Profil Penatalaksanaan Kanker Serviks Stadium IIB–IIIB dengan Terapi Radiasi dan Kemoradiasi di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung Periode Tahun 2015–2017
Abstract
Kanker serviks merupakan jenis kanker dengan kasus kedua terbanyak di Rumah Sakit Umum Pusat Dr. Hasan Sadikin (RSHS) dan 82% di antaranya merupakan stadium II dan III. Terapi yang direkomendasikan untuk kanker serviks stadium IIB–IIIB menurut Pedoman Nasional Pelayanan Kedokteran (PNPK) kanker serviks adalah kemoradiasi atau radioterapi. Tujuan penelitian ini adalah untuk memberikan gambaran profil penatalaksanaan kanker serviks stadium IIB–IIIB dengan radioterapi dan kemoradiasi di RSHS pada tahun 2015–2017. Penelitian ini merupakan penelitian observasional dengan metode potong lintang. Pengambilan data dilakukan secara retrospektif dari rekam medik pasien di Instalasi Onkologi Radiasi dan Sistem Informasi Rumah Sakit (SIRS) RSHS dengan kriteria inklusi pasien dewasa berusia lebih dari 18 tahun, memiliki data klinis dan data terapi yang lengkap serta tidak memiliki penyakit penyerta. Data yang diperoleh dianalisis secara deskriptif dan secara statistik dengan uji Kruskal Wallis untuk data numerik serta uji Chi-Square dan uji Fisher’s Exact untuk data kategorik. Terdapat 234 data pasien yang memenuhi kriteria. Sebanyak 94,01% pasien berasal dari Jawa Barat, 86,1% merupakan ibu rumah tangga dan 63,6% mengenyam pendidikan hingga tingkat Sekolah Dasar. Radioterapi merupakan terapi yang lebih banyak diberikan kepada pasien dengan dosis total sekitar 6700–7200cGy dan rata-rata lama terapi selama 14 minggu. Rata-rata waktu yang diperlukan pasien untuk mendapatkan terapi setelah mendaftar untuk terapi sekitar 7 minggu. Regimen kemoterapi sisplatin merupakan regimen pilihan utama yang diberikan pada pasien dengan kemoradiasi dengan frekuensi 1–5 kali pemberian. Efek samping yang paling sering terjadi pada terapi kanker serviks baik dengan radioterapi maupun kemoradiasi adalah mual dan muntah. Analisis efektivitas biaya akan dilakukan pada penelitian selanjutnya untuk mengetahui terapi mana yang lebih baik dari segi efektivitas terapi dan biaya.
Kata kunci: Kanker serviks, kemoradiasi, radioterapi, stadium IIB–IIIB, tatalaksana kanker serviks
Management Profile of Stage IIB–IIIB Cervical Cancer with Radiation Therapy and Chemoradiation at Dr. Hasan Sadikin General Hospital Bandung in 2015–2017
Abstract
Cervical cancer is a type of cancer with the second most cases at Dr. Hasan Sadikin General Hospital (RSHS) Bandung and 82% of those cases are stage II and III. Recommended therapy for cervical cancer stage IIB–IIIB according to the National Medical Services guidelines for cervical cancer (PNPK) is chemoradiation or radiotherapy. The purpose of this study was to provide an overview of the management profile of stage IIB–IIIB cervical cancer with radiotherapy and chemoradiation at RSHS in 2015–2017. This study was an observational study with a cross-sectional method. Retrospective data collection was carried out from medical records of patients in Radiation Oncology Installation and Hospital Information System (SIRS) with inclusion criteria of adult patient with over 18 years of age, having complete clinical and therapeutic data and not having any comorbidities. Obtained data were analyzed descriptively and statistically with Kruskal Wallis test for numerical data and Chi-Square test and Fisher’s Exact test for categorical data. A total of 234 patients’ data met the criteria. Ninety four percent of patients came from West Java, 86.1% were housewives and 63.6% had a primary school education level. Most of patients were given radiotherapy with a total dose of about 6700–7200cGy and the average length of therapy was 14 weeks. The average time for a patient to obtain therapy after registering for therapy was about 7 weeks. Cisplatin was the first line chemotherapy regimen given to patients with chemoradiation with a frequency of 1–5 times administration. The most common side-effects of cervical cancer therapy with radiotherapy or chemoradiation were nausea and vomiting. Cost-effectiveness analysis will be carried out in further research to find out which therapies are better in terms of therapy and cost-effectiveness.
Keywords: Cervical cancer, chemoradiation, management of cervical cancer, radiotherapy, stage IIB–IIIB
Keywords
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DOI: https://doi.org/10.15416/ijcp.2019.8.3.205
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