Nasopharyngeal Carcinoma - Copy-1

8/9/2019 Nasopharyngeal Carcinoma - Copy-1

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CURICULUM VITAE

Yogyakarta, 10Maret 1967

SMA Negeri 3 Yogyakarta

F U!MF UI

"#$e#ia%i#a#i & S '(

S)* +agia

-ko%ogi, Larig


2/30

ETI-L-!I, /IA!N-SIS,TATALASANA & UAYA

ENCE!AAN ARSIN-MANAS-FARIN!

Dr. A. Budi Sulistya, Sp THT-KL, MARS

DEPARTEMEN THT PAV KARTIKA

RSPAD GATOT SOEBROTO


3/30

A$aka2 ar#ioaa#o.arig it) 4

Tumor ganas yang tumbuh di rongganasofaring .

Nasopharyngeal

Carsinoma (NPC),

“Kwangtung

Tumors” 5 besar keganasan

/iago#i# 5ii 4


4/30

AN!A EERAAN

• Usia : 20-60 tahun (usia produktif) Keompok usia terbanyak 50-60 thn

• !enis Keamin

2-" : #

• $thnik : %hinese& 'aay& %auasian

*+, 0

""2, "0

NC

'ae

emae


5/30

NF 5a T)or L

dr. /bnu arris adiah& 1p. TT-K

1 ka#)#

1008000ta2)

6,' ka#)# 1008000ta2

)

30:0 ka#)#

1008000ta2)

7 ka#)# 1008000ta2)

1 ka#)# 1008000ta2

)


6/30


7/30

FAT-R ENYE+A+ & AT-L-!IANAT-MI

NF;- Ti$e

1;- Ti$e

';- Ti$e

3

o%ai5)$ &

ar#iogeik

eretaa

!eetika

E+V


8/30

FAT-R ENYE+A+"ETI-L-!I)

NPCEthnicity

Diet(“smoke”)

(Immuno)genetic

factors

Gender

Herba

Drugs!

ois

En"ironmenta

factors

Ch ATC T PML J h PJ N h l C i A l f O l 2002 13 100! 1#Ch ATC T PML J h PJ N h l C i A l f O l 2002 13 100! 1#


9/30

T)origee#i#

E$ite% Nora%Na#o.arig

/i#$%a#ia/era


10/30

!EALA /AN TAN/A

5*.##6.#

#2.+

6.56.5

3en4oan eher

gn. endengaran #sisi

$pistaksis

idung tersumbat

7yeri

gn. end # sisi

'imisanberuangidungtersumbat7yeri

3en4oan eher


11/30

$!88K/7/1

%efagia

9ipopiaphtamopeg

iaagophtamus

bstruksihidung1ekret ;

darah8nosmia

$pistaksis79

Trismus 9isfagiaangguan

pengeap 8tro<paatum moearese parsia

idah

imfadenopati oie

=asa penuh diteinga Tinitustagia

Tuikonduktif

uniateraerforasi

'$

EARLY A/VANCE


12/30


13/30

/IA!N-SE

• 8namnesis

• emeriksaan isik TT =inoskopi 8nterior > osterior

$ndoskopi: =igid? iber

nasopharyngoaryngosopy

• eerik#aa $e)


14/30

@1/%8$A8'/78T/7

8nterior=hinosopy

osterior=hinosopy

7asoendosopyiber?rigid

apation


15/30

AT-L-!I ANAT-MI

B, #+*: Type #: KeratiniCing 1%% Type 2: 7on KeratiniCing1%%

Type ": UndiDerentiated

B: Borking ormuation: degree of anapasia andtumor e

#. igh maignant degree 1%%

2. Type 8: 8napasia?obEious peomorphi&/ntermediate maignant degree

". Type 3: 8napasia? ight peomorphi& oF maignantdegree

=adiation response: Type 3 good& Type 8: ess


16/30

EMERISAAN ENUNAN!

%T 1an:

G eruasan tumor

G 1uperior: destruksi tuang& densitas

4aringanunak

'=/:

G =esousi tinggi

G 1uperior: residua?reurent& inHamasi&


17/30

SEROLOGY EPSTEIN BAR VIRUS

1eroogy

!akarta 1ingaporeongkon

g/g8 anti I%8

1ensitiEity

1pei


18/30

ERLUASAN TUM-R

rimary Tumor

TA rimary tumor annot be assessed

T0 7o eEidene of primary tumor

Tis %arinoma in situ

T# Tumor on


19/30

TEMUAN LINIS &

RA/I-L-!IS


20/30

ERLUASAN TUM-R

T# M7 T2a 7asa T2barapharyn


21/30

ERLUASAN TUM-R

T" paranasa sinus TLintrarania

pterygopaatine fossa


22/30

K81//K81/

ymph 7ode7 =egiona ymph nodes annot be

assessed

70 7o regiona ymph node metastasis

7# Uniatera metastasis in ymphnode(s)& not more than 6 m ingreatest dimension& aboEe thesupraaEiuar fossaG

72 3iatera metastasis in ymphnode(s)& not more than 6 m ingreatest dimension& aboEe thesupraaEiuar fossaG

7" 'etastasis in a ymph node(s)G

arger than 6 m and?or tosupraaEiuar fossa 7"a: arger than 6 m 7"b: $tension to thesupraaEiuar fossaGG

G O7ote: 'idine nodes are onsidered ipsiatera nodes.PGG O7ote: 1upraaEiuar Cone or fossa is reeEant to the staging ofnasopharyngea arinoma and is the trianguar region originay

desribed in the o-stage assi


23/30

1T89/U' TU'=Nati$"al %$&pr'('"si)' %a"*'r N't+$r N%%N# /

*er5a#arka A&'ri*a" 0$i"t %$&&itt'' $" %a"*'r 1 2"i$"I"t'r"ati$"al' %$"tr' l' %a"*'r A0%%-2I%%# 3/,45


24/30

eet)a Sta5i)T)or

9istant 'etastasis

'A 9istant metastasis annot beassessed

'0 7o distant metastasis

'# 9istant metastasis

8!%% 1tage rouping

1tage 0 Tis& 70& '0

1tage / T#& 70& '0

1tage //8 T2a& 70& '0

1tage //3 T#& 7#& '0 T2& 7#& '0 T2a& 7#& '0

T2b& 70& '0 T2b& 7#& '0

1tage / // T#& 72& '0 T2a& 72& '0 T2b& 72& '0 T"& 70& '0 T"& 7#& '0 T"& 72& '0

1tage /I 8 TL& 70& '0 TL& 7#& '0 TL& 72& '0

1tage /I 3 8ny T& 7"& '0

1tage /I % 8ny T& any 7& '#


25/30

ENATALASANAAN

• = a d i o t e r a p i

1tadium #

• K e m o r a d i a s i

1tadium 2 >"

• K e m o r a d i a

s i1tadium La

> b • K e m o t e r a p i

1tadium L


26/30

ENATALASANAAN

=espon terapi : Complete respon , PartialResponse, No Change, Progressive Disease

Terapi bedah pada K7 9iagnosis harus

tepat QQ

7asopharingektomi

9eseksi K3 eher


27/30

1U=I/I8 =8T$1Stage Re%ati=e S)r=i=a% Rate#

:year 10year

/ * 62

// 6L 52

/// 60 L6

/I L "


28/30

REVENTIVE ACT

!aga kesehatan? sport atiEity

reEent U=T/ as possibe

$ary detetion

Kurangi makanan denganpengaFet?arinogenKurangi pemakaian aat rumah tangga

yang mengandung karsinogen

8Eoiding aoho?smoking?batte nutR


29/30

$8=@ 9$T$%T/7& may saEe

many iEeseru ker4asama intas sektora


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TERIMAASI

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Nasopharyngeal Carcinoma - Copy-1