Referat

PRINSIP DASAR KEMOTERAPI KANKER KEPALA - LEHER

Oleh :

Rini Kartika Dewi

S921902003

Pembimbing :

Dr. dr. Made Setiamika, Sp.T.H.T.K.L(K)FICS

DEPARTEMEN ILMU KESEHATAN TELINGA HIDUNG TENGGOROK

BEDAH KEPALA DAN LEHER
FAKULTAS KEDOKTERAN UNIVERSITAS SEBELAS MARET
RSUD Dr. MOEWARDI
SURAKARTA
2020
 LEMBAR PENGESAHAN
Telah dipresentasikan Referat dengan judul

Prinsip Dasar Kemoterapi Kanker Kepala Leher

Oleh
Rini Kartika Dewi

Pada Hari/Tanggal : Kamis, 18 Maret 2021

Tempat : Ruang Perpustakaan KSM/Bag. I K THT-KL. Gedung Wijaya

Kusuma Lt.3 RSUD. Dr. Moewardi Surakarta.

Mengetahui

Pembimbing
Dr. dr. Made Setiamika, Sp.T.H.T.K.L(K)FICS (…………….)

NIP. 196604222000121001

Evaluator
1. dr. Putu Wijaya Kandhi, Sp.T.H.T.K.L (K) FICS (.....................)
NIP. 197806202011011004

2. dr. Novi Primadewi, Sp.T.H.T.K.L, (K) M.Kes (…………….)

NIP. 196604222000121001
Penguji

1. Dr. dr. Hadi Sudrajad, Msi.Med, Sp.T.H.T.K.L(K) (....................)

NIP. 196604222000121001

2. Dr. dr. S. Hendradewi, Msi.Med, Sp.T.H.T.K.L(K) FICS (....................)

NIP. 196511212010012001

3. dr. Vicky Eko N.H., Msc, Sp.T.H.T.K.L (K) FICS (.....................)

NIP. 197709142005011001

4. dr. Dewi Pratiwi, Sp.T.H.T.K.L, (K) M.Kes (.....................)

NIP. 198105152013012001

5. dr. Niken Dyah Aryani, Sp.T.H.T.K.L, M.Kes (.....................)

6. dr. Bayu Aristanto, Sp. T.H.T.K.L (.....................)

7. dr. Aziza Viquisa BP, Sp. T.H.T.K.L (.....................)

8. dr. Ahmad Nurdiansyah, Sp. T.H.T.K.L (.....................)

 DAFTAR ISI

DAFTAR ISI.....................................................................................................1
ABSTRAK.........................................................................................................4
PENDAHULUAN.............................................................................................5
1.1. Latar Belakang............................................................................................5
TINJAUAN PUSTAKA....................................................................................7
2.1. Kanker kepala dan leher........................................................................7
2.2. Morfologi dan siklus sel normal.............................................................9
2.3. Faktor yang berperan dalam onkogenesis..........................................10
2.4. Kemoterapi.................................................................................................12
2.4.1. Definisi.................................................................................................12
2.4.2. Peranan Kemoterapi dalam Terapi Tumor...........................................13
2.4.3. Penggolongan Obat anti-tumor dan Mekanisme Kerjanya...................15
2.5. Efek Toksik Obat Anti-tumor Jangka Pendek.......................................17
2.5.1. Depresi Sumsum Tulang.......................................................................17
2.5.2. Reaksi Gastrointestinal.........................................................................18
2.5.3. Rudapaksa fungsi hati...........................................................................18
2.5.4. Ruda paksa fungsi ginjal.......................................................................18
2.5.5. Kardiotoksisitas....................................................................................19
2.5.6. Pulmotoksisitas.....................................................................................19
2.5.7. Neurotoksisitas.....................................................................................19
2.5.8. Reaksi alergi.........................................................................................20
2.5.9. Lainnya.................................................................................................20
2.5.10. Efek toksik lokal.................................................................................20
2.6. Efek Toksik Obat Anti-tumor Jangka Panjang.....................................21
2.6.1. Karsinogenisitas....................................................................................21
2.6.2. Inferilitas...............................................................................................21
2.7. Kinetika Siklus sel.....................................................................................21
2.8. Penggunaan Klinis Kemoterapi...............................................................24
2.8.1. Kemoterapi kuratif................................................................................24
2.8.2. Kemoterapi adjuvan..............................................................................24
2.8.3. Kemoterapi neoadjuvan........................................................................25
 2.8.4. Kemoterapi Paliatif...............................................................................25
2.8.5. Kemoterapi investigatif........................................................................25
2.9. Tata Laksana Terapi Sistemik pada Kanker Kepala-Leher.................26
2.10. Prinsip Kemoterapi pada kanker kepala-leher menggunakan beberapa regimen
............................................................................................................................27
2.10.1. Cisplatin mingguan – Radioterapi......................................................27
2.10.2. Docetaxel – Cisplatin – 5-Fluorouracil...............................................28
2.10.3. 5-Fluorouracil – Cisplatin...................................................................29
2.10.4. Methotrexate.......................................................................................31
2.10.5. Paclitaxel – Cisplatin..........................................................................32
2.10.6. Capecitabine.......................................................................................33
2.10.7. Cisplatin – Radioterapi + ajuvan Cisplatin – Fluorouracil.................34
2.10.8. Gemcitabine – Cisplatin.....................................................................36
PEMBAHASAN..............................................................................................38
KESIMPULAN...............................................................................................44
DAFTAR PUSTAKA......................................................................................45
 DAFTAR TABEL

TabeL 1. Cisplatin mingguan - Radioterapi...........................................................27

Tabel 2. Docetaxel – Cisplatin – 5-Fluorouracil....................................................29
Tabel 3. 5-Fluorouracil - Cisplatin.........................................................................30
Tabel 4. Methotrexate............................................................................................32
Tabel 5. Paclitaxel – Cisplatin...............................................................................33
Tabel 6. Capecitabine.............................................................................................34
Tabel 7. Cisplatin – Radioterapi + ajuvan Cisplatin – Fluorouracil......................35
Tabel 8. Gemcitabine – Cisplatin...........................................................................37
 ABSTRAK

Kanker kepala dan leher termasuk kelompok tumor yang bersifat heterogen yang meluas dari
bibir ke esofagus bagian bawah. Kemoterapi merupakan salah satu pengobatan kanker
dengan mengunakan obat-obatan khusus yang dapat membunuh sel kanker dalam tubuh.
Tujuan dari penulisan referat tentang Prinsip Dasar Kemoterapi Kanker Kepala Leher ini
adalah untuk mengetahui teori dasar, peranan, penggolongan obat, mekanisme obat, efek
samping dan penggunaan klinis dari kemoterapi pada kanker kepala leher. Dalam penulisan
referat ini, penulis menggunakan kajian pustaka. Sehingga dari penulisan referat ini, pembaca
dapat memahami tentang Prinsip Dasar Kemoterapi Kanker Kepala Leher, dan kemudian
dapat mengaplikasikan secara klinis.

Kata kunci : referat, kemoterapi, kanker kepala leher

ABSTRACT

Head and neck cancer is a heterogeneous group of tumors that extend from the lips to the
lower esophagus. Chemotherapy is a cancer treatment using special drugs that can kill cancer
cells in the body. The purpose of writing a reference on the Basic Principles of Head and
Neck Cancer Chemotherapy is to find out the basic theory, role, drug classification, drug
mechanism, side effects and clinical use of chemotherapy in head and neck cancer. In writing
this reference, the author uses literature review. So that from writing this reference, readers
can understand the basic principles of chemotherapy for head and neck cancer, and then can
apply it clinically.

Key words: referat, chemotherapy, head and neck cancer