Neoadjuvant Kemoterapi Ifosfamide-Cisplatin pada Kanker Serviks Stadium IB2-IIA2 di RSUP. H. Adam Malik Medan

Abstract

Background: Early-stage bulky cervical carcinoma treated with conventional surgery or radiotherapy has a higer rate of recurrence compared to smaller tumors at the same stage. Despite, many cases have shown bulky tumor, making difficulties in the surgery. lncreased operability of cervical cancer has been done with neoadjuvant chemotherapy. From every chemotherapy agent, ifosamide and cisplatin shoold be chossen, Known response operability of this regiment can help choose the choices therapy for operable cervical cancer with bulky tumor, hoping high radical level, decrease pasca operation adjuvant indication therapy and therefore increase the quality of life. Aim:To determine the rate of tumor mass reduction following administration of ifosfamide-cisplatin neoadjuvant chemotherapy for cervical cancer. Methods: This is an experimental research with one group pre and post test design of 32 medical records of patients with cervical cancer stage FIGO lB2-

llA2 which is operable whom received neoadjuvant chemotherapy ifosfamide- cisplatin in H. Adam Malik Hospital since January 2014 until June 2015.

Parameters of this study is the size of the tumor before and after neoadiuvant chemotherapy. Data analysis is done by Fischer Exact test and Wilcoxon on SFSS 17 (limit of significance p <0.05). Results: The mean size of the tumor decreased significantly after than before administration of neoadjuvant chemotherapy is 66,7% (p=0.002), independent on stage (p=0.473), histopathologic type (p=0.061) differentiation (p=0.516) of cervical cancer. ln this study, 14 of 32 patients has decreased the tumor mass. After surgery, 71.4% showed no lymph node involvement. All patient had free survival margin and no parametrial involvement (100%). Conclusion:There is a significant reduction in the size of the tumor mass following administration of neoadjuvent chemotherapy. Surgary after neoadjuvant chemotherapy show all the patients tumor free on vaginal margin and no parametrial involvement and majority there is no lymph node involvement.