Perbandingan Evaluasi Respon Terapi Transarterial Chemoembolization Antara Kriteria Recist 1.1 dan Volumetric Recist Pada Pasien Hepatocellular Carcinoma

Amalia Oktorina, Dr. dr. Bagaswoto Poedjomartono, Sp.Rad(K)RI, Sp.KN, M.Kes, FICA;dr. Sudarmanta, Sp.Rad(K)RI

2024 | Tesis | S2 Kedokteran Klinik

Latar Belakang: Hepatocellular Carcinoma (HCC) merupakan kanker hepar primer dengan angka morbiditas dan mortalitas tinggi di seluruh dunia. Transarterial chemoembolization (TACE) merupakan terapi lini pertama untuk pasien dengan HCC stadium intermediate. Berbagai metode dapat digunakan untuk mengevaluasi respon terapi ini, antara lain RECIST 1.1 dan vRECIST. Tujuan penelitian ini adalah mengetahui perbedaan respon terapi setelah TACE konvensional pada pasien HCC antara kriteria RECIST 1.1 dan vRECIST.

Metode: Penelitian ini merupakan penelitian analitik observasional dengan desain cross sectional. Penilaian ukuran lesi dilakukan menggunakan perangkat lunak komputer untuk kemudian diklasifikasikan berdasarkan kriteria RECIST 1.1 dan vRECIST menjadi complete response (CR), partial response (PR), stable disease (SD), dan progressive disease (PD).

Hasil: Sebanyak 70 orang disertakan dalam penelitian ini. Penelitian ini mendapati bahwa berdasarkan kriteria RECIST 1.1, mayoritas (78,6%) pasien termasuk dalam kategori Stable Disease sedangkan berdasarkan kriteria vRECIST, mayoritas (67,1%) pasien termasuk dalam kategori Stable Disease. Berdasarkan responnya, didapatkan mayoritas pasien termasuk dalam kategori tidak respon, baik dengan kriteria RECIST 1.1 maupun vRECIST (masing-masing 95,7?n 95,7%). Hasil analisis menunjukkan bahwa terdapat perbedaan evaluasi respon terapi berdasarkan RECIST 1.1 dan vRECIST 

Kesimpulan: Terdapat perbedaan yang signifikan secara statistik antara evaluasi respon terapi berdasarkan RECIST 1.1 dengan evaluasi respon terapi berdasarkan vRECIST. 

Background: Hepatocellular Carcinoma (HCC) is a primary liver cancer with high morbidity and mortality rates throughout the world. Transarterial chemoembolization (TACE) is the first line therapy for patients with intermediate stage HCC. Various methods can be used to evaluate the response to this therapy, including RECIST 1.1 and vRECIST. The aim of this study was to determine the difference in response to therapy after conventional TACE in HCC patients between RECIST 1.1 and vRECIST criteria.

Method: This research is an observational analytical study with a cross sectional design. Lesion size assessment was carried out using computer software and then classified based on RECIST 1.1 and vRECIST criteria into complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD).

Results: A total of 70 people were included in this study. This research found thatbased on RECIST 1.1 criteria, the majority (78.6%) of patients are included in the Stable Disease category, while based on vRECIST criteria, the majority (67.1%) of patients are included in the Stable Disease category. Based on their responses, it was found that the majority of patients fell into the non-response category, both by RECIST 1.1 and vRECIST criteria (95.7% and 95.7% respectively). The results of the analysis show that there are differences in the evaluation of therapy response based on RECIST 1.1 and vRECIST

Conclusion:There is a statistically significant difference between the evaluation of therapy response based on RECIST 1.1 and the evaluation of therapy response based on vRECIST.

Kata Kunci : Carcinoma, Hepatocellular; Chemoembolization, Therapeutic; Response Evaluation Criteria in Solid Tumors