nā lāʻau maʻi maʻi maʻi ʻaʻai liʻiliʻi ʻole

ʻAʻole liʻiliʻi liʻiliʻi ka maʻi ʻaʻai ʻana o ka maʻi maʻi ʻaʻai māmā (NSCLC) he 'ano ma'amau o ka ma'i 'a'ai ma'amau. He ʻokoʻa nā koho lapaʻau no ka NSCLC a hilinaʻi ʻia i nā kumu he nui, me ke ʻano o ka maʻi kanesa, ke olakino holoʻokoʻa o ka mea maʻi, a me nā hoʻololi genetic kikoʻī i loko o ka ʻōpū. Hāʻawi kēia alakaʻi i kahi hiʻohiʻona o nā ala lapaʻau koʻikoʻi no ka NSCLC, mai ka hōʻoki ʻana a me ka radiation therapy a hiki i ka therapy targeted a me immunotherapy, e hoʻoikaika ana i nā poʻe maʻi a me nā mea mālama i ka ʻike e hana i nā hoʻoholo ʻike.ʻAʻole liʻiliʻi liʻiliʻi ka maʻi ʻaʻai ʻana o ka maʻi maʻi ʻaʻai māmā (NSCLC) he hui ia o na ma'i ma'i ma'i ma'i e hana like ana. ʻO nā ʻano nui o ka NSCLC ka adenocarcinoma, squamous cell carcinoma, a me ka carcinoma cell nui. He mea koʻikoʻi ka ʻike pololei, me ka hoʻokō ʻana a me ka hoʻāʻo molecular no ka hoʻoholo ʻana i ka hoʻolālā lapaʻau kūpono loa. Hoʻolaʻa ʻia ʻo Shandong Baofa Cancer Research Institute i ka noiʻi maʻi maʻi a me ka hoʻomohala ʻana i nā ʻano lapaʻau hou, e aʻo hou ma https://baofahospital.com.Staging o NSCLCNSCLC e hoʻohana ana i ka TNM system (Tumor, Node, Metastasis). Hōʻike ke kahua i ka nui a me ka wahi o ka maʻi ʻaʻai mua (T), inā paha ua laha ka maʻi maʻi i nā pūnaʻi lymph kokoke (N), a inā ua metastasized ke kanesa i nā wahi mamao (M). ʻO nā pae mai ka I (pae mua) a hiki i ka IV (pae holomua). ʻO ka hoʻāʻo ʻana Molecular no ka NSCLCMolecular hoʻāʻo e ʻike i nā hoʻololi ʻana o nā gene a i ʻole nā ​​​​mea ʻino ʻole o ka protein i loko o nā pūnana tumo. Hiki i kēia mau biomarkers ke kōkua i ka hoʻoholo inā he moho ka mea maʻi no nā lāʻau lapaʻau. ʻO nā hoʻololi maʻamau ka EGFR, ALK, ROS1, BRAF, a me nā mea ʻē aʻe. ʻO nā hopena o ka hoʻāʻo molecular e hoʻopilikia nui i nā hoʻoholo lapaʻau NSCLC lapaʻauʻO ka ʻokiʻoki ʻana ʻo ia ka lāʻau lapaʻau mua no ka NSCLC pae mua (pae I a me II). ʻO ka pahuhopu ka wehe ʻana i ka ʻōpū a me nā ʻōpū lymph kokoke. ʻO nā ʻano o ka ʻoki ʻana he: Wedge Resection: Ka wehe ʻana i kahi ʻāpana liʻiliʻi o ke akemāmā. Hoʻokaʻawale ʻia: ʻO ka wehe ʻana i kahi ʻāpana nui o ka māmā ma mua o kahi ʻoki ʻoki. Lobectomy: Ka wehe ʻana i kahi lobe holoʻokoʻa o ka māmā. ʻO kēia ke kaʻina hana maʻamau maʻamau no NSCLC. Pneumonectomy: Ka wehe ʻana i kahi māmā holoʻokoʻa. He mea maʻamau kēia a mālama ʻia no nā maʻi maʻi nui. Hiki ke hoʻohana ʻia ma ke ʻano he lāʻau lapaʻau mua, ma hope o ke ʻoki ʻana e pepehi i nā keʻena maʻi kanesa i koe, a i ʻole e hoʻomaha i nā hōʻailona (palliative radiation). Aia nā ʻano like ʻole o ka radiation therapy: ʻO ka hoʻomaʻamaʻa ʻana i ka lāʻau lapaʻau waho (EBRT): Hāʻawi ʻia ka radiation mai kahi mīkini ma waho o ke kino. ʻO ka hoʻomaʻamaʻa ʻana o ke kino stereootactic (SBRT): Hāʻawi i nā kiʻekiʻe kiʻekiʻe o ka radiation i kahi wahi liʻiliʻi i kuhikuhi pono ʻia. Hoʻohana pinepine ʻia no ka NSCLC hoʻomaka i ka wā ʻaʻole he koho. ʻO Brachytherapy (Hoʻomaʻamaʻa Radiation Loko): Hoʻokomo pololei ʻia ka mea radioactive i loko o ka ʻōpū a kokoke paha. Hoʻohana pinepine ʻia me ka ʻoki ʻana a i ʻole ka radiation therapy, a i ʻole ma ke ʻano he lapaʻau mua no ka holomua NSCLC. ʻO nā lāʻau lapaʻau maʻamau no ka NSCLC me cisplatin, carboplatin, paclitaxel, docetaxel, pemetrexed, a me gemcitabine. NSCLC lapaʻauʻO nā lāʻau lapaʻau i hoʻopaʻa ʻia he mau lāʻau e hoʻopaʻa ʻia i nā molekole kikoʻī e pili ana i ka ulu ʻana o ka maʻi maʻi a me ke ola. Hoʻohana wale ʻia kēia mau lāʻau lapaʻau inā loaʻa i ka maʻi he mutation genetic kikoʻī a i ʻole ka maʻi protein. NSCLC me nā hoʻololi EGFR. Hoʻopaʻa kēia mau lāʻau i ka protein EGFR, e kōkua ana i ka ulu ʻana o nā maʻi kanesa. Eia kekahi laʻana: Gefitinib (Iressa) Erlotinib (Tarceva) Afatinib (Gilotrif) Osimertinib (Tagrisso)ALK InhibitorsALK (anaplastic lymphoma kinase) inhibitors ua hoʻohana ʻia e mālama. NSCLC me ka hoʻonohonoho hou ʻana o ka gene ALK. Hoʻopaʻa kēia mau lāʻau i ka protein ALK, e kōkua ana i ka ulu ʻana o nā maʻi kanesa. Eia kekahi laʻana: Crizotinib (Xalkori) Ceritinib (Zykadia) Alectinib (Alecensa) Brigatinib (Alunbrig) Lorlatinib (Lorbrena) ROS1 InhibitorsROS1 inhibitors hoʻohana ʻia e mālama NSCLC me ka hoʻonohonoho hou ʻana o ROS1 gene. Hoʻopaʻa kēia mau lāʻau i ka protein ROS1, e kōkua ana i ka ulu ʻana o nā maʻi kanesa. Eia kekahi laʻana: Crizotinib (Xalkori) Entrectinib (Rozlytrek) BRAF Inhibitors Hoʻohana ʻia nā mea hoʻopale BRAF no ka mālama ʻana. NSCLC me nā hoʻololi BRAF V600E. Hoʻopaʻa kēia mau lāʻau i ka protein BRAF. Eia kekahi laʻana: Dabrafenib (Tafinlar) Trametinib (Mekinist) (hoʻohana pū ʻia me Dabrafenib) Nā Lapaʻau Hoʻolālā ʻē aʻe Hiki ke hoʻohana ʻia nā lāʻau lapaʻau ʻē aʻe e pili ana i nā hoʻololi kikoʻī i loaʻa i ka ʻōpū. Eia kekahi laʻana nā mea hoʻopaneʻe RET (no RET fusions) a me MET inhibitors (no MET exon 14 skipping mutations). NSCLC lapaʻauʻO nā lāʻau lapaʻau Immunotherapy ke kōkua i ke kino o ke kino e hakakā i ka maʻi kanesa. Hana lākou ma ka pale ʻana i nā protein e pale ai i ka ʻōnaehana pale mai ka hoʻouka ʻana i nā maʻi maʻi maʻi. Hoʻohana pinepine ʻia kēia mau mea i loko NSCLC lāʻau lapaʻau.PD-1/PD-L1 InhibitorsPD-1 (programmed cell death protein 1) a me PD-L1 (programmed death-ligand 1) inhibitors block the PD-1/PD-L1 pathway, which help cancer cells escape the immune system. Eia kekahi laʻana: Pembrolizumab (Keytruda) Nivolumab (Opdivo) Atezolizumab (Tecentriq) Durvalumab (Imfinzi) Cemiplimab (Libtayo) CTLA-4 InhibitorsCTLA-4 (cytotoxic T-lymphocyte-associated protein 4) kōkua pū i nā pūnaeho maʻi maʻi maʻi CTLA-4. ʻO kahi laʻana ʻo Ipilimumab (Yervoy), hoʻohana pinepine ʻia i ka hui pū ʻana me PD-1 inhibitors.Combining TherapiesOften, NSCLC lapaʻau hoʻopili i ka hui ʻana o nā lāʻau lapaʻau like ʻole. No ka laʻana, hiki ke hahai ʻia ke ʻoki ʻana e ka chemotherapy a i ʻole ka radiation therapy. Hiki ke hui pū ʻia ka lāʻau lapaʻau a i ʻole immunotherapy me ka chemotherapy. ʻO ka hui kūikawā e pili ana i ke kūlana o kēlā me kēia maʻi. No ka 'ike hou aku e pili ana i ka 'imi 'ana i ka ma'i 'a'ai e kipa mai Shandong Baofa Cancer Research Institute.Clinical TrialsClinical trials he noiʻi noiʻi e loiloi ana i nā lāʻau lapaʻau hou a i ʻole nā hui pū ʻana o nā lāʻau lapaʻau. ʻO nā maʻi me NSCLC hiki ke noʻonoʻo i ke komo ʻana i nā hoʻokolohua lapaʻau e komo i nā lāʻau lapaʻau ʻokiʻoki. Hiki ke loaʻa ka ʻike e pili ana i nā hoʻokolohua lapaʻau ma ka pūnaewele National Cancer Institute a me nā kumu kaulana ʻē aʻe. Side Effect ManagementAll NSCLC lapaʻau hiki ke hana i nā hopena ʻaoʻao. He mea nui e kūkākūkā i nā hopena ʻaoʻao me kāu kauka a aʻo pehea e mālama ai. ʻO ka mālama kākoʻo, e like me ka mālama ʻana i ka ʻeha a me ke kākoʻo meaʻai, hiki ke kōkua i ka hoʻomaikaʻi ʻana i ka maikaʻi o ke ola i ka wā o ka mālama ʻana.Prognosis and Follow-Up Care NSCLC pili i ka pae o ka maʻi kanesa, ke olakino holoʻokoʻa o ka mea maʻi, a me ka maikaʻi o ka pane ʻana o ke kanesa i ka lāʻau lapaʻau. He mea nui nā koho maʻamau e nānā no ka hoʻi hou ʻana a mālama i nā hopena ʻaoʻao lōʻihi o ka mālama ʻana.Disclaimer: Hāʻawi kēia ʻatikala i ka ʻike maʻamau e pili ana nā lāʻau lapaʻau non-small cell lung cancer (NSCLC). a ʻaʻole pono e manaʻo ʻia he ʻōlelo aʻo lapaʻau. E kamaʻilio mau me kāu kauka a i ʻole kekahi ʻoihana mālama olakino kūpono no nā ʻōlelo aʻoaʻo pilikino e pili ana i kou kūlana olakino.