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Abstract

In Indonesia, there were more than 58,000 new breast cancer cases with nearly 23,000 deaths in 2020. Radiotherapy is one of the adjuvant therapy modalities for breast cancer. Interruptions of more than five days increase the risk of local recurrence. This study aimed to describe the risk factors associated with prolonged overall treatment time (OTT) in breast cancer patients at Dr. Kariadi General Hospital during 2023. This was a cross-sectional study using bivariate logistic regression analysis to examine the association between national holidays, deterioration of general condition, age, residence, and type of surgery prior to radiation therapy with prolonged OTT. Data were obtained from electronic medical records, and a total population sampling method was applied, resulting in 261 post-surgical breast cancer patients who met the inclusion criteria, namely newly diagnosed breast cancer patients who had undergone breast-conserving surgery (BCS) or modified radical mastectomy (MRM) followed by adjuvant radiotherapy. Patients were considered to have prolonged OTT if the interruption exceeded the number of recorded national holidays. Among the 261 patients, 21.8% (n = 57) experienced prolonged OTT. The highest proportion of prolonged OTT occurred in patients aged 50–59 years (43.9%), residing outside Semarang City/Regency (64.9%), undergoing MRM (77.2%), affected by national holidays (78.9%), and without deterioration of general condition (82.5%). Bivariate analysis showed that only national holidays and machine maintenance were statistically significantly associated with prolonged OTT (p < 0.001). As an effort to improve treatment outcomes, hospitals need to implement strategies to prevent prolonged OTT, including ensuring continuous access to radiotherapy without interruption due to machine maintenance.

Keywords : Breast Cancer, Overall Treatment Time (OTT), Radiotherapy Interruption

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Bahasa Abstract

Di Indonesia, terdapat lebih dari 58 ribu kasus baru kanker payudara dengan hampir 23 ribu kematian pada tahun 2020. Radioterapi sebagai salah satu modalitas dalam terapi adjuvan kanker payudara. Interupsi lebih dari lima hari berisiko meningkatkan kekambuhan lokal. Penelitian ini bertujuan untuk melihat gambaran faktor risiko terjadinya overall treatment time (OTT) yang berkepanjangan pada pasien kanker payudara di RSUP Dr. Kariadi selama tahun 2023. Studi ini menggunakan desain potong lintang dengan analisis regresi logistik bivariat untuk melihat hubungan hari libur nasional, perburukan kondisi umum, usia, domisili, dan metode operasi sebelum terapi radiasi, dengan perpanjangan OTT. Berdasarkan data rekam medis elektronik serta menggunakan metode total population sampling, didapatkan total 261 pasien pasca operasi payudara yang memenuhi kriteria inklusi, yaitu pasien baru yang terdiagnosis kanker payudara dan telah menjalani operasi breast conserving surgery (BCS) ataupun modified radical mastectomy (MRM) dilanjutkan dengan terapi adjuvan radiasi. Pasien dianggap mengalami perpanjangan OTT jika interupsi OTT melebihi jumlah hari libur nasional yang tercatat. Dari 261 pasien, 21,8% (n=57) mengalami OTT berkepanjangan. Proporsi OTT berkepanjangan paling besar pada pasien kelompok usia 50–59 tahun (43,9%), berdomisili di luar Kota/Kabupaten Semarang (64,9%), pasien dengan MRM (77,2%), pasien terdampak libur nasional (78,9%), dan pasien tanpa perburukan kondisi umum (82,5%). Hasil analisis bivariat menunjukkan hanya hari libur nasional dan pemeliharaan alat yang berhubungan signifikan secara statistik dengan OTT berkepanjangan (p< 0,001). Sebagai salah satu upaya meningkatkan hasil terapi, Rumah Sakit perlu melakukan upaya mencegah OTT berkepanjangan, diantaranya dengan memastikan akses kontinyu terhadap radioterapi tanpa terinterupsi pemeliharaan alat.

Kata Kunci : Kanker Payudara, Perpanjangan OTT, Interupsi Radioterapi

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