Kemoterapi pada Pasien Operasi Tumor Otak Metastasis: Apa Implikasi Anestesinya?

Abstract

Tumor otak metastasis adalah salah satu jenis keganasan intrakranial yang paling umum di temukan pada dewasa. Di Amerika Serikat sendiri tumor otak metastasis mencapai 150.000 – 170.000 kasus pertahun. Lebih dari 50% tumor otak metastasis terletak di supratentorial, dapat memberikan gejala neurologis, sangat bergantung akan jumlah lesi, ukuran lesi, serta ukuran dari edema vasogenik yang terjadi dan menekan jaringan otak sekitarnya. Lima sumber paling umum dari tumor otak metastasis adalah payudara, colorectal, ginjal, jantung dan melanoma. Dari keseluruhan pasien dengan tumor otak akibat metastasis 8 – 14% akan menjalani operasi pengangkatan tumor dengan beberapa pertimbangan seperti didapatkan tanda – tanda kegawatdaruratan neurologis, ukuran massa yang besar, jenis tumor primer, grade tumor, lokasi tumor, resiko, komplikasi operasi dan Karnofsky Performance Score (KPS). Pasien tumor otak metastasis tentunya datang dengan dengan riwayat tumor ganas pada organ tubuh lainnya dan telah menjalani kemoterapi sebagai terapi. Pasien dengan riwayat kemoterapi memerlukan perhatian khusus karena selain membunuh sel kanker, kemoterapi dapat memberi efek toksik pada sistem organ, baik efek jangka pendek maupun efek jangka panjang, sehingga di perlukaan tatalaksana perioperatif yang seksama pada operasi tumor otak metastasis agar didapatkan hasil luaran yang baik. Chemotherapy In Patients with Metastatic Brain Tumor Surgery: What are the Implications of Anesthesia? Metastatic brain tumor is one of the most common types of intracranial malignancies found in adults. In the United States alone metastatic brain tumors attain. 150,000 - 170,000 cases per year. Metastatic brain tumor of more than 50% is located in the supratentorial, may provide neurological symptoms, highly dependent on the number of lesions, the size of the lesion, as well as the size of the vasogenic edema that occurs and suppress the surrounding brain tissue. The five most common sources of metastatic brain tumors are breast, colorectal, kidney heart and melanoma. Of all patients with brain tumors due to metastasis 8 to 14% will undergo tumor removal surgery with some considerations such as the emergence of signs of neurological emergency, large mass size, type of primary tumor, tumor grade, tumor location, risk complication of surgery, and Karnofsky performance score (KPS). Patients with metastatic brain tumors certainly come with a history of malignant tumors in other organs and have undergone chemotherapy as therapy. Patients with a history of chemotherapy require special attention because in addition to killing cancer cells, chemotherapy can have a toxic effect on the organ system, both short-term and long-term effects, so a careful perioperatif treatment in patients with brain tumor metastasis surgery is mandatory in order to obtain good results.

Keywords

• implikasi anestesi
• kemoterapi
• tumor otak metastasis
• anesthesia implications
• chemotherapy
• metastatic brain tumor