Sel-sel kanker dengan kemampuannya bermetastasis, terkadang sulit ditangani dengan menggunakan pembedahan konvensional atau strategi radioterapi dan kemoterapi. Di sisi lain, perkembangan terapi sel punca menunjukkan peningkatan keberhasilan yang menjanjikan dalam pengobatan kanker. Sel punca dapat berfungsi sebagai sarana pengiriman obat anti kanker dan menargetkan tumor primer maupun fokus metastasis. Sel punca dapat direkayasa untuk mengekspresikan berbagai agen sitotoksik sehingga dapat mengurangi volume tumor dan memperpanjang kesintasan hidup pada model hewan praklinis. Sel punca juga telah digunakan sebagai pembawa virus dan partikel nano untuk meningkatkan efektivitas terapi utama dan meringankan efek samping pengobatan. Selain itu, sel punca dapat diterapkan dalam kedokteran regeneratif, imunoterapi, terapi bertarget sel punca kanker. Sayangnya penggunaan terapi sel punca untuk mengobati kanker pada manusia, masih menghadapi beberapa tantangan seperti tumorigenesis dan biaya yang tinggi. Oleh sebab itu diperlukan penelitian lebih lanjut untuk meningkatkan kinerja terapi dan penerapannya.
Cancer is the leading cause of death in children worldwide. Pediatric cancer is challenging to detect early because it generally appears with signs and symptoms that are not typical. The increase in cancer cases in pediatric must be followed by an increase in cancer management in all fields of scientific disciplines. Radiation oncology, as one of the areas of science, has an essential role in definitive, adjuvant, palliative, and prophylactic cancer in pediatric. Apart from these uses, radiation management is a significant contributor to the complications of pediatric cancer survivors. Complications that arise can be in the form of growth retardation, tissue changes, secondary cancer, neurocognitive changes, infertility, or other hormonal dysfunction and preterm labor. An increase in radiation techniques followed the development of treatment machines able to reduce radiation-related morbidity and mortality rates. In pediatric radiotherapy, the entire process from the pre-procedure anesthesia to radiotherapy requires special attention. Psychological issues are also worth observing. This study will briefly discuss these matters and the management of some of the most common pediatric cancers in Dr. Cipto Mangunkusumo Hospital.
Background Sur ger y is the mainstay ther apy for color ectal car cinoma with curative intent, while radiotherapy and chemotherapy act as adjuvant or neoadjuvant therapy. The desicion for surgery depends on tumor resectability. Neoadjuvant radiotherapy, both short-course radiotherapy (SRT) or long-course radiotherapy (LRT) with or without concurent chemotherapy, is aimed to increase tumor resectability. This article compares advantages of SRT and LRT. Method We designed a sear ch filter using r elevant synonyms for the domain: "rectal carcinoma", "resectable", "preoperative radiotherapy", and "short-course". Publications are retrieved from PubMed, Cochrane Library, and EBSCO using MESH terms and search terms in title and abstract fields. Articles' titles and abstracts from search result are screened for relevance. Eligible articles are selected based on inclusion and exclusion criterias. Selected articles are critically appraised for methods validity. Result Six ar ticles ar e included in our study, consists of four r andomized clinical trials and two metaanalyses. Conclusion SRT is as effective as LRT with or without chemother apy in ter ms of overall survival, disease free survival, local recurrence rate, disease metastasis rate, free resection rate, and grade 3-4 toxicity. LRT with or without chemotherapy showed superiority in increasing pathological complete response rate and sphincter preservation rate. SRT is a better choice in centers with a long waiting list.
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