Terapi Kanker dengan Radiasi: Konsep Dasar Radioterapi dan Perkembangannya di Indonesia
Abstract
Kanker merupakan salah satu penyakit yang menyebabkan kematian yang tinggi di dunia. Berdasarkan data WHO, pada tahun 2015 terdapat 8,8 juta kematian yang diakibatkan oleh penyakit kanker. Berdasarkan data riskesdas tahun 2013, prevalensi kanker di Indonesia mencapai 1,4% atau sekitar 347.792 orang. Berbagai metode telah dikembangkan untuk mengobati kanker, salah satunya dengan menggunakan terapi radiasi atau radioterapi. Berdasarkan International Agency for Research on Cancer (IARC), dari 10,9 juta orang yang didiagnosis menderita kanker di seluruh dunia setiap tahun, sekitar 50% membutuhkan radioterapi. Penggunaan radiasi untuk terapi kanker belum banyak digunakan dan masih terbatas di Indonesia. Tujuan penulisan review ini adalah untuk memaparkan konsep dasar terapi kanker dengan radiasi dan perkembangan radioterapi di Indonesia melalui penelusuran pustaka. Metode penelusuran pustaka dalam artikel review ini adalah penelusuran pustaka pada mesin pencari Google, Google Scholar dan PubMed basis data dengan kata kunci “basic radiotherapy” “radiation therapy in Indonesia” “novel radiotherapy in Indonesia” serta peraturan perundang-undangan Republik Indonesia yang berkaitan dengan radioterapi. Hasil penelusuran pustaka menunjukkan bahwa teknologi radiasi telah ada di Indonesia sejak tahun 1927. Sampai tahun 2013, terdapat 29 pusat pelayanan radioterapi di Indonesia. Radioterapi telah menjadi salah satu terapi yang penting dalam pengobatan kanker di Indonesia. Pemerintah Indonesia mendukung kemajuan teknologi ini dengan menerbitkan peraturan tentang standar pelayanan radioterapi di rumah sakit. Semakin banyak dan berkembangnya fasilitas radioterapi diharapkan dapat mengurangi prevalensi penyakit kanker di Indonesia.
Kata kunci: Kanker, radioterapi, regulasi, terapi radiasi
Cancer Therapy with Radiation: The Basic Concept of Radiotherapy and Its Development in Indonesia
Cancer is one of the leading causes of death worldwide. According to WHO, 8,8 million deaths in 2015 was caused by cancer. In Indonesia, based on basic health research data in 2013, the prevalence of cancer was 1.4% or 347.792 people in Indonesia suffer from cancer. Various methods have been developed to treat cancer, one of them is by using radiation therapy or radiotherapy. According to International Agency for Research on Cancer (IARC), from 10.9 million people diagnosed with cancer, about 50% require radiotherapy. The use of radiation for cancer therapy has not been widely used and is still limited in Indonesia. This review article was aimed to describe the basic concept of cancer therapy with radiation and its development in Indonesia. Literature review was conducted from Google search engine, Google Scholar and PubMed database with keyword “basic radiotherapy” “radiation therapy in Indonesia” “novel radiotherapy in Indonesia” and radiotherapy regulations in Indonesia. The results revealed that radiation technology has been availabe in Indonesia since 1927. Until 2013, 29 radiotherapy centers were available in Indonesia. Radiotherapy has become one of important modalities for cancer treatment in Indonesia. Indonesian government supports the development of this technology, by issuing regulations on radiotherapy service standards in hospitals. More technology development and radiotherapy facilities are expected to reduce the prevalence of cancer in Indonesia.
Keywords: Cancer, radiation therapy, radiotherapy, regulation
Keywords
Full Text:
PDF (Bahasa Indonesia)References
Kementerian Kesehatan Republik Indonesia. Pusat data dan informasi kesehatan: Stop kanker. Jakarta: Kementerian Kesehatan Republik Indonesia; 2015.
NIH. Treatment for cancer-National Cancer Institute. [diunduh 15 Agustus 2017]. Tersedia dari: https://www.cancer.gov/about-cancer/treatment.
Round CE, Williams MV, Mee T, Kirkby NF, Cooper T, Hoskin P, et al. Radiotherapy demand and activity in England 2006–2020. Clin Oncol (R Coll Radiol). 2013;25(9):522–30. doi: 10.1016/j.clon.2013.05.005
Liauw SL, Connell PP, Weichselbaum RR. New paradigms and future challenges in radiation oncology: An update of biological targets and technology. Sci Transl Med. 2013;5(173):173sr2. doi: 10.1126/scitranslmed.3005148.
Baskar R, Lee KA, Yeo R, Yeoh KW. Cancer and radiation therapy: Current advances and future directions. Int J Med Sci. 2012;9(3):193–9. doi:10.7150/ijms.3635.
Malicki J. Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession’s role in research, education, and quality control. Rep Pract Oncol Radiother. 2015;20(3):161–9. doi:10.1016/j.rpor.2015.01.001.
Mehta SR, Suhag V, Semwal M, Sharma N. Radiotherapy: Basic concepts and recent advances. Med J Armed Forces India. 2010;66(2):158–62. doi: 10.1016/S0377-1237(10)80132-7.
Laramore GE. Role of particle radiotherapy in the management of head and neck cancer. Curr Opin Oncol. 2009; 21(3):224–31. doi:10.1097/CCO.0b013e328329b716.
Schardt D, Elsässer T, Schulz-Ertner D. Heavy-ion tumor therapy: Physical and radiobiological benefits. Rev Mod Phys. 2010;82(1):383–425. doi:10.1103/RevModPhys.82.383.
Orth M, Lauber K, Niyazi M, Friedl AA, Li M, Maihöfer C, et al. Current concepts in clinical radiation oncology. Radiat Environ Biophys. 2014;53(1):1–29. doi: 10.1007/s00411-013-0497-2.
Bovi JA, White J. Radiation therapy in the prevention of brain metastases. Curr Oncol Rep. 2012;14(1):55-62. doi: 101007/s11912-011-0208-6.
Rödel C, Trojan J, Bechstein WO, Woeste G. Neoadjuvant short-or long-term radio(chemo)therapy for rectal cancer: how and who should be treated?. Dig Dis. 2012;30(2):102–8. doi: 10.1159/000342038.
Guedea F. Perspectives of brachytherapy: patterns of care, new technologies, and “new biology”. Cancer Radiother. 2014;18(5–6):434–6. doi: 10.1016/j.canrad.2014.07.143.
Zhuang H, Zhao X, Zhao L, Chang JY, Wang P. Progress of clinical research on targeted therapy combined with thoracic radiotherapy for non-small-cell lung cancer. Drug Des Devel Ther. 2014;8:667–75. doi: 10.2147/DDDT.S61977.
Ho K, Lin H, Ann DK, Chu PG, Yen Y. An overview of the rare parotid gland cancer. Head & Neck Oncol. 2011;3:40. doi:10.1186/1758-3284-3-40.
Bhandare N, Mendenhall WM. A literature review of late complications of radiation therapy for head and neck cancers: Incidence and dose response. Nucl Med Radiat Ther. 2012;S2:009. doi: 10.4172/2155-9619.S2-009.
Wong RS. Apoptosis in cancer: from pathogenesis to treatment. J Exp Clin Cancer Res. 2011;30(1):87. doi:10.1186/1756-9966-30-87.
White E. The role for autophagy in cancer. J Clin Invest. 2015;125(1):42–6. doi:10.1172/JCI73941.
Mathew R, Karantza-Wadsworth V, White E. Role of autophagy in cancer. Nat Rev Cancer. 2007;7(12):961–7. doi:10.1038/nrc2254.
Proskuryakov SY, Gabai VL. Mechanisms of tumor cell necrosis. Curr Pharm Des. 2010;16(1):56–68.
Caruso Ra, Branca G, Fedele F, Irato E, Finocchiaro G, Parisis A, et al. Mechanisms of coagulative necrosis in malignant epithelial tumors (review). Oncol Lett. 2014;8(4):1397–402. doi: 10.3892/ol.2014.2345.16(1):56-68.
Campisi J. Aging, Cellular Senescence, and Cancer. Annual review of physiology. 2013;75:685–705. doi:10.1146/annurev-physiol-030212-183653.
Chan K-S, Koh C-G, Li H-Y. Mitosis-targeted anti-cancer therapies: where they stand. Cell Death Dis. 2012;3(10):e411. doi: 10.1038/cddis.2012.148.
Ganapati NPD, Djakaria H. Tinjauan pustaka: Efek samping radiasi pada jantung. J Indones Radiat Oncol Soc. 2016;7(1):26–35.
Baudino TA. Targeted cancer therapy: The next generation of cancer treatment. Curr Drug Discov Technol. 2015;12(1):3–20.
National Cancer Institute. Common terminology criteria for adverse events (CTCAE) common terminology criteria for adverse events v4.0 (CTCAE). [diunduh 23 Agustus 2017]. Tersedia pada: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4. 03_2010-06-14_QuickReference_5x7pdf.
Hoppe BS, Laser B, Kowalski AV, Fontenla SC, Pena-Greenberg E, Yorke ED, et al. Acute skin toxicity following stereotactic body radiation therapy for stage I non-small-cell lung cancer: who’s at risk?. Int J Radiat Oncol Biol Phys. 2008;72(5):1283–6. doi: 10.1016/j.ijrobp.2008.08.036.
Soussain C, Ricard D, Fike JR, Mazeron JJ, Psimaras D, Delattre JY. CNS complications of radiotherapy and chemotherapy. Lancet. 2009;374(9701):1639–51. doi: 10.1016/S0140-6736(09)61299-X.
Surjadi N, Amtha R. Radiotherapy reduced salivary flow rate and might induced C. albicans infection. J Dentistry Indones. 2012;19(1):14–9. doi: 10.14693/jdi.v19i1.124
Madan R, benson R, Sharma DN, Julka PK, Rath GK. Radiation induced heart disease: Pathogenesis, management and review literature. J Egypt Natl Canc Inst. 2015;27(4):187–93. doi: 10.1016/j.jnci.2015.07.005
Djakaria M. Radiotherapy. In: Rukmono, Wiknjosastro H, Samino. History of Cipto Mangunkusumo Hospital and Faculty of Medicine University of Indonesia. Jakarta: Balai Penerbit FKUI; 1989.
Gondhowiardjo S, Prajogi G, Sekarutami S. History and growth of radiation oncology in Indonesia. Biomed Imaging Interv J. 2008;4(3):e42. doi:10.2349/biij.4.3.e42.
Perhimpunan Onkologi Radiasi Indonesia. Usulan rencana straegik roadmap pengembangan radioterapi Indonesia [diunduh 22 Agustus 2017]. Tersedia dari: http://www.pori.or.id/pori-activity/usulan-rencana-strategik-dan-roadmap-pengembangan-radioterapi-indonesia.
Hartanto S, Djakaria HM. Peran radioterapi pada karsinoma neuroendokrin jenis karsinoma sel kecil pada serviks. J Indones Radiat Oncol Soc. 2016;7(1):18–25.
Setyawan A, Gondhowiardjo S. Terapi radiasi ex juvantibus pada tumor regio pineal. J Indones Oncol Soc. 2016;7(1):10–7.
Novirianthy R, Djakaria M. Brakiterapi implan pada oral tongue carcinoma. J Indones Radiat Oncol Soc. 2012;3(1):14–21.
Indarti AF, Sekarutami SM. Radiasi pada Kanker Esofagus. J Indones Radiat Oncol Soc. 2013;4(2):70–6.
Primasari M, Sekarutami SM. Peranan radiasi eksterna dalam tatalaksana juvenile nasopharingeal angiofibroma. J Indones Radiat Oncol Soc. 2013;4(2):61–70.
Marlina YS, Sekarutami SM. Brakiterapi intraoperatif pada soft tissue sarkoma. J Indones Radiat Oncol Soc. 2012;3(1):22–30.
Humas Sekretariat Kabinet Republik Indonesia. Penggunaan tenaga nuklir di Indonesia: Aspek hukum | Sekretariat Kabinet Republik Indonesia [diunduh 23 Agustus 2017]. Tersedia dari: http://setkab.go.id/penggunaan-tenaga-nuklir-di-indonesia-aspek-hukum.
Republik Indonesia. Peraturan Pemerintah Republik Indonesia Nomor 29 Tahun 2008 tentang Perizinan Pemanfaatan Sumber Radiasi Pengion dan Bahan Nuklir; 2008.
Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 780 Tahun 2008 tentang Penyelenggaraan Pelayanan Radiologi; 2008.
Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor 1427 tentang Standar Pelayanan Radiografi di Rumah Sakit; 2006.
Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 1248 Tahun 2009 tentang Penyelenggaraan Pelayanan Siklotron di Rumah Sakit; 2009.
DOI: https://doi.org/10.15416/ijcp.2017.6.4.311
Refbacks
- There are currently no refbacks.
Indonesian Journal of Clinical Pharmacy is indexed by
