Introduction: A Giant Cell Tumor (GCT) is a benign tumor, but often aggressive with recurrence or metastasis tendency. Often, distal radius GCT is presented in relatively small or medium sizes. Large and fungating distal radius GCT is characterized by its higher ability to infiltrate, destruct, and compromise its surrounding tissue. Therefore, it increases the risk of complications including amputation. The treatment requires more complex surgery and reconstruction than usual GCT. In this case series, we prefer to perform the limb salvage surgery with wide en bloc resection, followed by reconstruction of the bone and soft tissue, instead of amputation. Case Presentation: We report 4 patients with massive GCT at the distal radius. All complained about pain and a lump in the wrist. The tumors are large in dimension with the size of 12 x 8 x 6 cm, 10 x 10 x 8 cm, 11 x 9 x 9 cm, and 17 x 14 x 8 cm respectively, fungating and compromised surrounding soft tissue. Limb salvage procedures are performed with wide en-bloc resection, bone cement spacer insertion, K-wire fixation, dissection, and tendon reconstructions followed by soft tissue defect closure using distant flap and primary suture. Follow-up post-surgery was variable within 2 to 36 months. All patients had a reduced scale of VAS, increased functional outcome measured with quick DASH score, no major complications, and no sign of recurrence or metastasis during the follow-up period. Conclusion: Large and fungating GCT of distal radius managed by limb salvage surgery and complex reconstruction deliver a good result. Thus, it can give other options other than amputation.
{"title":"Limb Salvage Surgery in Large and Fungating Giant Cell Tumors of Distal Radius: A Case Series","authors":"Muhamad Naseh Sajadi Budi, A. Abidin","doi":"10.33371/ijoc.v17i2.963","DOIUrl":"https://doi.org/10.33371/ijoc.v17i2.963","url":null,"abstract":"Introduction: A Giant Cell Tumor (GCT) is a benign tumor, but often aggressive with recurrence or metastasis tendency. Often, distal radius GCT is presented in relatively small or medium sizes. Large and fungating distal radius GCT is characterized by its higher ability to infiltrate, destruct, and compromise its surrounding tissue. Therefore, it increases the risk of complications including amputation. The treatment requires more complex surgery and reconstruction than usual GCT. In this case series, we prefer to perform the limb salvage surgery with wide en bloc resection, followed by reconstruction of the bone and soft tissue, instead of amputation. Case Presentation: We report 4 patients with massive GCT at the distal radius. All complained about pain and a lump in the wrist. The tumors are large in dimension with the size of 12 x 8 x 6 cm, 10 x 10 x 8 cm, 11 x 9 x 9 cm, and 17 x 14 x 8 cm respectively, fungating and compromised surrounding soft tissue. Limb salvage procedures are performed with wide en-bloc resection, bone cement spacer insertion, K-wire fixation, dissection, and tendon reconstructions followed by soft tissue defect closure using distant flap and primary suture. Follow-up post-surgery was variable within 2 to 36 months. All patients had a reduced scale of VAS, increased functional outcome measured with quick DASH score, no major complications, and no sign of recurrence or metastasis during the follow-up period. Conclusion: Large and fungating GCT of distal radius managed by limb salvage surgery and complex reconstruction deliver a good result. Thus, it can give other options other than amputation. ","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75444193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Firman, Fakhri Rahman, A. Hamid, C. Mochtar
Background: Prostate cancer (PCa) screening and diagnosis are mandatory to deliver optimal management in the early phase. Even though it has been discussed in many guidelines, the implementation of PCa screening and diagnosis in Indonesia remains unknown. This study aims to evaluate the pattern of PCa screening and diagnosis among Indonesian urologists and their adherence to guidelines. Methods: This cross-sectional study was conducted between February and July 2019. Respondents were Indonesian urologists registered as members of the Indonesian Urological Association (IUA) and had already practiced for at least six months. Data were collected using questionnaires, which were distributed at a national urology symposium and electronically via Google Form. Data were presented descriptively, and all data were processed using SPSS version 23. Results: Of 458 urologists, 195 (42.6%) gave full responses. Most of the respondents, 181 (92.8%) urologists, used the IUA guidelines. Among the 103 (52.8%) respondents who performed screening, nearly half (42.7%) agreed to screen patients aged ≥ 50 years or ≥ 45 years with a family history of PCa. Moreover, 76.8% would repeat screening annually, and 35.6% would stop when the patient’s age reached 70 years old. Digital rectal examination (DRE) was frequently performed for screening (74.5%), while prostate-specific antigen (PSA) tests were only performed in 52.3% of cases. The PSA test was available in 74.8% of hospitals. Transurethral resection of the prostate (TURP) was still used by 67.2% of respondents for diagnosis. Only 52.3 % of participants used transrectal prostate biopsy for diagnosis, using anesthesia (78.1%) during the procedure, and increased PSA level (98%) as its indication. However, Transrectal Ultrasound (TRUS) was only available in 49% of hospitals. This study found that Indonesian urologist adherence level toward guidelines was 63.3% (9–100%). Conclusions: PCa screening and diagnosis are still varied among Indonesian urologists, which might arise due to the different availability of diagnostic modalities.
背景:前列腺癌(PCa)的筛查和诊断是在早期提供最佳治疗的必要条件。尽管在许多指南中已经讨论过，但在印度尼西亚实施前列腺癌筛查和诊断仍然未知。本研究旨在评估印尼泌尿科医师的前列腺癌筛查和诊断模式及其对指南的依从性。方法:本横断面研究于2019年2月至7月进行。调查对象为印度尼西亚泌尿科医师，注册为印度尼西亚泌尿科协会(IUA)会员，并已执业至少6个月。数据通过问卷收集，问卷在全国泌尿学研讨会上分发，并通过谷歌表格进行电子调查。数据以描述性方式呈现，所有数据均使用SPSS version 23进行处理。结果:458名泌尿科医生中，195名(42.6%)给出了完整答复。大多数调查对象，181名(92.8%)泌尿科医生使用了IUA指南。在103名(52.8%)接受筛查的受访者中，近一半(42.7%)同意筛查年龄≥50岁或≥45岁且有前列腺癌家族史的患者。76.8%的人会每年重复筛查，35.6%的人会在患者年龄达到70岁时停止筛查。直肠指检(DRE)占74.5%，而前列腺特异性抗原(PSA)检测仅占52.3%。74.8%的医院开展PSA检测。经尿道前列腺切除术(TURP)仍被67.2%的应答者用于诊断。只有52.3%的参与者使用经直肠前列腺活检进行诊断，在手术过程中使用麻醉(78.1%)，PSA水平升高(98%)作为其指征。然而，经直肠超声(TRUS)仅在49%的医院提供。本研究发现印度尼西亚泌尿科医生对指南的依从性为63.3%(9-100%)。结论:印度尼西亚泌尿科医师对前列腺癌的筛查和诊断仍然存在差异，这可能是由于诊断方式的不同。
{"title":"The Pattern of Prostate Cancer Screening and Diagnosis among Indonesian Urologists: A Questionnaire Survey","authors":"Muhammad Firman, Fakhri Rahman, A. Hamid, C. Mochtar","doi":"10.33371/ijoc.v17i2.970","DOIUrl":"https://doi.org/10.33371/ijoc.v17i2.970","url":null,"abstract":"Background: Prostate cancer (PCa) screening and diagnosis are mandatory to deliver optimal management in the early phase. Even though it has been discussed in many guidelines, the implementation of PCa screening and diagnosis in Indonesia remains unknown. This study aims to evaluate the pattern of PCa screening and diagnosis among Indonesian urologists and their adherence to guidelines. Methods: This cross-sectional study was conducted between February and July 2019. Respondents were Indonesian urologists registered as members of the Indonesian Urological Association (IUA) and had already practiced for at least six months. Data were collected using questionnaires, which were distributed at a national urology symposium and electronically via Google Form. Data were presented descriptively, and all data were processed using SPSS version 23. Results: Of 458 urologists, 195 (42.6%) gave full responses. Most of the respondents, 181 (92.8%) urologists, used the IUA guidelines. Among the 103 (52.8%) respondents who performed screening, nearly half (42.7%) agreed to screen patients aged ≥ 50 years or ≥ 45 years with a family history of PCa. Moreover, 76.8% would repeat screening annually, and 35.6% would stop when the patient’s age reached 70 years old. Digital rectal examination (DRE) was frequently performed for screening (74.5%), while prostate-specific antigen (PSA) tests were only performed in 52.3% of cases. The PSA test was available in 74.8% of hospitals. Transurethral resection of the prostate (TURP) was still used by 67.2% of respondents for diagnosis. Only 52.3 % of participants used transrectal prostate biopsy for diagnosis, using anesthesia (78.1%) during the procedure, and increased PSA level (98%) as its indication. However, Transrectal Ultrasound (TRUS) was only available in 49% of hospitals. This study found that Indonesian urologist adherence level toward guidelines was 63.3% (9–100%). Conclusions: PCa screening and diagnosis are still varied among Indonesian urologists, which might arise due to the different availability of diagnostic modalities.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"36 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77368286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Herman Saputra, Ni Putu Sriwidyani, Putu Erika Paskarani, Silvia Khosasi
Introduction: Follicular Lymphoma (FL) is a B-cell neoplasm arising from the germinal center. Gastrointestinal FL is a rare case, accounting for less than 4% of all primary lymphoma of the gastrointestinal tract. Duodenal-type Follicular Lymphoma (DTFL) was included in an entity of primary intestinal FL. However, in the 2017 World Health Organization (WHO) Classification, this entity was included in a specific variant called DTFL. In this article, we report a case of DTFL in a 56-year-old man which was incidentally found during upper gastrointestinal endoscopy Case Presentation: : We report a case of incidentally found DTFL in a 56-year-old man during an endoscopy. The endoscopic finding showed a small, hypertrophic, or nodular lesion on part two duodenum. Microscopic evaluation of duodenal mucosa consists of proliferative atypical lymphoid cells arranged in follicular architecture. The lesion was confined to the lamina propria. The atypical lymphoid cells were dominated by monotonous centrocyte-like cells, small-sized, with scant cytoplasm, and cleaved nuclei. There were some scattered larger centroblast-like cells with multiple nucleoli. No mantle zone and tingible body macrophage were found. The immunohistochemical evaluation showed positivity for CD 20, CD 10, Bcl-6, and Bcl-2 in the follicular structure. CD 21 was dominantly stained at the periphery of the follicular structure, and Ki-67 was low. Conclusions: According to clinical data, endoscopic findings, and histopathological and immunohistochemical findings, the patient was diagnosed with DTFL.
{"title":"Incidental Findings of Duodenal-Type Follicular Lymphoma by Endoscopic Screening: A Case Report","authors":"Herman Saputra, Ni Putu Sriwidyani, Putu Erika Paskarani, Silvia Khosasi","doi":"10.33371/ijoc.v17i2.965","DOIUrl":"https://doi.org/10.33371/ijoc.v17i2.965","url":null,"abstract":"Introduction: Follicular Lymphoma (FL) is a B-cell neoplasm arising from the germinal center. Gastrointestinal FL is a rare case, accounting for less than 4% of all primary lymphoma of the gastrointestinal tract. Duodenal-type Follicular Lymphoma (DTFL) was included in an entity of primary intestinal FL. However, in the 2017 World Health Organization (WHO) Classification, this entity was included in a specific variant called DTFL. In this article, we report a case of DTFL in a 56-year-old man which was incidentally found during upper gastrointestinal endoscopy Case Presentation: : We report a case of incidentally found DTFL in a 56-year-old man during an endoscopy. The endoscopic finding showed a small, hypertrophic, or nodular lesion on part two duodenum. Microscopic evaluation of duodenal mucosa consists of proliferative atypical lymphoid cells arranged in follicular architecture. The lesion was confined to the lamina propria. The atypical lymphoid cells were dominated by monotonous centrocyte-like cells, small-sized, with scant cytoplasm, and cleaved nuclei. There were some scattered larger centroblast-like cells with multiple nucleoli. No mantle zone and tingible body macrophage were found. The immunohistochemical evaluation showed positivity for CD 20, CD 10, Bcl-6, and Bcl-2 in the follicular structure. CD 21 was dominantly stained at the periphery of the follicular structure, and Ki-67 was low. Conclusions: According to clinical data, endoscopic findings, and histopathological and immunohistochemical findings, the patient was diagnosed with DTFL.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136355765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction:Hindquarter amputation or known as hemipelvectomy is a surgical technique that is primarily used for the eradication of malignant primary soft tissue and bone tumors of the pelvis, hip, and upper thigh regions. Occasionally, hindquarter amputation has been employed in the treatment of severe trauma, metastases, and infection. This case report aims to give a lesson in the case of the High-Grade Pleomorphic Sarcoma of the Groin because this is a very rare case and most patients are not willing to undergo amputation.Case Presentation: A 54-year-old male patient came with a complaint of a lump in the thigh. Initially, the lump was as big as a marble and has been getting bigger since last year. The size of the lump was approximately 30 x 30 x 30 cmConclusions: The most common indications for amputation in patients with the primary localized disease were extensive involvement of the limb-girdle, multiple muscle compartment involvement, multifocality, and unsuitability for limb-sparing surgery, typically due to lack of a salvage option. Hindquarter amputation was used as a treatment for 13% of all pelvic bone sarcomas where there is a realistic chance of control of symptoms or long-term survival.comas.
{"title":"Left Hindquarter Amputation due to High-Grade Pleomorphic Sarcoma of the Groin: A Case Report","authors":"M. Zaki, A. Hafiz, B. Brahma, R. Sofyan","doi":"10.33371/ijoc.v17i2.957","DOIUrl":"https://doi.org/10.33371/ijoc.v17i2.957","url":null,"abstract":"Introduction:Hindquarter amputation or known as hemipelvectomy is a surgical technique that is primarily used for the eradication of malignant primary soft tissue and bone tumors of the pelvis, hip, and upper thigh regions. Occasionally, hindquarter amputation has been employed in the treatment of severe trauma, metastases, and infection. This case report aims to give a lesson in the case of the High-Grade Pleomorphic Sarcoma of the Groin because this is a very rare case and most patients are not willing to undergo amputation.Case Presentation: A 54-year-old male patient came with a complaint of a lump in the thigh. Initially, the lump was as big as a marble and has been getting bigger since last year. The size of the lump was approximately 30 x 30 x 30 cmConclusions: The most common indications for amputation in patients with the primary localized disease were extensive involvement of the limb-girdle, multiple muscle compartment involvement, multifocality, and unsuitability for limb-sparing surgery, typically due to lack of a salvage option. Hindquarter amputation was used as a treatment for 13% of all pelvic bone sarcomas where there is a realistic chance of control of symptoms or long-term survival.comas.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86196371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Agusriani Putri, Sari Eka Pratiwi, Risa Febriana Musawaris
Background: Lung cancer is the second most commonly diagnosed malignancy and the leading cause of death in 2020. Preliminary studies from 2014 to 2019 at Dr. Soedarso Hospital Pontianak showed there was an increase in lung cancer cases. This study aimed to determine the clinical profile of patients with lung cancer in Dr. Soedarso HospitalMethods: This epidemiological study used medical records from patients diagnosed with lung cancer at Dr. Soedarso Hospital Pontianak from 2017 to 2019. It was a cross-sectional study, and 81 samples met the criteria. The inclusion criteria are the completeness of data and the results of cytopathology laboratory examinations. The data were processed using Microsoft Excel.Results: In this study, based on the characteristics of patients diagnosed with lung cancer in Dr. Soedarso Hospital, 82.7% are male with an average diagnosed age of 54.8 years, and 72.8% of patients do not have a smoking history. The common symptoms of patients are shortness of breath (77.8%), chest pain (55.6%), and weight loss (30.9%). The most common type is Non-Small Cell Lung Carcinoma (NSCLC) specifically Adenocarcinoma (76.5%).Conclusion: This study shows that lung cancer incidence in males was higher than in females, and most patients diagnosed did not have a smoking history. The most common symptom of patients is shortness of breath with the most common type of cytopathology results being adenocarcinoma.
背景:肺癌是第二常见的恶性肿瘤，也是2020年死亡的主要原因。2014年至2019年在Pontianak Soedarso医生医院进行的初步研究显示，肺癌病例有所增加。本研究旨在确定Dr. Soedarso医院肺癌患者的临床概况方法:本流行病学研究使用了Pontianak Dr. Soedarso医院2017年至2019年诊断为肺癌的患者的医疗记录。这是一项横断面研究，81个样本符合标准。纳入标准是资料的完整性和细胞病理学实验室检查的结果。数据使用Microsoft Excel进行处理。结果:本研究根据Dr. Soedarso医院确诊肺癌患者的特点，82.7%的患者为男性，平均确诊年龄54.8岁，72.8%的患者无吸烟史。患者的常见症状为呼吸短促(77.8%)、胸痛(55.6%)和体重减轻(30.9%)。最常见的类型是非小细胞肺癌(NSCLC)特别是腺癌(76.5%)。结论:本研究显示男性肺癌发病率高于女性，且大多数确诊患者无吸烟史。患者最常见的症状是呼吸急促，最常见的细胞病理学结果是腺癌。
{"title":"Characteristics of Lung Cancer Patients at Dr. Soedarso Hospital Pontianak from 2017 to 2019","authors":"Agusriani Putri, Sari Eka Pratiwi, Risa Febriana Musawaris","doi":"10.33371/ijoc.v17i2.950","DOIUrl":"https://doi.org/10.33371/ijoc.v17i2.950","url":null,"abstract":"Background: Lung cancer is the second most commonly diagnosed malignancy and the leading cause of death in 2020. Preliminary studies from 2014 to 2019 at Dr. Soedarso Hospital Pontianak showed there was an increase in lung cancer cases. This study aimed to determine the clinical profile of patients with lung cancer in Dr. Soedarso HospitalMethods: This epidemiological study used medical records from patients diagnosed with lung cancer at Dr. Soedarso Hospital Pontianak from 2017 to 2019. It was a cross-sectional study, and 81 samples met the criteria. The inclusion criteria are the completeness of data and the results of cytopathology laboratory examinations. The data were processed using Microsoft Excel.Results: In this study, based on the characteristics of patients diagnosed with lung cancer in Dr. Soedarso Hospital, 82.7% are male with an average diagnosed age of 54.8 years, and 72.8% of patients do not have a smoking history. The common symptoms of patients are shortness of breath (77.8%), chest pain (55.6%), and weight loss (30.9%). The most common type is Non-Small Cell Lung Carcinoma (NSCLC) specifically Adenocarcinoma (76.5%).Conclusion: This study shows that lung cancer incidence in males was higher than in females, and most patients diagnosed did not have a smoking history. The most common symptom of patients is shortness of breath with the most common type of cytopathology results being adenocarcinoma.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"476 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135045921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Aninditha, Dian Oktaria Safitri, H. Sofyan, S. D. Elvira, I. Kusumadewi, Feranindhya Agiananda
Background: Along with the increasing incidence of primary cancer, metastatic brain tumors are becoming more common. Metastatic brain tumor patients go through a great deal of distress. Therefore, providing adequate standard therapy can alleviate patients’ clinical symptoms and improve their overall quality of life. This study aimed to investigate the role of symptomatic treatments and adjunctive psychotherapy in patients with metastatic brain tumors. Methods: We conducted a randomized, single-blind, parallel design without matching and pragmatic clinical trial at Cipto Mangunkusumo Hospital from August 2019 – June 2020. A total of 30 metastatic brain tumor patients were divided into 2 groups: (1) The treatment group which received a combination of symptomatic and adjunctive psychotherapy, and (2) The control group which was given symptomatic therapy only. The patients’ distress level was evaluated using a distress thermometer (DT). Data analysis was carried out using the Chi-square test, Fisher exact’s, and binominal test.Results: All patients in the treatment group experienced a significant improvement in overall DT scores before and after adjunctive psychotherapy (p=0.01). Symptomatic therapy alleviates headaches and seizures significantly by 100% with or without psychotherapy. Conclusions: The standard symptomatic treatment of metastatic brain tumors can alleviate clinical symptoms in both groups, especially for headaches and seizures. An adjunctive psychotherapy may significantly improve the overall DT.
{"title":"The Symptomatic Improvement of Metastatic Brain Tumor Patients Based on Clinical and Distress Thermometer in Adjunctive Psychotherapy","authors":"T. Aninditha, Dian Oktaria Safitri, H. Sofyan, S. D. Elvira, I. Kusumadewi, Feranindhya Agiananda","doi":"10.33371/ijoc.v17i2.961","DOIUrl":"https://doi.org/10.33371/ijoc.v17i2.961","url":null,"abstract":"Background: Along with the increasing incidence of primary cancer, metastatic brain tumors are becoming more common. Metastatic brain tumor patients go through a great deal of distress. Therefore, providing adequate standard therapy can alleviate patients’ clinical symptoms and improve their overall quality of life. This study aimed to investigate the role of symptomatic treatments and adjunctive psychotherapy in patients with metastatic brain tumors. Methods: We conducted a randomized, single-blind, parallel design without matching and pragmatic clinical trial at Cipto Mangunkusumo Hospital from August 2019 – June 2020. A total of 30 metastatic brain tumor patients were divided into 2 groups: (1) The treatment group which received a combination of symptomatic and adjunctive psychotherapy, and (2) The control group which was given symptomatic therapy only. The patients’ distress level was evaluated using a distress thermometer (DT). Data analysis was carried out using the Chi-square test, Fisher exact’s, and binominal test.Results: All patients in the treatment group experienced a significant improvement in overall DT scores before and after adjunctive psychotherapy (p=0.01). Symptomatic therapy alleviates headaches and seizures significantly by 100% with or without psychotherapy. Conclusions: The standard symptomatic treatment of metastatic brain tumors can alleviate clinical symptoms in both groups, especially for headaches and seizures. An adjunctive psychotherapy may significantly improve the overall DT.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82052931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer was the second leading cause of death globally in 2018. On the other hand, immunotherapy is one of the most promising and effective therapies to fight against cancer. This area of research has highly increased over the last decade. Immunotherapy will modulate and initiate an effective immune response. Hence, the immune system in the body will be more potent in combating cancer. Cancer immunotherapy can utilize herbal products to modulate the immune system with low toxicity. In addition, the usage of herbal products has also proven to decrease the side effects of conventional cancer therapy. Some herbal products have been proven to have biological and pharmacological activity, such as anti-inflammatory, anticancer, and chemopreventive. Indonesia, with its immense biodiversity of herbal products, can use this advantage to develop these sources in the health sector. We showcase some active compounds such as quercetin, andrographolide, curcumin, resveratrol, capsaicin, epigallocatechin-3-gallate, genistein, 6-shogaol, and 6-gingerol. We further highlight the mechanism and signaling pathways that can occur in these active compounds to suppress cancer progression and development. This review discusses the mechanism and potency of herbal products as a modulator in cancer immunotherapy to combat cancer. In summary, this review summarizes herbal products’ active compounds and future promise within the field of immunotherapy.
{"title":"The Potency of Herbal Active Compounds as Immune Modulators for Cancer Therapy","authors":"Septelia Inawati Wanandi, Maria Maghdalena","doi":"10.33371/ijoc.v17i2.956","DOIUrl":"https://doi.org/10.33371/ijoc.v17i2.956","url":null,"abstract":"Cancer was the second leading cause of death globally in 2018. On the other hand, immunotherapy is one of the most promising and effective therapies to fight against cancer. This area of research has highly increased over the last decade. Immunotherapy will modulate and initiate an effective immune response. Hence, the immune system in the body will be more potent in combating cancer. Cancer immunotherapy can utilize herbal products to modulate the immune system with low toxicity. In addition, the usage of herbal products has also proven to decrease the side effects of conventional cancer therapy. Some herbal products have been proven to have biological and pharmacological activity, such as anti-inflammatory, anticancer, and chemopreventive. Indonesia, with its immense biodiversity of herbal products, can use this advantage to develop these sources in the health sector. We showcase some active compounds such as quercetin, andrographolide, curcumin, resveratrol, capsaicin, epigallocatechin-3-gallate, genistein, 6-shogaol, and 6-gingerol. We further highlight the mechanism and signaling pathways that can occur in these active compounds to suppress cancer progression and development. This review discusses the mechanism and potency of herbal products as a modulator in cancer immunotherapy to combat cancer. In summary, this review summarizes herbal products’ active compounds and future promise within the field of immunotherapy.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135045917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The treatment of medulloblastoma involves surgery, radiotherapy, and adjuvant chemotherapy. In radiotherapy, craniospinal irradiation (CSI) is prescribed, where two lateral cranial fields and one or two spinal beams are applied in CSI. Different multi-field techniques (coplanar and/or noncoplanar) are used to register the prescribed dose. The purpose of this study was to assess plan quality in terms of dose coverage of the spine with both photon and electron beam therapy and the sparing of organs at risks (OARs).Methods: Ten pediatric patients (ages 6 to 10 years) were immobilized in the prone position for simulation. The Clinical Target Volume (CTV) of the organ under treatment, Planning Target volume (PTV) of the organ under treatment, and OARs were contoured. Prowess Panther (v4.71) was used for dose computations. Two lateral parallel-opposed 6 MV photon cranial fields with the spinal beam(s) (either 6 Photons or 21 MeV electrons) were used in planning. Electron beams were added posteriorly on the spine with parallel-opposed cranial fields. The treatment plans were computed for 3600 c Gy in 21 fractions.Results: For comparable conformity number of electron versus photons beam plans (0.68 ± 0.41 versus 0.66 ± 0.47, is not significantly different at p < 0.05) and homogeneity index (1.22 ± 0.03 versus 1.25 ± 0.04, is significantly different at p < 0.05), the photon doses were higher for underlying OARs (heart, liver, and thyroid) and were lower for partially in-field organs (lungs and kidneys) compared to electrons.Conclusions: The underlying organs i.e., thyroid, heart, and liver receive a lesser dose in case of electrons, while partially in-field organs are exposed more compared to photons mainly due to the ballooning effect in electrons. The study shows that both electrons and photons can be used for CSI. However, the electron may be preferred due to its better sparing of underlying structures.
背景:髓母细胞瘤的治疗包括手术、放疗和辅助化疗。在放射治疗中，规定了颅脊髓照射(CSI)，其中两个侧颅野和一个或两个脊柱束在CSI中应用。使用不同的多场技术(共面和/或非共面)来登记规定剂量。本研究的目的是根据光子和电子束治疗对脊柱的剂量覆盖和对危险器官的保护来评估计划质量。方法:将10例6 ~ 10岁儿童患者固定于俯卧位进行模拟。绘制待治疗器官的临床靶体积(CTV)、待治疗器官的计划靶体积(PTV)和OARs轮廓。威力豹(v4.71)用于剂量计算。两个横向平行的6毫伏光子颅脑场与脊髓束(6光子或21 MeV电子)被用于规划。在脊柱后方以平行对置的颅脑场加电子束。计算了3600 cgy的21个分量的治疗方案。结果:电子束与光子束计划的一致性数(0.68±0.41 vs 0.66±0.47，差异无统计学意义(p < 0.05))和均匀性指数(1.22±0.03 vs 1.25±0.04，差异有统计学意义(p < 0.05)，与电子相比，光子剂量对潜在的OARs(心脏、肝脏和甲状腺)较高，对部分场内器官(肺和肾脏)较低。结论:甲状腺、心脏和肝脏等底层器官在电子照射下接受的剂量较小，而部分场内器官暴露于光子较多，主要是由于电子的气球效应。研究表明，电子和光子都可以用于CSI。然而，电子可能是优选的，因为它更好地节省了底层结构。
{"title":"Comparison of Electrons and Photons Treatment Plans in Medulloblastoma Patients","authors":"M. U. Ghani, Aasia Razzaq, N. Amjad, Ismat Fatima","doi":"10.33371/ijoc.v17i1.949","DOIUrl":"https://doi.org/10.33371/ijoc.v17i1.949","url":null,"abstract":"Background: The treatment of medulloblastoma involves surgery, radiotherapy, and adjuvant chemotherapy. In radiotherapy, craniospinal irradiation (CSI) is prescribed, where two lateral cranial fields and one or two spinal beams are applied in CSI. Different multi-field techniques (coplanar and/or noncoplanar) are used to register the prescribed dose. The purpose of this study was to assess plan quality in terms of dose coverage of the spine with both photon and electron beam therapy and the sparing of organs at risks (OARs).Methods: Ten pediatric patients (ages 6 to 10 years) were immobilized in the prone position for simulation. The Clinical Target Volume (CTV) of the organ under treatment, Planning Target volume (PTV) of the organ under treatment, and OARs were contoured. Prowess Panther (v4.71) was used for dose computations. Two lateral parallel-opposed 6 MV photon cranial fields with the spinal beam(s) (either 6 Photons or 21 MeV electrons) were used in planning. Electron beams were added posteriorly on the spine with parallel-opposed cranial fields. The treatment plans were computed for 3600 c Gy in 21 fractions.Results: For comparable conformity number of electron versus photons beam plans (0.68 ± 0.41 versus 0.66 ± 0.47, is not significantly different at p < 0.05) and homogeneity index (1.22 ± 0.03 versus 1.25 ± 0.04, is significantly different at p < 0.05), the photon doses were higher for underlying OARs (heart, liver, and thyroid) and were lower for partially in-field organs (lungs and kidneys) compared to electrons.Conclusions: The underlying organs i.e., thyroid, heart, and liver receive a lesser dose in case of electrons, while partially in-field organs are exposed more compared to photons mainly due to the ballooning effect in electrons. The study shows that both electrons and photons can be used for CSI. However, the electron may be preferred due to its better sparing of underlying structures.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73634974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Due to their immunosuppressive medication regimen, solid organ transplant recipients have an increased risk of developing cancer, which might jeopardize their survival. Specifically, cardiovascular disease and malignancy are the two leading causes of death in kidney transplant recipients. In solid organ recipients, cutaneous malignancies, lymphomas, and Kaposi’s sarcomas also appear to be the most prevalent cancer forms. Thus, carcinoma of unknown primary origin is a clinical entity that diagnosing requires a high level of suspicion and thorough reviewing of laboratory, radiological, and clinical findings. Further, susceptible patients, such as immunocompromised ones, should merit a careful analysis of findings and detailed analytic rationale. We, therefore, present the following case report demonstrating the importance of follow-up of specific suspicious serum markers in transplant patients. To our knowledge, this study is the first case to report an occult breast carcinoma as the initial presentation in a patient with a kidney transplant.Case Presentation: In the following case, the primary indication for malignancy was elevated alkaline phosphatase (ALP), a common finding in patients with chronic renal failure. Once noticed in a scheduled post-transplantation follow-up, further diagnostic tests, such as a broader serum panel, sternal puncture, and mammography, were ordered and returned normal. Subsequently, CT was ordered and revealed lytic and sclerotic bone changes. Afterward, serum tumor markers were ordered together with gynecological ultrasound and PET-CT. Finally, an iliac bone marrow biopsy confirmed a breast cancer diagnosis of unknown primary origin, causing the elevated ALP.Conclusions: This case report presents a uniquely difficult diagnostic challenge as an expected elevated value of ALP in a kidney transplant recipient was the only diagnostic clue for occult breast carcinoma. We discuss further the vigilance that physicians must exert when dealing with kidney transplant recipients and the implication of carcinoma of unknown primary in this population.
{"title":"Multiple Bone Metastases as the Initial Presentation of Occult Breast Carcinoma in a Kidney Transplant Recipient","authors":"Marina Kljajić, Guy Alush, N. Bašić-Jukić","doi":"10.33371/ijoc.v17i1.945","DOIUrl":"https://doi.org/10.33371/ijoc.v17i1.945","url":null,"abstract":"Introduction: Due to their immunosuppressive medication regimen, solid organ transplant recipients have an increased risk of developing cancer, which might jeopardize their survival. Specifically, cardiovascular disease and malignancy are the two leading causes of death in kidney transplant recipients. In solid organ recipients, cutaneous malignancies, lymphomas, and Kaposi’s sarcomas also appear to be the most prevalent cancer forms. Thus, carcinoma of unknown primary origin is a clinical entity that diagnosing requires a high level of suspicion and thorough reviewing of laboratory, radiological, and clinical findings. Further, susceptible patients, such as immunocompromised ones, should merit a careful analysis of findings and detailed analytic rationale. We, therefore, present the following case report demonstrating the importance of follow-up of specific suspicious serum markers in transplant patients. To our knowledge, this study is the first case to report an occult breast carcinoma as the initial presentation in a patient with a kidney transplant.Case Presentation: In the following case, the primary indication for malignancy was elevated alkaline phosphatase (ALP), a common finding in patients with chronic renal failure. Once noticed in a scheduled post-transplantation follow-up, further diagnostic tests, such as a broader serum panel, sternal puncture, and mammography, were ordered and returned normal. Subsequently, CT was ordered and revealed lytic and sclerotic bone changes. Afterward, serum tumor markers were ordered together with gynecological ultrasound and PET-CT. Finally, an iliac bone marrow biopsy confirmed a breast cancer diagnosis of unknown primary origin, causing the elevated ALP.Conclusions: This case report presents a uniquely difficult diagnostic challenge as an expected elevated value of ALP in a kidney transplant recipient was the only diagnostic clue for occult breast carcinoma. We discuss further the vigilance that physicians must exert when dealing with kidney transplant recipients and the implication of carcinoma of unknown primary in this population.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79445572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christiana Cahyani Prihastuti, A. H. B. Widodo, Nabila Prandita Bagasworo, Arundito Widikusumo, Dody Novrial, D. Wahyono, Tirta Wardana
Background: Radiotherapy is generally used to treat head and neck malignancy through high radiation, focusing on killing cancer cells. However, some adverse effects in oral mucosal tissue, including cell morphology changes and apoptosis, are commonly found. This study aims to determine the morphological changes and apoptosis of buccal mucosa epithelium after radiotherapy in head and neck cancer (HNC) patients.Methods: This study involved 8 subjects of patients diagnosed with HNC. Buccal mucosal smear samples were collected using cytobrush two times, before and after radiotherapy, with a dose of 70 Gy in 7 weeks. The specimens were prepared and stained using Feulgen and Rosenbeck technique. Observations were made using a light microscope with a count per 1000 epithelial cells. Statistical analysis was performed using statistical software with Pearson’s correlation test and significance t-test (p < 0.05) between irradiated and non-irradiated samples.Results: Data analysis showed significant changes in cell morphological damage and apoptosis in patients before and after radiotherapy. It increases in the number of micronuclei (p = 0.001), broken egg (p = 0.001), binuclei (p = 0.003), pyknosis (p = 0.033), karyorrhexis (p = 0.020), and karyolysis (p = 0,004). Conclusions: The effects of radiation reflect morphological changes and apoptosis in the buccal mucosa basal epithelium in HNC patients.
{"title":"Morphological Changes and Apoptosis of Buccal Mucosa Basal Epithelium in Heads and Necks during Cancer Radiotherapy","authors":"Christiana Cahyani Prihastuti, A. H. B. Widodo, Nabila Prandita Bagasworo, Arundito Widikusumo, Dody Novrial, D. Wahyono, Tirta Wardana","doi":"10.33371/ijoc.v17i1.944","DOIUrl":"https://doi.org/10.33371/ijoc.v17i1.944","url":null,"abstract":"Background: Radiotherapy is generally used to treat head and neck malignancy through high radiation, focusing on killing cancer cells. However, some adverse effects in oral mucosal tissue, including cell morphology changes and apoptosis, are commonly found. This study aims to determine the morphological changes and apoptosis of buccal mucosa epithelium after radiotherapy in head and neck cancer (HNC) patients.Methods: This study involved 8 subjects of patients diagnosed with HNC. Buccal mucosal smear samples were collected using cytobrush two times, before and after radiotherapy, with a dose of 70 Gy in 7 weeks. The specimens were prepared and stained using Feulgen and Rosenbeck technique. Observations were made using a light microscope with a count per 1000 epithelial cells. Statistical analysis was performed using statistical software with Pearson’s correlation test and significance t-test (p < 0.05) between irradiated and non-irradiated samples.Results: Data analysis showed significant changes in cell morphological damage and apoptosis in patients before and after radiotherapy. It increases in the number of micronuclei (p = 0.001), broken egg (p = 0.001), binuclei (p = 0.003), pyknosis (p = 0.033), karyorrhexis (p = 0.020), and karyolysis (p = 0,004). Conclusions: The effects of radiation reflect morphological changes and apoptosis in the buccal mucosa basal epithelium in HNC patients.","PeriodicalId":13489,"journal":{"name":"Indonesian Journal of Cancer","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89533004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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