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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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Enhancement of mRNA Vascular Endothelial Growth Factor-A (VEGF-A) Induced Anemia in Oral Squamous Cell Carcinoma (OSCC) Ramadian, Kurnia Jelang; Mahardika, Choirumminanisa Imma; Pangastuti, Aliffala Widianaputri Setya; Ramadhani, Nabella Deby; Sulistyo, Hidayat; Widodo, Haris Budi; Indah Sari, Dwi Nur; Wardana, Tirta
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1278

Abstract

Background: Oral squamous cell carcinoma (OSCC) is a malignant epithelial neoplasm that can lead to mechanical disturbances and malnutrition, potentially causing anemia. Vascular endothelial growth factor-A (VEGF-A) plays a crucial role in angiogenesis and vascularization, which may impact anemia in OSCC patients. This study aimed to investigate the differential mRNA expression of VEGF-A in OSCC patients with and without anemia.Method: This cross-sectional observational study analyzed 39 formalin-fixed paraffin-embedded (FFPE) samples from OSCC patients (13 with anemia, 26 without anemia). VEGF-A mRNA expression was quantified using qPCR with GAPDH as a reference gene. The Livak method was used to determine VEGF-A expression levels. Data were analyzed using GenEX MultiD 6.0 software, and statistical significance was assessed using independent T-tests. Results: VEGF-A mRNA expression in OSCC patients varied based on anemia status (1.94-fold), tumor size (1.44-fold), histological grade (1.21-fold), and anemia severity (1.30-fold). Significant differences in VEGF-A mRNA expression were observed for anemia status and tumor size (p 0.05), while histological grading and anemia severity showed no significant differences. Conclusion: This study demonstrates a significant difference in VEGF-A mRNA expression in OSCC patients with anemia, particularly in relation to tumor size. These findings contribute to our understanding of the relationship between VEGF-A expression and anemia in OSCC, potentially informing future diagnostic and therapeutic strategies.
Craniospinal Irradiation in Adult Medulloblastoma: A Case Report and Analysis of Treatment Planning Comparing Volumetric Modulated Arc Therapy and Three-Dimensional Conformal Radiotherapy Banjarnahor, Christine Tiarma Ully; Nainggolan, Andreas; Hariyanto, Agustinus Darmadi
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1231

Abstract

Introduction: Adult medulloblastoma is a very uncommon case. Multimodal treatment, including surgery, radiation therapy, and chemotherapy, has led to an improvement not only in long-term survival but also in major-related toxicity. Case Presentation: We report the case of a 24-year-old man with medulloblastoma who underwent surgery followed by volumetric modulated arc therapy (VMAT) craniospinal irradiation (CSI) three weeks after resection. The radiation dose was 36 Gy in 20 fractions to the craniospinal axis, with an 18 Gy boost dose in 10 fractions to the posterior fossa. Threedimensional conformal radiotherapy (3D-CRT) planning was done to compare the dosimetric results of VMAT and 3D-CRT.Conclusion: The VMAT CSI technique delivers a better dose of homogeneity, conformity, and OARs-sparing than 3D-CRT
Key Predictors for Reducing Chemotherapy-Induced Nausea and Vomiting Among Cancer Patients Sari, Ike Wuri Winahyu; Rukmi, Dwi Kartika; Yulaikhah, Lily
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1289

Abstract

Background: Chemotherapy-induced nausea and vomiting (CINV) is a common and distressing side effect for many cancer patients. Given its high prevalence, it is essential to investigate additional factors associated with CINV. This study aimed to identify key predictors for reducing CINV in cancer patients undergoing chemotherapy.Method: This study used a descriptive-analytical design with a cross-sectional approach conducted in one of the public hospitals in Yogyakarta from March to September 2023. Of the 100 samples purposively selected, they joined the study. Inclusion criteria were patients with any cancer type undergoing chemotherapy, aged 18 years or older, and who had signed informed consent. Exclusion criteria included patients experiencing sudden emergencies or families not consenting to data collection. Demographic characteristics and CINV moments were measured during chemotherapy sessions using the Index of Nausea, Vomiting, and Retching (INVR), which measures experiencing symptoms over the previous 12 hours. The collected data were then analyzed using descriptive statistics. The correlation between demographic characteristics and CINV was analyzed using bivariate and multivariate analyses to identify the predictors of CINV.Results: The average INVR score among patients experiencing CINV was 9.20 ± 7.29, with a range of 0–32, and most patients experienced moderate CINV. Bivariate analysis revealed that cancer stage and the type of family caregiver were significantly correlated with CINV (both with p 0.001). Multivariate analysis confirmed that cancer stage (β = 0.440; p 0.001) and family caregiver type (β = 0.255; p = 0.004) were strong predictors of CINV. Patients in advanced cancer stages and those cared for by child caregivers were at higher risk for more severe CINV symptoms.Conclusion: The findings highlight key factors associated with CINV among cancer patients. Understanding these predictors can help in developing targeted interventions to manage CINV better. Educating patients and their families about CINV management and incorporating patient feedback into care practices could improve patient outcomes and overall well-being.
Low Anterior Resection Syndrome (LARS) and Related Factors Variation Pattern in Indonesian Tertiary Hospital: Case-Controlled Study Jeo, Wifanto Saditya; Mazni, Yarman; Putranto, Agi Satria; Primadhani, Wendy; Ananti, Anggini T.; Yoladifa, Safira Farah
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1318

Abstract

Background: Dysfunctional bowel movement, also referred to as low anterior resection syndrome (LARS), is a regular issue correlated with rectal cancer, which significantly impacts overall wellbeing. Thisstudy intended to look for the LARS incidence in patients with colorectal cancer where rectal preservation was not possible and identify factors affecting major LARS incidence in Indonesia. Method: This study follows a case-control design. Patients with rectal cancer over 18 years old who underwent tumour removal with mesorectal excision and colorectal anastomosis at Dr. Cipto Mangunkusumo General Hospital, Indonesia, from January to March 2019. The control group includes patients of eligible age who had anal sphincter preservation, stoma closure, and fall into the No LARS or Minor LARS category. Data were collected from medical records and scored with a validated LARS questionnaire. Results: Among 40 patients included, 42.5% had major LARS. The surgical procedure of low anterior resection (LAR) was significantly associated with 31.7% of major LARS patients (p = 0.04). Preoperative radiotherapy [OR 0.1 (0.02–0.49)] and anastomosis levels [OR 0.07 (0.01–0.39)] were associated with major LARS. The ROC curve revealed an AUC of 0.77, indicating significant results with the threshold for anastomosis level was 5 cm. Biofeedback revealed group differences in resting anal and maximal squeeze pressures, indicating sphincter impairment and preoperative treatment impact LARS progression. Conclusion: Major LARS development was heightened by surgical methods, preoperative radiotherapy, and lower anastomotic levels, emphasizing the role of sphincter dysfunction and preoperative interventions in LARS development.
Role of Liquid Biopsy as a Future Approach to Early Diagnosis and Management of Colorectal Cancer Danardono, Edwin; Soediono, Mochammad Ridhwan; Amiruddin, Muhammad Tidar Abiyu
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1319

Abstract

Colorectal cancer (CRC) is a major global health challenge, ranking as the third most prevalent cancer worldwide. Traditional tumor biopsies are invasive and limited by issues such as tumor heterogeneity and the inability to perform repeated sampling. Liquid biopsy, a non-invasive diagnostic approach that analyzes biomarkers in bodily fluids like blood, offers an innovative solution to these challenges. By detecting circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes, and tumor-educated platelets (TEPs), liquid biopsy allows for real-time tumor monitoring, early cancer detection, and personalized treatment strategies. This review explores the clinical applications of liquid biopsy in CRC, highlighting its potential for early detection, monitoring treatment response, and guiding customized therapies. Key biomarkers such as CEA, ctDNA, CTCs, and exosomal miRNAs offer insights into tumor dynamics and prognosis. While liquid biopsy shows promise for broad clinical use, challenges remain in standardizing methodologies and validating its efficacy through large-scale trials. Advances in technology and improved biomarker discovery are expected to enhance the accuracy and utility of liquid biopsy, making it a pivotal tool in CRC management and beyond.
Diagnostic Accuracy of Modalities for Diagnosis of Thoracic Cancer: Retrospective Analysis Ariawan, Wily Pandu; Hanafi, Arif Riswahyudi; Pradipta, Jaka; Jayusman, Mulawarman; Hanif, Muhammad Alfin; Hutabarat, Jubillete Windy; Amira, Salsabila Nur
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1307

Abstract

Background: Thoracic cancer becomes a huge consideration, especially for lung cancer, because it quietly increases over time and needs highly sensitive diagnostic modalities. Thus, we aim to investigate the diagnostic accuracy of several cytology-based modalities to diagnose thoracic cancer. It would serve as a reference for other cancer centers in estimating diagnostic approaches for thoracic cancer.Method: Retrospective analysis with a cross-sectional study comprised of 2358 diagnostic procedures at Dharmais Cancer Hospital, Jakarta, Indonesia, from 2020 to 2023. Data were extracted from e-medical records. We compared seven cytology-based procedures to the gold standard, which is histopathology examination. Results: Study subjects (n=2358; mean age 60 ± 12.0; 62.6% male) predominantly used the mode of diagnostic Bronchial Brushing Cytology (BBC) about 676 (28.7%). Endobronchial Ultrasound (EBUS) was the highest sensitivity (88.1%) of the diagnostic approach for thoracic cancer (p 0.05).Conclusion: EBUS had the highest sensitivity in diagnosing thoracic cancer. However, multimodality diagnostic procedures should be considered for patients who have symptoms suggestive of thoracic cancer to get highly positive results and lower complications, both cytologically and histologically. As a national cancer center, providing data on diagnostic modalities is necessary, and an analysis of cancer services is required for informed policy recommendations.
Evaluating the Implementation of an Early Palliative Care Screening Tool for Inpatients at Persahabatan Hospital: Impact on Quality of Care, Length of Stay, and Clinical Outcomes Khonsa, Oni; Meliala, Andreasta; Darwito, Darwito
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1263

Abstract

Background: Palliative care is integrated medical care that is active and comprehensive, with a multidisciplinary approach to reduce the pain of terminally ill patients at the end of their lives. Persahabatan Hospital, as a national referral Type A hospital, receives many patients in severe and complex conditions, some of whom require palliative care. Early identification of Palliative Care Screening Tool (PCST) screening can result in more effective interventions and more optimal care in improving quality of life, reducing length of stay, and intensive care unit (ICU) admission rates. This study aims to assess the early implementation outcomes of the PCST in inpatients at Persahabatan Hospital. Method: This research is a sequential explanatory mixed methods design that examines how the implementation evaluation of PCST in palliative care at Persahabatan General Hospital is conducted, utilizing both retrospective quantitative and qualitative approaches. The quantitative approach involves utilizing secondary data from medical records and the PCST at Persahabatan General Hospital in Jakarta from January to December 2023. A random sampling technique was applied to select patients diagnosed with palliative care conditions, including severe liver disease,end-stage kidney disease, chronic obstructive pulmonary disease (COPD), advanced heart failure,and other chronic illnesses. At the same time, the qualitative approach employs the focus group discussion analysis method.Results: Out of 82 patients who underwent PCST screening, 56 patients underwent early screening, and 26 patients underwent late screening. The median length of stay for patients with early screening was 4 days, whereas for those with late screening, it was 18 days (p 0.001). Early screening had a relative risk of 4.34 (1.72–26.2) for successful palliative screening compared to late screening. Based on the analysis of the focus group discussion results, the main issues in implementing early screening were a lack of understanding of the screening process and difficulties in its implementation
Correlation of Age, Tumor Size, and Histopathological Type with Indicator Tumor Progression of Penile Squamous Cell Carcinoma in Bali Astuti, Ni Luh Putu Vina Juni; Lestari, Desak Putu Oki; Sari, Ni Luh Putu Eka Kartika; Armerinayanti, Ni Wayan; Evayanti, Luh Gde; Perdana, I Gede Sukma Okta
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1340

Abstract

Background: Penile cancer is a rare malignancy globally, but Bali accounts for approximately 40% of Indonesia’s cases. Age, tumor size, and histopathological type are recognized factors influencing penile cancer progression, with grade, depth of invasion, lymph node metastasis, and distant metastasis serving as key indicators. However, the prognostic value of these factors, particularly depth of invasion, remains debated. This study aimed to evaluate the correlation between age, tumor size, and histopathological type with indicators of tumor progression in penile squamous cell carcinoma (SCC) in Bali.Method: A cross-sectional analytical study was conducted on 160 cases of penile SCC. Dependent variables included tumor grade, depth of invasion, and lymph node metastasis, while independent variables were age, tumor size, and HPV status (inferred from histopathology). Age was categorized as 60 or ≥60 years, tumor size as 4 cm or ≥4 cm, and depth of invasion as T1–T4. Multivariate analysis using the chi-square test was performed to assess associations.Results:  Most patients were aged ≥ 60 years, had HPV-independent SCC, tumor size ≥ 4 cm, grade 2 tumors, and T1 depth of invasion, with lymph node metastasis observed in a minority. Multivariate analysis revealed significant correlations between age, tumor size, and histopathological type with grade (p = 0.026, R² = 0.056), depth of invasion (p 0.001, R² = 0.445), and lymph node metastasis (p = 0.004, R² = 0.075). Tumor size demonstrated the strongest association with depth of invasion (OR = 9.618, p 0.001) and lymph node metastasis (OR = 6.846, p 0.001).Conclusion: Tumor size is a significant predictor of both depth of invasion and lymph node metastasis in penile SCC. Clinical assessment of tumor size should be emphasized as a key prognostic factor to guide early intervention strategies in patients with penile SCC in Bali.
Determinants of Quality of Life of Cancer Patients Undergoing Chemotherapy at Dharmais Cancer Hospital Jakarta in 2024 -, Saman -; Ulfa, Laila; Sulistyowati, Yeny; Buwana, Cahya
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1298

Abstract

Background: Cancer is one of the non-communicable diseases that is a serious problem in health and one of the leading causes of death in the world. GLOBOCAN data shows new cases of cancer in Indonesia as many as 408,661 cases, with deaths amounting to 242,988 people. Cancer treatment, which is chemotherapy and its impact on it, can affect the patient’s quality of life. This study aims to investigate the factors that influence the quality of life of cancer patients undergoing chemotherapy at Dharmais Cancer Hospital in Jakarta. Method: Analytic observational research method with a cross-sectional design. The research was conducted in May 2024 in the inpatient room. The research sample consisted of 90 respondents using an accidental sampling technique. Data was collected on the quality of life in cancer patients undergoing chemotherapy using the European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire C30 (EORTC QLQ-C30) questionnaire instrument, which contains 30 questions about the global health scale, functional scale, and symptom scale. Data analysis in this research included univariate analysis, bivariate analysis with the Chi-square test, and multivariate analysis with multiple logistic regression test, and data processing using SPSS 25.Results: The results showed that global health status was 50% good, the functional scale was 63.3% good, the symptom scale was 55.6% good, and the patient’s quality of life was 55.6% good. Variables associated with the quality of life of cancer patients undergoing chemotherapy are nutritional status (p = 0.035) and chemotherapy education (p = 0.037). The variables of age (p = 0.178), cancer stage (p = 1.000), length of chemotherapy (p = 0.395), and family support (p = 1.000) were not significantly associated.Conclusion: Nutritional status is the most associated variable with the quality of life of cancer patients undergoing chemotherapy. It is recommended that this research be carried out, including all factors that can affect the quality of life of cancer patients undergoing chemotherapy, and evaluate changes in quality of life in each chemotherapy cycle.
Use of 177Lutetium-PSMA in the Treatment of Metastatic Castrate-Resistant Prostate Cancer: A Case Report Nerli, R B; Ghagane, Shridhar C; Bokare, Ashwin; Shetty, Rakesh; Ramesh, Sudha; Rai, Shreyas
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1324

Abstract

Introduction: Despite several recent advances and the introduction of newer anti-cancer agents, metastatic castrate-resistant prostate cancer (mCRPC) remains challenging to treat and remains fatal. Recent studies have raised the possibility of targeted radionuclide therapies such as 177Lutetium-PSMA (prostate-specific membrane antigen) as a viable therapeutic option in men with metastatic prostate cancer. Case Presentation: A 53-year-old male presenting with lower urinary tract symptoms was found to have cancer of the prostate on further evaluation. The patient underwent radical prostatectomy, and during follow-up, bony metastasis was noted at the end of two years. The patient received androgen deprivation therapy and, over the next ten years, underwent chemotherapy, enzalutamide therapy, and secondary chemotherapy. The patient continued to have painful bony metastasis and was treated with 177Lutetium-PSMA therapy. Conclusion: 177Lutetium-PSMA demonstrates a promising treatment response in men with metastatic castration-resistant prostate cancer (mCRPC).

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