Nasopharyngeal Carcinoma - Copy-1

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    CURICULUM VITAE

     Yogyakarta, 10 Maret 1967

    SMA Negeri 3  Yogyakarta

      F U!M F UI

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

    S)* +agia

    -ko%ogi, Larig

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    ETI-L-!I, /IA!N-SIS, TATALASANA & UAYA

    ENCE!AAN ARSIN-MA NAS-FARIN!

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

    DEPARTEMEN THT PAV KARTIKA

    RSPAD GATOT SOEBROTO

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    A$aka2 ar#ioa a#o.arig it) 4

     Tumor ganas yang tumbuh di rongga nasofaring .

    Nasopharyngeal

    Carsinoma (NPC),

    “Kwangtung

      Tumors”    5 besar keganasan

    /iago#i# 5ii 4

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    AN!A EERAAN

    • Usia : 20-60 tahun (usia produktif)  Keompok usia terbanyak 50-60 thn

    •  !enis Keamin

      2-" : #

    • $thnik : %hinese& 'aay& %auasian

    *+, 0

    ""2, "0

    NC

    'ae

    emae

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    NF 5a T)or L

    dr. /bnu arris adiah& 1p. TT-K

    1 ka#)# 

    1008000ta2)

    6,' ka#)#  1008000ta2

    )

    30:0 ka#)# 

    1008000ta 2)

    7 ka#)#  1008000ta2)

    1 ka#)#  1008000ta2

    )

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    FAT-R ENYE+A+ & AT-L-!I ANAT-MI

    NF ;- Ti$e

    1 ;- Ti$e

    ' ;- Ti$e

    3

    o%a i5)$ &

    ar#ioge ik 

    ereta a

    !eetika

    E+V

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    FAT-R ENYE+A+ "ETI-L-!I)

    NPC Ethnicity

    Diet(“smoke”)

    (Immuno)genetic

    factors

    Gender 

    Herba

    Drugs!

    ois

    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#

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    T)origee#i#

    E$ite% Nora% Na#o.arig

    /i#$%a#ia /era

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    !EALA /AN TAN/A

    5*.# #6.#

    #2.+

    6.5 6.5

    3en4oan eher

    gn. endengaran # sisi

    $pistaksis

    idung tersumbat

    7yeri

      gn. end # sisi

      'imisan beruangidung tersumbat7yeri

    3en4oan eher

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    $!88 K/7/1

    %efagia

    9ipopia phtamopeg

    ia agophtamus

    bstruksi hidung 1ekret ;

    darah 8nosmia

    $pistaksis 79

     Trismus 9isfagia angguan

    pengeap 8tro< paatum moe arese parsia

    idah

    imfadenop ati oie

    =asa penuh diteinga Tinitus tagia

     Tui konduktif

    uniatera erforasi

    '$

    EARLY  A/VANCE

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    /IA!N-S E

    • 8namnesis

    • emeriksaan isik TT   =inoskopi 8nterior > osterior

      $ndoskopi: =igid? iber

      nasopharyngoaryngosopy

    • eerik#aa $e)

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    @1/%8 $A8'/78T/7

    8nterior =hinosopy

    osterior =hinosopy

    7asoendosopy iber?rigid

    apation

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    AT-L-!I ANAT-MI

    B, #+*:  Type #: KeratiniCing 1%%  Type 2: 7on KeratiniCing 1%%

     Type ": UndiDerentiated

    B: Borking ormuation: degree of anapasia and tumor e

    #. igh maignant degree 1%%

    2. Type 8: 8napasia?obEious peomorphi& /ntermediate maignant degree

    ". Type 3: 8napasia? ight peomorphi& oF maignant degree

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

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    EMERISAAN ENUNAN!

    %T 1an: 

    G eruasan tumor

      G 1uperior: destruksi tuang& densitas

     4aringan unak

    '=/:

      G =esousi tinggi

      G 1uperior: residua?reurent& inHamasi&

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    SEROLOGY EPSTEIN BAR VIRUS

    1eroogy

     

     !akarta 1ingapore ongkon

    g /g8 anti I%8

    1ensitiEity 

    1pei

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    ERLUASAN TUM-R

    rimary Tumor

     TA rimary tumor annot be assessed

     T0 7o eEidene of primary tumor

     Tis %arinoma in situ

     T# Tumor on

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    TEMUAN LINIS &

    RA/I-L-!IS

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    ERLUASAN TUM-R

     T# M7 T2a 7asa T2b arapharyn

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    ERLUASAN TUM-R

     T" paranasa sinus TL intrarania

      pterygopaatine fossa

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    K81//K81/

    ymph 7ode 7 =egiona ymph nodes annot be

    assessed

    70 7o regiona ymph node metastasis

    7# Uniatera metastasis in ymph node(s)& not more than 6 m in greatest dimension& aboEe the supraaEiuar fossaG

    72 3iatera metastasis in ymph node(s)& not more than 6 m in greatest dimension& aboEe the supraaEiuar fossaG

    7" 'etastasis in a ymph node(s)G

    arger than 6 m and?or tosupraaEiuar fossa  7"a: arger than 6 m  7"b: $tension to the supraaEiuar fossaGG

    G O7ote: 'idine nodes are onsidered ipsiatera nodes.P GG O7ote: 1upraaEiuar Cone or fossa is reeEant to the staging of nasopharyngea arinoma and is the trianguar region originay

    desribed in the o-stage assi

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    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 

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    eet)a Sta5i) T)or

    9istant 'etastasis

    'A 9istant metastasis annot be assessed

    '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& '#

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    ENATALASANAAN

        •    =   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 i 1tadium La

    > b     •    K   e     m   o  t   e   r   a    p  i

    1tadium L 

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    ENATALASANAAN

      =espon terapi : Complete respon , Partial Response, No Change, Progressive Disease

      Terapi bedah pada K7   9iagnosis harus

    tepat QQ

      7asopharingektomi

    9eseksi K3 eher  

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

    :year 10year

    / * 62

    // 6L 52

    /// 60 L6

    /I L "

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    REVENTIVE ACT

     !aga kesehatan? sport atiEity

    reEent U=T/ as possibe

    $ary detetion

    Kurangi makanan denganpengaFet?a