Latar belakang: Hasil terapi penderita kanker umumnya dinilai dari angka kelangsungan hidup dan angka kontrol penyakit secara lokal/regional. Penilaian ini dilakukan oleh dokter dan tidak menunjukkan bagaimana kepuasan penderita terhadap hasil terapi. Di Indonesia, karsinoma nasofaring (KNF) menempati peringkat keempat keganasan tertinggi, dengan tipe terbanyak adalah KNF WHO tipe III. Penilaian kualitas hidup penting dilakukan karena penyakit dan terapi KNF dapat mempengaruhi beberapa fungsi penting kehidupan (makan, komunikasi, dan hubungan sosial). Belum pernah dilaporkan penelitian mengenai kualitas hidup penderita KNF setelah terapi di Indonesia. Tujuan: Mengetahui hubungan antara respons terapi dengan kualitas hidup penderita KNF WHO tipe III setelah radioterapi atau kemoradioterapi. Metode: Penelitian observasional analitik dengan pendekatan cross-sectional. Dinilai respons terapi dan kualitas hidup 8 subyek dari kelompok radioterapi, dan 8 subyek dari kelompok kemoradioterapi, dengan waktu evaluasi minimal 3 bulan setelah terapi. Penilaian respons terapi berdasarkan hasil pemeriksaan terakhir: biopsi nasofaring, foto Rontgen toraks, ultrasonografi abdomen,biopsi aspirasi jarum halus kelenjar getah bening leher (jika ada indikasi), dan foto Rontgen torakolumbal (jika ada indikasi). Penilaian kualitas hidup menggunakan kuesioner EORTC QLQ-C30 dan EORTC QLQ-H&N35. Hasil: Tidak didapati perbedaan respons terapi antara kelompok radioterapi dan kemoradioterapi. Seluruh subyek memiliki respons terapi positif (tidak didapati tumor menetap, kambuh secara lokal dan regional, dan metastasis jauh). Penderita dengan respons terapi positif memiliki kualitas hidup tinggi. Uji perbedaan kualitas hidup menunjukkan perbedaan bermakna hanya dalam hal fungsi emosi (p=0,031). Kesimpulan: Penderita KNF WHO tipe III dengan respons terapi positif memiliki kualitas hidup tinggi. Tidak didapati perbedaan respons terapi antara kelompok radioterapi dengan kemoradioterapi. Penderita yang mendapatkan kemoradioterapi memiliki kualitas hidup lebih tinggi dalam hal fungsi emosi.Kata kunci: Karsinoma nasofaring, radioterapi, kemoradioterapi, respons terapi, kualitas hidupABSTRACT Introduction: The endpoint of medical care for cancer patients usually focused on the survival rate and locoregional control rate. These endpoints were assessed by doctor and not the patient’s satisfaction rate to treatment outcome. In Indonesia, nasopharyngeal carcinoma (NPC) is the fourth most common cancer, especially NPC type III WHO. Assessment of quality of life is important because both the disease and the therapy of NPC could affect several important functions in life (eating, communication, and social relationships). There was no study reported about quality of life of NPC patients after therapy in Indonesia. Purpose: To assess the relationship between treatment response and quality of life of NPC WHO type III patients after radiotherapy or chemoradiotherapy. Method: Analytic observational study with cross-sectional design assessed treatment response and quality of life in 8 subjects of radiotherapy group and 8 subjects of chemoradiotherapy group with minimal evaluation time 3 months after therapy. Treatment response was assessed by the latest examination result of nasopharyngeal biopsy, thorax plain photo, abdomen ultrasonography, fine needle aspiration biopsy of neck mass (if indicated), and thoracolumbal plain photo (if indicated). Quality of life was assessed by EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaire. Result: There was no treatment response difference between radiotherapy and chemoradiotherapy group. All subjects had positive treatment response (no cancer remained, no locoregional recurrence, and no distant metastasis). Subjects with positive treatment response had high quality of life. Statistical analysis on the quality of life only showed a marked difference in emotional function (p=0.031). Conclusion: NPC WHO type III patients with positive treatment response had high quality of life. There was no treatment response difference between radiotherapy and chemoradiotherapy subjects. Patients treated with chemoradiotherapy had a better quality of life in emotional function.Keywords: Nasopharyngeal carcinoma, radiotherapy, chemoradiotherapy, treatment response, quality of life
Background: Chronic rhinosinusitis has a significant impact on the quality of life and health of adult population. Role of airborne fungi remains a controversy and have become the source of discussion for decades. Objective: to know the prevalence of airborne fungi in the chronic rhinosinusitis with or without polyps patients and to know the possible effect of airborne fungi on chronic rhinosinusitis inflammation. Methods: This is a cross sectional research in the Saiful Anwar Public Hospital Malang, there were 29 patients involved. We examine fungi culture, H&E staining and DNA fungi by using PCR from sinus lavage sample. From the blood serum we examine allergen specific IgE, IgG3, IL-13 and IL-5.Results: Fungi culture there were 31,03 % of sample growth but only matches the PCR result in 3 samples (10,34 %). From PCR examinations we found all sample were positive with 2-5 species fungi, Alternaria alternata was found positive in 24,13% samples. There was an increment of IgE allergen specific and IL-5, a decrement of IL-13 and IgG3 in all of our samples regardless presence of nasal polyps and species of fungi found in PCR. Conclusions: PCR is a more reliable method compare to fungal culture. The presence of fungi in all of our samples could indicate fungi contribution to the disease pathophysiology. The increased level of Il-5 was not followed by IL-13; it may happen through PRR pathway.
Latar belakang: Inflamasi adenoid ditandai dengan ditemukannya pembesaran ukuran adenoid atau hipertrofi adenoid. Telah banyak dilakukan penelitian yang mendukung IL-6 merupakan dasar patofisiologi terjadinya hipertrofi adenoid sehingga dibutuhkan terapi yang dapat mengurangi peran IL-6. Saat ini, kortikosteroid intranasal menjadi pilihan terapi pada hipertrofi adenoid karena memiliki efek anti inflamasi. Terdapat penelitian mengenai manfaat penggunaan kortikosteroid intranasal terhadap penderita hipertrofi adenoid, dimana terjadi penurunan kadar IL-6, tetapi pengaruhnya terhadap kadar IL-6 serum tidak diteliti. Tujuan: Mengetahui pengaruh pemberian mometasone furoate semprot hidung terhadap kadar IL-6 serum pada penderita hipertrofi adenoid. Metode: One group pre and post test design ini melibatkan 16 subjek. Dilakukan pemeriksaan foto polos skull lateral soft tissue dan pengambilan darah tepi untuk menghitung kadar IL-6 serum. Diberikan terapi mometasone furoatesemprot hidung selama 6 minggu. Setelah 2 minggu dan 6 minggu dilakukan pengambilan darah tepi untuk menghitung kadar IL-6 serum, serta evaluasi foto polos skull lateral soft tissue setelah 6 minggu. Hasil:Terdapat perbedaan bermakna antara kadar IL-6 serum sebelum dan sesudah perlakuan baik, pada minggu kedua maupun minggu keenam (p=0.00). Terdapat perbedaan bermakna antara nilai foto polos skull lateral soft tissue sebelum dan sesudah perlakuan (p=0.00). Berdasarkan uji Pearson, nilai kadar IL-6 serum darah berkorelasi secara signifikan yang bersifat negatif (p<0,05) dengan foto polos skull lateral sebelum dan sesudah perlakuan dengan hasil -0,819 dan -0,692. Kesimpulan: Mometasone furoatesemprot hidung dapat menurunkan kadar IL-6 serum pada penderita hipertrofi adenoid secara bermakna, disertai dengan mengecilnya ukuran adenoid, penurunan gejala dan keluhan penderita hipertrofi adenoid. Kata kunci: Hipertrofi adenoid, Interleukin 6, Mometasone FuroateABSTRACT Background:Adenoid inflammation is characterized by adenoid hypertrophy (AH). Numerous studies had stated that Interleukin 6 (IL-6) is the pathophysiological basis for the occurrence of AH, thus, a therapy is needed to reduce the role of IL-6. Intranasal corticosteroid (IC) is the drug-of-choice for AH for its anti-inflammatory nature. Previous research had shown a decrease in IL-6 levels in adenoid tissue after IC administration, but its effect on IL-6 serum level had not yet been studied. Purpose: To find out the effect of Mometasone Furoate (MF) on IL-6 serum level in AH patients. Methods: One group pre and post test design, involving 16 subjects, underwent a soft tissue skull lateral plain x-ray, also a peripheral blood examination for IL-6 serum level. Afterwards, subjects were treated with MF nasal spray for 6 weeks. The IL-6 serum level was evaluated after 2 and 6 weeks, and the soft tissue x- ray was assessed after 6 weeks. Results: There were significant differences between IL-6 serum levels before and after treatment both in the second and sixth week (p = 0.00). There were significant differences between the value of soft tissue skull lateral plain x-ray before and after treatment (p = 0.00). Based on the Pearson test, IL-6 serum levels correlated significantly negatively (p <0.05) with soft tissue skull lateral plain x-ray before and after treatment with results -0.819 and -0.692. Conclusion: MF nasal spray significantly reduce IL-6 serum levels in AH patients, reducing adenoid size and decreasing symptoms of AH patients.
β-glucan can be used to establish the diagnosis of chronic fungal rhinosinusitis. However, differential diagnosis of allergy or infection cannot be excluded by examination of blood NER. Still, it is hoped that the process of diagnosis can be obtained quickly and precisely without the need for invasive procedure although it requires more research, especially related to the diagnostic test.
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