Tren Tata Laksana Kanker Prostat Lokal Lanjut di Indonesia

GAMPO ALAM IRDAM

Abstract


ABSTRACT
Aim: to evaluate treatment trend of stage T3 prostate cancer based on several factors. Methods: a retrospective study
was done on stage T3 prostate cancer patients from year 1995-2013, at two national referral hospitalsin Indonesia.
Treatment trends between hormonal therapy and radiotherapy based on year of treatment, PSA level, tumor grade and
age groups were evaluated.Results: On 50 patients subjects, 25 (50%), 23 (46%) and 2 (4%) subjects were treated by
radiotherapy, hormonal therapy and radical prostatectomy, respectively. Year of treatment were significantly associated
with treatment selection (p=0.012), after excluding year of treatment 1995-1999 group. Hormonal therapy was preferred
on high grade tumor group (53.8%) and more applied for older patients. Treatment trend was not affected by PSA level.
Conclusion: Year of treatment were significantly associated with treatment selection of stage T3 prostate cancer.
Hormonal therapy was preferred on high grade tumor group and older age groups.
Keyword: treatment trend, locally advanced prostate cancer, radiotherapy, hormonal therapy

ABSTRAK
Penelitian ini bertujuan mengevaluasi tren tata laksana kanker prostat stage T3 berdasarkan faktor-faktor yang
memengaruhi. Metode: studi retrospektif tata laksana kanker prostat stage T3 di Rumah Sakit Cipto Mangunkusumo
dan Rumah Sakit Kanker Dharmais periode 1995-2013. Data tren pemilihan terapi antara radioterapi atau terapi
hormonal dianalisis berdasarkan kelompok tahun terapi, kadar PSA, grade tumor, dan kelompok usia. Hasil penelitian
menunjukkan dari 50 subjek, 25 (50%), 23 (46%), dan 2 (4%) subjek mendapatkan tata laksana radioterapi, terapi
hormonal, dan prostatektomi radikal secara berturutan. Perubahan tren pemilihan terapi berdasarkan tahun terapi
secara statistik signifikan (p=0,012), dengan mengeksklusikan kelompok periode terapi 1995-1999. Terapi hormonal
lebih menjadi pilihan untuk kelompok tumor high grade (53,8%) dan lebih sering dipilih seiring bertambahnya usia
pasien. Kadar PSA tidak memengaruhi tren pemilihan terapi. Kesimpulan: terdapat perubahan yang bermakna dalam
pemilihan terapi kanker prostat stage T3 berdasarkan tahun terapi. Terapi hormonal lebih menjadi pilihan pada kasus
dengan tumor high grade dan kelompok usia yang semakin tua.
Kata Kunci: tren terapi, kanker prostat lokal lanjut, radioterapi, terapi hormonal

Keywords


treatment trend; locally advanced prostate cancer; radiotherapy; hormonal therapy

References


Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin

DM. GLOBOCAN 2012 Vol. 2. Cancer Incidence and mortality

worldwide: IARC Cancer Base No 10 . Lyon: International

Agency for Research on Cancer; 2012. Available from: http://

globocan.iarc.fr.

Umbas R. Characteristics and management of prostate cancer

in Jakarta over ten years period. Indones J Surg. 2005;33:10714.

Heidenreich A, Bellmunt J, Bolla M, et al. Guidelines on

prostate cancer. Eur Urol. 2014 Feb;65(2):467-79.

Australian cancer network management of metastatic prostate

cancer working party. Clinical practice guidelines for the

management of locally advanced and metastatic prostate

cancer. Cancer council australia and austalian cancer network,

Sydney. 2010.

Umbas R, Hardjowijoto S, Mochtar CA, Safriadi F, Djatisoesanto

W, et al. Panduan penanganan kanker prostat. Ikatan Ahli

Urologi Indonesia, Jakarta. 2011.

Rosenfeld S. NCCN Clinical Practice Guidelines in Oncology

(NCCN Guidelines) Prostate Cancer. 2014.

Schmoll H, JFL Greene, DL Page, ID Fleming et al. (eds).

AJCC Cancer Staging Manual, 6th edition. Ann Oncol. 2003

Feb 1;14(2):345346.

Gerber GS, Thisted RA, Chodak GW, Schroder FH, Frohmuller

HG, Scardino PT, et al. Results of radical prostatectomy in

men with locally advanced prostate cancer: multi-institutional

pooled analysis. Eur Urol. 1997 Jan 1;32(4):38590.

Hellerstedt BA, Pienta KJ. The Current State of Hormonal

Therapy for Prostate Cancer. CA Cancer J Clin. 2002 May

;52(3):15479.

Mcleod DG. Hormonal therapy: historical perspective to

future directions. Urology. 2003 Feb;61(2 Suppl 1):37.

Tammela T. Endocrine treatment of prostate cancer. J Steroid

Biochem. 2004;92:28795.

Fellows GJ, Clark PB, Beynon LL, Boreham J, Keen C, Parkinson

MC, et al. Treatment of advanced localised prostatic cancer

by orchiectomy, radiotherapy, or combined treatment. A

Medical Research Council Study. Urological Cancer Working

Party--Subgroup on Prostatic Cancer. Br J Urol. 1992

Sep;70(3):304-9.

Wirth M, Tyrrell C, Delaere K, Snchez-Chapado M, Ramon

J, Wallace DMA, et al. Bicalutamide (Casodex) 150 mg in

addition to standard care in patients with nonmetastatic

prostate cancer: updated results from a randomised doubleblind

phase III study (median follow-up 5.1 y) in the early

prostate cancer programme. Prostate Cancer Prostatic Dis.

Jan;8(2):194200.

Wirth M, Tyrrell C, Wallace M, Delaere K., Snchez-Chapado

M, Ramon J, et al. Bicalutamide (Casodex) 150 mg as

immediate therapy in patients with localized or locally

advanced prostate cancer significantly reduces the risk of

disease progression. Urology. Elsevier; 2001 Aug 8;58(2):1465.

Akaza H, Homma Y, Usami M, Hirao Y, Tsushima T, Okada

K, et al. Efficacy of primary hormone therapy for localized

or locally advanced prostate cancer: Results of a 10-year

follow-up. BJU Int. 2006;98:5739.

Nilsson S, Norln BJ, Widmark A. A systematic overview of

radiation therapy effects in prostate cancer. Acta Oncol

;43(4):31681.

Plantade A, Massard C, de Crevoisier R, Fizazi K. Locally

advanced prostate cancer: definition, prognosis and treatment.

Bull Cancer. 2007 Jul;94(7 Suppl):5061.

Bolla M, Gonzalez D, Warde P. Improved survival in patients

with locally advanced prostate cancer treated with radiotherapy

and goserelin. N Engl J Med. 1997 Jul 31;337(5):295-300.

Cooperberg MR, Grossfeld GD, Lubeck DP, Carroll PR. National

practice patterns and time trends in androgen ablation for

localized prostate cancer. J Natl Cancer Inst. 2003;95:9819.

Supit W, Mochtar CA, Santoso RB, Umbas R. Outcomes and

predictors of localized or locally-advanced prostate cancer

treated by radiotherapy in Indonesia. Prostate Int. 2013 Jan

;1(1):1622.

Wei JT, Dunn RL, Sandler HM, McLaughlin PW, Montie JE,

Litwin MS, et al. Comprehensive comparison of health-related

quality of life after contemporary therapies for localized

prostate cancer. J Clin Oncol. 2002;20:55766.

Penson DF, Schonfeld WH, Flanders SC, Henke CJ, Warolin

KL, Carroll PR, et al. Relationship of first-year costs of treating

localized prostate cancer to initial choice of therapy and

stage at diagnosis: Results from the CAPSURE database.

Urology. 2001;57:499503.

Widmark A, Klepp O, Solberg A, Damber J-E, Angelsen A,

Fransson P, et al. Endocrine treatment, with or without

radiotherapy, in locally advanced prostate cancer (SPCG-7/

SFUO-3): an open randomised phase III trial. Lancet. 2009

Jan 24;373(9660):3018.

Harlan LC, Potosky A, Gilliland FD, Hoffman R, Albertsen

PC, Hamilton AS, et al. Factors associated with initial therapy

for clinically localized prostate cancer: prostate cancer

outcomes study. J Natl Cancer Inst. 2001;93:186471.

Alibhai SMH, Naglie G, Nam R, Trachtenberg J, Krahn MD.

Do older men benefit from curative therapy of localized

prostate cancer? J Clin Oncol. 2003;21:331827.

Situmorang GR, Umbas R, Mochtar C a., Santoso RB. Prostate

Cancer in Younger and Older Patients: Do We Treat Them

Differently? Asian Pacific J Cancer Prev. 2012 Sep 30;13(9):4577

Nakamura K, Mizowaki T, Imada H, Karasawa K, Uno T, Onishi

H, et al. External-beam radiotherapy for localized or locally

advanced prostate cancer in Japan: A multi-institutional

outcome analysis. Jpn J Clin Oncol. 2008;38:2004.


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DOI: 10.33371/ijoc.v9i1.366

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