Hipertensi pada Pasien Kanker Kolorektal Metastatik dengan Terapi Bevacizumab di RSUP Dr. Kariadi
DOI:
https://doi.org/10.36408/mhjcm.v7i2.502Keywords:
Kanker kolorektal, bevacizumab, hipertensiAbstract
Latar belakang: Kanker kolorektal saat ini sudah menjadi penyebab utama ketiga kematian akibat kanker di dunia, penyakit ini membutuhkan terapi yang progresif dimana salah satu terapinya adalah bevacizumab. Namun diketahui bevacizumab dapat menimbulkan hipertensi pada sebagian pasien. Penelitian ini bertujuan untuk untuk mengetahui onset terjadinya hipertensi akibat bevacizumab dengan rejimen kemoterapi apa yang digunakan.
Metode: Penelitian ini merupakan sebuah tinjauan deskriptif restrospektif yang dilakukan di RSUP Dr. Kariadi, Semarang. Kriteria inklusi terdiri dari pasien kanker kolorektal metastatik yang berusia ? 18 tahun dengan hipertensi tingkat ?2 berdasarkan NCI CTCAE version 5.0 setelah diberikan terapi bevacizumab 5 mg/kg berat badan di RSUP Dr. Kariadi. Pengambilan data dalam 1 tahun (bulan April 2018 hingga April 2019) melalui peninjauan dari rekam medis, laporan penggunaan obat bevacizumab dan laporan penggunaan obat kardiovaskuler instalasi farmasi. Kriteria ekslusi dalam penelitian ini yaitu hipertensi tingkat ?2 berdasarkan NCI CTCAE version 5.0 yang muncul setelah ?4 kali waktu paruh bevacizumab (t 1/2 = 20 hari) dari kemoterapi yang terakhir.
Hasil: Total 95 pasien sesuai kriteria, sebanyak 24 pasien (25,26%) teridentifikasi mengalami hipertensi tingkat ? 2 berdasarkan NCI CTCAE version 5.0. Dengan 20 pasien (83,33%) pasien mendapatkan kemoterapi rejimen FOLFOX4, sedangkan sisanya (16,66%) dengan rejimen de Gramont. Hipertensi ini muncul sebagian besar pada siklus III, diikuti siklus ke II, ke I dan ke VI. Tidak satupun pasien dengan kombinasi FOLFIRI yang terdeteksi mengalami hipertensi ini.
Kesimpulan: Penelitian ini menunjukkan onset munculnya hipertensi tingkat ?2 NCI CTCAE version 5.0 paling banyak adalah pada siklus awal terapi yaitu I-III dan dengan rejimen kombinasi FOLFOX4 + bevacizumab.
Kata Kunci: Kanker kolorektal, bevacizumab, hipertensi
Background: Colorectal cancer nowadays is the third leading cause of cancer deaths in the world, this disease requires progressive therapy where one of the treatments is bevacizumab. But it is known that bevacizumab can cause hypertension in some patients. This study aims to determine the onset of the hypertension with chemotherapy regimen used.
Method: This research is a retrospective descriptive review conducted at Dr. Kariadi General Hospital, Semarang. Inclusion criteria consisted of metastatic colorectal cancer patients aged ?18 years old with hypertension level ?2 based on NCI CTCAE version 5.0 after being given bevacizumab therapy dose 5 mg/kg body weight. Retrieval of data in 1 year (April 2018 to April 2019) through a review of medical records, reports on the use of bevacizumab drugs and reports on the use of cardiovascular drugs in Department of Pharmacy. The exclusion criteria in this study were hypertension level on NCI CTCAE version 5.0 which appeared after 4 times the half-life of bevacizumab (t 1/2 = 20 days) from the last chemotherapy.
Result: Total 95 patients according to the criteria, 24 patients (25.26%) were identified as having hypertension level ? 2 based on NCI CTCAE version 5.0. With 20 patients (83.33%) patients received FOLFOX4 regimen, while the rest (16.66%) with de Gramont regimen. This hypertension occurs mostly in cycle III, followed by cycle II, to I and to VI. None of the patients with a combination of FOLFIRI.
Conclusion: This research shows that the onset of hypertension level ?2 NCI CTCAE version 5.0 mostly in the initial cycle of therapy (I-III) with the FOLFOX4 + bevacizumab combination regimen.
Keywords: Colorectal cancer, bevacizumab, hypertension
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