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Profil Efek Toksisitas Hematologi Concurrent Chemoradiation Therapy (CCRT) Dengan Kombinasi Cisplatin Dan 5-Fluorouracil Pada Pasien Kanker Serviks Stadium IIB – IVA
https://doi.org/10.22146/jkr.114139 Farid Nurdiansyah(1*), Heru Pradjatmo(2), Rukmono Siswishanto(3)
(1) PPDS 1 Obstetri dan Ginekologi FKKMK UGM
(2) Departemen Obstetri dan Ginekologi FKKMK UGM
(3) Departemen Obstetri dan Ginekologi FKKMK UGM
(*) Corresponding Author
Abstract
Latar Belakang: Terapi kemoradiasi bersamaan (CCRT) merupakan pengobatan standar untuk kanker serviks stadium IIB–IVA, terapi kemoradiasi konkuren (CCRT) biasanya menggunakan cisplatin saja atau kombinasi cisplatin dan 5-fluorourasil (5-FU) yang diberikan bersamaan dengan radioterapi. Selama kemoterapi, penting untuk memantau dampak toksisitas hematologi. Efek toksisitas hematologi yang disebabkan oleh kemoterapi dapat memengaruhi kelancaran terapi dan bahkan dapat menyebabkan siklus kemoterapi berikutnya tertunda.
Tujuan: Untuk menentukan gambaran toksisitas hematologi yang disebabkan oleh CCRT dengan kombinasi cisplatin dan 5-FU pada pasien dengan kanker serviks stadium IIB–IVA.
Metode: Penelitian ini menggunakan studi observasi deskriptif dengan subjek penelitian adalah pasien yang didiagnosis kanker serviks pertama kali pada periode Januari tahun 2018 sampai dengan Maret 2021. Sejumlah 31 pasien mendapatkan kemoterapi 5-Fluorouracil 500 mg dilanjutkan cisplatin 70 mg yang diberikan bersamaan dengan External Beam Radiation Therapy (EBRT). Kemoterapi diberikan setiap minggu, maksimal 6 kali siklus selama CCRT. Pasien mendapat terapi radiasi berupa EBRT selama 5 hari setiap minggu kemudian dilanjutkan dengan brakiterapi.
Hasil: Dari analisis univariat didapatkan bahwa dari 31 pasien didapatkan sebagian besar berusia ≥ 50 tahun dengan paritas ≥ 3, hasil histopatologi SCC derajat differensiasi sedang – buruk dan stadium II B - III A. Hampir mayoritas pasien mengalami toksisitas hematologi derajat 1 (anemia 51,6%, leukopenia 22,6%, trombositopenia 12%). Sedangkan yang mengalami toksisitas neutropenia sebagian besar derajat 2 (9,7%).
Kesimpulan: CCRT dengan regimen cisplatin ditambah 5-fluorouracil memiliki risiko efek toksisitas hematologi berupa anemia, leukopenia, trombositopenia, dan neutropenia dengan derajat toksisitas masing – masing berbeda.
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DOI: https://doi.org/10.22146/jkr.114139
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