Peningkatan berat badan pada penderita kanker payudara yang mendapat kemoterapi ajuvan berbasis antrasiklin
HARDIN, Achmad, dr. Johan Kurnianda, SpPD-KHOM
2010 | Tesis | S2 Ilmu Penyakit DalamKanker payudara merupakan keganasan yang paling banyak didapatkan pada wanita yang insidensinya makin meningkat dari tahun ke tahun dan 97% kematian kanker payudara terjadi pada wanita usia 40 tahun atau lebih. Kemoterapi ajuvan yang diberikan pada wanita dengan kanker payudara stadium dini terbukti menurunkan mortalitas penyakit ini. Penelitian menunjukkan kemoterapi ajuvan pada pasien kanker payudara dapat meningkatkan berat badan dan dihubungkan dengan rekurensi dan penurunan disease free survival, tetapi sebagian besar penelitian tersebut dilakukan di negara-negara Eropa dan sedikit negara Asia. Penelitian ini bertujuan untuk mengetahui pengaruh kemoterapi ajuvan berbasis antrasiklin terhadap berat badan penderita kanker payudara. Pada penelitian ini digunakan desain longitudinal prospektif dengan subyek penderita kanker payudara yang memperoleh kemoterapi ajuvan berbasis antrasiklin di bangsal penyakit dalam dan poliklinik TULIP RSUP Dr. Sardjito Yogyakarta. Subyek yang memenuhi kriteria inklusi dan eksklusi, kemudian diukur berat badan sebelum mendapat kemoterapi, setiap akan menjalani seri kemoterapi dan 3 bulan setelah kemoterapi ajuvan IV. Perbedaan rerata berat badan dianalisis menggunakan Wilcoxon-signed ranks test dan nilai P<0,05 dianggap bermakna secara statistik. Didapatkan 49 subyek penelitian yang memenuhi kriteria penelitian selama periode 1 Juli 2009 – April 2010. Sebanyak 47 subyek menyelesaikan penelitian dan dianalisis dengan rerata usia 49,04±8,3 tahun (interval 34 – 65 tahun). Tingkat pendidikan terbanyak Sekolah Dasar 20 orang (42,6%). Rerata berat badan sebelum kemoterapi (T0) 55,83±9,55 kilogram, 3 minggu setelah kemoterapi ajuvan I (T1) 55,47±9,55 minggu setelah kemoterapi ajuvan II (T2) 55,43±9,64, 3 minggu setelah kemoterapi ajuvan III (T3) 55,15±9,60 dan 3 bulan setelah kemoterapi ajuvan IV (T4) 55,02±9,87. Rerata perubahan berat badan (ΔT0-T1), (ΔT0-T2), (ΔT0-T3) dan (ΔT0-T4) berturut-turut adalah 0,36±1,86, 0,40±2,12, 0,68±2,45 dan 0,81±3,66. Berat badan subyek penelitian sebelum dan 3 bulan setelah kemoterapi tetap pada 40 subyek (85,1%) dan terjadi peningkatan berat badan ≥5% dibanding berat badan awal sebanyak 7 subyek (14,9%) dengan rerata peningkatan berat badan 4,57±2,93 kg. Pada penelitian ini tidak didapatkan peningkatan berat badan ≥5%, namun pada penelitian didapatkan 14,9% penderita kanker payudara berat badan meningkat ≥ 5% setelah 3 bulan dibandingkan berat badan sebelum pemberian kemoterapi ajuvan berbasis antrasiklin di RSUP Dr. Sardjito Yogyakarta.
Breast cancer most often found in women and the insidence increases from year to year. About 97% breast cancer mortality found in women aged 40 years or more. Adjuvant chemotherapy given to women with early stage breast cancer can reduce mortality caused by this disease. The study on adjuvant chemotherapy for breast cancer that can increase weight and its association with reccurence and disease free survival mostly were done in European countries and only few studies were done in Asia countries. This study aims to find out the effect of adjuvant chemotherapy anthracycline based on breast cancer patients weight. The study design used is longitudinally prospective with the subject consisting of breast cancer patients who received adjuvant chemotherapy anthracycline - based in Internal Ward and TULIP outpatient department RSUP Dr. Sardjito Yogyakarta. Subjects who met inclusion and exclusion criteria were measured their weight before receiving adjuvant chemotherapy, before every serial chemotherapy and three months after the sixth serial chemotherapy. The difference in average weight were analyzed with Wilcoxon-signed ranks test with P < 0.05 is statistically significant. There were fourty nine subjects that met the criteria during the period from 1st July 2009 to April 2010, 47 finished the study and analyzed. The age of the subjects were 49.04 ± 8.3 years (from 34 to 65 years) and the education were mostly primary high school or 20 patients (42.6%). The average weight before the chemotherapy (T0) were 55.83 ± 9.55 kilogram, three weeks after the first serial adjuvant chemotherapy (T1) were 55.47 ± 9.55, three weeks after the second serial (T2) were 55.36 ± 9.606, three weeks after the third (T3) were 55.43 ± 9.64 and three weeks after the forth (T4) were 55.02 ± 9.87. The average weight difference (ΔT0 – T1), (ΔT0 – T2), (ΔT0 – T3), (ΔT0 – T4) consecutively were 0.36 ± 1.86, 0.40 ± 2,12, 0.68 ± 2.45 and 0.81 ± 3.66. The body weight before and three months after chemotherapy remains the same in 40 subjects (85.1%), and 7 subjects (14.9%) had an increase in body weight ≥ 5% average from base line or the average increase were 4.57 ±2.93 kg. In this study we could not find body weight increase ≥ 5%, but we found there were 14.9% breast cancer patients had an increase in body weight ≥ 5% from their baseline after three months adjuvant chemotherapy anthracyclin based in RSUP Dr. Sardjito Yogyakarta.
Kata Kunci : Berat badan,Kanker payudara,Kemoterapi ajuvan,Antrasiklin
