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INDONESIA
Indonesian Journal of Cancer
Published by National Cancer Center-Dharmais Cancer Hospital
ISSN : 19783744     EISSN : 23556811     DOI : https://www.doi.org/ 10.33371
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health
Indonesian Journal of Cancer is a peer-reviewed and open-access journal. This journal is published quarterly (in March, June, September, and December) by Dharmais Cancer Hospital - National Cancer Center. Submissions are reviewed under a broad scope of topics relevant to experimental and clinical cancer research. Articles are original research that needs to be disseminated and written in English. All submitted manuscripts will go through the double-blind peer review and editorial review before being granted acceptance for publication. The journal publishes original research articles, case reports, and review articles under the following categories: cancer management, cancer prevention, cancer etiology, epidemiology, molecular oncology, cancer diagnosis and therapy, tumor pathology, surgical oncology, medical oncology, radiation oncology, interventional radiology, as well as early detection.
Arjuna Subject : Kedokteran - Onkologi
Articles 562 Documents
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Characteristics and Survival of Patients with WHO Grade 4 Diffuse Glioma in Dharmais National Referral Cancer Hospital Tadjoedin, Hilman; Suryana, Kresna Dharma; Rosalina, Rosalina; Hartono, Bryan Arista; Widarta, Oskar Ady; Dewin, Nikrial; Andriani, Rini
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.v18i3.1261

Abstract

Background: The WHO grade 4 diffuse glioma are extremely aggressive and account for over 60% of adult Central Nervous System (CNS) tumors. The diagnosis and management pose significant challenges due to the need for comprehensive evaluation and holistic treatment approaches. This study aims to determine the clinical characteristics of WHO grade 4 diffuse glioma in Indonesia and the overall survival as a secondary goal. Methods: This is a retrospective cohort study of all WHO grade 4 glioma patients from 2017 to 2022 at Dharmais National Cancer Hospital, Jakarta, Indonesia. Demographic characteristics were presented descriptively. Kaplan-Meier plot was used to evaluate the median survival. Results: Twenty-eight patients were eligible for this study. The median age group is 45 years old, with equal male and female prevalence. Headache was the most prevalent primary symptom. The therapy following surgery was radiotherapy (RT) with chemosensitizer (82.1%) and RT alone (14.3%) with both followed by adjuvant chemotherapy. There was one patient (3.6%) underwent palliative therapy. The median survival of all patients was 10 months, whereas 10 months in RT with the chemo-sensitizer group and 1 month in RT only group. There was no statistically significant difference between RT with and without chemotherapy sensitizer in terms of survival rates. Conclusions: Our study reports a younger median age of WHO Grade 4 diffuse glioma. Male subjects were equivalent to females. Median OS was 10 months and were longer in RT with the chemosensitizer group. Further multicentered and at the genetic level investigation was needed, to achieve optimal outcomes.
An Overview of The Spinal Metastasis Pain with Opioid Therapy and The Affecting Factor Djohansjah, Joice Rosewitasari Aryanti; Andriani, Rini; Aninditha, Tiara; Sofyan, Henry Riyanto
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.v18i2.1065

Abstract

Background: Spinal metastasis is the most frequent type of spinal tumor. Opioid is the first line of treatment for cancer pain despite a multitude of side effects. This study aimed to evaluate the effectiveness of opioids as the latest ladder in the treatment of spinal cancer pain. Methods: A retrospective cross-sectional study was performed comprising 89 spinal metastasis patients at the National Cancer Centre, Dharmais Hospital from November 2021 to March 2022. The demographic and clinical data were retrieved from medical records. This study used the Numerical Rating Scale (NRS) to evaluate the improvement of pain. The change of NRS ≥ 2 was considered significant. The data was analyzed using bivariate (Wilcoxon, Mann-Whitney, and Fisher Exact test) and multivariate (linear regression) analysis. Results: A total of 89 subjects were included in the study (median age = 51 years, 57,3% females). There was a significant decrease in the severity of cancer pain (p0.005) between admission (initial NRS 7) and treatment completion (final NRS 2) in the first hospitalization of all groups. There was no correlation between the clinical characteristics of the participants and the NRS score determined upon admission and at the end of the course of treatment. Conclusions: There was a significant improvement in the cancer pain intensity in the subjects with spinal metastasis cancer pain who received opioid naive therapy.
Factors Influencing Quality of Life of Parents with Children Affected by Acute Lymphoblastic Leukemia: A Study at Childhood Cancer International Foundation, Jakarta Trisya, Michelle; Tjhay, Francisca; Hasan, Surilena; Widjaja, Nelly Tina
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1005

Abstract

Background: The diagnosis and management of chronic diseases, such as Acute Lymphoblastic Leukemia (ALL), are significant for the quality of life of parents. In addition, several factors contribute to the quality of life of parents whose children battle ALL, including characteristics, duration of childcare, mental health, and family functioning. Therefore, this study aims to identify factors influencing the quality of life of parents whose children have ALL at the Childhood Cancer International Foundation in Jakarta. Methods: This cross-sectional study recruited 109 parents at the Childhood Cancer International Foundation as respondents. The assessment tools used included a Characteristics questionnaire, Self-Rating Questionnaire-20, APGAR Questionnaire, and WHOQOL-BREF questionnaire. Additionally, collected data were subjected to univariate, bivariate, and multivariate analysis. Results: Among the 109 respondents with an average age of 38 years and mean childcare duration of 28 months, 66.1% were females, 100% believed in God, 73.4% had partners, 47.7% possessed higher education, 83.5% earned below the regional minimum wage, 66.1% experienced mental health problems, and 11.9% had family dysfunction. Bivariate analysis showed a significant relationship between gender, mental health, and quality of life (p0.05). Multivariate analysis showed that marital status, education, economic status, and family functioning significantly correlated with quality of life. Conclusions: In conclusion, gender, marital status, education, economic status, mental health, and family functioning were found to exert a significant influence on the quality of life of parents raising children with ALL.
Characteristics of Chemotherapy Treatments for Breast Cancer Patients at Bhayangkara Tk.1 Pudsdokkes Polri Hospital, Jakarta Febriani, Amelia; Pujiastuti, Fitria; Teodhora, Teodhora
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.v18i3.1131

Abstract

Background: Breast cancer is a malignant breast tumor that develops in the ductal or lobular epithelium and usually attacks women. Chemotherapy is a cornerstone of breast cancer treatment, particularly for patients with advanced disease or those who are not candidates for surgery or radiation therapy. This research aims to observe the use of chemotherapy drugs for breast cancer patients in terms of chemotherapy regimens and cycles at Bhayangkara Tk.1 Pudsdokkes Polri  Hospital. Methods: This study employs descriptive quantitative approaches. Data were gathered retrospectively from medical records of breast cancer patients receiving chemotherapy at Bhayangkara Tk.1 Pudsdokkes Polri  Hospital Jakarta from July to December 2021. Results: From 110 patients, 86 (78.18%) patients used the CAF regimen, 18 (16.36%) patients used the AC regimen, and 3 (2.73%) patients used the TAC regimen, while the regimen that did not comply with the guidelines was 2 (1.82%) patients using the combination of paclitaxel and epirubicin, 1 patient utilizing the combination of paclitaxel and doxorubicin. Forty-six (41.82%) patients with the CAF regimen had completed six cycles of chemotherapy with intervals of 3 weeks or 21 days, while only 5 patients (3.63%) completed four cycles of the AC regimen at 3-week or 21-day intervals. At the time of data collection, 11 patients, and 1 patient utilizing the AC regimen. This was because 59 patients had not yet finished the chemotherapy cycle, specifically in the advanced stage. Conclusions: The CAF regimen was the most commonly used chemotherapy regimen, followed by the AC and TAC regimens. This finding aligns with current clinical guidelines for breast cancer treatment. A significant number of patients had not yet completed their chemotherapy cycles, particularly those with advanced-stage breast cancer. This highlights the challenges associated with treating advanced disease and the need for more effective and less toxic treatment options.
Profiles of Cancer Patients at Surgical Oncology Outpatient Clinic at Dharmais Cancer Hospital as National Referral Hospital in Indonesia from 2017 to 2021 Sofyan, Rian Fabian; Ramadhan, Ramadhan; Purwanto, Denni Joko; Gautama, Walta; Dien, Alban W; Brahma, Bayu; Iskandar, Bob Andinata; Kurniawan, Febriyanto; Husein, Abdul Muhaimin; Sabatini, Nafilla Nesantya; Ginawang, Asto
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.v18i2.1090

Abstract

Background: Cancer is one of the leading causes of death in the world. Dharmais Cancer Hospital is set to be the National Cancer Center with an obligation to support all hospitals throughout the country that specialize in cancer. Surgical Oncology is one of the departments that handles the most cases in Dharmais Cancer Hospital. The types of cancers that are managed in Surgical Oncology Departments are breast cancer, head and neck cancer, thyroid cancer, skin cancer, and soft tissue cancer. Objective: This paper aims to find the newly diagnosed cancer patients’ characteristics and socioeconomic features in Dharmais National Cancer Center from 2017 to 2021. Methods: The study was a cross-sectional descriptive study using the medical record database of outpatients at Dharmais Cancer Hospital as a data collection method from 2017 until 2021. The sample size includes all new cancer patients in Dharmais Cancer Hospital that have been recorded. Result: Over 500,000 patients visited Dharmais Cancer Hospital in the last 5 years with an average of over 100,000 visits per year. Over 90% of the patients have solid tumors, and over eight thousand patients were admitted to the Surgical Oncology Outpatient Clinic, it was concluded that the most frequently diagnosed type of cancer is breast cancer (66.7%) of all types of cancer in the past 5 years. Most of the new patients are female (88.1%) with the most common age group of 40 to 55 years old (50.7%). Most of the patients are senior high school graduates (42.8%). Conclusions: The general characteristic of cancer patients is dominated by breast cancer patients, most patients are female, in the age group between 40 to 55 years old, and senior high school graduates. Further studies need to be done on each type of cancer to have a better understanding of the profiles and characteristics of solid cancer patients in Dharmais Cancer Hospital. 
Differentiation of Serous and Non-serous Epithelial Ovarian Cancer by Radiological Imaging Yudistiarta, Devina; Dhamiyati, Wigati; Choridah, Lina
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1007

Abstract

Background: Ovarian cancer has a high incidence and fatality rate, with the most prevalent type is epithelial origin. The serous subtype of epithelial cancer predominates. For therapy selection, it is important to differentiate this subtype by histopathological examination as a gold standard method. Since some patients are not eligible for a biopsy, radiological modalities such as Magnetic Resonance Imaging (MRI) are superior in discriminating tissue compared to computed tomography (CT) or ultrasound. The use of the T1 weighted imaging (T1WI) and T2WI sequences can best differentiate between a cystic and a solid lesion. The goal of this study was to use radiological examination to assist in the identification of ovarian cancer.Methods: This cross-sectional study used secondary data from histopathology and MRI results from patients with ovarian cancer. Data was gathered utilizing electronic medical records in Dr. Sardjito Hospital between January 2017 and May 2022. The following MRI characteristics are evaluated including ascites, papillary projection, solid nodule, signal intensity of solid and cystic components, size, configuration, enhancement of contrast, and bilateral of the lesion.Results: Thirty-eight subjects made up the study’s sample, and 63% of them had serous subtypes. Bilateral lesion suggested a three times greater likelihood that it was serous ovarian cancer (p 0.02; binary logistic regression). Age 50 years old and strong enhancement on contrast was also relevant for separating the serous subtype from other subtypes (enhancement p 0.02; age p 0.044). Conclusions: A bilateral lesion with a significantly enhanced pattern can be seen on the MRI of a serous subtype of epithelial ovarian cancer. The elderly are also more likely to develop this cancer.
Extensive Vulvectomy and Reconstructive Flaps for Advanced Vulvar Cancer in Young Woman: Case Reports Malik, Nasdaldy; Soemanadi, M; Mukarramah, Dewi Aisiyah
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.1062

Abstract

Introduction: : Vulvar cancer is a rare disease accounting for approximately 5% of female genital tract tumors worldwide. It is a squamous cell cancer that mostly affects older women over the age of 65. In the existing body of literature, no instances of vulvar cancer have been documented in the form of case reports. Therefore, this study aimed to report the challenges and outcomes of vulvectomy with reconstructive flap in vulvar cancer survivors in a 39-year-old woman. Case Presentation: A 39-year-old woman with a palpable lump around the vulva was present and being examined. The anatomic pathology report (APR) features suggested poorly differentiated malignant tumors. A neoadjuvant chemotherapy was then administered to the patient aimed at shrinking the size of the tumor. However, there was no effective response to the chemotherapy, which resulted in a progressive tumor. Extensive vulvectomy and reconstructive flap were carried out to support quality of life, and the outcomes were reported, including flap, survival, complications, and mortality. These outcomes were evaluated between November 2021 and March 2023. No total flap loss was observed, and neither was there any donor site morbidity or mortality during the process. Conclusions: This study showed that vulvar cancer was a rare condition at a young age. Advanced vulvar cancer was found in the patients and extensive vulvectomy surgery was carried out followed by a pedicled ALT flap. This option was currently the best for immediate reconstruction due to the preservation of sensibility and tissue availability in the donor areas. The result showed no wound dehiscence, marginal necrosis, or surgical site infection. After 15 months of follow-up, the flap was observed to have good vascularization. The association of the Gynecologist with the Plastic Surgeon offered palliative care to improve the quality of life of the patient and provide good postoperative results.  
Myocardial Infiltration in Primary Mediastinal B-Cell Lymphoma Detected by Cardiac Magnetic Resonance Imaging Sutedjo, Verawati; Soewondo, Widiastuti; Yuniarti, Mira; Tenggara, Jeffry Beta; Erawati, Dini Rachma
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.966

Abstract

Introduction: Cardiac involvement, particularly myocardial infiltration in primary mediastinal lymphoma, is a rare occurrence with an incidence of only 9% in known cases of primary malignancy. Neoplasm infiltration into the myocardium manifests through direct invasion, hematogenous spread, transvenous invasion through the great veins, or lymphangitic spreading in the mediastinal. Myocardial infiltration in lymphoma presents a grim prognosis and its treatment may be associated with specific risks, such as myocardial rupture. Various imaging modalities may detect cardiac involvement, with cardiac magnetic resonance (CMR) imaging considered the gold standard. CMR enables clear delineation of myocardial infiltration, making it valuable for local staging, pretreatment planning, and evaluating treatment response. Case Presentation: : A 37-year-old woman patient was diagnosed with primary mediastinal large B-cell lymphoma. Mild chest discomfort and shortness of breath were observed 3 months before hospital admission. A thorax CT scan showed a heterogeneous contrast-enhancing mass with a central necrotic area in the anterior mediastinum. Following thoracotomy and tumor debulking, the patient complained of severe crushing chest pain radiating to her back, accompanied by new T wave inversion on ECG and elevated cardiac troponin levels a week after surgery. Coronary angiogram results showed a normal coronary artery. Subsequent cardiac MRI showed tumor infiltration into the anterior pericardial space, as well as the myocardium of the left and right ventricles. Chemotherapy was promptly initiated, resulting in a gradual improvement of symptoms. Conclusions: In this study, we discuss the use of 3D-CRT in the re-irradiation of NPC with its limitation on obtaining optimum dose sculpture compared to more sophisticated and widely spread modalities like IMRT. However, with careful planning, we can still obtain optimum tumor dose, minimize OAR dose, and subsequently late toxicities that come after. We hope that this study can bring hope to centers with limited facilities, and we suggest further studies on reirradiation, especially in OAR dose tolerance guidelines. 
National Lung Cancer Screening: Recommended Age for Screening Ramadhaniah, Fariha; Suzanna, Evlina; Syahruddin, Elisna; Shalmont, Grace; Rahayu, Pradnya Sri
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1223

Abstract

Indonesia, as a developing country, faces a significant burden of lung cancer, with the incidence and mortality rates ranking third. Unfortunately, the majority of patients are diagnosed at advanced stages of the disease. Indonesia has implemented a national cancer control program; screening and early detection are part of this program, which needs firm criteria to restrict the high-risk population due to limited resources. This article aims to recommend age criteria for National Lung Cancer Screening based on cancer registry data. We explore lung cancer screening policies across various countries, discuss the extent of the lung cancer burden and smoking prevalence as factors in determining age criteria for screening. Lung cancer is coded using ICD-O, third edition, C33–C34, and the incidence data were obtained from the Jakarta cancer registry. Data on the prevalence of smoking were obtained from national surveys and other research. Our review suggests that lung cancer screening should start at 35 years old, considering the distribution of lung cancer, the prevalence of smoking in Indonesia, as well as the carcinogenesis process of an individual when they start smoking.
Assessing the Potential of Valproic Acid as an Adjuvant Agent among Various Histological Subtypes of Thyroid Cancer: A Systematic Review Makbul, Firshan; Ahani, Ardhi Rahman
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1169

Abstract

Background: Valproic acid (VPA) has gained attention as an anticonvulsant drug with potential anti-cancer effects, including in thyroid cancer. It hampers the viability of cancer cells by blocking their cell cycle progression, specifically in the G1 or sub-G1 phases. However, the clinical role of VPA as an adjuvant agent, in addition to the thyroid cancer primary treatment, remains an area of investigation.Methods: We conducted a comprehensive systematic literature review from the first publication available to July 2021. We comprised clinical trials and preclinical investigations that explored VPA’s underlying mechanisms and treatment strategies in thyroid cancer.Results: Fifteen eligible studies were included. Thirteen preclinical studies revealed that VPA significantly enhances therapeutic responses across various histological subtypes of thyroid cancer cells. Regarding clinical implications, recent clinical studies indicated no significant effect on tumor response or overall survival.Conclusions: Our findings highlight the key role of VPA as an alternative therapeutic strategy for thyroid cancer, considering its favorable impact on various histological subtypes. Further welldesigned studies in clinical settings are required to identify the knowledge gap regarding its use in other multimodal treatments such as chemotherapy, surgery, and radiotherapy.

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