kurapwa kwete diki kenza yemapapu

Kurapwa kwekenza yemapapu isiri-diki (NSCLC) sarudzo dzakasiyana uye zvinoenderana nedanho, subtype, uye murwere ega ega zvinhu. Kurapa kwakajairika kunosanganisira kuvhiyiwa, radiation therapy, chemotherapy, yakanangwa kurapwa, uye immunotherapy, inowanzoshandiswa pamwe chete. Gwaro rino rinoongorora sarudzo yega yega zvakadzama, richikubatsira kunzwisisa zvingabvira uye kuita sarudzo dzine ruzivo mukubvunzana nechikwata chezvehutano.Kunzwisisa Gomarara Repamapapu Risiri Duku (NSCLC)Chii chinonzi NSCLC?Kenza yemapapu isiri-diki (NSCLC) ndiyo yakajairika mhando yekenza yemapapu, inoverengera inosvika 80-85% yekese dzekenza yemapapu. Itemu reamburera rinosanganisira matinji akati wandei, anonyanya kunzi adenocarcinoma, squamous cell carcinoma, uye hombe cell carcinoma.NSCLC StagingDanho reNSCLC rakakosha pakuona nzira yekurapa yakanaka. Danho racho rinotariswa nehukuru uye nzvimbo yebundu racho, ringave rapararira kumalymph nodes ari pedyo, uye kuti rine metastasized kunhengo dziri kure.Kurapwa Options for NSCLCSurgerySurgery inowanzova iyo yekutanga kurapwa kwekutanga-nhanho NSCLC. Chinangwa ndechekubvisa bundu uye chero malymph nodes ari pedyo anogona kunge aine cancer maseru. Lobectomy: Kubviswa kwerobe rose remapapu. Pneumonectomy: Kubviswa kwemapapu ose. Wedge Resection: Kubviswa kwechikamu chidiki chemapapu chakaita seweji. Segmentectomy: Kubviswa kwechikamu chemapapu, icho chakakura kudarika wedge resection asi idiki pane lobectomy.Cherechedza: Kuvhiya kunogona kusava sarudzo kune varwere vane NSCLC yepamusoro kana avo vane humwe hutano hunoita kuti kuvhiyiwa kuve nengozi.Radiation TherapyRadiation therapy inoshandisa mwaranzi ine simba guru kuuraya masero egomarara. Inogona kushandiswa kurapa NSCLC munzira dzinoverengeka: Kunze Beam Radiation Therapy (EBRT): Radiation inoburitswa kubva pamushini uri kunze kwemuviri. Stereotactic Body Radiation Therapy (SBRT): Chimiro chakanyatsojeka cheEBRT chinoendesa chiyero chikuru chemwaranzi kunzvimbo diki. Inowanzoshandiswa kurapa kenza yemapapu yepakutanga kana kuvhiyiwa kusingagoneki. Brachytherapy: Radioactive material inoiswa zvakananga mukati kana pedyo nebundu racho.Radiation therapy inogona kushandiswa yoga kana kusanganiswa nemamwe marapirwo, akadai sechemotherapy. Isu tiri Shandong Baofa Cancer Research Institute nzwisisa kukosha kwekubatanidza marapirwo kuti uwane mhedzisiro yakanaka. Baofa ndiye mutungamiri muhutano hwegomarara hwakabatanidzwa.ChemotherapyChemotherapy inoshandisa mishonga kuuraya maseru egomarara mumuviri wese. Inowanzo shandiswa kurapa yepamusoro NSCLC kana kudzivirira gomarara kuti risadzoke mushure mekuvhiyiwa. Zvakajairwa chemotherapy mishonga yeNSCLC inosanganisira: Cisplatin Carboplatin Pemetrexed Docetaxel PaclitaxelChemotherapy inowanzo kupihwa mumatenderedzwa, nenguva dzekurapa dzichiteverwa nenguva dzekuzorora. Migumisiro inogona kusiyana zvichienderana nemishonga inoshandiswa uye murwere mumwe nomumwe.Targeted TherapyTargeted therapy inoshandisa mishonga inotarisa chaiwo mamorekuru anobatanidzwa mukukura kwekenza uye kurarama. Mishonga iyi inowanzoshanda uye ine mhedzisiro shoma pane chemotherapy. Mishonga inotarirwa inowanzoitirwa varwere vane genetic mutations chaiyo. Zvinangwa zvakajairika zvinosanganisira: EGFR: Epidermal Kukura Factor Receptor ALK: Anaplastic Lymphoma Kinase ROS1: ROS1 Proto-Oncogene Receptor Tyrosine Kinase BRAF: B-Raf Proto-Oncogene, Serine/Threonine Kinase NTRK: Neurotrophic Tyrosine Receptor KinaseMienzaniso yeanonangwa kurapa zvinodhaka anoshandiswa kuNSCLC anosanganisira: Gefitinib (Iressa) Erlotinib (Tarceva) Afatinib (Gilotrif) Osimertinib (Tagrisso) Crizotinib (Xalkori) Ceritinib (Zykadia) Alectinib yakajairika yekutanga kurapa varwere genetic test kuti vaone kana vane a targetable mutation.ImmunotherapyImmunotherapy inoshandisa mishonga kubatsira masoja emuviri kurwisa gomarara. Mishonga iyi inogona kuvhara mapuroteni anodzivirira immune system kurwisa cancer maseru. Mishonga yakajairika yekudzivirira zvirwere yeNSCLC inosanganisira: Pembrolizumab (Keytruda) Nivolumab (Opdivo) Atezolizumab (Tecentriq) Durvalumab (Imfinzi)Immunotherapy inogona kushandiswa yoga kana pamwe chete nekemotherapy kana mamwe marapirwo. Migumisiro inogona kusanganisira kuneta, kuputika kweganda, uye kuzvimba kwenhengo dzakasiyana-siyana.NSCLC Kurapa neStageStage I NSCLCSurgery inowanzova yekutanga kurapwa kweStage I NSCLC. SBRT inogona kutariswa kana murwere asiri kuvhiyiwa.Danho rechipiri NSCLCKurapa kweDanho rechipiri NSCLC rinowanzobatanidza kuvhiyiwa kunoteverwa nekemotherapy. Radiation therapy inogonawo kushandiswa.Stage III NSCLCKurapa kweDanho III NSCLC yakanyanya kuoma uye inogona kusanganisira musanganiswa wekuvhiya, chemotherapy, uye kurapa kwemwaranzi. Immunotherapy inogonawo kushandiswa mushure mechemoradiation mune dzimwe nguva.Stage IV NSCLCKurapa kweDanho IV NSCLC inotarisa pakudzora kukura kwegomarara uye kubvisa zviratidzo. Sarudzo dzinogona kusanganisira chemotherapy, yakanangwa kurapa, immunotherapy, uye neradiation therapy. Sarudzo yekurapa inobva pane chaiwo maitiro egomarara uye hutano hwemurwere hwese.Clinical TrialsClinical miedzo itsvakurudzo yetsvakiridzo inoedza mishonga mitsva yegomarara. Varwere vane NSCLC vanogona kuve vakakodzera kutora chikamu muzviedzo zvekiriniki. Taura nachiremba wako kuti udzidze zvakawanda nezvemiedzo yekiriniki uye kuti yakakunakira here. Shandong Baofa Cancer Research Institute's kuzvipira kuita tsvakiridzo kunoreva kuti tinoramba tiri padanho repamusoro-soro remamwe marapirwo matsva, dzimwe nguva kuburikidza nemiedzo yekiriniki.Kuita Sarudzo dzeMarapirwoKusarudza marapirwo akakodzera eNSCLC isarudzo yakaoma inofanira kuitwa mukutaurirana nechikwata chezveutano. Zvinhu zvekufunga nezvazvo zvinosanganisira danho uye subtype yegomarara, hutano hwemurwere hwese, uye zvavanoda. Usazeze kubvunza mibvunzo uye tsvaga maonero echipiri kana zvichidiwa.Kufanoziva uye Kurarama MatengoKupona kweNSCLC kunosiyana zvichienderana nedanho regomarara, marapirwo agamuchirwa, nezvimwe zvinhu. Kukurumidza kuonekwa uye kurapwa kunogona kuvandudza mikana yekupona. Nhanho 5-Yegore Kupona Kwemakore Chikamu I 68-92% Danho II 53-60% Danho III 13-36% Danho IV Pasi pe10% *Kunobva: American Cancer Society (www.cancer.org)Kurarama neNSCLCKurarama neNSCLC kunogona kunetsa, asi pane zvakawanda zvekushandisa kubatsira varwere nemhuri dzavo kurarama. Zvishandiso izvi zvinosanganisira mapoka ekutsigira, mabasa ekuraira, uye zvirongwa zvekubatsira mari.