Hasil pengobatan External Beam Radiotherapy Box System + Booster Brachytherapy Dibandingkan External Beam Radiotherapy Ap-Pa + Booster Box System pada penderita Carcinoma Cervix Uteri di RSUP Dr. Sardjito

GUNARTI, Hesti, Dr.dr. Salungu Maesadji Tjokronagoro, SpRad.(K)Onk

2004 | Tesis | PPDSI Radiologi

Latar belakang : Carcinoma cervix uteri merupakan keganasan yang paling sering terjadi di Indonesia. Pengobatan carcinoma cervix uteri tergantung dari stadium pada waktu datang pertamakali ke poli radiotheraphy. Carcinoma cervix uteri stadium IIB, IIIA, IIIB adalah inoperable jadi pengobatan yang berperan tinggal radiotheraphy dan chemotheraphy. Radiotheraphy berupa External Beam Radiotheraphy (EBRT) dan boosternya. EBRT dapat dilakukan secara box system atau secara anteroposterior-posteroanterior (AP-PA). Boosternya dapat secara brachytheraphy atau box system. Tujuan penelitian : Mengetahui hasil pengobatan pada penderita carcionoma cervix uteri yang dilakukan EBRT box system + brachytheraphy dibandingkan dengan EBRT AP-PA + box system. Metoda penelitian : Suatu non randomised retrospective cohort study, pada rekam medis penderita carcinoma cervix uteri stadium IIB, IIIA dan IIIB dengan membandingkan hasil pengobatan EBRT box system + brachytheraphy dengan EBRT AP-PA + box system yang dianalisa secara statistik menggunakan chi square test. Hasil : Didapatkan 453 penderita carcinoma cervix uteri yang dirawat jalan di poli radioterapi RS DR Sardjito tahun 1999-2002 , diambil 180 kasus yang memenuhi kriteria inklusi. Usia rata-rata penderita carcinoma cervix uteri 51 tahun (antara 31 –83 tahun). Jenis sel terbanyak adalah epidermoid carcinoma atau squamous cell carcinoma 160 (88,9%), sisanya adenocarcinoma 20 (11,1%). Dari 90 penderita carcinoma cervix uteri stadium IIB, IIIA, IIIB yang dilakukan EBRT box system + brachytheraphy dibandingkan 90 penderita carcinoma cervix uteri stadium IIB yang dilakukan EBRT AP-PA + box system didapatkan perbedaan respon pengobatan yang bermakna secara statistik ( stadium IIB, p= 0,003; stadium IIIA, p=0,011, stadium IIIB, p=0,028 ). Kesimpulan : hasil pengobatan EBRT box system + brachytheraphy lebih baik bila dibandingkan hasil pengobatan EBRT AP-PA + box system pada penderita carcinoma cervix uteri stadium IIB, IIIA dan IIIB.

Back ground : Uterine cervical cancer is the most common cancer in Indonesia. Treatment uterine cervical cancer depend on stage in the first diagnosis. Uterine cervical cancer stage IIB, IIIA and IIIB is inoperable so radiotheraphy and chemotheraphy have important role. Radiotheraphy could be external beam radiotheraphy box system or external beam radiotheraphy anteroposterior-posterior anterior (AP-PA). The booster could be brachytheraphy or external beam radiotheraphy box system. Objective : To know the treatment result of EBRT box system + brachytheraphy compared with EBRT AP-PA + booster box system in uterine cervical cancer. Methode : A non randomised retrospective cohort study to medical records of the treatment result EBRT box system + brachytheraphy compared the treatment result of EBRT AP-PA + booster box system were used chi square test for analyzed. Result : 453 patients with uterine cervical cancer treated with radiotheraphy at Dr. Sardjito General Hospital from 1999-2002, taken 180 cases with inclusion and exclusion criterion. Median age was 51 (range 31-83yr). Squamous cell carcinoma or epidermoid carcinoma was the common histologic type (88,9%). From 90 patients with uterine cervical cancer stage IIB, IIIA, and IIIB were treated EBRT box system + booster brachytheraphy compared 90 patients with uterine cervical cancer stage IIB, IIIA and IIIB were treated EBRT AP-PA + box system, that were found statisticaly significant different in the result treatment (stage IIB, p=0,03; stage IIIA, p=0,011; stage IIIB, p=0,028). Conclusion : The treatment result EBRT box system + brachytheraphy was much better if compared the treatment result EBRT AP-PA + box system in patients uterine cervical cancer stage IIB, IIIA and IIIB.

Kata Kunci : Radioterapi,Carcinoma Cervic Uteri,EBRT Box System + Boooster Brachytherapy and EBRTAP,PA dan Box System