Pengaruh Radioterapi Terhadap Kadar TSH dan T4 pada Pasien Tumor Ganas Kepala dan Leher

Abstract

Latar belakang: Tumor ganas kepala dan leher adalah tumor ganas yang berasal dari epitel traktus aerodigestif atas. Radioterapi adalah salah satu modalitas talaksana pada tumor ganas kepala dan leher. Kelenjar tiroid akan terpapar radioterapi selanjutnya merangsang terjadinya kelainan pada kelenjar tiroid. Hipotiroid merupakan efek samping yang paling umum terjadi akibat radioterapi. Diagnosis hipotiroid ditegakkan melalui pemeriksaan laboratorium yaitu didapatkan peningkatan TSH dan penurunan T₄. Tujuan: Mengetahui pengaruh radioterapi terhadap kadar TSH dan T₄ pasien tumor ganas kepala dan leher di RSUP Dr. M. Djamil, Padang. Metode: Analitik cross sectional dengan desian pre and post test only pada                            10 responden tumor ganas kepala dan leher. Sampel berupa darah vena yang dihitung kadar TSH dan T₄ menggunakan alat Vidas 3. Data dianalisis dengan uji t berpasangan. Hasil analisis statistik dinyatakan bermakna bila didapatkan hasil p<0,05. Hasil: Nilai rerata kadar TSH sebelum dan setelah radioterapi didapatkan 0,57 ± 0,512 µIU/ml. Nilai rerata kadar T₄ sebelum dan setelah radioterapi didapatkan 0,721 ± 0,508 µg/dL. Uji t bepasangan didapatkan peningkatan rerata kadar TSH setelah radioterapi dengan p = 0,004 yang menunjukkan peningkatan bermakna rerata kadar TSH setelah radioterapi dan didapatkan penurunan rerata kadar T₄ setelah radioterapi dengan p = 0,001 yang menunjukkan penurunan bermakna rerata kadar T₄ setelah radioterapi. Kesimpulan: Terdapat peningkatan bermakna rerata kadar TSH serta penurunan rerata kadar T₄ sebelum dan setelah radioterapi pada pasien tumor ganas kepala dan leher walau belum melewati nilai normal.

ABSTARCT

Background: Head and neck cancers are malignancies that originate from upper aerodigestive tract epithelium. Radiotherapy is one of the modalities treatments for head and neck cancer. Thyroid glands which exposed by radiotherapy, furthermore can induce abnormalities. Hypothyroid is a most common abnormality that occur after radiotherapy. Diagnosis hypothyroidism can be established through laboratory examination that is obtained an increased levels of TSH and decreased levels of T₄. Purpose: To determine effect radiotherapy on levels of TSH and T₄ in patients with head and neck cancer in Dr. M. Djamil Hospital, Padang.     Methods: Cross sectional analytic study with pre and post test only on 10 respondents with head and neck cancer. Samples taken from venous blood then TSH and T₄ were counted with Vidas 3. Data was analyzed with paired t-test. The statistical result was significant with p<0,05.             Result: Mean value of TSH before and after radiotherapy is 0,57 ± 0,512 µUI/ml. Mean value of T₄ before and after radiotherapy is 0,721 ± 0,508 µg/dL. From paired t-test resulted an increase of TSH mean value after radiotheraphy with p = 0,004 which implies a significant enhancement of TSH mean value after radiotheraphy and decreasing T4 mean value after radiotheraphy with p = 0,001 which implies a significant deflation of T₄ mean value after radiotheraphy. Conclusions: There was significant enhancement of TSH mean and significant deflation of T₄ mean value before and after radiotherapy on patients with head and neck cancer even still within normal value.

Keywords: Radiotheraphy, TSH, T_4, head and neck cancer.