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All Journal Medical Journal of Indonesia Oto Rhino Laryngologica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Indonesian Journal of Cancer Jurnal Penyakit Dalam Indonesia
Rahmat Cahyanur
Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo General Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Kerentanan dan Kanker pada Usia Lanjut: Sebuah Tantangan Cahyanur, Rahmat
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
Publisher : UI Scholars Hub

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Abstract

Peran radioterapi lokoregional pada kasus karsinoma nasofaring dengan metastasis jauh: laporan serial kasus berbasis bukti Mayangsari, Ika Dewi; Rahman, Muhammad Ade; Adham, Marlinda; Prajogi, Gregorius Ben; Cahyanur, Rahmat; Safitri, Eka Dian
Oto Rhino Laryngologica Indonesiana Vol. 53 No. 2 (2023): VOLUME 53, NO. 2 JULY - DECEMBER 2023
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v53i2.638

Abstract

Background: Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer primarilytreated with platinum-based chemotherapy. The oligometastasis hypothesis proposed by Hellman andWeichselbaum suggested that controlling the primary tumor through locoregional radiotherapy couldsignificantly improve prolonged disease-free survival. Purpose: To evaluate the effectiveness of combining locoregional radiotherapy with chemotherapy for metastatic NPC. Case series report: The first case involved a 57-year-old male with NPC at T4N3M1 (lungs) with partial response to chemotherapy, who then underwent concurrent chemoradiotherapy. However, his condition deteriorated after completing chemoradiation. The second case featured a 56-year-old male with NPC at T4N3M1 (liver), exhibiting partial response to chemotherapy and remaining at a stable condition after concurrent chemoradiotherapy. Method: Using specific keywords based on clinical questions in the PubMed, Cochrane, EBSCOhost, and Proquest databases. Inclusion criteria, exclusion criteria, and critical appraisal were carried out to find relevant studies. Result: Eleven articles were appraised critically based on the Oxford Centre for Evidence-based Medicine (CEBM) worksheet and include the validity, importance, and applicability in clinical scenarios. Conclusion: Metastatic NPC patients had better overall survival outcomes when treated with locoregional radiotherapy and systemic chemotherapy. Predictive factors influencing survival included oligometastasis, locoregional radiotherapy, chemotherapy response, lactate dehydrogenase, C-reactive protein, EBV DNA, total chemotherapy administration, Karnofsky performance score, number of metastatic lesions, and liver metastases. Platinum-based chemotherapy combined with locoregional radiotherapy could be considered as a management approach for cases of oligometastatic NPC.Keywords: nasopharyngeal carcinoma, chemotherapy, metastasis, overall survival, radiotherapy
Association between immune system parameter and clinical characteristics among patients with solid cancer Cahyanur, Rahmat; Widhani, Alvina; Pantoro, Nico Iswanto; Madadika, Annisa Tsana
Medical Journal of Indonesia Vol. 33 No. 2 (2024): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247272

Abstract

BACKGROUND Lymphopenia has been reported to be a major predictor of chemotherapy-related toxicity. This study aimed to investigate the correlation between neutrophils, lymphocytes, CD4, and CD8 in solid cancer patients and cancer clinical characteristics. METHODS This was a cross-sectional study of patients who will undergo chemotherapy at the Hematology and Medical Oncology Clinic, Cipto Mangunkusumo Hospital, from June to September 2023. Clinical characteristics, CD4 and CD8 levels, and neutrophil and lymphocyte counts were assessed at the first visit. A comparative test was carried out on the patients’ average CD4, CD8, neutrophil, and lymphocyte counts. RESULTS Types of cancer were associated with CD4 levels. Patients with head and neck cancer had lower CD4 levels (411.3 [119.3–1,427.5] cells/mm³) compared with colorectal (514.7 [129.2–861.3] cells/mm³), breast and gynecological (567.5 [180.1–939 cells/mm³), and other cancers (681.4 [175.1–2,056.9] cells/mm³), with p = 0.009. Patients aged ≥40 years had higher CD8 levels than those aged <40 years (376.4 [142.8–1,293.1] cells/mm³ versus 565.3 [185.9–1,944] cells/mm³, p = 0.01). Additionally, lymphocyte count was associated with cancer type, with the lowest number in head and neck cancer (1,380 [280–2,660] μl, p = 0.044). CONCLUSIONS CD4 levels and lymphocyte counts were associated with the cancer type, whereas CD8 levels were influenced by age.
Co-Authors Affadhia, Hanna Lianti Alvina Widhani, Alvina Andhika Rachman Andree Kurniawan Asicha, Nur Budiman Darmowidjojo, Budiman Cosphiadi Irawan Dimas Priantono, Dimas Esthika Dewiasty, Esthika Gurmeet Singh Hasan Maulahela Hayatun Nufus Ikhwan Rinaldi Johannes Sarwono Josephine, Jennifer Linda Armelia Madadika, Annisa Tsana Maharani, Sausan Hana Marlinda Adham Maruhum B.H. Marbun Mayangsari, Ika Dewi Mayangsari, Ika Dewi Nadia Ayu Mulansari, Nadia Ayu Nur Atikah Pangestu, Andhika Pantoro, Nico Iswanto Pradana Soewondo Prajogi, Gregorius Ben Pravita, Aravinda Rahman, Muhammad Ade Ramadan, Edwin Ti Renindra Ananda Aman Resultanti, Resultanti Safitri, Eka Dian Sharfina, Ratuafni Sri Wahdini Teguh Harjono Karjadi, Teguh Harjono Wulyo Rajabto