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Results in Journal Indonesian Journal of Cancer: 79

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Widiyono Widiyono, Sri Setiyarini, Christantie Effendy
Indonesian Journal of Cancer, Volume 13, pp 59-68; doi:10.33371/ijoc.v13i3.632

Abstract:
Background: Depression is a psychological distress that often occurs on cancer patients. Depression can increase patient perception about pain, resulting reduced drug efficacy and longer length of stay. Drug treatment for depression sometimes has side effects. Another intervention to decrease depression on cancer patients is music therapy. Music therapy might avoid polypharmacy in cancer patients. The purpose of this study was to determine the effects of self-selected individual music therapy toward depression of cancer patients.Methods: The method used in this study was the randomized control trial (RCT). Simple Random Sampling was assigned randomly by three researcher assistants to participants (N=70) of intervention and control group. The intervention used was self-selected individual music therapy (SeLIMuT). SeLIMuT was applied four times in 2 days with a duration of 15 minutes each session. Beck Depression Inventory (BDI) was employed for selection purposes. The data were analyzed using Mann-Whitney with p < 0.05 and 95% CI. The effectiveness of therapy was analyzed by the effect size test using abs r.Results: Based on the result of the bivariate analysis, there was an effect of giving self-selected individual music therapy to reduce depression with depression gap in both groups with p-value of 0.001 (p < 0.05). The value of the effect test obtained abs r = 0.82 (r > 0.5). At the end, the self-selected individual music therapy had moderate effect toward depression of cancer patients.Conclusions: Music therapy is safe, inexpensive, and easy to use, for and by patients. The nurse can safely recommend any of these interventions for depression on cancer patients. Specific selections or types of music may have different effects on different patients and may provide different effects at different time, so the use of self-selected individual music therapy is recommended.
Rinto Hariwibowo, Agus Rizal Ah Hamid, Chaidir Arif Mochtar
Indonesian Journal of Cancer, Volume 13, pp 75-79; doi:10.33371/ijoc.v13i3.656

Abstract:
Background: The variation of sizes, shapes, and location of kidney cancer complicates the choices of surgical treatment.To determine which technique to use, R.E.N.A.L. nephrometry scoring systems were established. This study was conducted to evaluate R.E.N.A.L.-NS profile in kidney cancer patients at CMHMethod: The data were collected retrospectively from patients that underwent both open and laparoscopic Radical (RN) and Partial Nephrectomy (PN) procedure from 2014-2017. R.E.N.A.L.-NS was calculated based on (R)adius, (E)xophytic/ Endophytic properties, (N)earness to the collecting system, (A)nterior or Posterior position of the tumor, and (L)ocation of the tumor. It was categorized into three complexity: low (4-6 points), medium (7-9 points), and high (10-12 points). Subjects then divided based on the procedure given. Profile of R.E.N.A.L.-NS was shown based on each procedure.Result: In this study, 63 patients were included. 52 underwent RN and 11 underwent PN. In low complexity tumors, all patients received PN. In medium complexity tumors, 22 (78.5%) patients received RN and 6 (21.5%) received PN. All high complexity tumors received RN. Mean renal score in all patient 9.03 (+1.72), RN 9.59 (+1.11), PN 6.36 (+1.6). Higher (R), (N), and (L) scores mean a higher prevalence of RN.Conclusion: Higher complexity tumors were more likely to be treated with RN. Furthermore, (R), (N), and (L) score can be useful to determine RN or PN as a treatment of choice. This study could be used as a reference to another study regarding R.E.N.A.L.-NS in Indonesia.
Rendy Cahya Soetanto, Muhammad Naseh Budi, Darmadji Ismono
Indonesian Journal of Cancer, Volume 13, pp 91-95; doi:10.33371/ijoc.v13i3.663

Abstract:
Background: Pelvic chondrosarcoma may be difficult to manage due to its proximities with vital structures. The study aimed to explain an alternative surgical technique for acetabular reconstruction.Case Presentation: We present a case of a 48-year-old female with large chondrosarcoma of the superior and inferior pubic rami with medial acetabular wall involvement. Pelvic type 3 resection was performed. There was a defect at medial acetabulum after resection. The defect was covered by autograft from iliac and fixation using screws. Rotational pelvic stability was maintained using a reconstruction plate. The functional outcome was assessed 6 months after operation using MSTS and the score was 30, which was painless, full weight bearing, normal gait, and no pain. Conclusions: Reconstruction of the pelvis after tumor resection requires a careful preoperative patient evaluation and extensive bone and soft tissue resection to achieve negative tumor margins and stable reconstruction of the osseous and soft tissue defects.
Rizki Kamalia, H Mihardja, Adiningsih Srilestari, Atikah C Barasila, Husniah Rubiana Thamrin Akib
Indonesian Journal of Cancer, Volume 12, pp 23-30; doi:10.33371/ijoc.v12i1.551

Abstract:
Background: Breast cancer patients often experience decreased the immune system such as a decreased of lymphocytes, which can increase mortality. Acupuncture is expected to be a therapeutic option to increase lymphocyte because current pharmacological therapy is very expensive with the risk of adverse event. This study aims to prove the action of Electroacupuncture (EA) as an immunomodulator for cellular immunity by increasing the percentage of lymphocytes of Peripheral Blood Smear (PBS) in C3H mice of breast adenocarcinoma model. Methods:Laboratory experimental study with post test only controls group design involving twenty PBS preparations taken from 20 C3H mice of breast adenocarcinoma models divided into 4 groups. Group K with no EA treatment, group P1 was given 1 time EA treatment, group P2 was given 2 times EA treatment and P3 was given 3 times EA treatments (with seven days interval). EA stimulation was performed at ST36 Zusanli, BL18 Ganshu, BL20 Pishu with frequency of 2 Hz for 15 minutes. Result:The mean weight of mice was 23.90 ± 3.03 gr in control group, 25.40 ± 1.54 gr in P1 group, 27.00 ± 3.87 gr in P2 group and 25.90 ± 5.83 gr in P3 group, with most of them were female mice. The mean volume tumor in mice of control group was 14.49 ± 2.75 mm3, 16.72 ± 6,40 mm3 in P1 group, 20.18 ± 5.94 mm3 in P2 group and 22.07 ± 6.51 mm3 in P3 group. The mean percentage of lymphocyte was 44.20 ± 15.72 in control group, 43.00 ± 11.70 in P1 group, 49.60 ± 7.02 in P2 group and 43.20 ± 13.10 in P3 group. The correlation between the number of electro­acupuncture treatments on the number of lymphocytes in the treatment group were compared to the control group with p = 0.811. Conclusions: Research acupuncture on cancer management has been done and provided good result. Acupuncture in particular EA has benefits in improving immunity by affecting lymphocyte enhancement. Acupuncture can be considered as adjuvant therapy in cancer patients breast. ABSTRAKLatar Belakang: Pada pasien kanker payudara sering terjadi penurunan sistemimun antara lain menurunnya limfosit, yang dapatm eningkatkan angka kematian. Akupunktur diharapkan dapat menjadi pilihan terapi untuk meningkatkan limfosit karena terapi farmakologi saat ini harganya sangat mahal dengan resiko efek samping. Penelitian ini bertujuan untuk membuktikan bahwa tindakan elektroakupunktur (EA) dapat berefek sebagaii mmunomodulator terhadap imunitas seluler dengan meningkatkan persentase limfosit sediaan apus darah tepi (SADT) pada mencit C3H model adenokarsinoma payudara. Metode: Penelitian eksperimental ini dilakukan dengan post test only control group design terhadap dua puluh sediaan apus darah tepi yang diambil dari 20 mencit C3H model adenokarsinoma payudara. Kelompok studi dibagi menjadi 4 kelompok yaitu Kelompok K tidak diberi perlakuan EA, kelompok P1 dilakukan EA 1 kali, kelompok P2 dilakukan EA 2 kali dan P3 dilakukan EA 3 kali. Tindakan EA dilakukan pada titik ST36 Zusanli, BL18...
I Made Dira Swantara, Wiwik Susanah Rita, Anisa Hernindya
Indonesian Journal of Cancer, Volume 10, pp 123-129; doi:10.33371/ijoc.v10i4.456

Abstract:
Isolation, anticancer activity test, and identification of the toxic isolate from ethanol extract of the sponge Hyrtios erecta taken from Pari Island beach (Jakarta) has conducted. Extraction of the sponges was carried out by 70% ethanol at room temperature. Partition and purification of the compounds were done by column chromatography with the stationary phase of silica gel and the mobile phase of n-hexane-chloroform (2:8). Toxicity screening test was done based on BhrineShrimp Lethality Test (BSLT). In vitro anticancer activity test of the isolate was carried out using HeLa cell line. Identification of the compounds was performed by Gas chromatography-mass spectroscopy (GC-MS). Based on theresults, it was found that the toxic isolate of H. erecta sponges has anticancer activity with IC50 of 30,497 ppm. Four compounds was detected from the anticancer isolate i.e: 4-nonylphenol; dibutyl phthalate; hexanedioic acid bis(2-ethylhexyl) ester; and cholesterol. ABSTRAKTelah dilakukan isolasi, uji aktivitas antikanker, dan identifikasi isolat toksik yang berasal dari ekstrak etanol spons Hyrtios erecta yang diambil dari perairan Pulau Pari (Jakarta). Ekstraksi dilakukan dengan cara maserasi menggunakan etanol 70% pada temperatur kamar. Pemisahan dan pemurnian komponen menggunakan kromatografi kolom dengan fase diam silikagel dan fase gerak n-heksana-kloroform (2:8). Skrining toksisitas dilakukan dengan metode Bhrine Shrimp Lethality Test (BSLT). Uji antikanker secara in vitro isolat toksik tersebut menggunakan sel HeLa. Senyawanya diidentifikasi menggunakan Gas chromatography-mass spectroscopy (GC-MS). Berdasarkan hasil penelitian ini diperoleh bahwa isolat toksik spons H. erecta bersifat antikanker dengan IC50 sebesar 30,497 ppm. Pada isolat antikankertersebut terdeteksi empat senyawa, yaitu 4-nonylphenol; dibutil phtalat; ester heksadioat bis(2-etilheksil); dan kolesterol.
Widiastuti Widiastuti, Rachmi Fauziah Rahayu, Djoko Susianto, Rita Budianti, Heru Priyanto, Ambar Moedigdo, Soegiartiningsih Soegiartiningsih
Indonesian Journal of Cancer, Volume 12, pp 31-35; doi:10.33371/ijoc.v12i1.552

Abstract:
Orbital metastases of cervical cancer cell are very rare. There is only one case reported in Dr. Moewardi Public Hospital Surakarta between 1999 and 2017. A 45-year-old woman was admitted with the upper right orbital lesion. She had not received a routine gynecologic examination for more than 10 years. She had normal chest X-ray. Abdominal ultrasonography revealed a heteroechoic lesion poor defined edge in cervix utery expands to corpus utery and rectum. Bilateral uropathy obstruction occured. Bone survey demonstrated osteolytic bone metastasis in the right supra orbital bone and a compression fracture of the twelfth thoracal spine. Head and orbital Computed Tomography (CT) scan, which revealed multiple metastatic lesions in the right orbital expanding to extra cranial, was performed. Our diagnosis was cervical cancer FIGO IV-B stage with distant metastasis thus chemoradiation was given. The aim of this report is to give more references regarding this complicated clinical condition. ABSTRAKKanker serviks metastasis ke orbita sangat jarang terjadi. Hanya satu kasus yang dilaporkan di Rumah Sakit Umum Daerah Dr. Moewardi Surakarta antara tahun 1999 - 2017. Seorang wanita usia 45 tahun dirawat oleh karena lesi di orbita kanan atas sejak 2 bulan yang lalu. Pasien tersebut belum pernah mendapatkan pemeriksaan kandungan rutin selama lebih dari 10 tahun. Foto Chest X Ray normal. Ultrasonografi abdomen tampak lesi heteroekoik batas tak tegas pada serviks uterus meluas ke korpus uterus dan rektum. Terjadi obstruksi uropati kanan dan kiri. Bone survei memperlihatkan gambaran metastasis tipe litik pada tulang supra orbita kanan dan fraktur kompresi pada tulang belakang toraks ke dua belas. Computed Tomography (CT) Kepala dan Orbita memperlihatkan beberapa lesi metastasis pada supra orbita kanan yang meluas ke tulang tengkorak. Diagnosis kami adalah kanker serviks tahap FIGO IV-B dengan metastasis jauh dan diberikan therapi kemoradiasi. Tujuan penulisan ini adalah untuk memberikan lebih banyak referensi data tentang kondisi klinis yang rumit ini.
Rovi Anggoro, Etty Hary Kusumastuti
Indonesian Journal of Cancer, Volume 12, pp 15-22; doi:10.33371/ijoc.v12i1.550

Abstract:
Background: Colorectal adenocarcinoma is the third most common cancer in the world with increasing incidence in Indonesia. Most presented ones were in late stage with more unfavorable prognosis. It is necessary to evaluate new markers for prognosis, identify staging and new possibilities for targeted therapy. Over-proliferating tumor cells will enhance the expression of CXCR4, a chemokine receptor. Activating CXCR4 will further activate various downstream signaling pathways, including one which will increase MMP13 secretion through MAPK/ERK signaling pathway. MMP13 then will degrade extracellular matrix, thus facilitate the migration or metastasis of tumor cells. Methods: A cross sectional study, conducted on 32 samples of colorectal adenocarcinoma. The samples were divided into four groups based on the Dukes staging system (A, B, C and D) and stained immunohistochemically with antibody against CXCR4 and MMP13. The expressions were assessed using immunoreactive score (IRS) and were statistically analyzed. Results: There were positive correlation between the expression of CXCR4 and MMP13 with Dukes staging, with rs = 0,628 and rs = 0,597, respectively. The expression of CXCR4 positively correlated with the expression of MMP13 with rs = 0,670 (p = 0,05). Conclusions: CXCR4 and MMP13 expressions were proven to correlate with the depth of invasion and migration of tumor cells in colorectal adenocarcinoma, hence could be considered as prognostic markers, however both could not be used as predictive marker for staging. Tailored therapies targeting these two proteins could be an interest for further investigation. ABSTRAKLatar Belakang: Adenokarsinoma kolorektal adalah keganasan terbanyak ketiga di dunia, dengan insidensi semakin meningkat di Indonesia. Sebagian besar kasus terdeteksi pada stadium lanjut dengan prognosis buruk. Diperlukan penemuan marker baru yang dapat membantu penentuan stadium, prognosis dan kemungkinan terapi target yang baru. Sel tumor yang berproliferasi berlebihan akan menyebabkan peningkatan ekspresi CXCR4, suatu reseptor kemokin. Aktivasi CXCR4 akan meningkatkan pelepasan proteinase MMP13 melalui jalur MAPK/ERK. MMP13 akan mendegradasi matriks ekstraseluler sehingga menyebabkan migrasi atau metastasis sel tumor. Metode: Studi cross sectional, dilakukan pada 32 sampel adenokarsinoma kolorektal. Sampel dibagi menjadi 4 grup; stadium Dukes A, B, C dan D. Dilakukan pulasan imunohistokimia dengan antibodi CXCR4 dan MMP13, ekspresi keduanya dinilai menggunakan immunoreactive score (IRS) dan dianalisis secara statistik. Hasil: Didapatkan korelasi positif bermakna antara ekspresi CXCR4 dan MMP13 dengan stadium Dukes, dengan rs = 0,628 dan rs = 0,597. Ekspresi CXCR4 berkorelasi positif dengan ekspresi MMP13 dengan rs = 0,670 (p = 0,05). Kesimpulan: Ekspresi CXCR4 dan MMP13 terbukti berkorelasi dengan kedalaman invasi dan migrasi sel ganas pada adenokarsinoma kolorektal. Keduanya dapat dipertimbangkan sebagai marker prognostik namun...
Marliana Sri Rejeki, Wawaimuli Arozal, Rianto Setiabudy, Djumhana Atmakusuma
Indonesian Journal of Cancer, Volume 12, pp 60-66; doi:10.33371/ijoc.v12i2.581

Abstract:
Background: Cisplatin has a potency of causing nephrotoxicity. Serum BUN and creatinine levels have been well-known for detecting kidney dysfunction; while KIM-1 and NGAL urine levels are relatively new measurements. The study was aimed to evaluate urinary KIM-1 and NGAL level to detect kidney dysfunction in patients with advanced stage NPC who received cisplatin-based chemotherapy.Methods: The study was a cohort-prospective study with 3 subject groups, i.e. patients who had never received and who had received 75-100 mg/m2 cisplatin-based chemotherapy as well as those who had never received 40 mg/m2 cisplatin-based chemotherapy. The levels of urinary KIM-1, NGAL and serum level of BUN and creatinine were measured before and after receiving cisplatin. Statistical analyses were ANOVA, Pearson, Spearman, Kolmogorov-Smirnov test and SPSS version 22.0.Result: There was a significant difference of delta BUN level (p=0.0001) and delta urinary NGAL level (p = 0.025) before and after treatment in all three groups; while delta KIM-1 level showed no significant difference in all three groups (p=0.275). Cisplatin may cause accumulated nephrotoxicity, which has dose-dependent manner.Conclusion: Measuring urinary NGAL level can detect an early stage of kidney dysfunction; however, it still cannot replace the role of BUN. Measurement of urinary KIM-1 level cannot detect kidney dysfunction.
Arifin Musthafa, Fielda Djuita, Iin Kurnia
Indonesian Journal of Cancer, Volume 12, pp 47-51; doi:10.33371/ijoc.v12i2.576

Abstract:
Background: Exposure ionizing of radiation in radiation workers has the potential to cause DNA damage in the form of double strand break as the beginning of genomic instability. DNA damage can be observed with γ-H2AX as the biomarker of DNA double strand breaks (DSBs). The formation of γ-H2AX in the nucleus can occur after radiation exposure of 1 mGy. This study aims to determine the radiation effects in radiation work environments as a study of adaptive responses of peripheral blood mononuclear cell (PBMCs) after radiation by observing γ-H2AX foci expression.. Methods: Blood samples from nine radiation workers and nine non-radiation workers were irradiated with doses 0 Gy, 1 Gy, 1.5 Gy, and 2 Gy. Detection of γ-H2AX foci was done by immunofluorescence assay. The mean of γ-H2AX foci was counted in 50 PBMCs per sample. The comparison mean of γ-H2AX foci was analyzed using tindependent test. Result: Based on the result study, there were no significant differences in the number of γ-H2AX foci without treatment (p = 0.807). The results of study showed that the formation of 2-3 foci per cell after exposure of 2 Gy increases along with the increasing irradiation doses. Conclusion: The mean of index of γ-H2AX foci in PBMCs within normal limits between non-radiation workers and radiation workers and level of risk DSBs damage is relatively similar after exposure at doses 1 Gy, 1.5 Gy, and 2 Gy.
Ayu Tyasmara, Willy Sandhika
Indonesian Journal of Cancer, Volume 12, pp 1-5; doi:10.33371/ijoc.v12i1.548

Abstract:
Background: Breast carcinoma dynamics can be seen from the inflammatory mediator produced and some of expressed cytokine mediators mostly found in breast cancer tissues are TNF-α and TGF-β. This research analyzed TNF-α and TGF-β influence in axillary lymph nodes metastasis to prove the role of cytokines in breast cancer dynamics and to be taken as prognosis. Methods: This research used paraffin block of breast carcinoma in various stages of axillary lymph nodes metastasis and TNF-α and TGF-β antibody to observe the expressions. Result: There were significant differences in TNF-α expressions improvement with p < 0.05 in lymph nodes metastasis N1 (13.18%) and TNF-α expressions reduction in lymph nodes metastasis N2 (52.27%) and N3 (27.27%) compared with lymph nodes without metastasis (52.73%). There were no significant differences in TGF-β expressions of all N groups. Conclusion: The result stated that TNF-α cytokines can be used as biomarker independently predicting breast carcinoma prognosis and progressivity. ABSTRAKLatar Belakang: Dinamika karsinoma payudara tercermin dari mediator inflamasi yang dihasilkannya dan salah satu mediator sitokin yang terekspresi banyak pada jaringan tumor payudara adalah TNF-α and TGF-β. Kami menganalisis pengaruh TNF-α dan TGF-β pada metastasis kelenjar getah bening aksila untuk membuktikan peran sitokin dalam dinamika kanker payudara dan untuk dimanfaatkan sebagai alat prognosis. Metode: Penelitian ini menggunakan blok parafin karsinoma payudara pada berbagai stadium metastasis kelenjar getah bening aksila dan menggunakan antibodi TNF-α dan TGF-β untuk mendeteksi ekspresinya. Hasil: Hasil penelitian ini didapatkan perbedaan peningkatan ekspresi TNF-α yang signifikan dengan p < 0,05 pada metastasis kelenjar getah bening N1 (73,18%) dan penurunan ekspresi TNF-α pada metastasis kelenjar N2 (52,27%) dan N3 (27,27%) dibandingkan dengan tanpa metastasis (52,73%). Tidak ada perbedaan signifika n pada ekspresi TGF-β antar semua kelompok N. Kesimpulan: Hasil ini menyatakan sitokin TNF-α dapat dipakai sebagai biomarker untuk memprediksi progresifitas dan prognosis karsinoma payudara secara independen
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