Marpaung, Mona Galatia
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A Comparative Analysis of Internal Radiation vs Box System in Treatment Efficacy and Patient Survival of Advanced Stage Cervical Cancer Marpaung, Mona Galatia; Iskandar, Teuku Mirza; Pramono, Noor; Suhartono, Suhartono
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.942

Abstract

Objectives: To evaluate the comparative effectiveness of brachytherapy and the box system in therapeutic success and patient survival in cervical cancer, along with associated prognostic factors.Methods: This retrospective analytical study used medical records from the Obstetrics & Gynecology Oncology Clinic and Radiotherapy Unit at Dr. Kariadi General Hospital in Semarang. The study included cervical cancer patients with stage IIB-IIIB disease who were treated between January 2017 and December 2022. Data analysis involved both statistical methods and survival analysis using the Kaplan-Meier approach.Results: During the 2017-2022 study period, a total of 939 patients with stage IIB-IIIB cervical cancer who completed full radiation therapy were evaluated for their 2-year survival rate. The cohort included 89 patients in the box system group and 850 in the brachytherapy/internal radiation group. Complete response was achieved in 46.1% of box system patients compared to 75.5% in the brachytherapy group (p<0.0001); partial response rates were 53.9% and 24.5%, respectively. Kaplan-Meier analysis showed a 2-year survival rate (2 YSR) of 41.6% for the box system and 64.0% for brachytherapy. The mean survival time was 15.37 months for the box system and 19.09 months for brachytherapy.Conclusion: Internal radiation therapy (brachytherapy) showed significantly better clinical outcomes compared to the box system approach. It resulted in a longer mean survival time (19.09 vs 15.37 months; p<0.001) and higher 2-year survival rates (64.0% vs 41.6%; log-rank p<0.001).Keywords: Cervical cancer, box system, brachytherapy, therapy response, survivalPerbandingan antara Radiasi Interna vs Box System dalam KeberhasilanTerapi dan Kelangsungan Hidup Pasien Kanker Servik Stadium LanjutAbstrakTujuan: Penelitian ini bertujuan untuk mengetahui perbandingan radiasi interna dan box system dalam keberhasilan terapi dan kelangsungan hidup pasien kanker serviks serta faktor-faktor yang memengaruhi.Metode: Penelitian ini menggunakan metode analitik retrospektif dengan menggunakan rekam medis Poli Kandungan dan Onkologi dan Instalasi Radioterapi RSUP Dr. Kariadi Semarang. Subyek penelitian adalah pasien kanker servik stadium IIB-IIIB mulai periode januari 2017-Desember 2022. Analisis statistika menggunakan analisis analitik dan analisis survival menggunakan metode Kaplan Meier.Hasil: Hasil penelitian menunjukkan bahwa selama tahun 2017– 2022 didapatkan total 939 pasien dengan diagnosis kanker servik stadium IIB-IIIB yang menjalankan terapi radiasi lengkap dan dapat dilakukan evaluasi survival rate 2 tahun. Total subjek pada kelompok box system sebanyak 89, sedangkan kelompok brakiterapi/radiasi interna sebanyak 850 subjek. Respon terapi komplet sebesar 46,1% pada kelompok box system, dan 75,5% pada kelompok radiasi interna, respon terapi parsial 53,9% pada kelompok box system dan 24,5% pada kelompok radiasi interna, dengan nilai p <0.0001. Analisis survival dengan metode Kaplan -Meier didapatkan 2-YSR 41,6% pada kelompok Box system, sedangkan 64% pada kelompok radiasi interna sedangkan mean survival time pada kelompok box system 15,37 bulan dan kelompok radiasi interna 19,09 bulan dengan nilai p <0.001Kesimpulan: Pemberian radiasi interna memberikan keberhasilan terapi klinis yang lebih tinggi dengan nilai mean survival time lebih tinggi. Pemberian radiasi interna memberikan kelangsungan hidup 2 tahun sebanyak 64%, sedangkan box system sebanyak 41,6%Kata kunci: Kanker servik, box system, brakiterapi, respon terapi, survival   
Baseline hemoglobin as a prognostic factor for radiotherapy outcomes and survival in advanced cervical cancer at Dr. Kariadi General Hospital, Semarang, Indonesia Marpaung, Mona Galatia; Iskandar, Teukur Mirza; Pramono, Noor; Suhartono
Majalah Obstetri & Ginekologi Vol. 34 No. 1 (2026): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V34I12026.16-22

Abstract

HIGHLIGHTS Baseline hemoglobin level is a relevant predictive factor in cervical cancer management, emphasizing the importance of maintaining optimal hematological status to enhance therapeutic effectiveness and improve patient survival. Patients with hemoglobin levels =11 g/dL demonstrated higher two-year survival rates and longer median survival times compared with those with levels <11 g/dL, supporting the role of hemoglobin as an important prognostic indicator of long-term clinical outcomes.   ABSTRACT Objective: This study aimed to evaluate the relationship between baseline hemoglobin concentration and the effectiveness of radiotherapy in patients with advanced cervical cancer, with emphasis on survival outcomes and therapeutic response. Materials and Methods: A retrospective observational study was conducted using medical records from the Oncology Clinic and Radiotherapy Unit between January 2017 and December 2022. Eligible subjects included women diagnosed with stage IIB–IIIB cervical cancer who had completed radiotherapy, either alone or combined with chemotherapy. Hemoglobin levels were compared between treatment groups using the chi-square test. Survival probabilities were assessed using Kaplan–Meier analysis and compared with the log-rank test, with p <0.05 considered statistically significant. Results: A total of 939 patients met the inclusion criteria. Among them, 89 patients received box system radiotherapy and 850 underwent brachytherapy. Hemoglobin levels <11 g/dL were observed in 55.1% of patients in the box system group and 42.7% in the brachytherapy group. Conversely, hemoglobin levels ≥11 g/dL were more frequent in the brachytherapy group (57.3%) than in the box system group (44.9%) (p = 0.034). Patients with hemoglobin levels ≥11 g/dL had a higher two-year survival rate (67.4%) compared with those with hemoglobin levels <11 g/dL (54.9%). Mean survival time was also longer in patients with higher hemoglobin levels (19.8 vs 17.4 months). Conclusion: Baseline hemoglobin level is significantly associated with radiotherapy outcomes and survival in advanced cervical cancer. Higher hemoglobin levels (≥11 g/dL) are associated with improved survival and reduced mortality, highlighting its role as an important prognostic indicator. Maintaining adequate hemoglobin levels may improve treatment effectiveness and clinical outcomes.