Photodynamic therapy (PDT) pada penderita karsinoma nasofaring: kajian angka harapan hidup

Abstract

Latar belakang: Terapi karsinoma nasofaring (KNF) yang adekuat dan efektif tidak selalu tercapaidi negara berkembang. Ketersediaan alat radioterapi yang tidak seimbang dengan jumlah penderita KNFmenyebabkan keterlambatan jadwal terapi, sehingga berakibat pada buruknya hasil terapi. Alternatifterapi lain perlu dikembangkan untuk mengatasi permasalahan tersebut. Photodynamic therapy (PDT)telah digunakan untuk terapi tambahan pada berbagai kanker, termasuk KNF residu maupun rekuren.

Tujuan: Mengetahui respon terapi lokal dan angka harapan hidup 5 tahun penderita KNF residu ataurekuren yang mendapatkan PDT.

Metode: Kohort retrospektif dengan data rekam medis penderita KNFresidu atau rekuren yang mendapatkan PDT di Departemen THT-KL RSUP Dr. Sardjito Yogyakarta tahun2005–2011.

Hasil: Local response rate sebesar 83,9% dan angka harapan hidup 5 tahun penderita sebesar60,7%. Angka harapan hidup 5 tahun penderita laki-laki lebih tinggi (73,5%) dibandingkan penderitaperempuan (42,2%), perbedaan ini bermakna secara statistik (p=0,045). Angka harapan hidup 5 tahunpenderita berusia <40 tahun lebih tinggi (76,2%) dibandingkan penderita berusia > 40 tahun (53,0%),meskipun tidak signifikan (p=0,417). Angka harapan hidup penderita yang masih terdapat tumor padanasofaring lebih baik (80%) dibandingkan penderita dengan hasil biopsi nasofaring negatif (57,8%),namun tidak signifikan (p=0,638). Angka harapan hidup penderita berdasarkan stadium saat ditegakkandiagnosis KNF, penderita stadium awal mempunyai angka harapan hidup lebih kecil (53,3%) dibandingkanpenderita stadium lanjut (62,1%), meskipun tidak signifikan (p=0,521).

Kesimpulan: Local responserate PDT 83,9% dan angka harapan hidup 5 tahun sebesar 60,7%. PDT merupakan modalitas terapi yangefektif untuk KNF residu maupun rekuren.

Kata kunci: Karsinoma nasofaring, photodynamic therapy, angka harapan hidup

ABSTRACT

Background: Adequate and effective nasopharyngeal carcinoma (NPC) treatment cannot bereached in developing countries. The lack of radiotherapy apparatus cause delayed treatment thatbring about bad treatment results. An alternative treatment modality should be created to overcome theproblem. Photodynamic therapy (PDT) has been conducted for many malignancies including recurrentor residual NPC.

Purpose: To find out the local response rate and 5-year overall survival amongrecurrent or residual NPC patients who got PDT.

Method: Retrospective cohort, data was taken frommedical records of patients with PDT in ENT-H&N Surgery Department Sardjito Hospital since 2005until 2011.

Results: Local response rate was 83.9%. Five-year overall survival was 6.7%. The 5-yearoverall survival among men was significantly higher than women (73.5%:42.2%) p=0.045. The 5-yearoverall survival among patients <40 years old was higher than patients > 40 years old (76.2%:53.0%)even though it was not significant (p=0.417). The 5-year overall survival among patients with tumor washigher than patients without tumor (80%:57.8%) although it was not significant (p=0.638). The 5-yearoverall survival among patients with previous early stage NPC was lower than previous advanced stage (53.3%:62.1%) although it was not significant (p=0.521).

Conclusion: Local response rate of PDT was83.9% and the 5-year overall survival was 60.7%. PDT was found as an effective treatment modalityfor recurrent or residual NPC.

Keywords: Nasopharyngeal carcinoma, photodynamic therapy, 5-year overall survival