Tesis

Korelasi antara Rasio Asupan Asam Lemak Omega-6/Omega-3 dengan Platelet To Lymphocyte Ratio pada Pasien Kanker Kepala Leher Malnutrisi sebelum Kemoradiasi = Correlation between Omega-6/Omega-3 Fatty Acid Intake Ratio and Platelet to Lymphocyte Ratio in Malnourished Head and Neck Cancer Patients Before Chemoradiation.

Latar belakang: Risiko malnutrisi semakin meningkat pada pasien kanker kepala leher yang menjalani kemoradiasi dan hal ini berkaitan dengan luaran yang lebih buruk. Kemoradiasi akan berdampak kepada penurunan asupan makanan seperti mual, muntah, anoreksia, disgeusia, mukositis, atau kelelahan. Sementara respons inflamasi yang terjadi pada pasien kanker dan kemoradiasi dapat memengaruhi perubahan hematologi seperti Platelet To Lymphocyte Ratio (PLR). Asam lemak omega-3 memiliki peran dalam menurunkan inflamasi, namun sebaliknya asam lemak omega-6 memiliki fungsi yang berlawanan. Kedua asam lemak berperan penting di dalam tubuh, dan kadarnya ditentukan oleh asupan makanan. Rasio antara asupan asam lemak omega-6/omega-3 yang optimal dapat mengurangi peningkatan inflamasi dalam tubuh. Tujuan penelitian ini adalah melihat korelasi antara rasio asupan asam lemak omega-6/omega-3 terhadap PLR pada pasien kanker kepala leher sebelum kemoradiasi. Metode: Penelitian potong lintang pada pasien kanker kepala leher dengan malnutrisi sebelum kemoradiasi di RSCM berusia 18 sampai dengan 60 tahun pada bulan Agustus-November 2025. Status malnutrisi diklasifikasikan menurut ASPEN. Analisis asupan asam lemak dengan cara wawancara menggunakan semi kuantitatif Food Frequency Questionnaire (FFQ) dan darah diambil sebelum kemoradiasi dilakukan, kemudian diperiksa kadar darah lengkap untuk mendapatkan PLR dan rasio asupan asam lemak omega-6/omega-3 dihitung dengan cara membagi rerata asupan harian asam lemak omega-6 total dengan rerata asupan harian asam lemak omega-3 total. Analisis korelasi menggunakan SPSS antara kadar asam lemak omega-6/omega-3 dan PLR. Hasil: Terdapat 95 subjek didapatkan rerata usia 48 tahun, sebanyak 69,5% adalah subjek laki- laki. Berdasarkan kriteria ASPEN, 53,7% malnutrisi sedang dan 46,3% malnutrisi berat. Median rasio asupan asam lemak omega-6/omega-3 6:1 (rentang 2:1-19:1) dengan median PLR 175 (rentang 75–497). Terdapat korelasi positif antara rasio asam lemak omega-6/omega-3 dengan PLR (r = 0,444; p < 0,001). Kesimpulan: Terdapat korelasi positif sedang yang bermakna secara statistik antara rasio asam lemak omega-6/omega-3 dengan Platelet to Lymphocyte Ratio pada pasien kanker kepala leher dengan malnutrisi sebelum kemoradiasi.
Kata kunci: kanker kepala leher, malnutrisi, platelet to lymphocyte ratio, rasio asupan asam lemak omega-6/omega-3


Background: The risk of malnutrition increases among patients with head and neck cancer undergoing chemoradiation, which is associated with poorer outcomes. Chemoradiotherapy leads to reduced food intake due to symptoms such as nausea, vomiting, anorexia, dysgeusia, mucositis, and fatigue. Meanwhile, the inflammatory response elicited by cancer and chemoradiation can influence hematologic changes, including alterations in the Platelet to Lymphocyte Ratio (PLR). Omega-3 fatty acids play a role in reducing inflammation, whereas omega- 6 fatty acids have opposing effects. Both fatty acids are essential to the body, and their levels are determined by dietary intake. An optimal omega-6 to omega-3 fatty acid intake ratio can mitigate the increase in systemic inflammation. This study aims to investigate the correlation between the dietary omega-6/omega-3 fatty acid ratio and PLR in patients with head and neck cancer before chemoradiation. Methods: A cross-sectional study was conducted on head and neck cancer patients with malnutrition, before chemoradiation, aged 18 to 60 years at Cipto Mangunkusumo National General Hospital (RSCM) during August–November 2025. Malnutrition status was classified according to ASPEN criteria. Fatty acid intake was assessed through interviews using a semi-quantitative Food Frequency Questionnaire (FFQ), and blood samples were collected before chemoradiation to measure complete blood counts for determining the Platelet to Lymphocyte Ratio (PLR). The dietary omega-6/omega-3 fatty acid intake ratio was calculated by dividing the average daily intake of total omega-6 fatty acids by the average daily intake of total omega-3 fatty acids. Correlation analysis between the dietary omega- 6/omega-3 ratio and PLR was performed using SPSS. Result: A total of 95 subjects were included in the study, with a mean age of 48 years; 69,5% of the subjects were male. Based on ASPEN criteria, 53,7% of subjects had moderate malnutrition and 46,3% had severe malnutrition. The median dietary omega-6/omega-3 fatty acid ratio was 6:1 (range: 2:1–19:1), with a median PLR of 175 (range: 75–497). A positive correlation was observed between the omega-6/omega-3 intake ratio and PLR (r = 0.444; p < 0.001). Kesimpulan: There is a statistically significant moderate positive correlation between the omega-6/omega-3 fatty acid intake ratio and Platelet to Lymphocyte Ratio (PLR) in malnourished patients with head and neck cancer before chemoradiation.
Keywords: head and neck cancer, malnutrition, platelet to lymphocyte ratio, omega-6/omega-3 fatty acid ratio