Komparasi respons tumor terhadap radiasi antara radioterapi dengan radioterapi plus vaksinasi BCG pada karsinoma nasofaring

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Komparasi respons tumor terhadap radiasi antara radioterapi dengan radioterapi plus vaksinasi BCG pada karsinoma nasofaring
The comparison of tumor irradiation response between radiotherapy versus radiotherapy plus BCG vaccination in nasopharyngeal carcinoma
JURNAL KEDOKTERAN YARSI 12 (3) : 007-016 (2004)
by
Widodo Ario Kentjono
Departement of Otolaryngology, Airlangga University School of Medicine, Dr. Soetomo General Hospital, Surabaya


ABSTRACT
The presence of nasopharyngeal tumor, which is resistant to irradiation (radiotherapy), is unexpected, as it generally may develop to become recurrent tumor. Results of radiation therapy, presenting as lower irradiation tumor response, may possibly result from radiotherapy effect on immune system. Radiotherapy, which is primarily directed to eradicate nasopharyngeal carcinoma (NPC) cells, often results in the reduction of cellular immunity. Reduced quality of cancer immune surveillance, undertaken particularly by CD8 T cells (CTL), NK cells, activated macrophage and LAK cells, will be very disadvantageous since tumor growth may persist, and even becomes more progressive. BCG vaccine is known to increase immunological effector cells, whose activity is influenced by the cytokine of Th1 lymphocyte (Th1 response). BCG vaccination (as immunogenic stressor) given simultaneously with NPC radiotherapy is expected to increase cancer cells eradication in the nasopharynx. This study was aimed to prove that there was higher tumor irradiation response in nasopharyngeal carcinoma patients receiving radiotherapy plus BCG vaccination than that in patients receiving radiotherapy only. An experimental study (clinical trial) was carried out towards 77 patients, consisting of 38 patients in the control group and 39 patients in the treatment group. Radiotherapy was given in standard (conventional) dose and method, while BCG vaccination was administered by means of modified multiple scarification technique. Results revealed that significant difference was found between post-radiotherapy volume of nasopharyngeal tumor in the control group and that in the treatment group (p<0.05). Tumor irradiation response in those groups was also significantly different (p<0.05). In conclusion, BCG vaccination administered simultaneously with NPC radiotherapy might increase nasopharyngeal tumor response.