Ketebalan Tunika Intima dan Media Arteri Karotis Komunis pada Karsinoma Nasofaring Pra dan Pascaradioterapi

Abstract

Radioterapi eksternal merupakan pengobatan utama karsinoma nasofaring. Radioterapi  eksternal menyebabkan disfungsi endotel arteri karotis komunis yang menurunkan produksi nitrogen oksida dan prostasiklin di sel endotel sehingga terjadi penebalan dinding pembuluh darah. Tujuan penelitian ini untuk mengetahui perubahan ketebalan intima media dan diameter lumen arteri karotis komunis akibat radioterapi eksternal  pada penderita karsinoma nasofaring. Tipe penelitian adalah  studi deskriptif dengan rancangan pre-post design. Penelitian dilakukan di Departemen Telinga Hidung Tenggorok-Bedah Kepala Leher-Rumah Sakit Dr. Hasan Sadikin Bandung mulai Maret 2009–Februari 2010. Pada penelitian ini dilakukan pemeriksaan  ultrasonografi  gray scale praradioterapi, pascaradioterapi, dan 10 minggu pascaradioterapi.  Hasil penelitian ini menggunakan uji Fischer dan T berpasangan. Terdapat 25 subjek karsinoma nasofaring dan hasil penelitian ditemukan peningkatan ketebalan intima media sebesar 0,1 mm di intima media arteri karotis komunis kanan dan 0,09 mm di intima media arteri karotis komunis kiri (p<0,001), juga ditemukan pengurangan diameter lumen arteri karotis komunis kanan sebesar 0,384 mm dan 0,342 mm di arteri karotis komunis kiri (p<0,001).  Simpulan, radioterapi eksternal menunjukkan ketebalan intima media dan pengurangan diameter lumen arteri karotis komunis pada penderita karsinoma nasofaring. [MKB. 2012;44(3):179–85].

Kata kunci: Diameter lumen, karsinoma nasofaring, ketebalan intima media, radioterapi eksternal 

Intima and Media Tunica Thickness of Common Carotid Artery in Nasopharyngeal Carcinoma Pre and Post External Radiotherapy

External radiotherapy is the main treatment for nasopharyngeal carcinoma. External radiotherapy  can cause endothelial dysfunction of common carotid artery and reduces nitrogen oxide and prostacyclin by endothelial cell and cause thickening of the vessels walls. Purpose of this study was to find out changes in intima-media thickness and lumen diameter of common carotid artery due to radiotherapy in patients with nasopharyngeal carcinoma. This research was descriptive with pre and post design and performed from March 2009 to February 2010 in the Ear Nose Throat-Head Neck Surgery Department of Dr. Hasan Sadikin Hospital Bandung. Gray scale ultrasound examination was performed before, after and ten weeks after radiotherapy and calculated by using Fischer’s test and paired T test.  They were 25 subjects and was found out 0.1 mm additional thickness in right intima media and 0.09 mm in left intima media common carotid artery (p<0.001), also found reduction in lumen diameter of common carotid artery in which 0.384 mm in the right and 0.342 mm in the left (p<0.001). In conclusions, external radiotherapy can cause increase intima media thickness  and reduction lumen  diameter  in common  carotid artery  in patients with nasopharyngeal carcinoma. [MKB. 2012;44(3):179–85].

Key words: External beam irradiation, intima media thickness, lumen diameter, nasopharyngeal carcinoma

DOI: http://dx.doi.org/10.15395/mkb.v44n3.206