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Journal : Academic Hospital Journal

A Study on Lung Cancer Chemotherapy Regimen Administration at Universitas Gadjah Mada Academic Hospital Oktariyanto, Efel Erlambang; Yasin, Nanang Munif; Puspitasari, Ika
Academic Hospital Journal Vol 6, No 2 (2024)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v6i2.99663

Abstract

Background: One of the main ways to treat lung cancer is through chemotherapy regimens. Due to the complexity of lung cancer pathophysiology, the variability of chemotherapy given tends to cause drug interactions and toxicity in patients.Objective: Based on this, this study aims to determine the characteristics of lung cancer patients and identify chemotherapy administration patterns based on the NCCN therapy guidelines, identify interactions and side effects of chemotherapy that occur in patients diagnosed with lung cancer who are undergoing outpatient therapy at the Universitas Gadjah Mada Academic Hospital.Method: This research was carried out with a case-series design, namely by conducting a study using descriptive methods that provide an overview of patient characteristics, chemotherapy regimen patterns and their conformity to NCCN guidelines, potential drug-drug interactions (DDIs), and the incidence of side effects experienced by patients. Data was collected retrospectively through medical records of lung cancer patients undergoing outpatient treatment in the period April 2022 – April 2023 who met the inclusion and exclusion criteria.Result: There were a total of 27 patients in this study with patient characteristics predominantly in the elderly age range (> 60 years), 18 patients (66.7%), with exon 19 mutation NSCLC lung cancer type (n = 13; 92.6%), stage IV (n = 25 ; 92.6%), as well as non-smoking patients (n = 15 ; 55.6%). Chemotherapy regimen patterns at Gadjah Mada University Academic Hospital for lung cancer patients included afatinib (n = 14; 51.9%), gefitinib (n = 12; 44.4%), and cisplatin pemetrexed (n = 1; 3.7 %) with conformity reaching 100% in the accuracy of indications, dosage and usage information. In this study, it was identified that there were 2 Potential DDIs that occurred in 1 patient (3.7%) with respective risks, namely C and B which included cisplatin-furosemide and cisplatin-ondansetron interactions. Side effects were known to occur in almost all patients (n = 23; 85.2%) where side effects in the form of skin toxicity and diarrhoea were the two most frequently identified types of side effects with a percentage of 59.3% (n = 16). and 40.7% (n = 11).Conclusion: More than 90% of NSCLC showed exon 19 mutation. The most chemotherapy given to the patients was afatinib. There were a potential interaction between cisplatin and either furosemide or ondansetron.
Tunneled Epidural Analgesia for Refractory Scrotal Cancer Pain: A Case-Based Evaluation of Therapeutic Efficacy Nur Azza, Kamala Kan; Tomo, Wahyu Kartiko; Darwito, Darwito; Puspitasari, Ika; Mahmud, Mahmud; Widyastuti, Yunita
Academic Hospital Journal Vol 7, No 2 (2025)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v7i2.109434

Abstract

Background: Scrotal Squamous Cell Carcinoma (SCC) is a rare malignancy. Although SCC typically demonstrates slow progression, in advanced stages with significant size, it can cause considerable pain due to mass effect and local tissue invasion. The management of cancer-related pain encompasses a wide spectrum of approaches, ranging from pharmacologic to surgical interventions. In cases where patients become intolerant to the side effects of pharmacologic therapies and adequate pain relief cannot be achieved, while surgical options are either not feasible, interventional pain management may offer an effective alternative. Tunneled Epidural Analgesia represents one such interventional technique that can be considered for refractory pain. This case report aims to evaluate the efficacy of tunneled epidural analgesia administration in managing intractable pain associated with advanced scrotal SCC.Materials and methods: This case report is structured according to the CARE (Case Report) guideline. The study was conducted at UGM Academic Hospital, where the patient received evaluation and treatment.Case: A 65-year-old male diagnosed with SCC presented experiencing refractory cancer pain. Despite receiving conventional analgesic therapy, he experienced no significant pain relief and developed adverse effects. Pain management was subsequently escalated to an interventional approach using a bupivacaine 0.125% and fentanyl 25 mcg administered via a tunneled epidural drug delivery system. This intervention resulted in effective pain control, enabling him to do daily activities. With this modality, the pain remained well managed, although occasional breakthrough pain occurred, which was successfully managed with 1% lidocaine as a rescue analgesic.Conclusion: Tunneled epidural analgesia using a combination of opioid and bupivacaine has demonstrated effectiveness in the management of refractory scrotal cancer pain.
Co-Authors Abdoellah, Siti Asfijah Abdul Gofir Achmad, Bayu Fandi Agil Novianto, Agil Agung Endro Nugroho Akhmad Kharis Nugroho Al-Muzzaki, Rizqi Hariyono Alchusnah, Retno Hayati Alexxander Alexxander, Alexxander Ali Djamhuri Amalia, Dita Ambar Yunita Nugraheni Amboro, Wisnu Andaru Dahesihdewi Annisa Oktafianti Nurlatifah, Annisa Oktafianti Arief Budiyanto Arief Nurrochmad Arifin, Shokhibul Arifin, Shokibul Astuti, Rini Budi Bakhruddin, Muhammad Bambang Sigit Riyanto Chairani, Farahdina Chandra Wahyu Purnomo Chandra, Lukman Ade Chusna, Nurul Darwito, Darwito Dibtyanusa, Ajib Djoko Wahyono Endang Lukitaningsih Ernawati, Hafifah Esti Dyah Utami Estiningsih, Daru Farisa Luthfiana Fatiha, Muvina Rizkia Fauziyah, Jihan Fitria Dina Riana Hafizah, Ilmi Nur Haryono, Eko Anwar Hemi Sinorita Hera Nirwati Heri Mulyanto, Heri HIDAYAT, MOCH CHARIS I Dewa Putu Pramantara Ida Safitri Laksanawati Ilham Perdana Ilmi, Miftakhun Nafidatul Indra Saputra Ismail, Asrul Khairunnisa, Dini Kumara, Intan Fatah Kurniawati, Fivy Kurniawaty, Yenni Dwi Kusharwanti, AM Wara Kusmantoro Edy S Lestari, Ayu Eka M. Yogi Riyantama Isjoni Maftuhah, Rifa’atul Mahmud Mahmud Marsila, Ulfi Ana Mika Tri Kumala Swandari, Mika Tri Kumala Mufida, Arizzatul Aulia Mulyani, Lili Nadiya, Salsabila Putri Nanang Munif Yasin Nastiti, Nindita Sari Naurah Alifah Rahmah Niken Puspitasari Nisa, Solikhatun Nunuk Aries Nurulita Nunung Yuniarti Nur Azza, Kamala Kan Nurul Hikmah Oktariyanto, Efel Erlambang Pratama, Alief Indra Pratiwi, Restu Dwi Probosuseno Probosuseno, Probosuseno Putri, Mukarromah Dita Rahmah, Naurah Alifah Rahmantika, Fitri Rizaldy Pinzon Rizka Humardewayanti Asdie Rochman, Zakki Tifani Ibadu Roni, Faishol Roostika, Raden Roro Ratna Rukmono Siswishanto Sarastuti, Dewi Sari Dewiyani, Sari Sarjito - Solekah, Putri Nur Sri Watini Sudar, Hasdiana Sugiarto S Sugiyarto, Okky Puspitasari Sujarwo Sumarningsih, Pebriati Suryani, Aliyatul Ilmi Susatyo Yuwono Susi Ari Kristina Sutono Sutono Suwito, Darwito Tambun, Sabrina Handayani Thulus Hidayat, Thulus Titik Nuryastuti Titik Rahayu Tomo, Wahyu Kartiko Tri Hartati, Tri Tri Murti Andayani Tri Yanto Triswandari, Retno Wahyuntari, Evi Wardoyo, Eko Yanuar, Wihda Yunita Widyastuti Yusmiyati, Yusmiyati