Fungsi Sistolik dan Diastolik Jantung pada Pasien Anak dengan Osteosarkoma yang Mendapat Terapi Doksorubisin Di RS Cipto Mangunkusumo
Sari
Latar belakang. Doksorubisin merupakan obat golongan antrasiklin yang penting dan efektif pada pengobatan tumor padat pada anak. Doksorubisin mencegah sintesis RNA dan DNA melalui proses interkalasi. Kardiotoksisitas dilaporkan paling banyak karena penggunaan doksorubisin tersebut sehingga penggunaannya masih terbatas.
Tujuan. Mengetahui fungsi jantung pada anak dengan osteosarkoma setelah mendapat terapi doksorubisin di RSCM.
Metode. Studi deskriptif potong lintang dilakukan di RSCM, Divisi Hematologi-Onkologi IKA dan Sub Bagian Onkologi Orthopedik dan Traumatologi, dengan menelusuri catatan registrasi dan rekam medis pasien anak dengan osteosarkoma sejak 1 Januari 2005 sampai dengan 31 Desember 2012.
Hasil. Terdapat 25 subjek penelitian, 21 di antaranya selesai menjalani kemoterapi dan mendapat total dosis kumulatif doksorubisin dengan rentang 300 mg/m2 sampai 675 mg/m2. Fungsi sistolik LV mengalami penurunan rerata fraksi ejeksi 3,3% dan pemendekan 2,5% setelah mendapat doksorubisin. Fungsi diastolik LV mengalami penurunan rerata rasio E/A 17,6%. Sembilan dari 18 pasien yang selesai menjalani kemoterapi dan mendapat total dosis kumulatif doksorubisin 375 mg/m2 mengalami gangguan fungsi diastolik tidak disertai gangguan fungsi sistolik. Kardiomiopati dilatasi ditemukan pada satu pasien setelah mendapat dosis kumulatif doksorubisin 300 mg/m2 dan satu pasien setelah mendapat dosis 675 mg/m2. Pasien berusia ≥10 tahun dan berjenis kelamin perempuan lebih banyak mengalami penurunan fungsi sistolik dan diastolik LV setelah mendapat doksorubisin.
Kesimpulan. Fungsi sistolik dan diastolik LV menurun setelah pasien mendapat terapi doksorubisin dengan dosis kumulatif 300 mg/m2. Penurunan fungsi diastolik mendahului penurunan fungsi sistolik LV. Dosis, usia, dan jenis kelamin perempuan dapat menjadi faktor risiko penurunan fungsi jantung setelah pemberian doksorubisin.
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DOI: http://dx.doi.org/10.14238/sp16.3.2014.149-56
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