE) has published several decision trees for each cancer to calculate optimal RTU. Currently, there is no study calculating optimal and actual RTU for leukemia and lymphoma in Indonesia. This study aims to estimate optimal and actual RTU for leukemia and lymphoma in Indonesia. Methods: This study was conducted with a cross-sectional design. Secondary data were used from cancer registry or medical records of hospitals with radiotherapy services in 2019 in Indonesia. Proportion and incidents were then entered into the decision tree to obtain RTU results. Results: Optimal RTU for leukaemia is 92.76% (92.44-93.06%) and lymphoma 79.31% (53.75-87.15%). Actual RTU for leukaemia is 0.72% and lymphoma is 12.65%, resulting in the unmet need in leukaemia is 92.76% (92.44-93.06%) and lymphoma is 84.05% (76.47-85.48%). Conclusion: A high percentage of leukaemia and lymphoma patients in Indonesia who needs radiotherapy as their part of treatment, has not met their need. Further studies are needed to understand what factors are affecting that.
Keyword: radiotherapy utilization rate, RTU, leukaemia, lymphoma