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All Journal Radioterapi & Onkologi Indonesia Oto Rhino Laryngologica Indonesiana Indonesian Journal of Cancer
Arie Munandar
Unit Pelayanan Onkologi Radiasi RSUPN Dr. Cipto Mangunkusumo, Fakultas Kedokteran Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Physics Public Health Other

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Peran Radioterapi dan Tatalaksana Umum Sindrom Vena Kava Superior Agung Tri Cahyono; Arie Munandar
Radioterapi & Onkologi Indonesia Vol 10, No 2 (2019): VOLUME 10 NO.2 JULI 2019
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1581.406 KB) | DOI: 10.32532/jori.v10i2.104

Abstract

Sindrom vena kava superior (SVKS) merupakan kumpulan gejala yang terjadi karena obstruksi aliran darah di vena kava superior. Gejala SVKS bervariasi dari yang tidak mengancam nyawa hingga kondisi yang mengancam nyawa. Target utama tatalaksana umum SVKS adalah mengurangi gejala dan tatalaksana penyakit penyebab. Radioterapi merupakan salah satu terapi yang efektif untuk mengurangi gejala pada SVKS. Dalam pelaksanaannya, radioterapi dapat dikombinasikan dengan pemberian kemoterapi. Teknik radioterapi 2 dimensi, 3 dimensi, stereotactic body radiotherapy (SBRT) dan image-guided radiation therapy (IGRT) dapat diberikan dalam tatalaksana SVKS. Tujuan pemberian radioterapi pada kasus SVKS pada umumnya paliatif, untuk menghindari asfiksia pada jaringan otak dan mengurangi gejala akibat obstruksi. Dalam laporan kasus ini, seorang laki-laki umur 29 tahun dengan tumor di mediastinum anterior yang menyebabkan SVKS (Stanford IV dan derajat keparahan berat), mendapatkan radiasi eksterna AP-PA 3 x 3Gy. Pasien merasakan perubahan signifikan 2 minggu pasca radiasi.
Efek Abscopal pada Kombinasi Radioterapi dan Imunoterapi Agustinus Darmadi Hariyanto; Arie Munandar
Radioterapi & Onkologi Indonesia Vol 11, No 1 (2020): VOLUME 11 NO.1 JANUARI 2020
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v11i1.105

Abstract

Radioterapi atau terapi radiasi merupakan salah satu prosedur medis lokal regional yang digunakan untuk menangani penyakit kanker. Bukti menunjukkan bahwa radiasi juga mampu memicu sistem imunitas tubuh dan hal ini berkontribusi pada efek abscopal, yang dapat didefinisikan sebagai "respons yang diperantarai oleh sistem imun pada jarak yang jauh dari volume atau target radiasi." Meskipun regresi tumor abscopal masih tetap merupakan peristiwa langka dalam praktik radioterapi, peningkatan jumlah kasus dilaporkan terutama sejak implementasi klinis agen imunoterapi. Beberapa hal terkait radiasi seperti regimen radiasi, biological equivalent dose/BED dan luas lapangan radiasi diketahui mampu memengaruhi efek abscopal
Dosimetric Parameter Analysis of Stereotactic Radiosurgery on Vestibular Schwannoma with Intensity-Modulated Radiotherapy Step-and-Shoot, Volumetric-Modulated Arc Therapy and Helical Tomotherapy Soehartati A. Gondhowiardjo; Aurika Sinambela; Handoko Handoko; Arie Munandar; Wahyu Edy Wibowo; Sri Mutya Sekarutami; Angela Giselvania
Radioterapi & Onkologi Indonesia Vol 12, No 2 (2021): VOLUME 12 NO.2 JULY 2021
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v12i2.140

Abstract

Introduction: SRS is a non-invasive modality in management of vestibular schwannoma. There is limited study comparing dosimetric parameters between three techniques SRS in vestibular schwannoma cases, thus IMRT Step and Shoot (IMRT-SS), VMAT, and Helical Tomotherapy (HT). Aim: To compare the dosimetry parameters on SRS among IMRT-SS, VMAT, and HT techniques on Vestibular ScwhanomaMethod: Treatment planning with IMRT-SS, VMAT, and HT on eleven CT plan data for schwannoma vestibular cases. The marginal dose is 12 Gy with single fraction. Results: Mean tumor size was 8.23 cm + 5.08 cm3. No significant difference were found in the mean CI, GI, V100%, and V50% among three techniques. There was no significant difference in maximal dose to brainstem, ipsilateral cochlea, chiasma opticum, ipsilateral and contralateral optic nerve between the three techniques. There was significant difference of maximum dose on contralateral cochlea between IMRT-SS and VMAT techniques. The longest beam-on time was obtained with HT technique (1209,18 +390,20 second), followed by IMRT-SS technique (665,05 + 73,40 second), and the shortest was with VMAT technique (362,87 + 24,55 second). There was significant difference in mean MU and beam on time between three techniques. Conclusion: VMAT technique could be an option for SRS for vestibular schwannoma cases to provide conformity and gradient index as well as IMRT-SS and HT techniques, with better sparing to contralateral cochlea compared with IMRT-SS technique, and provides shorter beam-on time rather than IMRT-SS and HT.
Radiasi Adjuvan Paska Operasi pada Sarkoma Pleiomorfik Jaringan Lunak Regio Torso yang Mengalami kekambuhan: Sebuah laporan kasus dalam 2 tahun follow up Ni Ayu Wulandari; Arie Munandar
Radioterapi & Onkologi Indonesia Vol 10, No 2 (2019): VOLUME 10 NO.2 JULI 2019
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1041.38 KB) | DOI: 10.32532/jori.v10i2.103

Abstract

Sarkoma jaringan lunak / soft tissue sarcoma (STS) merupakan keganasan yang jarang terjadi. Manajemen STS telah berkembang dalam beberapa dekade terakhir menuju pengobatan modalitas gabungan seperti operasi dan radioterapi untuk memungkinkan menjaga struktur jaringan agar masih  dapat berfungsi optimal. Radioterapi paska operasi telah terbukti meningkatkan kontrol lokal pada pasien dengan margin bedah positif. Metastasis paru pada sarkoma sering terjadi dengan profil prediktor seperti ukuran tumor yang besar (pada kasus ini > 10 cm), kedalaman, dan derajat tumor. Dalam laporan kasus ini, seorang wanita 73 tahun paska operasi eksisi luas akibat kekambuhan STS pada regio torso area flank dengan margin positif. Dalam kontrol lanjutan dua tahun paska radiasi terdapat kontrol lokal yang baik, tetapi didapatkan metastasis paru.
Epidemiology of 10 Cancer Types in Indonesia: A Multicenter Study Jayalie, Vito Filbert; Gondhowiardjo, Soehartati; Kotambunan, Charity; Apriantoni, Riyan; Manuain, Donald Arinanda; Hawariy, Salik; Prajogi, Gregorius Ben; Permata, Tiara Bunga Mayang; Handoko, Handoko; Munandar, Arie; Sekarutami, Sri Mutya
Radioterapi & Onkologi Indonesia Vol 14, No 1 (2023): Volume 14 No.1 July 2023
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v13i2.161

Abstract

Cancer remains one of the largest contributors to the burden of health and mortality around the world. A study estimated 19.3 million new cases of cancer in the year 2020. GLOBOCAN 2020 provides a list of the most common cancers in the world which are prostate, lung, and colorectal cancers in men and breast, colorectal, and lung cancer in women. Naturally, different sociodemographic and geographic characteristics will cause disparities in these estimates. Since valid epidemiological data on cancer types in Indonesia remains unavailable, this study intended to provide data on the pattern of distribution of the 10 most common cancer types amongst various hospitals in Indonesia. This was achieved through the collection of registries and/or medical records that were obtained from March to September 2022. The data were then sorted and analyzed using SPSS 20.0. The resulting epidemiological data in multi-centers in Indonesia yielded a similar top 10 most common cancers trend with the GLOBOCAN 2020 worldwide incidence, although some differences were seen. A universal similarity that is found amongst different databases seems to be the prevalence of breast cancers, which always ‘champions’ all databases as the most common cancers among women. This provides a reflection for policy and decision makers for their prompt action to promote the prevention, diagnosis, and treatment of cancers in Indonesia, especially breast cancers.
The Role of Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma Patients: A Literature Review Giselvania, Angela; Sekarutami, Sri Mutya; Munandar, Arie; Halim, Devina Adella; Wijovi, Felix
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1190

Abstract

Background: Globally, hepatocellular carcinoma (HCC) is the most prevalent kind of primary liver cancer. Treatment options for HCC include radiotherapy, immunotherapy, surgery, targeted therapy, transarterial chemoembolization, and hepatic arterial infusion chemotherapy. Limited efficacy was observed since 70-80% of cases are diagnosed late and unresectable. Growing evidence reported that SBRT is a viable option for locoregional treatments like radiofrequency ablation (RFA) or transarterial chemoembolization (TACE) for patients who did not respond to those treatments. Methods: A thorough search of electronic databases including PubMed, Cochrane Library, and Embase was conducted for studies on Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma published in English over the past 10 years. The review process followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to ensure a systematic approach. Inclusion criteria encompassed studies focusing on SBRT use in HCC treatment, with extracted data synthesized to provide a comprehensive overview of current evidence. Any discrepancies during the review were resolved through consultation with a third reviewer when necessary. Results: In comparison to conventional radiation therapy, Stereotactic Body Radiation Therapy (SBRT) offers precise administration of the high dose of radiotherapy, given in fewer fractions, and may be used in conjunction with other therapy modalities. Global guidelines, including in Indonesia, have proposed the implementation of SBRT. Local control was reportedly achieved in around 90–95% of HCC patients. Multimodal therapies, combined with TACE, showed superior results regarding the local control and overall survival. SBRT may eventually become the definitive treatment for early-stage HCC patients and has a critical role as a transitional therapy for patients awaiting liver transplantation. Improved outcomes and quality of life were also observed in patients with portal vein thrombosis (PVT) and extrahepatic metastases who underwent SBRT. Conclusions: SBRT results in promising local control, raises overall survival, and improves the quality of life in HCC patients with various stages.
Role of Radiotherapy in Oncologic Emergency Sebastian, Andreas Ronald Barata; Jayalie, Vito Filbert; Hanifah, Rizka; Adham, Marlinda; Munandar, Arie
Oto Rhino Laryngologica Indonesiana Vol. 53 No. 1 (2023): VOLUME 53, NO. 1 JANUARY - JUNE 2023
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v53i1.505

Abstract

Background: Oncologic emergencies often occur in patients who have metastases. This condition requires a prompt and accurate diagnosis. Radiotherapy (RT)  plays a substantial role in palliative aspect with the aim of reducing tumor size, reducing symptoms, and improving quality of life. Purpose: To discuss the role of radiotherapy in an oncologic emergency. Literature review: The most common cases requiring radiation in emergency management are superior vena cava syndrome, acute airway obstruction, uncontrolled tumor bleeding, spinal cord compression due to malignancy, and brain metastases. The selection of radiation dose and techniques may vary, taking into consideration patient factors such as poor general condition, the likelihood of receiving curative treatment afterward, severe comorbidities, tumor factors such as histology of malignancy, whether it is a metastatic disease or not, therapeutic factors such as previous radiation history and response to previous systemic therapy. Conclusion: Radiotherapy plays a significant role in oncologic emergency, particularly to reduce symptoms and improve quality of life. Several considerations should be evaluated before determining the appropriate radiation treatment are patient factors, previous radiation therapy and response to previous systemic therapy.
Co-Authors Agung Tri Cahyono Agustinus Darmadi Hariyanto Angela Giselvania Apriantoni, Riyan Aurika Sinambela Giselvania, Angela Halim, Devina Adella Handoko Handoko Handoko Handoko Hanifah, Rizka Hawariy, Salik Kotambunan, Charity Manuain, Donald Arinanda Marlinda Adham Ni Ayu Wulandari Permata, Tiara Bunga Mayang Prajogi, Gregorius Ben Sebastian, Andreas Ronald Barata Sekarutami, Sri Mutya Soehartati A. Gondhowiardjo Soehartati Gondhowiardjo Sri Mutya Sekarutami Vito Filbert Jayalie, Vito Filbert Wahyu Edy Wibowo Wijovi, Felix