unyango lomhlaza wemiphunga

Unyango lomhlaza wemiphunga lubandakanya uluhlu lweendlela, kubandakanya utyando, ichemotherapy, unyango lweradiation, unyango olujoliswe kuyo, kunye ne-immunotherapy. Olona cwangciso lonyango luxhomekeke kwimiba efana nenqanaba lomhlaza, impilo yesigulana iyonke, kunye nokhetho lomntu. Esi sikhokelo siphonononga olu khetho zonyango ngokweenkcukacha, lunika ulwazi ukunceda izigulane kunye neentsapho zabo zihambe ngolu hambo lunzima.Ukuqonda uMhlaza weLungUmhlaza wemiphunga sisifo apho iiseli zemiphunga zikhula zingalawuleki. Kukho iindidi ezimbini eziphambili: iseli engeyincinci umhlaza wemiphunga (NSCLC) kunye neseli encinci umhlaza wemiphunga (SCLC). I-NSCLC ixhaphake kakhulu kwaye ibandakanya iintlobo ezincinci ezifana ne-adenocarcinoma, i-squamous cell carcinoma, kunye ne-cell carcinoma enkulu. I-SCLC ayiqhelekanga kodwa ithande ukukhula kwaye isasazeke ngokukhawuleza. Ukufunyaniswa kwangoko kunye nokuxilongwa ngokuchanekileyo kubalulekile ukuze usebenze unyango lomhlaza wemiphunga. I-Shandong Baofa Cancer Research Institute izinikele ekuqhubeleni phambili uphando lomhlaza kunye nonyango onokukhetha kulo.Unyango loMhlaza weMiphungaUkhetho oluninzi lukhona umhlaza wemiphunga. Isicwangciso esithile sonyango siya kulungelelaniswa kwisigulane ngasinye kunye neempawu zomhlaza wabo. Kubandakanya ukususa ithumba kunye ne-lymph nodes ezikufutshane. Iindidi ezahlukeneyo zotyando ziquka: Ukususwa kweWedge: Ukususwa kweqhekeza elincinane lemiphunga emiphunga. Segmentectomy: Ukususwa kwenxalenye enkulu yomphunga kune-wedge resection. Lobectomy: Ukususwa kwelobe yonke yomphunga. Inyumoniya: Ukususwa komphunga wonke.Ukufaneleka kotyando kuxhomekeke kubungakanani bethumba kunye nendawo, kunye nempilo yonke yesigulane. IZiko loPhando ngoMhlaza laseBaofa linoogqirha botyando abanamava kubuchule botyando bamva nje.Unyango lweKhemotherapyI-Chemotherapy isebenzisa amayeza ukubulala iiseli zomhlaza. Ihlala isetyenziselwa i-NSCLC kunye ne-SCLC, kwaye inokunikwa phambi kotyando (i-neoadjuvant chemotherapy), emva kotyando (i-adjuvant chemotherapy), okanye njengonyango lokuqala lomhlaza wenqanaba eliphezulu. Amachiza aqhelekileyo echemotherapy umhlaza wemiphunga ziquka i-cisplatin, i-carboplatin, i-paclitaxel, i-docetaxel, kunye ne-etoposide.Unyango lwe-Radiation TherapyRadiation therapy isebenzisa imisebe ephezulu yamandla ukubulala iiseli zomhlaza. Inokuthi ihanjiswe ngaphandle (unyango lwangaphandle lwe-radiation ye-radiation) okanye ngaphakathi (i-brachytherapy). Unyango ngemitha lunokusetyenziswa lodwa okanye ludityaniswe nolunye unyango olufana nechemotherapy. Iindidi zonyango lwemitha ziquka: Unyango lweBeam Radiation yangaphandle (EBRT): Imitha ihanjiswa kumatshini ongaphandle komzimba. Unyango lweRadiation Body Stereotactic (SBRT): Ihambisa iidosi eziphezulu zemitha kwi-tumor encinci, echazwe kakuhle. Brachytherapy: Imbewu ngemitha okanye iingcingo zibekwe ngqo ngaphakathi okanye kufutshane nethumba.Targeted TherapyTargeted therapy therapy amayeza ajolise kwiimolekyuli ezithile (ezifana neeproteni okanye iigenes) ezibandakanyekayo ekukhuleni kweeseli zomhlaza nokusasazeka. La machiza asebenza ngakumbi kune-chemotherapy kwaye aneziphumo ebezingalindelekanga ezimbalwa. Unyango ekujoliswe kulo lusetyenziswa ikakhulu kwi-NSCLC. Imizekelo ibandakanya: I-EGFR inhibitors: Njenge-gefitinib, i-erlotinib, i-afatinib, kunye ne-osimertinib, esetyenziselwa ii-cancer ezinokuguqulwa kwe-EGFR. I-ALK inhibitors: Njenge-crizotinib, i-alectinib, i-ceritinib, i-brigatinib, kunye ne-lorlatinib, esetyenziselwa i-cancer kunye ne-ALK rearrangements. I-BRAF inhibitors: Njenge-dabrafenib kunye ne-trametinib, esetyenziselwa umhlaza kunye neenguqu ze-BRAF. I-RET inhibitors: Okufana ne-selpercatinib kunye ne-pralsetinib yomhlaza kunye ne-RET fusions.I-ImmunotherapyImmunotherapy inceda amajoni omzimba ukulwa nomhlaza. La machiza asebenza ngokuthintela iiproteni ezithintela amajoni omzimba ekuhlaseleni iiseli zomhlaza. Amachiza e-Immunotherapy asetyenziselwa zombini i-NSCLC kunye ne-SCLC. Imizekelo ibandakanya: PD-1 inhibitors: Njenge pembrolizumab, nivolumab, kunye ne-cemiplimab. PD-L1 inhibitors: Njenge-atezolizumab, i-durvalumab, kunye ne-avelumab. I-CTLA-4 inhibitors: Ezifana ne-ipilimumab.Ukusetyenziswa kwe-immunotherapy kwi unyango lomhlaza wemiphunga iye yawaphucula kakhulu amazinga okuphila kwezigulane ezininzi. Ngokutsho kwe Umbutho womhlaza waseMelika, i-immunotherapy ibonisa isithembiso kwizigaba ezahlukeneyo umhlaza wemiphunga. Amanqanaba oMhlaza wemiphunga kunye noNyangoInqanaba le umhlaza wemiphunga Inqanaba loku-1 Umhlaza Wemiphunga Kweli nqanaba lakwangoko, umhlaza wenziwa kwindawo emiphungeni. Unyango ludla ngokubandakanya utyando lokususa ithumba. Unyango ngemitha okanye ichemotherapy ingasetyenziswa njengonyango lwe-adjuvant ukubulala naziphi na iiseli zomhlaza eziseleyo.Inqanaba lesi-2 nelesi-3 Umhlaza weMiphungaUmhlaza unwenwele kwiilymph nodes ezikufutshane. Unyango lubandakanya indibaniselwano yotyando, ichemotherapy, kunye nonyango ngemitha.Inqanaba lesi-4 Umhlaza Wemiphunga Umhlaza unwenwele kumalungu akude. Unyango lujolise ekulawuleni ukukhula kunye nokusasazeka komhlaza kunye nokuthomalalisa iimpawu. Ukhetho lubandakanya ichemotherapy, unyango olujoliswe kuyo, i-immunotherapy, kunye nonyango lweradiation.Side Effects and ManagementUnyango lomhlaza wemiphunga kunokubangela iziphumo ebezingalindelekanga. Imiphumo ethile yecala ixhomekeke kuhlobo lonyango kunye nesigulane ngasinye. Iziphumo eziqhelekileyo ezichaphazelekayo ziquka: Ukukhathala I-Nausea kunye nokuhlanza Iinwele Ukulahleka Ukulahlekelwa ngumnqweno wokutya Umlomo wezilonda Iimpendulo zesikhumba Ababoneleli bezempilo banokunceda ukulawula le miphumo emibi ngamayeza kunye nezinye iindlela zokunyamekela ezixhasayo. Iqela kwi IZiko loPhando ngoMhlaza laseShandong Baofa ibonelela ngenkxaso ephangaleleyo kwizigulana kulo lonke uhambo lwazo lonyango.Uvavanyo lwezonyango Ulingo lwezonyango luphononongo lophando oluvavanya amatsha unyango lomhlaza wemiphunga iindlela. Ukuthatha inxaxheba kulingo lwezonyango kunokunika izigulane ukufikelela kunyango olukumgangatho ophezulu ongekafumaneki ngokubanzi. Izigulane zinokuxoxa ngeendlela zovavanyo lweklinikhi kunye nababoneleli babo bezempilo.Amazinga okusinda kunye ne-PrognosisAmazinga okusinda umhlaza wemiphunga ziye zaphucuka kwiminyaka yakutshanje ngenxa yokuhambela phambili kunyango. Nangona kunjalo, i-prognosis iyahluka ngokuxhomekeke kwinqanaba lomhlaza ekuxilongweni, uhlobo lomhlaza, kunye nempilo yonke yesigulana. Ukufunyaniswa kwangoko kunye nonyango lubalulekile ekuphuculeni amazinga okuphila. Izinga lokusinda leminyaka emihlanu kuzo zonke izigaba ze umhlaza wemiphunga imalunga ne-25%, ngokutsho kwe Umbutho womhlaza waseMelika. Inkqubela-phambili eNtsha kuNyango loMhlaza weMiphungaUmmandla we unyango lomhlaza wemiphunga ihlala iguquka. Unyango olutsha kunye nobuchwepheshe buphuhliswa ngalo lonke ixesha. Ezinye iindawo ezithembisayo zophando ziquka: Iibiopsies zolwelo: Uvavanyo lwegazi olunokubona iiseli zomhlaza okanye amaqhekeza eDNA. Iyeza elenzelwe wena: Ukulungelelanisa unyango kwisigulana ngasinye ngokusekelwe kwiimpawu zomhlaza wabo. Amachiza amatsha e-immunotherapy: Ukuqulunqa amachiza amatsha anokomeleza amajoni omzimba ukulwa umhlaza.Ukwenza Izigqibo ezinolwazi unyango lomhlaza wemiphunga kunokuba lucelomngeni. Izigulane kunye neentsapho zabo kufuneka basebenze ngokusondeleyo nababoneleli bezempilo ukuze benze izigqibo ezinolwazi malunga nokhathalelo lwabo. Kubalulekile ukubuza imibuzo, ukuvakalisa iinkxalabo, kwaye uqonde zonke iindlela zonyango ezikhoyo. Cinga ngokufuna uluvo lwesibini kwenye ingcali. Ulwazi lunamandla xa ujongene umhlaza wemiphunga. Itheyibhile: Uthelekiso loNyango lweMiphuphu oluQhelekileyo loNyango loNyango lweMechanism Iimpembelelo eziPhakamileyo eziLungileyo Amanqanaba afanelekileyo Utyando Ukususwa ngokwasemzimbeni kwezicubu ezinomhlaza Intlungu, ukosuleleka, ukopha Amanqanaba okuqala (I-III) I-Chemotherapy Isebenzisa amayeza okubulala iiseli ezahlula ngokukhawuleza Isicaphucaphu, ukudinwa, ukulahleka kweenwele Zonke izigaba, ngokuphindaphindiweyo ngokudityaniswa kweRadiation Therapy cell, Radiation cell Ubunzima bokuginya Umhlaza wasekhaya, ukhathalelo lwePalliative Therapy Ujoliso kwiimolekyuli ezithile ezibandakanyekayo ekukhuleni komhlaza Ukuqhawuka kwesikhumba, urhudo, iingxaki zesibindi Amanqanaba aphezulu anotshintsho oluthile lwe-Immunotherapy Yongeza amajoni omzimba ukulwa nomhlaza Ukudinwa, ukuqhama kwesikhumba, ukudumba Amanqanaba aphezulu, amanye amanqanaba okuqala.