Henry Kodrat, Henry
Faculty of Medicine, University Pelita Harapan, Karawaci, Indonesia.

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Stereotactic Ablative Body Radiotherapy (SABR) in The Management Spinal Metastases: A Brief Overview* KODRAT, HENRY; GONDHOWIARDJO, SOEHARTATI
Indonesian Journal of Cancer Vol 11, No 1 (2017): Jan-Mar
Publisher : Indonesian Journal of Cancer

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Abstract

It is well known that radiotherapy provides successful pain relief in bone metastases. Advancements in imaging and radiotherapy delivery technology have enabled safe delivery of higher dose radiotherapy, which will produce more durable tumor control. Over the last decades stereotactic radiosurgery (SRS), which delivers high dose radiation, has been successfully used for the treatment of intracranial lesions. The good results obtained in SRS have led to development of extra cranial stereotactic radiosurgery known as stereotactic ablative body radiotherapy (SABR). This review paper enlightens indication, target definition, efficacy and toxicity in spinal SABR.ABSTRAK Radioterapi telah terbukti sebagai modalitas yang dapat menghilangkan nyeri pada metastases tulang. Kemajuan dalam teknologi pencitraan dan pemberian radioterapi telah memungkinkan pemberian radioterapi dosis tinggi dengan aman, di mana hal ini dapat meningkatkan kontrol lokal. Selama dekade terakhir ini, stereotactic radiosurgery (SRS) yang memberikan radiasi dosis tinggi dinyatakan bermanfaat untuk tatalaksana berbagai kelainan intrakranial. Hasil cukup memuaskan yang diperoleh SRS mendorong untuk dikembangkan stereotactic radiosurgery ekstrakranial yang kemudian dikenal sebagai stereotactic ablative body radiotherapy (SABR). Tinjauan pustaka ini menjelaskan indikasi, target radiasi, efektivitas, dan efek samping pada prosedur SABR spinal.
Stereotactic Radiosurgery pada Benign Skull Base Tumor KODRAT, HENRY; NOVIRIANTHY, RIMA
Indonesian Journal of Cancer Vol 10, No 1 (2016): Jan - Mar 2016
Publisher : Indonesian Journal of Cancer

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ABSTRACTTotal removal is difficult to be performed in skull base tumors because its location is surrounded by important structures such as nerves and blood vessels. Therefore, radiotherapy is one of treatment modalities that has been proven efficacy. Simultaneous with the development of imaging technology and advancement of radiobiology, radiosurgery is an emerging therapeutic modality. Radiosurgery is radiotherapy method which delivers high doseirradiation in single fraction. Rational use of stereotactic radiosurgery on benign skull base tumor is from radiobiology point of view; there is no advantage can be achieved from conventional dose fractionated radiotherapy compared with high dose. However, if we want to delivered high dose radiation, we must apply rigid immobilization, target definition using stereotactic navigation and image guidance verification. Radiosurgery can only be delivered in small intracranial lesion.ABSTRAKReseksi total kadang sulit dilakukan pada tumor yang terletak pada dasar tengkorak. Hal ini disebabkan lokasinya dikelilingi oleh struktur saraf dan pembuluh darah penting. Oleh karena itu, radioterapi merupakan salah satu modalitas terapi yang sudah terbukti maanfaatnya. Sejalan dengan perkembangan teknologi pencitraan dan kemajuan pengetahuan radiobiologi, radiosurgery merupakan modalitas terapi yang melejit penggunannya. Radiosurgery adalah metode pemberian radioterapi dengan dosis tinggi dan diberikan dalam fraksi tunggal. Rasional penggunaan stereotactic radiosurgery pada tumor jinak dasar tengkorak adalah karena dari sudut pandang radiobiologi, tidak ada kelebihan dariradioterapi dengan dosis konvensional dibandingkan dengan dosis tinggi. Namun, untuk pemberian dosis tinggi diwajibkan imobilisasi yang rigid dan lokalisasi yang akurat dengan menggunakan navigasi stereotaktik dan verifikasi dengan panduan pencitraan radiologi. Radiosurgery hanya dapat diberikan pada kelainan intrakranial yang berukuran kecil.
Stereotactic Radiosurgery in Recurrent Brain Metastases After Prior Radiosurgery: A Case Report and Review of Literature KODRAT, HENRY; NOVIRIANTHY, RIMA
Indonesian Journal of Cancer Vol 10, No 4 (2016): October - December 2016
Publisher : Indonesian Journal of Cancer

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Abstract

ABSTRACTPreviously, all brain metastasis has been treated with whole brain radiotherapy and the survival is poor. Recently, the development of stereotactic radiosurgery (SRS) provides comparable efficacy with low toxicity, and in several cases have a better survival compared to historical data. We conducted a case review in brain metastasis, which has been treated with SRS previously and experienced distant brain recurrence, then re-treated with SRS.ABSTRAKDahulu, semua metastasis otak ditangani dengan modalitas radiasi seluruh otak dan memiliki kesintasan yang tidak terlalu baik. Saat ini berkembang modalitas stereotactic radiosurgery (SRS). SRS memberikan efektivitas yang sebanding dengan toksisitas yang rendah dan pada beberapa kasus memiliki kesintasan yang lebih baik dibandingkandata sebelumnya. Berikut adalah tinjauan kasus metastasis otak dengan penanganan SRS sebelumnya dan mengalami kekambuhan di lokasi lain pada otak, kemudian ditatalaksana ulang dengan SRS.
Stereotactic Radiosurgery for Classical Trigeminal Neuralgia Kodrat, Henry; Novirianthy, Rima
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Trigeminal neuralgia is a debilitating pain syndrome with a distinct symptom mainly excruciating facial pain that tends to come and go unpredictably in sudden shock-like attacks. Medical management remains the primary treatment for classical trigeminal neuralgia. When medical therapy failed, surgery with microvascular decompression can be performed. Radiosurgery can be offered for classical trigeminal neuralgia patients who are not surgical candidate or surgery refusal and they should not in acute pain condition. Radiosurgery is widely used because of good therapeutic result and low complication rate. Weakness of this technique is a latency period, which is time required for pain relief. It usually ranges from 1 to 2 months. This review enlightens the important role of radiosurgery in the treatment of classical trigeminal neuralgia.
Peranan Radiosurgery pada Berbagai Kelainan Intrakranial Kodrat, Henry; Novirianthy, Rima
Cermin Dunia Kedokteran Vol 43, No 8 (2016): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (706.013 KB) | DOI: 10.55175/cdk.v43i8.99

Abstract

Radiosurgery merupakan modalitas klinik yang makin banyak digunakan dalam tatalaksana berbagai kelainan intrakranial. Hal ini didukung oleh perkembangan teknologi pencitraan MRI yang sangat membantu dalam penentuan target, perkembangan ilmu radiobiologi, perkembangan teknologi komputer yang sangat membantu dalam ketepatan navigasi stereotaktik, dan penemuan metode imobilisasi yang tidak invasif. Radiosurgery dapat digunakan dalam tatalaksana berbagai kelainan antara lain tumor jinak, metastasis otak, malformasi arteriovenosa, dan neuralgia trigeminal. Efek terapi radiosurgery ini cukup memuaskan dengan risiko komplikasi rendah.
The Epstein-Barr Virus (EBV) DNA Test as a Predictor of The Course of Nasopharyngeal Cancer Maharani, Putri; Kodrat, Henry
Indonesian Journal of Cancer Vol 18, No 2 (2024): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i2.1120

Abstract

Background: Nasopharyngeal cancer (NPC) incidence has been largely found in Southern China and Southeast Asia and was associated with Epstein-Barr Virus (EBV). Some advanced-stage NPC may still rise to local recurrence or distant metastasis and higher plasma EBV DNA was still found in locally advanced nasopharyngeal cancer (LA-NPC) at 1 month or even 3 years after completing radiotherapy (RT). Even though EBV DNA has not been widely used in clinical practice, it could be an important value for determining treatment outcomes and risk of disease relapse.Methods: This review article gathered studies from the PubMed database from 2021 to 2022. Using various searching terms 434 articles were found and were narrowed down to 7 according to the inclusion criteria. The individual review was made for each article and endpoints such as overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and local recurrence-free survival (LRFS) were drawn.Results: Overall subjects for these studies ranged up to 2,354 LA-NPC patients (median of 1,073   subjects). All studies observed the pre-treatment and post-treatment EBV DNA and only two studies observed post-neoadjuvant chemotherapy (post-NAc). EBV DNA currently is the most reliable biomarker available for clinical purposes and its versatility can be useful, especially to value prognosis and to determine the course of treatment.Conclusions: Apart from survival outcomes, pre-treatment EBV DNA is considered good for predicting the overall prognosis. Meanwhile, post-induction chemotherapy (post-IC) or post-NAc EBV DNA is suitable for adjuvant therapy indicators, especially in LA-NPC. Even though the cut-off value for the tests was still varied across laboratories (ranging from 1,500 to 4,000), post-NAc and post-treatment might have some benefit to help predict any locoregional recurrence and distant metastasis, considering pre-treatment will not change the therapeutic course completely.
Multidiscpinary Approach in Nasopharyngeal Cancer Kodrat, Henry
Medicinus Vol. 5 No. 2 (2016): February 2016 - May 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i2.1168

Abstract

Nasopharyngeal cancer (NPC) is endemic in Indonesia. The purpose of the review is to describe the risk factors, clinical symptoms, diagnostic procedures and staging, management and treatment options, and follow-up. Multi-disciplinary approach to the NPC not only for treatment, but also has been started from the diagnosis proccess. The multidisciplinary approach also plays role after treatment, especially for the follow-up and rehabilitation of post-treatment toxicity.Keywords: cancer, nasopharynx, radiotherapy.
THE ROLE OF RADIOTHERAPY IN UTERINE CERVICAL CANCER Kodrat, Henry
Medicinus Vol. 5 No. 1 (2015): October 2015 - January 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i1.1179

Abstract

Uterine cervical cancer is the most common cancer in Indonesia. The purpose of the review is to describe diagnosis and staging, the basic principles of radiotherapy, the role of radiotherapy in cervical cancer treatment, and radiotherapy side effects. The goal of radiotherapy in cervical cancer consists of definitive, adjuvant, and palliative. Effort to increase radiation response also develops by administered small dose of chemotherapy as a radiosensitizer.Keywords: cancer, cervix, radiotherapy