Kejadian Mielosupresi Pada Penderita Kanker Kepala Dan Leher Yang Mendapat Kemoterapi Cisplatin Dan Carboplatin Di RSUP Dr. Kariadi Semarang
Authors: Dewi Nila Santia , Yusmawan Willy , Budiarti Rery 
Published: May 2020

Latar belakang : Kemoterapi bersifat sistemik dan non selektif sehingga tidak hanya sel kanker yang mati tetapi juga sel normal. National Comprehensive Cancer Network (NCCN) merekomendasikan Platinum-based sebagai rejimen kemoterapi untuk kanker kepala dan leher terutama Cisplatin dan Carboplatin. Cisplatin dan Carboplatin dapat menyebabkan efek samping mielosupresi.

Tujuan : Membuktikan bahwa terdapat perbedaan kejadian mielosupresi pada penderita Kanker Kepala dan Leher (KKL) yang mendapat kemoterapi Cisplatin dan Carboplatin.

Metode : Penelitian observasional dengan desain penelitian kohort prospektif di klinik THT-KL, bangsal dan bagian rekam medis instalasi rawat jalan/rawat inap RSUP Dr. Kariadi Semarang. Sampel ditentukan sebanyak 90 orang dan mendapat kemoterapi platinum based dengan salah satu komponen berupa Cisplatin atau Carboplatin sebanyak 3 seri. Analisis data dengan uji Pearson Chi-square dan Fisher’s exact test.

Hasil : Subyek penelitian 90 orang, 45 orang mendapatkan Paclitaxel Cisplatin dan 45 orang mendapatkan regimen Paclitaxel Carboplatin. Hasil penelitian ini didapatkan 48,9% pasien stadium IV, histopatologi terbanyak WHO 3 (83,3%). Rerata usia terbanyak 50-59 tahun, dan diagnosis terbanyak pada KNF (66,7%). Secara keseluruhan kemoterapi seri I menunjukkan Carboplatin menyebabkan perubahan kadar hemoglobin (p=1,000) dan leukosit (p=0,292) dengan jumlah subyek lebih banyak dibanding Cisplatin. Sedangkan pada kemoterapi seri III, Carboplatin menyebabkan perubahan kadar hemoglobin (p=<0,023), leukosit (p=0,670), dan trombosit (p=1,000) lebih banyak dibandingkan Cisplatin.

Simpulan : Kadar hemoglobin berbeda bermakna pada pasien yang mendapatkan kemoterapi Carboplatin seri III (p<0,023).

Kata kunci : Kemoterapi Cisplatin/Carboplatin., kanker kepala dan leher, mielosupresi.

 

Background : Chemotherapy is systemic and non-selective so it often results in not only cancer cells dying but normal cells will also die. The National Comprehensive Cancer Network (NCCN) recommends Platinum-based chemotherapy regimens for head and neck cancer, especially Cisplatin and Carboplatin. Cisplatin and Carboplatin chemotherapy can cause one of the side effects of myelosuppression. Myelosuppression is a decrease in cell production of leukocytes, erythrocytes, and / or platelets.   

Objective : Proving the difference incidence of myelosuppression in head and neck cancer patients receiving Cisplatin and Carboplatin chemotherapy.

Methode : An observational study with a prospective cohort study design in ENT clinic, ward and medical record department of outpatient installation Dr. Kariadi Semarang. Samples was determined by 90 people and received platinum based chemotherapy with one component in the form of Cisplatin or Carboplatin in 3 series. Data analysis by Pearson Chi-square and Fisher’s exact test.

Result : The study subjects were 90 people, 45 people received Paclitaxel Cisplatin regimen and 45 people received Paclitaxel Carboplatin regimen. The results of this study found 48.9% of patients in stage IV conditions with the most histopathological types were WHO 3 (83.3%). Overall series I chemotherapy shows Carboplatin causes changes in hemoglobin (p=1,000) and leukocyte (p=0,292) levels with a greater number of subjects than Cisplatin. Where as in series III chemotherapy, Carboplatin causes more changes in hemoglobin (p=<0,023), leukocyte (p=0,670) and platelet (p=1,000) levels than Cisplatin.

Conclusions : Hemoglobin level was significantly different in patients who received Carboplatin series III chemotherapy (p<0,023).

Keywords : Chemotherapy, head and neck cancer, myelosuppression, Cisplatin, Carboplatin.