Vol. 37 No. 4 September 2020
KARAKTERISTIK METASTASIS SISTEM SARAF PUSAT DARI KANKER PARU
Tan Yosephine*, Tiara Aninditha**, Henry Riyanto Sofyan**, Jonathan Odilo***, Rini Andriani****
CENTRAL NERVOUS SYSTEM METASTASIS OF LUNG CANCER CHARACTERISTIC
ABSTRACT
Introduction: As much as 40% of lung cancer patients will experience central nervous system (CNS) metastasis in the course of the disease. From those 40%, as much as 3-9% will experience leptomeningeal metastasis, but the clinical profile of CNS involvement in lung cancer has never been studied before in Indonesia.
Aim: To give a description of CNS metastasis from lung cancer inCipto Mangunkusumo General Hospital and National Cancer Referral Dharmais Hospital.
Methods: This is a cross-sectional study done in patients consulted to Neurology Department inCipto Mangunkusumo General Hospital and National Cancer Referral Dharmais Hospital in 2018. Inclusion cirteria is adult patients diagnosed with lung cancer based on histopathology with complete medical record to the extent of CT scan or Head MRI with contrast.
Results: There were 48 subjects with median age of 57 (36-76) years, men were more than women (56.2% vs 44.8%) and 31.3% had history of smoking. The most frequent lung cancer type is non-small cell lung cancer (NSCLC) (93,8%). Neurological symptoms found were motoric deficits (62.5%), headache (43.8%), cognitive dysfunction (20.8%), and seizure (18.8%). Majority of subjects suffered from brain metastasis (93.8%) and 8.3% were leptomeningeal metastasis.
Discussion: The majority of CNS metastasis were brain metastasis from NSCLC (93.8%) with main neurological deficits were motoric deficits (62.5%) and headache (43.8%).
Keywords: Brain metastasis, lung cancer, non-small cell lung carcinoma
ABSTRAK
Pendahuluan: Sebanyak 40% pasien dengan kanker paru akan mengalami metastasis sistem saraf pusat (SSP) dalam perjalanan penyakitnya. Dari 40% tersebut, sebanyak 3-9% akan mengalami metastasis leptomeningeal, namun profil klinis keterlibatan SSP pada kanker paru belum pernah diteliti di Indonesia.
Tujuan: Mengetahui gambaran metastasis SSP kanker paru di RSUPN Dr. Cipto Mangunkusumo (RSCM) dan RS Kanker Dharmais (RSKD).
Metode: Penelitian potong lintang terhadap pasien kanker paru yang dikonsulkan ke bagian Neurologi di RSCM dan RSKD sepanjang tahun 2018. Kriteria inklusi adalah pasien dewasa yang sudah terdiagnosis sebagai kanker paru berdasarkan pemeriksaan histopatologi dan memiliki data rekam medis lengkap, hingga gambaran CT scan atau MRI kepala dengan kontras.
Hasil: Didapatkan 48 subjek dengan median 57 (36-76) tahun, proporsi laki-laki lebih banyak dari pada perempuan (56,2% vs 44,8%) dan 31,3% mempunyai riwayat merokok. Jenis tumor paru tersering adalah kanker paru karsinoma bukan sel kecil (KPKBSK) atau non-small cell lung carcinoma (SCLC) (93,8%). Gejala neurologis terutama defisit motorik (62,5%), nyeri kepala (43,8%), gangguan fungsi luhur (20,8%), dan kejang (18,8%). Mayoritas subjek mengalami metastasis di otak (93,8%) dan sebanyak 8,3% di leptomeningeal.
Diskusi: Didapatkan tumor otak akibat metastasis dari kanker paru dengan jenis KPKBSK (93,8%) dengan gejala neurologis utama defisit motorik (62,5%) dan nyeri kepala (43,8%).
Kata kunci: Kankerparu, karsinoma sel kecil, metastasis otak.
* Staf SMF Neurologi RSUP Persahabatan, Jakarta; **Departemen Neurologi FK Universitas Indonesia/RSUPN Dr. Cipto Mangunkusumo, Jakarta;*** FK Universitas Indonesia, Jakarta; ****SMF Neurologi Pusat Kanker Nasional RS Dharmais, Jakarta.
Korespondensi:tanyosephinesps@gmail.com
