MODEL INDONESIA BREAST CANCER HEALTH RELATED QUALITY OF LIFE UNTUK PENGUKURAN KUALITAS HIDUP DAN COST UTILITY ANALYSIS PENDERITA KANKER PAYUDARA OPERABLE DI RS KANKER DHARMAIS

AGUSDINI BANUN S., DRA., APT., MARS, Prof. dr. Iwan Dwiprahasto, M.Med.Sc., Ph.D

2015 | Disertasi | S3 Ilmu Kedokteran

Penggunaan protokol kemoterapi kanker payudara operable di Rumah Sakit Kanker Dharmais (RSKD) sebagian besar menggunakan protokol kemoterapi Fluorouracil-Adriamicyn-Cyclophosphamid (FAC) dan Taxane base. Keefektifan kedua terapi ini hanya diukur dari hasil keluaran secara fisik seperti sembuh dari penyakit, kematian, angka kesakitan dan angka kekambuhan. Namun, kualitas hidup juga harus diperhatikan. Sementara itu, alat ukur kualitas hidup yang sudah ada tidak mengakomodasi budaya Indonesia. Penelitian ini bertujuan untuk memperoleh model pengukuran status kesehatan yang mengarah pada kualitas hidup penderita kanker payudara Indonesia (INA-BCHRQoL) dan diaplikasikan pada cost utility analysis pada penderita kanker payudara operable yang memperoleh kemoterapi FAC dan kemoterapi berbasis Taxan. Rancangan penelitian ini adalah eksploratif dan konfirmatif. Responden merupakan seluruh penderita kanker payudara operable yang telah dioperasi, dikemoterapi adjuvant FAC dan berbasis Taxan, serta diradiasi mulai Januari 2011 – Desember 2012. Perhitungan biaya meliputi biaya langsung dan tidak langsung. Pengukuran quality of life dilakukan dengan memetakan lima atribut kuesioner ke EQ5D Calculator. Hasil penelitian menunjukkan tidak terdapat perbedaan bermakna antara skor kualitas hidup dan utility pada responden yang mendapatkan kemoterapi FAC dan Taxan. Terdapat perbedaan bermakna utility pada kelompok kemoterapi Taxan. Kemoterapi berbasis FAC lebih cost effective dibandingkan denganTaxan. INA-BCHRQoL dapat digunakan untuk mengukur status kualitas hidup penderita kanker payudara di Indonesia. Kata kunci: kanker payudara, INA-BCHRQoL, cost QALY FAC dan Taxan

The use of chemotherapy protocols with early stage breast cancer in the Cancer Hospital Dharmais (RSKD) mostly uses chemotherapy protocol- Fluorouracil-Adriamicyn Cyclophosphamid (FAC) and taxane base. The effectiveness of the two therapies is only measured physical output such as recovering from illness, mortality, morbidity and recurrence rate. However the quality of life must also be considered. Meanwhile, quality of life measurement tool does not accommodate the existing Indonesian culture. This study aimed to obtain a model of health status measurements that lead to quality of life for Indonesian breast cancer patients (INA-BCHRQoL) and applied to the cost utility analysis in patients with early-stage breast cancer who obtain FAC chemotherapy and chemotherapy Taxanes-based. The design of this study is exploratory and confirmatory. Respondents were all patients with breast cancer stage I-IIIA who had surgery, adjuvant chemotherapy FAC and Taxanes based, and irradiated began in January 2011- December 2012. Cost calculation includes direct and indirect costs. Measurement of quality of life questionnaire done by mapping attributes to EQ5D Calculator. The results showed there was no significant difference between the scores of quality of life and utility in respondents who received FAC chemotherapy and Taxanes based. There are significant differences in the chemotherapy group Taxanes utility. FAC chemotherapy is more cost effective than taxanes. INABCHRQoL can be used to measure the status of the quality of life of breast cancer patients in Indonesia.

Kata Kunci : kanker payudara, INA-BCHRQoL, cost QALY FAC dan Taxan