Hāʻawi ʻia i nā lāʻau lapaʻau no ka maʻi maʻi: He alakaʻi piha 

ʻO ka hāʻawi ʻana i ka lāʻau lapaʻau kūloko no ka maʻi kanesa kahi ala lapaʻau e hoʻopaʻa pono i ka lāʻau lapaʻau ma ke kahua maʻi maʻi. Ke manaʻo nei kēia ʻano e hoʻomaikaʻi i ka maikaʻi o ka mālama ʻana me ka hōʻemi ʻana i nā hopena ʻaoʻao ʻōnaehana e pili pinepine me ka chemotherapy kuʻuna.

Introduction to Localized Drug Delivery

ʻO nā lāʻau lapaʻau maʻamau e like me ka chemotherapy e pili pinepine ana i ka hoʻokele lāʻau ʻōnaehana, ʻo ia hoʻi ka hele ʻana o ka lāʻau i loko o ke kino. ʻOiai ʻoi aku ka maikaʻi o ka huli ʻana i nā maʻi maʻi maʻi, hiki i kēia ala ke hoʻopōʻino i nā cell olakino, e alakaʻi ana i nā hopena ʻaoʻao nui. Hāʻawi ʻia ka lāʻau lapaʻau kūloko no ka maʻi kanesa hāʻawi i kahi ala i manaʻo nui ʻia, e hāʻawi pololei ana i ka lāʻau lapaʻau i ka pūnaewele tumor.

Hiki i kēia ala ke komo i nā ʻenehana like ʻole, me:

• Hoʻokomo pololei i nā lāʻau i loko o ka ʻōpū.
• Hoʻokomo ʻia nā implants a i ʻole nā ​​wafers.
• Ka hoʻohana ʻana i nā nanoparticles i manaʻo ʻia e hāʻawi i nā lāʻau lapaʻau kūikawā i nā maʻi maʻi maʻi.
• ʻO ka chemotherapy kūloko, kahi e lawelawe ʻia ai nā lāʻau lapaʻau i kahi kikoʻī o ke kino i loaʻa i ka ʻōpū.

Pōmaikaʻi o ka lawe ʻana i nā lāʻau lapaʻau kūloko

Hāʻawi ʻia ka lāʻau lapaʻau kūloko no ka maʻi kanesa hāʻawi i kekahi mau pōmaikaʻi nui ma mua o nā ʻōnaehana systemic:

• Nā hopena ʻaoʻao i hōʻemi ʻia: Ma ka hoʻopaʻa ʻana i ka lāʻau lapaʻau ma ka pūnaewele tumor, hoʻemi ʻia ka ʻike ʻana i nā ʻiʻo olakino, e alakaʻi ana i nā hopena ʻaoʻao liʻiliʻi.
• Hoʻonui ʻia ka nui o ka lāʻau i ka Tumor: Hiki i ka lawe ʻana i ka ʻāina ke hoʻokō i ka nui o ka lāʻau lapaʻau i loko o ka ʻōpū, hiki ke hoʻomaikaʻi i ka maikaʻi o ka mālama ʻana.
• Hoʻomaikaʻi i ka maikaʻi o ke ola o ka maʻi: Hiki ke hoʻonui i ka maikaʻi o ke ola o ka mea maʻi i ka wā o ka mālama ʻana i ka maʻi kanesa.
• Hiki i nā lāʻau lapaʻau hui: Hiki ke hoʻohui ʻia ka hoʻopuka kūloko me nā ʻano hana lapaʻau ʻē aʻe, e like me ke ʻoki, radiation therapy, a me ka chemotherapy systemic, e hoʻokō i nā hopena synergistic.

Nā ʻenehana no ka lawe ʻana i nā lāʻau lapaʻau kūloko

Hoʻohana ʻia kekahi mau ʻenehana no ka lawe ʻana i ka lāʻau lapaʻau kūloko no ka maʻi kanesa, kēlā me kēia me kona pono pono'ī a me nā palena:

Hoʻopili pololei

Hoʻopili pololei kēia i ka lāʻau i loko o ka ʻōpū. He ala maʻalahi a maʻalahi hoʻi i kūpono no nā maʻi maʻi hiki ke loaʻa. Hiki ke hoʻohana ʻia ke alakaʻi ultrasound a i ʻole CT e hōʻoia i ka hoʻokomo pololei ʻana. ʻO nā laʻana e pili ana i ka hoʻokomo ʻana i nā maʻi maʻi oncolytic a i ʻole nā ​​​​mea hana chemotherapeutic.

Nā mea hoʻokomo i ka lāʻau a me nā ʻōpala

Hoʻokomo pololei ʻia kēia mau mea hana i loko a kokoke paha i ka ʻōpū. Hoʻokuʻu mālie lākou i ka lāʻau i ka manawa, e hāʻawi ana i kahi hopena therapeutic mau. Gliadel^? ʻO nā wafers, loaʻa ka carmustine (BCNU), he laʻana kaulana i hoʻohana ʻia ma hope o ka wehe ʻana o ka lolo.

Nanoparticles

ʻO nā nanoparticles nā ʻāpana liʻiliʻi i hoʻolālā ʻia e hāʻawi i nā lāʻau lapaʻau kūikawā i nā maʻi maʻi maʻi. Hiki iā lākou ke hoʻolālā ʻia e hoʻopaʻa i nā māka kikoʻī ma nā pūla maʻi maʻi, hoʻonui i ka hōʻiliʻili lāʻau ma ka pūnaewele tumora a hōʻemi i nā hopena i waho. Hoʻohana mau ʻia nā liposomes, nā nanoparticles polymeric, a me nā nanoparticles metala.

Kemoterapi ʻĀpana

Hoʻopili kēia i ka hāʻawi ʻana i nā lāʻau lapaʻau chemotherapy i kahi ʻāpana kikoʻī o ke kino i loaʻa ka ʻōpū. Eia kekahi laʻana:

• Hepatic Artery Infusion (HAI): Hoʻohana ʻia no ka mālama ʻana i ka maʻi maʻi ate ma o ka hāʻawi pololei ʻana i ka chemotherapy i ke ake ma o ke aʻa hepatic.
• Intraperitoneal Chemotherapy (IP): Hoʻohana ʻia e mālama i ka maʻi maʻi ovarian ma o ka hāʻawi ʻana i ka chemotherapy i loko o ka ʻōpū o ka ʻōpū.
• Isolated Limb Perfusion (ILP): Hoʻohana ʻia e mālama i ka melanoma a me ka sarcoma o nā lālā ma o ka hoʻokaʻawale ʻana i ke kahe o ka lālā a me ka hāʻawi ʻana i nā kiʻekiʻe kiʻekiʻe o ka chemotherapy pololei i ka wahi i hoʻopilikia ʻia.

Nā Laʻana o ka lawe ʻana i nā lāʻau lapaʻau kūloko i ka maʻi maʻi maʻi

Hāʻawi ʻia ka lāʻau lapaʻau kūloko no ka maʻi kanesa hoʻohana ʻia i ka mālama ʻana i nā ʻano maʻi kanesa. Eia kekahi mau laʻana:

ʻO ka lolo lolo

Gliadel^? Hoʻokomo ʻia nā wafers i loko o ka lolo ma hope o ka wehe ʻana i nā gliomas kiʻekiʻe. Hoʻokuʻu kēia mau wafers i ka carmustine (BCNU), he lāʻau lapaʻau chemotherapy, pololei i loko o ka lua o ka ʻokiʻoki, e pepehi ana i nā keʻena maʻi maʻi i koe. Ua hōʻike ʻia kahi haʻawina i paʻi ʻia ma ka *Journal of Clinical Oncology* ʻo Gliadel^? Ua hoʻomaikaʻi nui nā wafers i ke ola ʻana i nā maʻi me nā gliomas kiʻekiʻe kiʻekiʻe.¹

Ka maʻi maʻi ʻaʻai

Hepatic artery infusion (HAI) kahi ʻenehana chemotherapy kūloko i hoʻohana ʻia e mālama i ka maʻi maʻi ate. Hoʻopili ia i ka hāʻawi pololei ʻana i nā lāʻau lapaʻau chemotherapy i ke ake ma o ke aʻa hepatic, ke kīʻaha koko nui e hāʻawi ana i ke ake. Hāʻawi kēia i nā kiʻekiʻe kiʻekiʻe o ka lāʻau lapaʻau e hōʻea i ka ʻōpū ʻoiai e hōʻemi ana i nā hopena ʻaoʻao systemic. Ua hōʻike nā haʻawina e hiki i ka HAI ke hoʻomaikaʻi i ke ola ʻana i nā poʻe maʻi me ka maʻi maʻi ʻaʻa ʻole hiki ke hoʻololi ʻia. Ka poe akamai ma Shandong Baofa Cancer Research Institute hoʻohana nui i kēia ʻenehana.

Ka ma'i 'ovarian

ʻO ka chemotherapy intraperitoneal (IP) kahi ʻenehana chemotherapy kūloko i hoʻohana ʻia e mālama i ka maʻi maʻi ovarian. Hoʻopili ia i ka hāʻawi ʻana i nā lāʻau lapaʻau chemotherapy i loko o ka ʻōpū o ka ʻōpū, kahi e laha pinepine ai ka maʻi maʻi ovarian. ʻO kēia ka mea e hiki ai i nā kiʻekiʻe kiʻekiʻe o ka lāʻau lapaʻau e hiki i nā keʻena maʻi maʻi i loko o ka ʻōpū. Ua hōʻike nā haʻawina e hiki i ka chemotherapy IP ke hoʻomaikaʻi i ke ola ʻana i nā maʻi me ka maʻi maʻi ovarian kiʻekiʻe.

Nā Luʻi a me nā kuhikuhi e hiki mai ana

ʻOiai ka lawe ʻana i ka lāʻau lapaʻau kūloko no ka maʻi kanesa hāʻawi i nā pono he nui, aia kekahi mau pilikia e lanakila ai:

• Heterogeneity Tumor: Hiki ke ʻano ʻokoʻa nā ʻano maʻi maʻi maʻi maʻi i loko o kahi ʻōpū, e paʻakikī ke hoʻopaʻa pono i nā cell āpau.
• Kūʻē Laʻau: Hiki i nā maʻi maʻi ke hoʻomohala i ke kūʻē ʻana i nā lāʻau lapaʻau chemotherapy, e kaupalena ana i ka pono o ka lawe ʻana i ka wahi.
• ʻO nā pale hoʻouna: He paʻakikī ke komo ʻana a i ʻole he mau pale kino e pale aku ai i nā lāʻau lapaʻau mai ke komo ʻana i nā maʻi maʻi āpau.
• ʻO ka hana ʻana a me nā pilikia hoʻoponopono: ʻO ka hoʻomohala ʻana a me ka hana ʻana i nā ʻōnaehana lawe lāʻau kūloko hiki ke paʻakikī a paʻakikī.

Hoʻokumu ʻia ka noiʻi e hiki mai ana i ka hoʻoponopono ʻana i kēia mau pilikia e:

• Ke hoʻomohala nei i nā hoʻolālā hoʻolālā ʻoi aku ka maʻalahi e lanakila ai i ka heterogeneity tumor.
• ʻO ka hoʻohui ʻana i ka hāʻawi ʻana i ka lāʻau lapaʻau kūloko me nā lāʻau lapaʻau ʻē aʻe, e like me ka immunotherapy a me ka lāʻau lapaʻau i hoʻopaʻa ʻia, e lanakila ai i ka pale ʻana i ka lāʻau.
• Ke hoʻomohala nei i nā ʻōnaehana hoʻopuka lāʻau hou e hiki ke komo pono i nā ʻōpū.
• E hoʻopololei i nā kaʻina hana a me nā hoʻoponopono no nā ʻōnaehana lawe lāʻau kūloko.

Ka hopena

Hāʻawi ʻia ka lāʻau lapaʻau kūloko no ka maʻi kanesa He ala hoʻohiki e hiki ke hoʻomaikaʻi i ka maikaʻi o ka mālama ʻana a hoʻemi i nā hopena ʻaoʻao. Ke hoʻomau nei ka noiʻi, ʻoi aku ka nui o kēia ʻano hana i ka maʻi maʻi maʻi. Ma ka huli ʻana i nā lāʻau lapaʻau i ka pūnaewele tumora, hiki i ka hoʻopuka kūloko ke hāʻawi i ka manaʻolana hou no nā poʻe maʻi e hakakā nei i kēia maʻi pōʻino.

Papa Huaolelo

Nā kuhikuhi

1. Westphal, M., Hilt, D. C., Bortey, E., Del Mastro, R. F., 习惯, Kieser, M., & Combs, S. E. (2003). ʻO kahi hoʻāʻo ʻo 3 o ka chemotherapy kūloko me nā wafers biodegradable carmustine (BCNU) (Gliadel wafers) i nā maʻi me ka glioma malignant mua. *Journal of Clinical Oncology*, *21*(24), 4414-4419.