Faktor Yang Mempengaruhi Penurunan Fraksi Ejeksi Ventrikel Kiri Pada Pasien Kanker Yang Mendapatkan Kemoterapi Doksorubisin Di Rumah Sakit Kanker Dharmais
DOI:
https://doi.org/10.12928/mf.v12i2.3761Keywords:
doksorubisin, faktor risiko, penurunan fraksi ejeksi ventrikel kiriAbstract
Doksorubisin masih sering digunakan dalam pengobatan kanker. Efek samping doksorubisin terhadap jantung perlu mendapatkan perhatian khusus. Penelitian ini bertujuan untuk memperoleh gambaran penurunan fraksi ejeksi ventrikel kiri dan faktor risiko yang mempengaruhinya pada pasien kanker yang mendapatkan kemoterapi doksorubisin di Rumah Sakit Kanker Dharmais (RSKD). Desain penelitian yang digunakan adalah cross sectional. Data diperoleh dari rekam medis pasien. Populasi adalah pasien kanker yang mendapatkan kemoterapi doksorubisin minimal 4 siklus periode Oktober 2011-Oktober 2013. Penilaian fungsi jantung didapatkan dari data Echocardiography jantung yaitu fraksi ejeksi ventrikel kiri sebelum kemoterapi dan setelah siklus terakhir kemoterapi. Penurunan fraksi ejeksi ventrikel kiri ≥10% pada penelitian dinilai sebagai penurunan yang bermakna. Analisis statistik menggunakan software Statistical Products Social Science (SPSS) versi 18. Sebanyak 77 pasien memenuhi kriteria inklusi dan eklusi. Sebanyak 37 pasien (48,05%) mengalami penurunan fraksi ejeksi ventrikel kiri <10% dan sebanyak 28 pasien (36,36%) mengalami penurunan fraksi ejeksi ventrikel kiri ≥10%. Hipertensi berpengaruh terhadap penurunan fraksi ejeksi ventrikel kiri ≥10% secara bermakna (p=0,032). Jenis kelamin laki-laki dan radiasi dada kiri menunjukkan adanya kecenderungan berhubungan dengan penurunan fraksi ejeksi ventrikel kiri ≥10% (p=0,095 dan p=0,051). Doksorubisin dapat menyebabkan penurunan fraksi ejeksi ventrikel kiri ≥10% pada lebih dari sepertiga pasien kanker di RSKD dan faktor yang paling mempengaruhinya adalah komorbiditas hipertensi.
Â
Kata Kunci: doksorubisin; faktor risiko; penurunan fraksi ejeksi ventrikel kiri
Â
References
Bovelli, D., Plataniotis, G., & Roila, F., 2010, Cardiotoxicity Chemotherapy Agents and Radiotheraphy Related Heart Disease: ESMO Clinical Practice Guidelines. Annals of Oncology, 21, 277-282.
Chatterjee, K, Zhang, J, Honbo, N, & Karliner, S, J., 2010, Doxorubicin Cardiomyopathy. Cardiology, 115 (2), 155-162.
Chu, E & Sartorelli, A, C., 2012, Cancer Chemotherapy. In Katzung, G, B., Masters, M, S., & Trevor, J, A., (Eds.), Basic & Clinical Pharmacology 12th Ed (pp. 949-975). New York: McGrawHill.
Chung, W, B., Yi, J, E., Choi, Y, S., Park, C, S., Park, W, C., Song, B, J., & Youn H, J., 2013, Early Cardiac Function Monitoring for Detection of Subclinical Doxorubicin Cardiotoxicity in Young Adult Patients with Breast Cancer. Journal of Breast Cancer, 16(2), 178-183.
Dahlan, S, M. , 2012, Analisis Multivariat Regresi Linier. PT. Epidemiologi Indonesia: Jakarta
Ewer, S. M., & Ewer, M. S., 2010. Cardiotoxicity of Anticancer Treatments: What Cardiologist Needs to Know. Nature Reviews Cardiology, 7, 564-75.
Goethals, I., De Winter, O., De Bondt, P., et al., 2002, The clinical value of nuclear medicine in the assessment of irradiation-induced and anthracycline-associated cardiac damage. Annals of Oncology, 13, 1331–1339.
Hershman L, D., McBride, B, R., Eisenberger, A., Wei Yann., Grann, R, V., & Jacobson J., 2008, Doxorubicin, Cardiac Risk Factor, and Cardiac Toxicity in Elderly Patients With Diffuse B-Cell Non-Hodgkin’s Lymphoma. Journal of Clinical Oncology, Vol 26.
Hequet, O., Lee, Q. H., Moullet, I., Pauli, E., Salles,G., Espinouse, D., Dumontet,C., Thieblemont,C., Arnaud, P., Antal D.,, Bouaï¬a, F., & Coifï¬er, B., 2004, Subclinical Late Cardiomyopathy After Doxorubicin Therapy for Lymphoma in Adults. Journal of Clinical Oncology, 22 (10).
Hunt, S, A., Abraham, W, T., Chin, M, H., Feldman, M, A., Francis, S, G., Ganiats, G, et al., 2009, Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for The Diagnosis and Management Of Heart Failure in Adults: a Report of The American College of Cardiology Foundation/American Heart Association Task. Force on Practice Guidelines. Journal of the American College Cardioogyl, 53:e1–90.
International Agency for Research on Cancer., 2012, GLOBOCAN 2012: Estimated Cancer Incidence Mortality and Prevalence Wordwide in 2012. Retrived from website: http://globocan.iarc.fr/Default.aspx.
Kamelia, T., 2008, Perubahan Konsentrasi Amino Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) dan Fraksi Ejeksi Ventrikel Kiri pada Pasien Kemoterapi Doksorubisin. Tesis. Jakarta: Program Studi Ilmu Penyakit Dalam FKUI.
Kementerian Kesehatan RI., 2013, Riset Kesehatan Dasar 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementererian Kesehatan RI.
Khattry, N., Malhotra, P., Grover., A, Sharma, C, S., & Varma, S., 2009, Doxocrubicin-induced Cardiotoxicity in Adult Indian Patients on Chemotherapy. Indian Journal Medical and Paediatric Oncology, 30 (1).
Jones LW, Haykowsky MJ, Swartz JJ., 2007, Early breast cancer: therapy and cardiovascular injury. Journal of the American College of Cardiology.; 50: 1435–1441.
Lipshultz, S, E., Lipsitz, S, R., Mone, S, M., et al,. 1995, Female sex and drug dose as risk factors for late cardiotoxic effects of doxorubicin therapy for childhood cancer. The New England Journal of Medicine, 332, 1738–1743.
Lu, P. , 2005, Monitoring Cardiac Function in Patients Receiving Doxorubicin. Seminars in Nuclear Medicine, 35, 197–201.
Moulin, M.., 2015, Sexual Dimorphism of Doxorubicin-Mediated Cardiotoxicity: Potential Role of Energy Metabolism Remodeling. Circulation: Heart Failure. 8 (1): 98-108.
National Cancer Institute, 2009, Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. National Cancer Institute, U.S Departement Of Health and Human Services.
National Cancer Institute., 2013, Breast Cancer Treatment. National Cancer Institute, U.S Departement Of Health and Human Services.
Nousiainen, T., Jantunen, E., Vanninen, E., & Hartikainen J., 2002, Early decline in left ventricular ejection fraction predicts doxorubicin cardiotoxicity in lymphoma patients. British Journal of Cancer, 86, 1697–700.
Octavia, Y., Tocchetti, G, C., Gabrielson, L, K., Janssens, S., Crijns, J, H., & Moens, L, A., 2012, Doxorubicn-Induced Cardiomyopathy: From Molecullar Mechanism. Journal of Molecular and Cellular Cardiology, 52, 6, 1213-1225.
Pinder, C. M., Zhigang, D., Goodwin, S. J,. Hortobagyi, N. G., & Giordano, H. S., 2007, Congestive Heart Failure in Older Women Treated With Adjuvant Anthracycline Chemotherapy for Breast Cancer. Journal Clinical of Oncology, 25 (25).
Putt M., et al., 2015, Longitudinal Changes in Multiple Biomarkers Are Associated with Cardiotoxicity in Breast Cancer Patients Treated with Doxorubicin, Taxanes, and Trastuzumab. Clinical Chemistry 61.9 : 1164-1172.
Sabri, L., & Hastono, S. P., 2006, Statistik Kesehatan (pp. 153). Jakarta: PT Rajagrafindo.
Sastroasmoro, S & Ismael, S., 2002, Dasar-Dasar Metodologi Penelitian Klinis. Jakarta: CV Sagung Seto.
Talbert. L., R., 2014, Hyperlipidemia. Dalam J.T. Dipiro, R. L. Talbert, & G.C. Yee (Eds.), Pharmacotherapy: a Patophysiologic Approach edisi ke-9. New York: Mc
Downloads
Issue
Section
License
Authors who publish with Media Farmasi agree to the following terms:
- Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
This work is licensed under a Creative Commons Attribution 4.0 International License
