Handoko Handoko
Unit Pelayanan Onkologi Radiasi, Fakultas Kedokteran Universitas Indonesia, RS. Dr. Cipto Mangunkusumo, Jakarta

Published : 2 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 2 Documents
Search

Xerostomia Severity and Quality of Life After Nasopharyngeal Cancer Radiotherapy: Intensity Modulated vs Two-dimensional Radiation Therapy in Indonesia Soehartati Argadikoesoema Gondhowiardjo; Nikrial Dewin; Andreas Ronald; Vito Filbert Jayalie; Handoko Handoko; Sri Mutya Sekarutami; Zanil Musa
Radioterapi & Onkologi Indonesia Vol 11, No 2 (2020): VOLUME 11 NO.2 JULY 2020
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v11i2.116

Abstract

Introduction: Two-dimensional technique (2DRT) is most commonly used in Indonesia. This technique causes severe late toxicity particularly in nasopharyngeal cancer (NPC). Radiation techniques such as Intensity-Modulated Radiation Therapy (IMRT) and Three-Dimensional Conformal Radiation Therapy (3DCRT) provide larger doses at the site of NPC while preserving normal tissue. This study aims to compare late side effects and quality of life (QoL) between IMRT and 2DRT groups.Method: This was a cross-sectional study with consecutive sampling. Salivae samples were collected at least 6 months after last radiation date. Xerostomia severity were determined by measuring whole saliva flow rate which then categorized based on Common Terminology Criteria for Adverse Events (CTCAE). European Organization for Research and Treatment of Cancer (EORTC) core questionnaire and EORTC head and neck module (QLQ-H&N35) wereused to assess QoL.Result: The IMRT group had higher saliva flow rate than 2DRT group (1,085 ±0,409 vs  0,188 ± 0,219 stimulated, 0,500±0,254 vs 0,196 ±0,156 unstimulated, p<0.001). According to CTCAE, IMRT group experienced less  grades 2 and 3 of xerostomia compared to 2DRT group (p<0.05). Moderate correlation between recovery time and saliva flow rate (p<0.05) was found in IMRT group at least 6 months after last radiation date. QLO-C30 scores were higher in IMRT group than those in 2DRT group, particularly in global health status, physical functioning, emotional functioning, pain and insomnia (p<0.05). IMRT group scored better in several QLQ-H&N35 subscales namely head and neck pain, swallowing, speech problems, trouble with social eating, trouble with social contact, dry mouth (p<0.05) and sticky saliva (p<0.001).Conclusion: IMRT was significantly superior to 2DRT in preserving and sparing the salivary gland especially parotid and improving quality of life .Thus, we recommend to treat NPC cases in Indonesia with IMRT to reduce toxicity of the treatment and improve quality of life, as it commonly affects people at productive age.
The Role of Radiotherapy towards Pediatric Cancer Agustinus Darmadi Hariyanto; Hari Murti Wijaya; Jellyca Anton; Seize Edwiena Yanuarta; Steven Octavianus; Handoko Handoko; Endang Nuryadi; Soehartati Argadikoesoema Gondhowiardjo
Radioterapi & Onkologi Indonesia Vol 11, No 2 (2020): VOLUME 11 NO.2 JULY 2020
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v11i2.117

Abstract

Cancer is the leading cause of death in children worldwide. Pediatric cancer is challenging to detect early because it generally appears with signs and symptoms that are not typical. The increase in cancer cases in pediatric must be followed by an increase in cancer management in all fields of scientific disciplines. Radiation oncology, as one of the areas of science, has an essential role in definitive, adjuvant, palliative, and prophylactic cancer in pediatric. Apart from these uses, radiation management is a significant contributor to the complications of pediatric cancer survivors. Complications that arise can be in the form of growth retardation, tissue changes, secondary cancer, neurocognitive changes, infertility, or other hormonal dysfunction and preterm labor. An increase in radiation techniques followed the development of treatment machines able to reduce radiation-related morbidity and mortality rates. In pediatric radiotherapy, the entire process from the pre-procedure anesthesia to radiotherapy requires special attention. Psychological issues are also worth observing. This study will briefly discuss these matters and the management of some of the most common pediatric cancers in Dr. Cipto Mangunkusumo Hospital.