Prophylactic Cranial Irradiation (Pci) Pada Kanker Paru Jenis Karsinoma Sel Kecil (Kpksk)
Abstract
Kanker Paru jenis Karsinoma Sel Kecil (KPKSK) merupakan tipe kanker paru yang sangat agresif dengan kecenderungan tinggi untuk metastasis otak. Prophylactic Cranial Irradiation (PCI) dikembangkan sebagai strategi preventif untuk menurunkan insidensi metastasis otak dan meningkatkan luaran klinis pada pasien KPKSK. Berbagai uji klinis dan meta-analisis menunjukkan bahwa PCI secara signifikan menurunkan risiko metastasis otak dan dapat memberikan manfaat pada survival, khususnya pada pasien KPKSK stadium terbatas yang merespons kemoterapi dan/atau radioterapi definitif. Namun demikian, manfaat PCI harus dipertimbangkan secara hati-hati terhadap potensi toksisitas, terutama dampak neurokognitif jangka pendek dan panjang. Referat ini membahas peran PCI pada KPKSK dengan meninjau dasar biologis, bukti klinis utama, rekomendasi guideline terkini, aspek toksisitas dan neurokognisi, serta pertimbangan klinis dalam pemilihan pasien, guna mendukung pengambilan keputusan yang rasional dan berbasis bukti dalam praktik onkologi toraks.
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