Pengaruh Alfa Tokoferol pada Efek Ototoksik Sisplatin

Yanuar Iman Santosa, Dindy Samiadi, Nur Akbar Aroeman, Pandji Irani Fianza

Abstract


Kemoterapi sisplatin memiliki efek samping ototoksik, diperantarai radikal bebas, mengakibatkan kematian sel rambut luar koklea, menyebabkan gangguan dengar. Alfa tokoferol memiliki efek otoprotektif terhadap sisplatin pada hewan coba. Diperlukan penelitian lebih lanjut pada manusia. Tujuan penelitian mengukur fungsi pendengaran untuk mengetahui pengaruh pemberian alfa tokoferol per oral pada pencegahan efek ototoksik sisplatin. Dilakukan penelitian uji klinis acak di Rumah Sakit Dr. Hasan Sadikin Bandung (RSHS) periode Desember 2011–Februari 2012 pada dua kelompok. Kelompok perlakuan menjalani pengobatan standar kemoterapi sisplatin dengan tambahan alfa tokoferol per oral dengan dosis 400 International Unit (IU) per hari sejak 1 hari sebelum kemoterapi selama 30 hari. Kelompok kontrol menjalani pengobatan standar kemoterapi sisplatin. Pemeriksaan fungsi pendengaran dilakukan dengan timpanometri, audiometri, dan distortion product otoacoustic emission (DPOAE) sebelum dan setelah kemoterapi siklus pertama dan kedua. Didapatkan hasil kejadian ototoksik setelah siklus pertama lebih rendah secara bermakna pada kelompok 1 (33,3%) dibandingkan dengan kelompok 2 (66,7%) (p=0,046; IK=95%). Demikian juga dengan kejadian ototoksik setelah siklus kedua lebih rendah secara bermakna pada kelompok 1 (50%) dibandingkan dengan kelompok 2 (88,9%) (p=0,027; IK=95%). Simpulan, terapi alfa tokoferol 400 IU per oral dapat mencegah efek ototoksik sisplatin. [MKB. 2012;44(4):205–12].

Kata kunci: Alfa tokoferol, ototoksik, sisplatin


Effects of Alpha Tocopherol Againts Cisplatin–Induced Ototoxicity

Ototoxicity is a known side effect of cisplatin chemotherapy due to formation of free radicals causing death to cochlear outer hair cells, resulting in hearing loss. Alpha tocopherol has otoprotective effects towards cisplatin in animal studies. Further human studies are needed. The objective of this study was to measure hearing function to know the otoprotective effects of alpha tocopherol against cisplatin. A randomized control trial was performed at Dr. Hasan Sadikin Hospital Bandung in December 2011–February 2012 in 2 groups. The treatment group received standard cisplatin chemotherapy treatment and alpha tocopherol 400 International Unit (IU)/day since day 1 before a 30-day-treatment. the control group received standard cisplatin chemotherapy treatment. Hearing evaluation was done using tympanometry, audiometry and distortion product otoacoustic emission (DPOAE) before and after the first and second cycles of chemotherapy. Results showed that ototoxic incidence after the first cycle of chemotherapy was significantly lower in group 1 (33.3%) than group 2 (66.7%) (p=0.046, CI=95%). Ototoxic incidence after the second cycle of chemotherapy was significantly lower in group 1 (50%) than group 2 (88.9%) (p=0.027, CI=95%). In conclusion, oral alpha tocopherol 400 IU can prevent cisplatin-induced ototoxicity. [MKB. 2012;44(4):205–12]

Key words: Alpha tocopherol, cisplatin, ototoxicity

 

DOI: http://dx.doi.org/10.15395/mkb.v44n4.176


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