Tesis

Hubungan antara Asupan Protein dan Asam Amino Rantai Cabang dengan Kapasitas Fungsional pada Pasien Kanker Kepala Leher dan Malnutrisi yang Menjalani Kemoradiasi = Correlation between branched-chain amino acids intake and total functional capacity in head and neck cancer patients with malnutrition undergoing chemoradiation.

Latar Belakang: Kanker kepala dan leher (KKL) memiliki risiko malnutrisi yang tinggi dan sering disertai penurunan kapasitas fungsional. Asupan protein dan asam amino rantai cabang (AARC) berperan pada sintesis protein otot dan diduga berhubungan dengan kapasitas fungsional pasien kanker. Penelitian ini bertujuan menilai korelasi antara asupan protein dan AARC dengan kapasitas fungsional pada pasien KKL yang mengalami malnutrisi dan sedang menjalani kemoradiasi. Metode: Sebanyak 94 subjek dianalisis dengan rerata usia 46,9 ± 11,9 tahun; 58 subjek (61,7%) berjenis kelamin laki-laki. Lokasi tumor tersering adalah nasofaring (44,7%), dan sebagian besar berada pada stadium IV (74,5%). Rerata fraksi radiasi adalah 18,7 ± 2,6. Median asupan energi subjek adalah 1060 kkal/hari (308–2461 kkal) atau 21,0 kkal/kgBB/hari (4–50 kkal/kgBB/hari). Median asupan protein adalah 40,65 g/hari (0,79 g/kgBB/hari), dengan 74,5% subjek memiliki kecukupan protein rendah. Median asupan total AARC adalah 9,08 g/hari; median leusin 4,20 g/hari, isoleusin 2,26 g/hari, dan valin 2,42 g/hari. Rerata jarak tempuh tes jalan 6 menit adalah 332,9 ± 123,9 m. Terdapat korelasi positif sedang yang signifikan antara asupan protein dan jarak tempuh tes jalan 6 menit (r = 0,444; p < 0,001), serta antara asupan AARC dan jarak tempuh tes jalan 6 menit (r = 0,419; p < 0,001). Kesimpulan: Pada pasien KKL dengan malnutrisi yang menjalani kemoradiasi terdapat korelasi positif sedang antara asupan protein maupun asupan AARC dengan kapasitas fungsional. Temuan ini mendukung pentingnya pemenuhan asupan protein dan AARC untuk mempertahankan fungsi fisik pada populasi tersebut.
Kata Kunci: asupan protein, asam amino rantai cabang, kapasitas fungsional, tes jalan 6 menit, kanker kepala leher


Background: Head and neck cancer (HNC) patients are at high risk of malnutrition and functional decline. Protein and branched-chain amino acids (BCAA) are key nutrients for muscle protein synthesis and may influence functional capacity. This study evaluated the correlation between protein and BCAA intake and functional capacity in malnourished HNC patients undergoing chemoradiation. Method: A cross-sectional study was conducted among malnourished head and neck cancer patients undergoing chemoradiation (week 4–5) at the radiotherapy outpatient clinic. Energy and protein intake were assessed using three nonconsecutive 24-hour food recalls, while BCAA intake was estimated using a semiquantitative FFQ. Functional capacity was evaluated using the six-minute walk test (6MWT). Spearman’s correlation test was used for analysis. Results: Ninety-four subjects were included (mean age 46.9 ± 11.9 years; 61.7% male). Nasopharynx was the most common tumor site (44.7%), and most subjects were in stage IV (74.5%). The mean radiation fraction was 18.7 ± 2.6. Median energy intake was 1060 kcal/day (308–2461 kcal/day), equivalent to 21.0 kcal/kgBW/day (4–50 kcal/kgBW/day). Median protein intake was 40.65 g/day (0.79 g/kgBW/day), with 74.5% classified as having inadequate protein intake. Median total BCAA intake was 9.08 g/day, with median leucine, isoleucine, and valine intakes of 4.20 g/day, 2.26 g/day, and 2.42 g/day, respectively. The mean 6MWT distance was 332.9 ± 123.9 m. Significant moderate positive correlations were found between protein intake and 6MWT distance (r = 0.444; p < 0.001) and between BCAA intake and 6MWT distance (r = 0.419; p < 0.001). Conclusion: In malnourished head and neck cancer patients undergoing chemoradiation, higher protein and BCAA intake were moderately associated with better functional capacity. These findings support nutritional strategies to ensure adequate protein and BCAA intake to preserve functional status in this population.
Keywords: protein intake, branched-chain amino acids, functional capacity, sixminute walk test, head and neck cancer