ANALISIS EFEKTIVITAS N-ASETILSISTEIN SEBAGAI ANTIOKSIDAN DAN ANTI NEFROTOXIC PADA PASIEN KARSINOMA NASOFARING DENGAN PEMBERIAN KEMOTERAPI CISPLATIN = ANALYSIS OF THE EFFECTIVENESS OF N-ACETYLCYSTEIN AS AN ANTIOXIDANT AND ANTI – NEPHROTOXIC IN NASOPHARYNGEAL CARCINOMA PATIENTS WITH CISPLATIN CHEMOTHERAPY

Nasopharyngeal carcinoma is a malignant tumor originating from nasopharyngeal epithelial cells, which is a squamous cell carcinoma (SCC). Platinum-based chemotherapy drugs, such as cisplatin, are effective therapeutic regimens for nasopharyngeal carcinoma, with nephrotoxicity being the main side effect of cisplatin administration. N-Acetylcysteine is the most commonly used antioxidant as a chemoprotective agent. Objective: To assess the effectiveness of N-Acetyl cysteine as an antioxidant and anti-nephrotoxic agent in patients with nasopharyngeal carcinoma receiving cisplatin chemotherapy. Method: This study is a prospective cohort study of an observational analytical nature conducted at the ENT-KL outpatient clinic of Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital in Makassar during the period from May 2024 to August 2024. Results: In the first treatment group given N-Acetylcysteine tablets at 600mg, the mean urea level in cycle 6 was significantly higher compared to cycles 5, 3, 2, and 1 (all with p<0.05), while the mean urea levels of cycles 1, 2, 3, 4, and 5 did not differ significantly from one another (all with p>0.05). The mean creatinine level in cycle 6 was significantly higher compared to cycle 4 (p<0.05), but did not differ significantly from cycles 5, 3, 2, and 1 (all with p>0.05). In the second treatment group that received N-Acetylcysteine 5 grams per 24 hours for 2 days, the mean urea level in cycle 4 was lower than that in cycle 3, but this difference was not statistically significant (p>0.05). The mean creatinine level in cycle 4 was found to be significantly lower compared to cycle 3 (p<0.01). Conclusion: In the first treatment group given N-Acetyl cysteine 600 mg tablets, the average urea levels were not significantly different from one another. Similarly, the creatinine levels were found to be not significantly different. Meanwhile, in the second treatment group given N-Acetyl cysteine 5 grams per 24 hours for 2 days intravenously, the average urea levels in the fourth cycle were lower than in the third cycle, although this difference was not statistically significant. However, the average creatinine levels showed a significantly lower result in the fourth cycle compared to the third cycle.