Tesis

Hubungan Chemotherapy-Induced Nausea and Vomiting Terhadap Kualitas Hidup Pasien Kanker Ovarium yang Mendapatkan Rejimen Kemoterapi Carboplatin-Paclitaxel di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo Juni-Oktober 2024 = The Relationship Between Chemotherapy-Induced Nausea and Vomiting and the Quality of Life of Ovarian Cancer Patients Receiving Carboplatin-Paclitaxel Chemotherapy Regimen at Dr. Cipto Mangunkusumo National General Hospital (RSCM).

Latar Belakang: Kanker ovarium, salah satu keganasan ginekologi paling agresif, secara signifikan memengaruhi kualitas hidup (QoL) pasien, terutama pada stadium lanjut. Kemoterapi dengan karboplatin dan paklitaksel, meskipun efektif, sering kali menyebabkan mual dan muntah akibat kemoterapi (CINV), yang berdampak buruk pada QoL. Meskipun regimen antiemetik profilaksis telah digunakan, CINV tetap terjadi pada sebagian besar pasien. Penelitian ini bertujuan untuk mengevaluasi dampak CINV terhadap QoL serta hubungannya dengan kadar albumin serum dan elektrolit pada pasien kanker ovarium yang menjalani kemoterapi. Metode: Penelitian potong lintang ini dilakukan di RSUPN Dr. Cipto Mangunkusumo dari Juni hingga Oktober 2024. Sebanyak 70 pasien kanker ovarium epitelial yang menerima kemoterapi lini pertama dengan karboplatin dan paklitaksel diikutsertakan. QoL dinilai menggunakan kuesioner EORTC QLQ-C30 dan QLQ-OV28 selama siklus kemoterapi pertama dan ketiga. Kadar albumin serum dan elektrolit diukur sebelum dan setelah kemoterapi untuk mengevaluasi perubahan fisiologis. Data dianalisis menggunakan analisis regresi bivariat dan multivariat. Hasil: Dari 70 pasien, 52,85% mengalami penurunan QoL, terutama pada fungsi fisik, emosional, dan sosial. Skor gejala meningkat pada kelelahan (28,57%), mual dan muntah (57,16%), diare (52,85%), dan kehilangan nafsu makan (37,14%). Sebanyak 35,71% pasien melaporkan CINV, namun tidak terdapat perubahan signifikan pada kadar albumin atau elektrolit setelah kemoterapi. Namun demikian, CINV secara signifikan berhubungan dengan penurunan QoL, khususnya dalam fungsi sosial, dan terkait dengan gejala mual, muntah, serta diare. Kesimpulan: CINV secara signifikan memengaruhi QoL pasien kanker ovarium yang menjalani kemoterapi dengan karboplatin dan paklitaksel. Manajemen CINV yang efektif, disertai dukungan psikososial dan nutrisi, sangat penting untuk menjaga QoL selama pengobatan.
Kata kunci: kanker ovarium, kualitas hidup, kemoterapi, mual muntah akibat kemoterapi


Background: Ovarian cancer, one of the most aggressive gynecologic malignancies, significantly impacts patients quality of life (QoL), especially in advanced stages. Chemotherapy with carboplatin and paclitaxel, while effective, frequently causes chemotherapy-induced nausea and vomiting (CINV), which adversely affects QoL. Despite prophylactic antiemetic regimens, CINV persists in a substantial proportion of patients. This study aims to evaluate the impact of CINV on QoL and its relationship with serum albumin and electrolyte levels in ovarian cancer patients undergoing chemotherapy. Methods: This cross-sectional study was conducted at RSCM from June to October 2024. A total of 70 epithelial ovarian cancer patients receiving first-line chemotherapy with carboplatin and paclitaxel were enrolled. QoL was assessed using EORTC QLQC30 and QLQ-OV28 questionnaires during the first and third chemotherapy cycles. Serum albumin and electrolyte levels were measured pre- and post-chemotherapy to evaluate physiological changes. Data were analyzed using bivariate and multivariate regression analyses. Results: Among 70 patients, 52.85% experienced a decline in QoL, particularly in physical, emotional, and social functioning. Symptom scores increased for fatigue (28.57%), nausea and vomiting (57.16%), diarrhea (52.85%), and appetite loss (37.14%). While 35.71% of patients reported CINV, no significant changes were observed in albumin or electrolyte levels post-chemotherapy. However, CINV was significantly associated with reduced QoL, particularly in social functioning, and linked to nausea, vomiting, and diarrhea. Conclusions: CINV significantly affects the QoL of ovarian cancer patients undergoing chemotherapy with carboplatin and paclitaxel. Effective management of CINV, alongside psychosocial and nutritional support, is crucial to preserving QoL during treatment.
Keywords: ovarian cancer, quality of life, chemotherapy, chemotherapy-induced nausea vomitting