Keberhasilan Terapi Argon Plasma Coagulation pada Penderita Kolitis Radiasi dan Faktor yang Memengaruhinya

Aru Ariadno, Dadang Makmun, Andri S Sulaiman, Sukamto Koesnoe

Abstract

Pendahuluan. Argon plasma coagulation (APC) merupakan modalitas terapi yang banyak digunakan untuk pengobatan kolitis radiasi pada pasien keganasan ginekologi, kolorektal, dan urologi yang mendapatkan radioterapi di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSCM), Jakarta. Penelitian ini dilakukan untuk menilai hasil dari APC yang dilakukan pada penderita kolitis radiasi dan faktor perancunya.

Metode. Penelitian deskriptif analitik dengan desain kohort retrospektif dilakukan pada penderita kolitis radiasi yang menjalani terapi APC di RSCM Jakarta. Data diambil dari rekam medis pasien antara bulan April 2012 sampai dengan Oktober 2019.

Hasil. Sebanyak 180 pasien kolitis radiasi yang mendapatkan terapi APC memenuhi kriteria penelitian dengan proporsi terbanyak berjenis kelamin perempuan sebesar 89,4%, dan berusia >50 tahun sebanyak 83,9%. Sedangkan, jenis tumor terbanyak adalah keganasan ginekologi sebanyak 88,9%. Sebanyak 81,3% subjek mengalami keberhasilan terapi APC. Median frekuensi APC sebanyak 2 sesi dengan rentang 1–12 sesi. Seluruh subjek didapati menderita anemia sebelum menjalani APC yang pertama. Kadar hemoglobin pada penderita APC meningkat dengan median Hb sebelum APC pertama sebesar 8 g/dL (rentang 3-11 g/dL) menjadi 12 g/dL (rentang 10-14 g/dL) sebelum APC terakhir. Sebanyak 59,2% subjek yang mengalami keberhasilan APC tidak lagi menderita anemia setelah terapi APC, dengan perbaikan status anemia meningkat sebesar 1,628 kali lebih baik pada subjek yang mengalami keberhasilan APC dibandingkan dengan subjek yang mengalami ketidakberhasilan terapi APC (p=0,017). Usia, jenis kelamin, jenis keganasan, hipertensi dan diabetes melitus bukan merupakan faktor perancu terhadap status anemia pada keberhasilan APC.

Simpulan. Terdapat perbaikan status anemia pada penderita kolitis radiasi yang mendapatkan terapi APC di RSCM Jakarta. Usia, jenis kelamin, jenis keganasan, hipertensi dan diabetes melitus bukan merupakan faktor perancu terhadap status anemia pada keberhasilan APC.

 

Efficacy of Argon Plasma Coagulation Treatment in Radiation Colitis Patients and Its Confounding Factors

Introduction. Argon Plasma Coagulation (APC) is widely used in the treatment  of radiation colitis among patients with gynecology, colorectal and urology malignancy. This study aimed to measure the result of APC conducted on radiation colitis patients and its counfounding factors.

Methods. An analytic descriptive study with retrospective cohort design was conducted among radiation colitis patients received APC treatment in Cipto Mangunkusumo Hospital, Jakarta.  Data were collected from medical record database between April 2012 until October 2019.

Results. As much as 180 radiation colitis patients received APC treatment fulfilled inclusion criteria with characteristics female patients (89.4%) and age >50 years old (83.9%) were included in this study. Types of tumor were dominated by gynecology malignancy (88.9%). As much as 81.3% subjects had successful APC treatment. Median number of efficacy of APC treatment in this study was 2 sessions. All of the subjects had anemia before the first APC treatment. There was improvement in Hb level, median Hb before the first APC treatment was 8 g/dL (3-11 g/dL) and median Hb level before the last APC treatment was 12 g/dL (10-14 g/dL). As much as 59.2% subjects who had successful APC treatment were no longer had anemia after APC treatment, improvement of anemia status was 1.628 times more likely in subjects who had successful APC treatment compared to subjects who did not have successful APC treatment (p=0.017). Age, gender, malignancy types, hypertension, and diabetes mellitus were not the confounding factors to anemia status in successful APC treatment.

Conclusion. There was improvement in anemia status on radiation colitis patients receiving APC treatment in RSUPN-CM.


Keywords

Anemia, argon plasma coagulation, radiation colitis

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