Perbedaan β-crosslaps Serum Penderita Karsinoma Payudara Pascamenopause antara yang Diberikan Anastrozol dan Tamoksifen

Abstract

Tamoksifen dan inhibitor aromatase sebagai terapi adjuvan memiliki peranan penting pada karsinoma payudara (KPD) pascamenopause dengan reseptor estrogen positif. Saat ini inhibitor aromatase dapat menggantikan tamoksifen karena memiliki keuntungan yang lebih baik dibanding dengan  tamoksifen. Inhibitor aromatase juga memiliki efek samping meningkatkan penyerapan tulang yang memicu osteoporosis dan fraktur dibanding dengan tamoksifen. Saat terjadi proses penyerapan tulang, matriks tulang yang 90% terdiri atas kolagen tipe I akan terurai sehingga salah satu hasil penguraiannya berupa β-CrossLaps terdapat dalam darah dan dapat diukur kadarnya. Penelitian ini mengukur perbedaan kadar β-CrossLaps serum baik pada pasien KPD pascamenopause yang diberikan anastrozol dan tamoksifen di Rumah Sakit Dr. Hasan Sadikin Bandung periode Januari−Juli 2013. Penelitian ini merupakan penelitian potong lintang. Terdapat 32 pasien, yaitu 16 pasien tiap kelompok. Hasil pengolahan data statistik dengan derajat kepercayaan 95% menunjukkan perbedaan yang bermakna kadar β-CrossLaps serum KPD yang diberikan anastrozol dibanding dengan yang diberikan tamoksifen (p<0,05). Simpulan, kadar β-CrossLaps rata-rata serum KPD yang diberikan anastrozol lebih tinggi dibanding dengan tamoksifen, artinya  pemberian obat anastrozol pada pasien KPD pascamenopause dalam jangka waktu >6 bulan meningkatan proses penyerapan tulang dibanding dengan yang diberikan tamoksifen. [MKB. 2015;47(4):207–11]

DOI: 10.15395/mkb.v47n4.615

Kata kunci: Anastrozol, β-CrossLaps serum, tamoksifen

Comparison of β-crosslaps Serum Levels between Postmenopausal Breast Carcinoma Patients Receiving Anastrozol and Tamoxifen

Abstract

Tamoxifen and inhibitor aromatases as adjuvant therapy plays an important role in postmenopausal breast cancer patients with positive estrogen receptor. Currently, inhibitor aromatases can replace tamoxifen because it has more advantages than tamoxifen. Inhibitor aromatases also have side effects which is increased bone resorption that triggers osteoporosis and fractures when compared to tamoxifen. During the process of bone resorption, bone matrix, composed of 90% type I collagen, were broken down resulting in β-crosslaps content in the blood, which is measurable. This study measured the levels of serum β-crosslaps in postmenopausal breast cancer patients who received anastrozol and tamoxifen in Dr. Hasan Sadikin General Hospital Bandung between January and July 2013. This was a cross-sectional study with comparative analytics to compare the mean levels of serum β-crosslaps in postmenopausal breast cancer patients between the two groups. There were 32 patients in this study, 16 patients in each group. The results of data processing using statistical tests at 95% confidence level revealed that there was significant differences in serum levels of β-crosslaps between the group who received anastrozol and those who received tamoxifen (p<0.05). In conclusion, the mean value of β-crosslaps serum in anastrozol group is higher than in tamoxifen group. This means that postmenopausal breast cancer patients receiving anastrozol for more than 6 months could may experienced a higher degree of bone resorption compared to those receiving tamoxifen. [MKB. 2015;47(4):207–11]

Key words: Anastrozol, serum β-crosslaps, tamoxifen