Hubungan Kadar Hemoglobin Sebelum dan Selama Terapi Radiasi dengan Respon Tumor pada Pasien Kanker Serviks di RSUD Abdul Wahab Sjahranie Samarinda

Association Between Hemoglobin Levels Before and During Radiation Therapy in Cervical Cancer Patients at Abdul Wahab Sjahranie Hospital Samarinda

Authors

  • Luthfa Hubbalkhairi Ulfa Fakultas Kedokteran Universitas Mulawarman
  • Andriansyah Andriansyah Laboratorium Ilmu Obstetri Ginekologi, Fakultas Kedokteran Universitas Mulawarman
  • Abdillah Iskandar Laboratorium Fisiologi, Fakultas Kedokteran Universitas Mulawarman

DOI:

https://doi.org/10.25026/jsk.v3i6.659

Keywords:

Kanker Serviks, Kadar Hemoglobin Sebelum Terapi Radiasi, Kadar Hemoglobin Selama Terapi Radiasi, Respon Tumor.

Abstract

Kanker serviks menempati peringkat ke empat jenis kanker pada wanita yang paling umum, dimana kasus baru kanker serviks lebih sering muncul di negara berkembang dibanding negara maju, yaitu sebesar 76% kasus pada semua kelompok usia. Di Indonesia kanker serviks merupakan penyakit dengan prevalensi tertinggi. Pengobatan utama pada pasien kanker serviks adalah operasi atau radiasi. Terapi radiasi sendiri dapat menyebabkan penurunan proses pembentukan sel-sel darah merah sehingga sel darah merah akan menurun. Secara fisiologis, penurunan kadar hemoglobin dapat mendorong pertumbuhan tumor dan merusak respons terhadap pengobatan. Penelitian ini bertujuan untuk mengetahui hubungan kadar hemoglobin sebelum dan selama terapi radiasi dengan respon tumor pada pasien kanker serviks di RSUD Abdul Wahab Sjahranie Samarinda. Penelitian analitik observasional dengan metode cohort dilakukan pada 102 pasien kanker serviks yang melakukan pemeriksaan kadar hemoglobin sebelum terapi dan selama terapi radiasi. Analisis data menggunakan uji Chi-Square. Hasil penelitian menunjukkan kelompok usia terbanyak adalah 50-59 tahun (45.1%). Hasil uji statistik menunjukkan variabel yang tidak berhubungan adalah kadar hemoglobin sebelum terapi (p = 0.572) dan kadar hemoglobin selama terapi (p = 0.466). Disimpulkan bahwa tidak terdapat hubungan antara kadar hemoglobin sebelum dan selama terapi dengan respon tumor pada pasien kanker serviks.

References

1. Ferlay, J., et al., 2014. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012, Internationan Journal of Cancer, 359-386.
2. Forouzanfar, M., et al., 2011. Breast and cervical cancer in 187 countries between 1980: a sytemic review, The Lancet, 1461-1484.
3. Kementrian Kesehatan RI, 2015. Infodatin Kanker, Jakarta: Pusat Data dan Informasi Kementrian Kesehatan RI.
4. Bruni, L., et al., 2017. Human Papillomavirus and Related Diseases in Indonesia. Barcelona: ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre).
5. WHO, 2010. Immunization, Vaccines and Biologicals of Human Papilloma Virus (HPV). Retrieved Agustus 16, 2018, from World Health Organization Web Site: http://www.who.int/immunization/topics/hpv/en/
6. Gillison, M., Chaturvedi, A., & Lowy, D., 2008. HPV Prophylactic Vaccines and the Potential Prevention of Noncervical Cancers in Both Men and Women, Cancer, 3036-3046.
7. Edianto, D., 2010. Onkologi Ginekologi. Dalam M. A. Farid, & S. A. Bari, Kanker Serviks (pp. 442-454), Jakarta: PT. Bina Pustaka Sarwono Prawirohardjo.
8. Koh, W.-J., et al., 2013. Cervical cancer: Clinical practice guidelines in oncology, JNCC Journal of the National Comprehensive Cancer Network, 11, (3), 332-336.
9. Nisa, A. K., Juswono, U. P., & Martono, S., 2014. Efek Radioterapi Terhadap Produksi Sel Darah Pada Penderita Ca Mammae Dan Ca Cervix, Media Neliti, 1-4.
10. Dunst, J., 2004. Management of Anemia in Patients Undergoing Curative Radiotherapy: Erythropoietin, Transfusions, or Better Nothing?, Anemia in Radiotherapy Patients, 180, (11), 671-681.
11. Lebovic, D., 2018. Anemia in Malignancy. Dalam R. Provenzano, E. V. Lerma, & L. Szczech, Management of Anemia (pp. 157-171). New York: Springer.
12. Bahar, I., Tjokroprawiro, B., Suhatno, & Erawati, D., 2013. Radiotherapy Response of Advanced Squamous and AdenocarcinomaTypes of Cervical Cancer at Dr Soetomo Hospital Surabaya, Majalah Obstetri dan Ginekologi, 21, 2, 48-55.
13. Fitri, Nurul., 2014, Pengaruh Kadar Hemoglobin, Kadar Hematokrit dan Transfusi Terhadap Respon Tumor dan Kesintasan Penderita Kanker Serviks Stadium Lanjut Lokal, Tesis Fakultas Kedokteran Universitas Indonesia, 39-44.
14. Rozi, A. F., Susanti, D. & Annas, J. Y. 2, 2019, Karakteristik Pasien Kanker Serviks di RSUD DR. Soetomo Surabaya Periode Januari – Desember 2017, Majalah Biomorfologi, 29, 45-48.
15. Hoffman, B. L., et al., 2012. Williams Gynecology. New York: McGraw-Hill Medical.
16. Watulingas, A., Lobo, M., & Wagey, F., 2016. Karakteristik Penderita Kanker Serviks di RSUP Prof. Dr. R. D. Kandou Manado Periode 1 Januari 2013 - 31 Desember 2015, Jurnal e-Clinic (eCl), 4, (2), 1-5.
17. Widiasti, Alifta, 2019. Gambaran Karakteristik Penderita Kanker Serviks di RSUD Kota Yogyakarta, Publikasi Universitas Aisyiyah Yogyakarta. 1-11.
18. Utami, N., Mahendra, I., Widianti, E., & Sudiman, J., 2020. Karakteristik Pasien Kanker Serviks di RSUP Sanglah Denpasar Periode 1 Januari - 31 Desember 2017, Jurnal Medika Udayana, 9, (4), 38-44.
19. Notoatmodjo, 2003. Pendidikan dan Perilaku Kesehatan. Jakarta: Rineka Cipta.
20. Theresia, E., Karningsih, & Delmaifanis, 2012. Pengetahuan Merupakan Faktor Dominan Perilaku Wanita Dalam Pemerisaan Visual Inspection With Acetic Acid (VIA), Jurnal Madya, 13, (2), 13.
21. Shurianto, L., Abbas, E., & Fasihah, I., 2017. Karakteristik Pasien Karsinoma Serviks Berdasarkan Manifestasi Klinis dan Histopatologis di Rumah Sakit Hasan Sadikin Bandung Periode 2015-2016, Repositori Unjani, 1-10.
22. Iskandar, T. M., et al., 2011. Respons Histopatologik Karsinoma Serviks Uteri Setelah Pemberian Kemoradiasi, Media Medika Indonesiana, 45, (3), 174-180.
23. Lax, S., 2011. Histopathology of Cervical Precursor Lesions and Cancer, Acta Dermatoven APA, 20, (3), 125-133.
24. Sattar, H. A., 2015. Sistem Genitalia Wanita dan Payudara. Dalam K. Vinay, A. Abbas, J. Aster, S. Robbins, S. Cornain, & I. Nasar, Buku Ajar Patologi Robbins. 681-714. Singapore.
25. Hidayati, A. O. & Arifah, S., 2020. Faktor Kejadian Anemia pada Pasien Kanker yang Mendapat Radioterapi dan atau Kemoterapi, Jurnal Kesehatan. 11, 29-36.
26. Rodgers, G., Becker, P., Blinder, M., & Chanan-Khan, A., 2012. Cancer and Chemotherapy Induced Anemia : Clinical Practice Guidelines in Oncology, J Natl Compr Cancer Network, 10, (5), 628-653.
27. Barkati, M., Fortin, I., Mileshkin, L., Bernshaw, D., Carrier, J.-F., & Narayan, K., 2013. Hemoglobin Level in Cervical Cancer A Surrogate for an Infiltrative Phenotype, International Journal of Gynecological Cancer, 23, (4), 724-729.
28. Stauder, R., Valent, P. & Theurl, I., 2018. Anemia at Older Age: Etiologies, Clinical Implications, and Management. Blood, The Journal of the American Society of Hematology. 131. 505-514.
29. Harrison, L., Daniel, S., Lauren, S., Carol, W., & Ramden, R., 2001. Prevalence of Anemia in Cancer Patients Undergoing Radiation Therapy, Seminars in Oncology, 28, (2), 54-59.
30. Nurjanah, A., Etika, R., Niken, P., & Ahmad, S., 2016. Hubungan Jumlah Fraksi Radioterapi dengan Kadar Hemoglobin Pasien Kanker Serviks di RSUP DR Kariadi, Journal of Nutrition College, 5, (1), 1-7.
31. Abdelhalim, M., Al-Ayed, M., Moussa, S., & Al-Sheri, A., 2015. The Effects of Gamma-Radiation on Red Blood Cell Corpuscles and Dimensional Properties in Rats, Pak J Pharm Sci, 28, (5), 1819-1822.
32. Amin, Y., Mulawardhana, P., & Erawati, D. (2015). Demografi, Respon Terapi dan Survival rate Pasien Kanker Serviks Stadium III-IVA yang Mendapat Kemoterapi Dilanjutkan Radioterapi, Majalah Obstetri dan Ginekologi, 23, (3), 97-105.
33. Rahakbauw, E. & Winarto, H., 2018. Radiotherapy Response and Related Clinicopathological Factors of Patients with Cervical Cancer, Journal of Physics: Conference Series. 1-8.
34. Caro, J., Salas, M., Ward, A., & Goss, G., 2001. Anemia As An Independent Prognostic Factor for Survival in Patients with Cancer: A Systemic, Quantitative Review, Cancer, 91, 2214-2221.
35. Fyles, A., Milosevic, M., Pintilie, M., Syed, A., & Hill, R., 2000. Anemia, Hypoxia, and Tranfusion in Patients with Cervix Cancer: A Review, Radiother Oncol, 57, 13-19.
36. Ferlay, J., et al., 2015. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012, International Journal of Cancer, 381.
37. Jemal, A., Sieger, R., Xu, J., & Ward, E., 2010. Cancer Statistic, 2010, CA Cancer J Clin, 60, 277-300.
38. Choi, Y. S., Yi, C. M., Sin, J. I., Ye, G. W., Shin, I. H., & Lee, T. S., 2006. Impact of Hemoglobin on Survival of Cervical Carcinoma Patients Treated with Concurrent Chemoradiotherapy is Dependent on Lymph Node Metastasis Findings by Magnetic Resonance Imaging, Int J Gynecol Cancer, 16, 1846-1854.
39. Obermair, A., Cheuk, R., Horwood, K., Neudorfer, M., Janda, M., & Giannis, G., 2003. Anemia Before and During Concurrent Chemoradotherapy in Patients with Cervical Carcinoma: Effect on Progression-free Survival, Int J Gynecol Cancer, 13, 633-639.
40. Seo, Y., et al., 2011. Nomogram Prediction of Overall Survival After Curative Irradiation for Uterine Cervical Cancer, Int J Radiat Oncol Biol Phys, 79, 782-787.
41. Shin, N. R., Lee, Y. Y., Kim, S. H., Choi, C. H., Kim, T. J., Bae, D. S., & Kim, B. G., 2014. Prognostic Value of Pretreatment Hemoglobin Level in Patients with Early Cervical Cancer, Obstetrics & Gynecology Science, 57, 28-36.
42. Vias, P., Angural, H., Seam, R. K., Gupta, M. K., Gupta, M., Fotedar, V., & Negi, A., 2020. A Prospective Study Comparing Hemoglobin Levels and Response in Patients of Locally Advanced Carcinoma Cervix Receiving Accelerated Chemoradiation versus Conventional Chemoradiation, Journal of Radiation and Cancer Research, 10, (3), 135-140.
43. Perez, C. A., Grigsby, P. W., Nene, S. M., Camel, H., Galakatos, A., Kao, M., & Lockett, M., 1992. Effect of Tumor Size on The Prognosis of Carcinoma of The Uterine Cervix Treated with Irradiation Alone, Cancer, 69, 2796-2806.
44. Dunst, J., Kuhnt, T., Strauss, H. G., Krause, U., Pelz, T., Koelbl, H., & Hae, G., 2003. Anemia in Cervical Cancer: Impact on Survival, Patterns of Relapse, and Association with Hipoxia and Angiogenesis, Int J Radiat Oncol Biol Phys, 53, 778-787.
45. Bush, R. S., Jenkin, R. D., Allt, W. E., Beale, F., Bean, H., Dembo, A., & Pringle, J., 1978. Definitive Evidence for Hypoxic Cells Influencing Cure in Cancer Therapy, Br J Cancer Suppl, 3, 302-306.
46. Lim, M., et al., 2008. Allogenic Blood Transfusion Given Before Radiotherapy is Associated with The Poor Clinical Outcome in Patients with Cervical Cancer, Yonsei Medical Journal, 49, (6), 993-1003.
47. Bishop, A. J., Allen, P. K., Klopp, A. H., Meyer, L. A., & Eifel, P. J., 2014. Relationship Between Low Hemoglobin Levels and Outcomes After Treatment With Radiation or Chemoradiation in Patients With Cervical Cancer: Has the Impact of Anemia Been Overstated?, International Journal of Radiation Oncology, 91, 1-10.
48. Vaupel, P. & Hockel, M., 2001. Tumor hypoxia: definitions and current clinical, biologic, and molecular aspects, J Natl Cancer Inst. 93, 4, 266-276.
49. Vaupel, P., Hockel, M. & Mayer, A., 2006. Impact of Hemoglobin Levels on Tumor Oxygenation: the Higher, the Better?, Strahlentherapie und Onkologie. 182. 63-71.
50. Mayr, N., et al., 2009. Synergistic Effects of Hemoglobin and Tumor Perfusion on Tumor Control and Survival in Cervical Cancer, Int J Radiation Oncology , 74, 1513-1521.

Downloads

Published

2021-12-31

How to Cite

Ulfa, L. H., Andriansyah, A., & Iskandar, A. (2021). Hubungan Kadar Hemoglobin Sebelum dan Selama Terapi Radiasi dengan Respon Tumor pada Pasien Kanker Serviks di RSUD Abdul Wahab Sjahranie Samarinda: Association Between Hemoglobin Levels Before and During Radiation Therapy in Cervical Cancer Patients at Abdul Wahab Sjahranie Hospital Samarinda. Jurnal Sains Dan Kesehatan, 3(6), 786–794. https://doi.org/10.25026/jsk.v3i6.659