Perbaikan Klinis dan Harapan Hidup pada Pasien Glioblastoma Multiforme (Gbm): Laporan Tiga Kasus

Clinical and Survival Improvement in Patient with Glioblastoma Multiforme (Gbm): Three Case Reports

Erlindah Ernawati*, Djohan Ardiansyah**
* Peserta PPDS I Departemen Neurologi FK Universitas Airlangga – RSUD Dr. Soetomo Surabaya
** Staf Pengajar Departemen Neurologi FK Universitas Airlangga – RSUD Dr. Soetomo Surabaya

Abstract

         Pendahuluan: GBM adalah tumor otak jenis astrositoma derajat keempat berdasarkan klasifikasi histologi WHO; kejadiannya 50% dari seluruh jenis glioma. Pasien GBM memiliki prognosis buruk, bertahan hidup 14,6 bulan dengan modalitas terapi operasi, radiasi, dan kemoterapi. Kami melaporkan tiga kasus GBM otak dengan terapi operasi, radioterapi, dan kemoterapi yang menunjukkan perbaikan klinis dan harapan hidup yang lebih panjang. Laporan Kasus: Tiga kasus GBM otak sesuai gambaran MRI dan histopatologi dilakukan operasi eksisi pada dua diantaranya dan semua mendapatkan concomittant Temozolomide 75 mg/m2 dan radioterapi 60 Gray dalam 42 hari. Dilanjutkan adjuvant Temozolamide 150 mg/m2 hari 1–5, siklus 28 hari, selama 6–12 kali. Ketiga pasien dievaluasi kondisi klinis dan lama hidup. Pada ketiga pasien klinis membaik, satu pasien meninggal dalam 22 bulan, dua pasien bertahan hidup selama 21 bulan dan 10 bulan sampai sekarang. Kesimpulan: Saat ini, terdapat perbaikan harapan hidup pasien GBM otak sejak Temozolomide digunakan sebagai standar terapi tahun 2005. Temozolomide adalah obat alkylating agent peroral yang mampu menembus sawar darah otak, dan disahkan oleh FDA (Food and Drug Oral Administration). Pemberian radioterapi concomittant dengan kemoterapi Temozolomide yang dilanjutkan adjuvant Temozolomide pada pasien GBM otak baru memberikan respon yang cukup baik pada klinis dan harapan hidup pasien.

Kata Kunci: glioblastoma, GBM, Temozolomide

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