Kejadian Demam Neutropenia pada Pasien Kanker Payudara setelah Menerima Regimen Kemoterapi TAC-G-CSF dan FAC di RSUP Dr. Hasan Sadikin Bandung

Abstract

Demam neutropenia merupakan efek samping yang sering terjadi setelah kemoterapi. Demam neutropenia dapat menyebabkan penundaan dosis kemoterapi sehingga dapat mengurangi efektivitas terapi. Kejadian demam neutropenia setelah kemoterapi dapat dicegah dengan pemberian Granulocytecolony Stimulating Factor (G-CSF). Regimen kemoterapi yang digunakan dapat memengaruhi kejadian demam neutropenia. Selain itu, usia, stadium kanker, riwayat kemoterapi dan kadar hemoglobin sebelum kemoterapi merupakan faktor risiko demam neutropenia setelah kemoterapi. Penelitian ini bertujuan untuk mengetahui perbandingan kejadian demam neutropenia regimen Dosetaksel, Doksorubisin, Siklofosfamid (TAC) dengan profilaksis primer G-CSF dan regimen Fluorourasil, Doksorubisin, Siklofosfamid (FAC) pada pasien kanker payudara di RSUP Dr. Hasan Sadikin Bandung periode Januari 2017-Juni 2019. Desain penelitian adalah cross sectional uji dua populasi. Jumlah sampel sebanyak 61 regimen TAC-G-CSF dan 102 regimen FAC. Kejadian demam neutropenia dianalisis menggunakan Chi-Square, Kruskal Wallis dan regresi logistik. Hasil penelitian menunjukkan kejadian demam neutropenia setelah kemoterapi pada regimen TAC dengan profilaksis primer G-CSF lebih tinggi dibanding pada regimen FAC. Usia, stadium kemoterapi, riwayat kemoterapi dan kadar hemoglobin sebelum kemoterapi secara statistik tidak signifikan memengaruhi kejadian demam neutropenia setelah kemoterapi.

The occurrence and risk factors of chemotherapy-induced neutropenia in patients with breast cancer not receiving primary G-CSF prophylaxis

“…Moreover, similar prior studies [ 11 – 13 , 23 , 27 , 28 ] have also incorporated various stages of breast cancer patients in their cohort. We also did not explore the risk factors for FN in our study due to the constraints on timely and measured reporting of fever development which led to under-reporting, a challenge that was encountered by previous real-world observational studies as well [ 10 – 13 ]. In our setting routine clinical assessment after chemotherapy is customarily set every 1 week.…”

“…In the literature, only few explorations conducted on the burden and predictors of CIN in Indonesian breast cancer patients. Previous studies have analysed CIN following the administration of anthracycline-based regimens, but only focused on limited clinical risk factors and had small sample size [ 10 , 15 ]. No study has explored the issues in breast cancer patients from Yogyakarta province despite the fact that the region has the most cancer prevalence in Indonesia according to the current national health survey [ 16 ].…”

“…Capturing FN rates in real-world settings outside clinical trials is often challenging since it requires that patients consistently alert their clinicians to the development of fever and be available for absolute neutrophil count (ANC) quantification. This has made previous studies investigate the predictive utility of grade 4 [10][11][12][13]. Previous meta-analysis has revealed a significant association between grade 4 CIN and FN, duration of severe neutropenia, and the nadir ANC, all of which serve as predictors of morbidity.…”

Pengaruh Kemoterapi terhadap Kadar Hematologi pada Pasien Kanker Payudara di RSUD dr. Kanujoso Djatiwibowo Balikpapan

“…Sebanyak 36 pasien (44%) berada pada stadium II, 45 pasien (55%) stadium III, dan 1 pasien (1%) stadium IV. Stadium lanjut ≥ 2 lebih berisiko terhadap penurunan kadar sel darah [7]. Sebanyak 35 pasien (40%) dengan berat badan ideal, 9 pasien (11%) obesitas, 5 pasien (6%) underweight, dan 33 pasien (40%) overweight.…”