ANGKA KEBERHASILAN TERAPI EKSISI DAN RADIOTERAPI ADJUVAN PADA PASIEN KELOID YANG DIOPERASI DI RUMAH SAKIT UNAND
DOI:
https://doi.org/10.36973/jkih.v13i1.709Kata Kunci:
Keloid, Excision, Adjuvant Radiotherapy.Abstrak
Keloid adalah tumor jinak fibroproliferatif jinak dermal meluas di luar luka asli dan menginvasi jaringan dermal yang berdekatan akibat respons penyembuhan abnormal dari luka di dermis. Keloid dapat berdampak mengganggu bagi individu seperti gangguan kosmetik, pruritus, nyeri, dan pada kasus yang parah, pergerakan sendi yang terbatas sehingga sangat perlu untuk ditatalaksana. Salah satu terapi keloid dengan hasil yang cukup menjanjikan adalah bedah eksisi dan radioterapi adjuvan. Tujuan dari penelitian ini adalah mengetahui angka keberhasilan terapi eksisi dan radioterapi adjuvan pada pasien keloid yang dioperasi di Rumah Sakit Unand. Penelitian ini merupakan penelitian deskriptif observatif dan menggunakan desain cross-sectional dengan menggunakan teknik total sampling sebanyak 12 sampel. Analisis data memakai analisis univariat dan data penelitian disajikan dalam bentuk tabel angka keberhasilan. Hasil Pada penelitian ini didapatkan angka keberhasilan tertinggi berada pada kelompok usia 12-16 tahun, jenis kelamin perempuan, predileksi esktremitas bawah. Seluruh pasien mendapatkan jenis radiasi eksterna dengan angka keberhasilan tertinggi berada pada kelompok pasien yang diberikan dosis total 20 Gy dalam 5 fraksi, jarak follow up 6 bulan, dan jarak eksisi dan radioterapi adjuvan selama < 3x24 jam, dan patuh terhadap protokol tetap terapi.Keberhasilan terapi sebagian besar dipengaruhi oleh predileksi, umur, jenis kelamin, besar dosis radiasi, serta kepatuhan pasien terhadap terapi.
Unduhan
Referensi
Alhady, S., & Sivanantharajah, K. (1969). Keloids In Various Races: A Review of 175 Cases. Plastic and Reconstructive Surgery, 44(6), 564–566. https://doi.org/10.1097/00006534-196912000-00006
Andrews, J., Marttala, J., Macarak, E., Rosenbloom, J., & Uitto, J. (2016). Keloids: The paradigm of skin fibrosis - Pathomechanisms and treatment. Matrix Biology, 51(37), 37–46. https://doi.org/10.1016/j.matbio.2016.01.013
Azzahra, A., Perdanakusuma, D., Indramaya, D., & Saputro, I. (2023). Keloid and Hypertrophic Scar Post-Excision Recurrence: A Retrospective Study. Jurnal Plastik Rekonstruksi., 9(2).
Betarbet, U., & Blalock, T. (2020). Betarbet U, Blalock TW. Keloids: A Review of Etiology, Prevention, and Treatment. Journal Clin Aesthet Dermatol, 1(13), 33–43.
Brock, D. (1991). The ideal of shared decision making between physicians and patients. Kennedy Institute of Ethics Journal, 1(1), 28–47. https://doi.org/10.1353/ken.0.0084
Cecarani, O. (2017). Profil Keloid Pada Pasien RSUP DR. M. DJAMIL PADANG Tahun 2016-2020. Universitas Andalas.
Choirunnada, A. (2019). Profil Gangguan Kualitas Hidup akibat keloid pada Mahasiswa Fakultas Kedokteran Universitas Udayana Angkatan 2012-2014. Jurnal Medika Udayana, 8(8).
Gozal, F., & Sekarutami, M. (2018). Tinjauan Pustaka Peran Radiasi Pada Tata Laksana Keloid. Media Dermato-Venereologica Indonesiana, 45(4). https://doi.org/10.33820/mdvi.v45i4.45
Hedvall, G. (1991). Conginetal heart defect among children are surveyed in a Swedish registry. Lakartidningen, 88(24), 30–31.
Huan, C., Liu, L., You, Z., Du, Y., & Ogawa, R. (2019). Managing keloid scars: From radiation therapy to actual and potential drug deliveries. International Wound Jour, 16(3), 852–859. https://doi.org/10.1111/iwj.13104
Kataria, T., Cutter, T., & Apfelbaum, J. (2013). Patient selection in outpatient surgery. Clinics in Plastic Surgery, 40(3), 371–382. https://doi.org/10.1016/j.cps.2013.04.004
Kim, H., Hwang, S., Lim, K., Jung, Y., Ahn, S., & J, K. S. (2013). Recurrent Auricular Keloids during Pregnancy. Archives of Plastic Surgery, 40(1), 70–72. https://doi.org/10.5999/aps.2013.40.1.70
Lee, J., & Seol, K. (2021). Adjuvant Radiotherapy after Surgical Excision in Keloids. Medicina (Kaunas, Lithuania), 57(7), 730. https://doi.org/10.3390/medicina57070730
Li, Y., Zhang, D., Hang, B., & Wang, H. (2022). The Efficacy of Combination Therapy Involving Excision Followed by Intralesional 5-Fluorouracil and Betamethasone, and Radiotherapy in the Treatment of Keloids: A Randomized Controlled Trial. Clinical, Cosmetic and Investigational Dermatology, 15(November), 2845–2854. https://doi.org/10.2147/CCID.S388717
Limandjaja, G., Niessen, F., Scheper, R., & Gibbs, S. (2020). The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models. Frontiers in Cell and Developmental Biology, 26(8). https://doi.org/10.3389/fcell.2020.00360
Liu, C., & Yuan, Z. (2019). Retrospective study of immediate postoperative electron radiotherapy for therapy-resistant earlobe keloids. Archives of Dermatological Research, 311(6), 469–475. https://doi.org/10.1007/s00403.019-01922-z
Lu, W., Zheng, X., Yao, X., & Zhang, L. (2015). Clinical and epidemiological analysis of keloids in Chinese patients. Archives of Dermatological Research, 307(2), 109–114. https://doi.org/10.1007/s00403-014-1507-1
Mari, W., Alsabri, S., Tabal, N., Younes, S., Sherif, A., & Simman, R. (2015). Novel Insights on Understanding of Keloid Scar: Article Review. Journal of the American College of Clinical Wound Specialists, 7, 1–7. https://doi.org/10.1016/J.JCCW.2016.10.001
Miles, O., Zhou, J., Paleri, S., Fua, T., & Ramakrishnan, A. (2021). Chest keloids: effect of surgical excision and adjuvant radiotherapy on recurrence, a systematic review and meta-analysis. ANZ Journal of Surgery, 91(6), 1104–1109. https://doi.org/10.1111/ans.16561
Mohamed, R., Elawadi, A., Al-Gendi, R., Al-Mohsen, S., Wani, S., & Wafa, A. (2022). The outcome of postoperative radiation therapy following plastic surgical resection of recurrent ear keloid: a single institution experience. Journal of the Egyptian National Cancer Institute, 34(1). https://doi.org/10.1186/s43046-022-00105-8
Nang’ole, F., Anzala, O., Ogeng’o, J., & Agak, G. (2023). Determinants of Keloid study: The nairoby keloid requrrence scoring system; A cohort, prospective study. International Journal of Surgery Open, 52. https://doi.org/10.1016/J.IJSO.2023.100596
Ogawa, R., Dohi, T., Tosa, M., Aoki, M., & Akaishi, S. (2021). The latest strategy for keloid and hypertrophic scar prevention and treatment: The nippon medical school (NMS) protocol. Journal of Nippon Medical School, 88(1), 2–9. https://doi.org/10.1272/jnms.JNMS.2021_88-106
Oriji, G., & Keiser, H. (1997). Protein kinase C mediates angiotensin II-induced contractions and the release of endothelin and prostacyclin in rat aortic rings. Prostaglandins, Leukotrienes, and Essential Fatty Acids, 57(2), 135–141. https://doi.org/10.1016/s0952-3278(97)90003-x
Shaffer, J., Taylor, S., & Cook-Bolden, F. (2002). Keloidal scars: a review with a critical look at therapeutic options. Journal of the American Academy of Dermatology, 46(2 Suppl Understanding), S63–S97. https://doi.org/10.1067/mjd.2002.120788
Wagner, W., Alfrink, M., Micke, O., Schäfer, U., Schüller, P., & Willich, N. (2000). Results of prophylactic irradiation in patients with resected keloids--a retrospective analysis. Acta Oncologica (Stockholm, Sweden), 39(2), 217–220. https://doi.org/10.1080/028418600430806
Widiatmoko, A., Brahmanti, H., Padesa, T., & Pranowo, B. (2019). Kombinasi Bedah Eksisi Injeksi Kortikosteroid Intralesi, dan Gel Silikon pada Tata Laksana Keloid di Cuping Telinga. 2019. Media Dermato-Venereologica Indonesiana, 46(2). https://doi.org/10.33820/mvdi.v46i2.61
Wu, C., Wu, P., Fang, A., & Lan, C. (2012). FK506 inhibits the enhancing effects of transforming growth factor (TGF)-β1 on collagen expression and TGFβ/Smad signalling in keloid fibroblasts: implication for new therapeutic approach. British Journal of Dermatology, 167(3), 532–541. https://doi.org/10.1111/j1365-2133.2012.11023.x
Yoshiaki, C., & Rei Ogawa, H. (2019). Sex Differences in Keloidogenesis: An Analysis of 1659 Keloid Patients in Japan. Dermatology and Theraphy, 9(4), 747–754. https://doi.org/10.1007/S13555-019-00327-0
Zainib, M., & Amin, N. (2025). Terapi Radiasi dalam Pengobatan Keloid. Treasure Island (FL).
