vi

DAFTAR ISI

HALAMAN JUDUL ............................................................................................... i

HALAMAN PENGESAHAN ................................................................................ ii

SURAT PERNYATAAN ...................................................................................... iii

PRAKATA ............................................................................................................. iv

DAFTAR ISI .......................................................................................................... vi

DAFTAR GAMBAR ............................................................................................. ix

DAFTAR TABEL ....................................................................................................x

DAFTAR SINGKATAN ....................................................................................... xi

DAFTAR LAMPIRAN ......................................................................................... xii

INTISARI ............................................................................................................ xiii

BAB I PENDAHULUAN ...................................................................................1

1.1 Latar Belakang .................................................................................1

1.2 Rumusan Masalah ............................................................................4

1.3 Tujuan ...............................................................................................4

1.3.1 Tujuan Umum .........................................................................4

1.3.2 Tujuan Khusus ........................................................................4

1.4 Manfaat Penelitian ............................................................................5

1.4.1 Manfaat Teoritis ......................................................................5

1.4.2 Manfaat Praktis .......................................................................5

BAB II TINJAUAN PUSTAKA ..........................................................................6

2.1 Karsinoma Nasofaring ......................................................................6

2.1.1. Anatomi Nasofaring ................................................................6

2.1.2. Fisiologi ..................................................................................9

2.1.3. Histopatologi .........................................................................10

2.1.4. Epidemiologi .........................................................................13

2.1.5. Etiologi ..................................................................................14

2.1.6. Gambaran Klinis ...................................................................15

2.1.7. Klasifikasi Stadium ...............................................................18

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2.1.8. Diagnosis...............................................................................19

2.1.9. Penatalaksanaan ....................................................................22

2.1.10. Penatalaksanaan Terkait Penelitian Sebelumnya ...............23

2.2 Kemoterapi .....................................................................................24

2.2.1 Definisi Kemoterapi ..............................................................24

2.2.2 Macam-macam Obat Kemoterapi .........................................25

2.2.3 Mekanisme Cara Kerja Kemoterapi......................................28

2.2.4 Cara Pemberian Kemoterapi .................................................29

2.2.5 Dosis obat Kemoterapi ..........................................................30

2.2.6 Skala Status Penampilan Menurut ECOG (Eastern

Cooperative Oncology Group) Pada Tahun 1982: ...............31

2.2.7 Persyaratan Pasien Sebelum Melakukan Kemoterapi...........31

2.2.8 Efek Samping Kemoterapi ....................................................32

2.3 Angka Harapan Hidup ....................................................................33

2.3.1 Definisi ..................................................................................33

2.3.2 Faktor - faktor Yang Mempengaruhi Harapan Hidup Pada

Karsinoma Nasofaring yaitu : ...............................................35

2.4 Faktor – faktor Yang Mempengaruhi Pasien Karsinoma

Nasofaring ......................................................................................38

2.4.1. Jenis Kelamin ........................................................................38

2.4.2. Umur .....................................................................................38

2.4.3. Sumber Biaya ........................................................................39

2.4.4. Stadium .................................................................................40

2.5 Kerangka Teori ...............................................................................41

2.6 Kerangka Konsep ...........................................................................42

2.7 Hipotesis .........................................................................................42

BAB III METODE PENELITIAN ......................................................................44

3.1 Jenis dan Rancangan Penelitian .....................................................44

3.2 Variabel dan Definisi Operasional .................................................44

3.2.1 Variabel dalam penelitian ini adalah : ..................................44

3.2.2 Definisi Operasional dalam penelitian ini adalah : ...............44

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3.3 Populasi dan Sampel ......................................................................46

3.3.1 Populasi .................................................................................46

3.3.2 Sampel...................................................................................47

3.4 Instrumen dan Bahan Penelitian .....................................................48

3.4.1 Rekam Medis ........................................................................48

3.5 Cara Penelitian ...............................................................................48

3.5.1 Perencanaan ..........................................................................48

3.5.2 Pengambilan sampel .............................................................49

3.5.3 Pengumpulan data .................................................................49

3.5.4 Pengolahan Data ...................................................................49

3.5.5 Pelaporan...............................................................................49

3.6 Alur Penelitian ................................................................................50

3.7 Tempat dan Waktu Penelitian ........................................................50

3.7.1 Tempat ..................................................................................50

3.7.2 Waktu ....................................................................................50

3.8 Analisis Data ..................................................................................50

BAB IV HASIL PENELITIAN DAN PEMBAHASAN .....................................51

4.1 Hasil Penelitian...............................................................................51

4.2 Pembahasan ....................................................................................54

BAB V KESIMPULAN DAN SARAN .............................................................59

5.1. Kesimpulan .....................................................................................59

5.2. Saran ...............................................................................................59

DAFTAR PUSTAKA ............................................................................................60

LAMPIRAN ...........................................................................................................65

ix

DAFTAR GAMBAR

Gambar 2.1 Anatomi nasofaring (Netter, 2014) ......................................................9

Gambar 2.2 Karsinoma sel skuamosa berkeratin ...................................................11

Gambar 2.3 Karsinoma Tidak Berkeratin Berdiferensiasi .....................................12

Gambar 2.4 Karsinoma Tidak Berkeratin Tidak Berdiferensiasi ..........................13

x

DAFTAR TABEL

Tabel 2.1 Dosis obat-obat kemoterapi yang sering digunakan adalah : ................ 30

Tabel 2.2 Data angka harapan hidup 5 tahun berdasarkan stadium ...................... 34

Tabel 4.1 Karakteristik demografi pasien karsinoma nasofaring (n: 121) ............ 51

Tabel 4.2 Faktor-faktor yang mempengaruhi karakteristik demografi pasien

KNF berdasarkan angka kelangsungan hidup 5 (lima) tahun (n: 121) . 52

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DAFTAR SINGKATAN

3 DRT : 3 Dimensional Radiotherapy

ACS : American Cancer Society

BMC : Bleomycin / Methotrexate / Cisplatin

CFBM : Cisplatin / Flurouracil / Bleomycin / Mcthotrexate

CMBV : Cisplatin / Mcthotrexate / Blcoraycin / Vincristine

CTX : Cyclophosphamide

DNA : Deoxyribo Nucleic Acid

ECOG : Eastern Cooperative Oncology Group

FDA : Food and Drug Administration

FKUI : Fakultas Kedokteran Universitas Indonesia

FNAB : Fine Needle Aspiration Biopsy

HLA : Human Leucocyte Antigen

IMRT : Intensity Modulated Radiation Therapy

KGB : Kelenjar Getah Bening

KNF : Karsinoma Nasofaring

KNPK : Komite Nasional Penanggulangan Kanker

LED : Laju Endap Darah

mRNA : Reoxyribo Nucleic Acid

PBF : Cisplatin / Bleomycin / Fluorouracil

PFL : Cisplastin / Fluorouracil / Lcucovorin

RSCM : Rumah Sakit Cipto Mangunkusumo

RSI : Rumah Sakit Islam

RSUP : Rumah Sakit Umum Pusat

SCC : Squamosa Cancer Cell

SGOT : Serum Glutamic Oxaloacetic Transaminase

SGPT : Serum Glutamic Pyruvic Transaminase

THT : Telinga, Hidung dan Tenggorok

USG : Ultrasonografi

WHO : World Health Organizations

xii

DAFTAR LAMPIRAN

Lampiran 1 Survey Pendahuluan .........................................................................65

Lampiran 2 Surat Ijin Survey Pendahuluan .........................................................65

Lampiran 3 Surat Ijin Pengambilan Data .............................................................66

Lampiran 4 Surat Ijin Penelitian ..........................................................................67

Lampiran 5 Surat Keterangan ..............................................................................66

Lampiran 6 Ethical Clearance .............................................................................67

Lampiran 7 Hasil Uji Statistik ..............................................................................72

Lampiran 8 Photo Dokumentasi ...........................................................................78