Tesis

Hubungan Indeks Massa Otot dan Derajat Mukositis pasca Radiasi Pasien Kanker Kepala Leher dalam Radioterapi di RSUPN Cipto Mangunkusumo = The Association between Skeletal Muscle Index and the Grade of Post-Radiation Mucositis in Patients with Head and Neck Cancer Undergoing Radiotherapy at Dr. Cipto Mangunkusumo National General Hospital.

Latar Belakang: Mukositis merupakan manifestasi tersering dari toksisitas akut pasca radiasi pada kanker kepala dan leher yang dapat mengganggu keberlangsungan terapi. Massa otot rangka diduga berperan dalam toleransi jaringan terhadap radiasi melalui mekanisme antiinflamasi dan antioksidan, sehingga penurunan massa otot dapat meningkatkan kerentanan terhadap mukositis. Bukti mengenai hubungan indeks massa otot dan derajat mukositis pasca radiasi pada populasi Indonesia masih terbatas. Metode: Penelitian kohort ini melibatkan 53 pasien dewasa dengan kanker kepala dan leher yang menjalani radioterapi di RSUPN Dr. Cipto Mangunkusumo dan dilakukan selama 3 minggu. Indeks massa otot diukur menggunakan BIA sebelum terapi, dan mukositis dinilai pada minggu ketiga radioterapi menggunakan skor dari Radiation Therapy Oncology Group (RTOG). Analisis dilakukan menggunakan uji T tidak berpasangan untuk menilai perbedaan rerata indeks massa otot terhadap kelompok mukositis dan tidak mukositis. Hasil: Rerata indeks massa otot pada kelompok tidak mukositis adalah 7,88 ± 1,71 kg/m², sedangkan pada kelompok mukositis adalah 6,72 ± 2,46 kg/m².Sebanyak 64,2% subjek mukositis derajat ringan pada minggu ketiga radioterapi, dan sisanya tidak terjadi mukositis. Perbedaan rerata indeks massa otot berdasarkan derajat mukositis pasca radiasi tidak signifikan secara statistik (p = 0,075). Kesimpulan: Tidak terdapat kemaknaan perbedaan rerata indeks massa otot terhadap derajat mukositis pasca radiasi pasien kanker kepala leher yang menjalani radioterapi
Kata Kunci: indeks massa otot, kanker kepala dan leher, mukositis, radioterapi


Background: Mucositis is the most frequent manifestation of acute post-radiation toxicity in head and neck cancer and may interfere with the continuity of therapy. Skeletal muscle mass is thought to play a role in tissue tolerance to radiation through anti-inflammatory and antioxidant mechanisms; therefore, a decrease in muscle mass may increase susceptibility to mucositis. Evidence regarding the association between skeletal muscle index and the grade of post-radiation mucositis in the Indonesian population remains limited. Methods: This cohort study involved 53 adult patients with head and neck cancer undergoing radiotherapy at Dr. Cipto Mangunkusumo National General Hospital and was conducted over a period of 3 weeks. Skeletal muscle index was measured using BIA before therapy, and mucositis was assessed in the third week of radiotherapy using the Radiation Therapy Oncology Group (RTOG) scoring system. Analysis was performed using the independent t-test to assess differences in mean skeletal muscle index between the mucositis and non-mucositis groups. Results: The mean skeletal muscle index in the non-mucositis group was 7.88 ± 1.71 kg/m², while in the mucositis group it was 6.72 ± 2.46 kg/m². A total of 64.2% of subjects experienced mild-grade mucositis in the third week of radiotherapy, while the remainder did not develop mucositis. The difference in mean skeletal muscle index based on the grade of post-radiation mucositis was not statistically significant (p = 0.075). Conclusion: There was no statistically significant difference in mean skeletal muscle index according to the grade of post-radiation mucositis in patients with head and neck cancer undergoing radiotherapy.
Keywords: skeletal muscle index, head and neck cancer, mucositis, radiotherapy