Dampak Penundaan Jadwal Kemoterapi Terhadap Rekurensi Pada Pasien Kanker payudara
Walit Uhkri Mukrinin(1*), Arief Nurrochmad(2), Fita Rahmawati(3)
(1) Program Pascasarjana Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta
(2) Departemen Farmakologi dan Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(3) Departemen Farmakologi dan Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(*) Corresponding Author
Abstract
Kemoterapi merupakan modalitas pengobatan utama pada kanker payudara bersama dengan operasi dan radioterapi. Kemoterapi memberikan manfaat dalam peningkatan ketahanan hidup pasien, namun manfaat tersebut dipengaruhi oleh kepatuhan terhadap jadwal kemoterapi. Dampak prognostik negatif dari keterlambatan dosis kemoterapi ini dapat berpengaruh pada hasil ketahanan hidup. Tujuan dari penelitian ini adalah untuk mengetahui gambaran penundaan jadwal kemoterapi (alasan dan durasi penundaan) serta dampaknya terhadap rekurensi. Penelitian ini menggunakan desain kohort retrospektif, melibatkan 138 pasien wanita kanker payudara stadium awal (stadium I-IIB) yang mendapatkan kemoterapi. Ekposur dalam penelitian adalah penundaan jadwal kemoterapi dan durasi penundaan, sedangkan luaran penelitian adalah rekurensi kanker payudara. Data penelitian diperoleh dari rekam medik pasien di RSUP Dr. Sardjito Yogyakarta. Analisis penelitian menggunakan metode Chi-square, Kaplan-Meier serta Cox-regression untuk mengetahui Hazard Ratio dengan tingkat kepercayaan 95%. Hasil penelitian menunjukkan bahwa penundaan jadwal kemoterapi pada pasien kanker payudara berhubungan dengan meningkatkan resiko rekurensi (HR 4,718; 95% Cl: 1,533-14,520, log rank tes p=0,003). Sementara durasi penundaan jadwal kemoterapi ≤7 hari dan >7 hari tidak berhubungan dengan peningkatan resiko rekurensi (HR 1,001; 95% Cl: 0.307-3,260, log rank tes p=0,999). Keterlibatan farmasi klinis sangat diperlukan untuk mencegah dan menyelesaikan masalah terkait efek samping obat serta monitoring pengobatan sehingga luaran pengobatan menjadi optimal.
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DOI: https://doi.org/10.22146/farmaseutik.v20i1.75491
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