KEJADIAN DEMAM NEUTROPENIA PADA PASIEN KANKER PAYUDARA YANG MENDAPAT KEMOTERAPI

AbstrakKemoterapi memiliki peranan penting dalam penatalaksanaan kanker payudara. Obat ini bekerjamembunuh sel-sel kanker, namun dapat juga menghancurkan sel-sel sehat termasuk sel darahsehingga dapat menyebabkan neutropenia. Penelitian ini bertujuan untuk mengetahui kejadiandemam neutropenia pada pasien kanker payudara yang mendapat kemoterapi. Jenis penelitianini adalah obsevasional dengan desain cross sectional study. Jumlah sampel sebanyak 98 orangpenderita kanker payudara yang menjalani kemoterapi di RSUP Dr. M Djamil Padang.Pemeriksaan yang dilakukan adalah differential count dan suhu tubuh oral, kemudian dilakukananalisis statistik dengan uji non parametrik. Kejadian demam neutropenia ditemukan pada 10pasien (10,2%), dimana didapatkan hubungan yang bermakna antara regimen kemoterapidengan kejadian demam neutropenia (p=0,028), dan tidak terdapat hubungan yang bermaknaantara kejadian demam neutropenia dengan umur pasien (p=0,683) serta setting kemoterapi(p=0,631). Hubungan antara kejadian demam neutropenia dengan siklus kemoterapi tidak dapatdianalisis secara statistik. Penelitian ini dapat disimpulkan bahwa regimen kemoterapi non FACmeningkatkan resiko kejadian demam neutropenia pada pasien kanker payudara yangdikemoterapi.AbstractChemotherapy has an important role in breast cancer management. Chemotherapy works bykilling cancer cells in the body. However, healthy cells including blood cells are also destroyedleading to a condition called neutropenia. This study aimed to determine the incidence ofneutropenia febrile in patients with breast cancer who received chemotherapy in thechemotherapy unit of Dr. M. Djamil Padang Hospital. This study was a cross-sectional study of98 samples. Leucosite differential count and oral body temperature were examined and wereanalyzed with non parametric test. Neutropenia febriles were found on 10 out of 98 patients(10.2%). There was a significant association found between chemotherapy regimen and theincidence of neutropenia febrile (p=0.028), however, there were no significant associationbetween the incidence of neutropenia febrile with patient’s age (p=0.683) and the setting ofchemotherapy (p=0.631). While the correlation between the incidence of neutropenia febrile andchemotherapy cycle can not be statistically analyzed. It is concluded that chemotherapy causesincidence of neutropenia febrile at 10.2% patient. Non FAC chemotherapy regimens increasesthe risk of neutropenia febrile in patients with breast cancer patient receiving chemotherapy.

The role of hormonal ovarian ablation in adjuvant treatment of premenopausal breast cancer

Introduction. Breast cancer is the most frequent malignant disease in women with about 25% compared to all malignant tumours. Chemotherapy, antiestrogen and ovarian ablation/ supression present effective adjuvant approach for premenopausal women diagnosed with hormonal depended, operable breast cancer. Objective. To evaluate benefits of combined chemo/hormonal therapy that is undutiful, but optimal application has not yet been clearly determined. Methods. Thirty-six women were divided into three therapy groups. The first group (13 women) was treated with six cycles of adjuvant FAC chemotherapy followed by regular check-ups; the second group (13 women) after six cycles of adjuvant FAC chemotherapy continued treatment with a two-year application of goserelin given by subcutaneous injections (FAC-Z); the third group (10 women), after six cycles of adjuvant FAC chemotherapy continued with once per month application of gorselin for two years and a daily application of 20 mg tamoxifen for five years (FAC-Z-T). The length of overall disease free period and survival were analyzed in all three groups. Results. The benefit of LH-RH analogues in premenopausal women with hormone-dependent breast cancer was found to be low, and probably limited to smaller subgroups of patients, possibly such as those with either both steroid receptors positive (ER and PR) or those with an extremely high level of steroid receptors. In our paper, analyses of such subgroups could not been performed due to a small sample of patients. The effect of therapy is better in patients, who developed amenorrhoea, regardless of the type of later hormonal therapy. Conclusion. Ovarial ablation, whatever the method, should be probably applied as early as possible within the treatment of early breast cancer, especially in patients in whom chemotherapy induced amenorrhoea is not expected, i.e. in very young female patients.

Oxidative stress parameters in women with breast cancer undergoing neoadjuvant chemotherapy and treated with nutraceutical doses of oral glutamine

PURPOSE: To evaluate the effects of oral administration of GLN on the oxidative stress in women with breast cancer undergoing neoadjuvant FAC chemotherapy (5 fluouracil 500 mg/m²+Doxorubicin 50 mg/m²+Cyclophosphamide 500 mg/m² body surface area). METHODS: Twenty women (mean age: 51.7 years) with breast ductal carcinomas classified as T3 or T4 were included in the study, regardless of pre or post menopause status. Sachets containing glutamine 15g ("A") or milk protein 15g ("B") were prepared by a registered pharmacist. Allocation of patients was made by software program. Patients who received sachets labeled "A" were included in G1 group. The remaining patients, treated with the preparation labeled "B", were included in group G2. Sachets contents were blended in 150 ml of drinking water, and were given daily to each patient during the entire course of neoadjuvant chemotherapy. Peripheral blood samples were collected in the first day of each of the three cycles of chemotherapy before drug infusion. Tumor and normal breast samples were collected at the end of Patey´s surgical procedure. Samples were analysed for GSH and TBARS contents. RESULTS: TBARS and GSH values were not different in breast healthy and tumor tissues nor blood when comparing control (G-2) and glutamine-treated (G-1) patients. Also, no significant differences were found in TBARS and GSH levels comparing different timepoints within the same group. CONCLUSION: Oral GLN (15g/kg/day) offers no protection against systemic or local oxidative stress in women with breast Ca undergoing neoadjuvant chemotherapy (FAC).