Parameter CT Scan Pasca Terapi sebagai Prediktor Progression Free Survival pada Pasien Karsinoma Nasofaring

Pratama Widi Permana, Dr. dr. Bambang Supriyadi, Sp. Rad., Subsp. MSK (K), MM.; dr. Evi Artsini, Sp. Rad., Subsp. TR (K)

2026 | Tesis | S2 Kedokteran Klinik

Latar belakang: Karsinoma nasofaring sering terdiagnosis pada stadium lanjut dan masih memiliki risiko progresi setelah terapi. Parameter CT scan pasca terapi mencerminkan respons tumor primer dan metastasis nodal, sehingga dapat digunakan untuk memprediksi progression-free survival (PFS).

Metode: Penelitian kohort retrospektif dengan follow-up 12 bulan. Subjek penelitian adalah pasien karsinoma nasofaring pasca terapi yang menjalani CT scan nasofaring pasca terapi di RSUP Dr. Sardjito Yogyakarta periode 1 Januari 2022-31 Desember 2024. Variabel bebas meliputi persentase penurunan volume tumor primer, persentase penurunan enhancement tumor, persentase penurunan jumlah limfonodi yang terlibat, dan persentase penurunan volume limfonodi metastatik. Variabel tergantung adalah PFS. Analisis kesintasan dilakukan menggunakan Kaplan-Meier dan Cox regression.

Hasil: Tidak terdapat perbedaan usia, jenis kelamin, maupun stadium N antara pasien yang mengalami progresi/meninggal dan pasien tanpa progresi/meninggal dalam 1 tahun (p>0,05). Stadium T berhubungan kuat pada analisis bivariat. Seluruh pasien T4 mengalami progresi/meninggal, sedangkan seluruh pasien T1–T3 tidak mengalami progresi/meninggal (p<0 p=0,146;>0,05).

Kesimpulan: Parameter CT scan pasca terapi tidak menunjukkan akurasi yang baik untuk memprediksi PFS 1 tahun pada pasien karsinoma nasofaring.

Background: Nasopharyngeal carcinoma is often diagnosed at an advanced stage and still carries a risk of progression after therapy. Post-therapy CT scan parameters reflect the response of the primary tumor and nodal metastases and can therefore be used to predict progression-free survival (PFS).

Methods: This was a retrospective cohort study with 12-month follow-up. Subjects were post-therapy nasopharyngeal carcinoma patients who underwent post-therapy nasopharyngeal CT scans at Dr. Sardjito General Hospital, Yogyakarta, between January 1, 2022, and December 31, 2024. Independent variables included the percentage reduction in primary tumor volume, the percentage reduction in tumor enhancement, the percentage reduction in the number of involved lymph nodes, and the percentage reduction in metastatic lymph node volume. The dependent variable was PFS. Survival analysis was performed using Kaplan-Meier and Cox regression.

Results: There were no differences in age, gender, or N stage between patients who progressed/died and those who did not progress/died within 1 year (p>0.05). T stage was strongly associated in bivariate analysis. All T4 patients progressed/died, while all T1–T3 patients did not progress/died (p<0 p=0.146;>0.05).

Conclusion: Post-therapy CT scan parameters did not demonstrate good accuracy in predicting 1-year PFS in nasopharyngeal carcinoma patients.

Kata Kunci : karsinoma nasofaring, CT scan pasca terapi, progression free survival