iindlela zonyango zomhlaza we-metastatic prostate

Umhlaza wedlala lobudoda ngumhlaza wedlala lobudoda oye wasasazeka ngaphaya kwedlala lengqula ukuya kwamanye amalungu omzimba. Iinketho zonyango ziyahluka ngokuxhomekeke kubungakanani bokusasazeka, unyango lwangaphambili, kunye nempilo yonke yesigulana. Unyango oluqhelekileyo lubandakanya unyango lwehomoni, ichemotherapy, i-immunotherapy, kunye nonyango lweradiation. Unyango olutsha olunje ngeradiopharmaceuticals kunye ne-PARP inhibitors nazo ziyasetyenziswa kakhulu. I-Shandong Baofa Cancer Research Institute izinikele ekuboneleleni ngophando olukwinqanaba eliphezulu kunye neendlela zonyango zokuphucula iziphumo zesigulana. Ukuqonda iMetastatic Prostate Cancer Umhlaza weProstate uba umhlaza we-metastatic prostate xa isasazeka ukusuka kwidlala lengqula ukuya kwezinye iindawo, ubukhulu becala amathambo, iilymph nodes, isibindi, kunye nemiphunga. Kubalulekile ukuqonda inqanaba kunye nebakala lomhlaza ukumisela eyona ndlela ilungileyo yokwenza. Uxilongo ngokuqhelekileyo lubandakanya iimvavanyo zemifanekiso efana ne-bone scans, i-CT scans, kunye ne-MRIs, kunye ne-biopsies.Yintoni eyenza i-Prostate Cancer Metastatic?Iiseli zomhlaza ziphuhlisa ukukwazi ukukhupha kwi-tumor yokuqala kwi-prostate, ukuhamba ngegazi okanye inkqubo ye-lymphatic, kunye nokuseka amathumba amatsha kumalungu akude. Ukuguqulwa kofuzo oluthile kunye nezinto ezinxulumene ne-tumor microenvironment zinokufaka isandla kule nkqubo. Amanqaku eGleason kunye nobukho beempawu ezithile zebhayoloji nazo zidlala indima ebalulekileyo ekucingeni umngcipheko we-metastasis.Iinketho zoNyango oluQhelekileyo lweMetastatic Prostate CancerUkhetho oluninzi olusekiweyo lukhona ukuze lulawuleke. umhlaza we-metastatic prostate. Ezi zidla ngokusetyenziswa ngokudibeneyo okanye ngokulandelelanayo ukuze kwandiswe ukusebenza kakuhle.Unyango lweHormone (Androgen Deprivation Therapy - ADT)Unyango lweHormone, nokwaziwa ngokuba yi-androgen deprivation therapy (ADT), ijolise ekuthobeni amanqanaba eehomoni zamadoda (androgens) emzimbeni, ezithi ziphembelele ukukhula kweeseli zomhlaza wedlala lesinyi. Oku kunokufezekiswa ngokuchithwa kotyando (i-orchiectomy) okanye ukuthenwa kwezonyango kusetyenziswa i-LHRH agonists okanye abachasi. Iziphumo ebezingalindelekanga eziqhelekileyo zibandakanya ukukhanya okutshisayo, ukulahleka kwe-libido, ukungasebenzi kakuhle kwe-erectile, kunye nokudinwa. I-ADT isoloko ilunyango lodidi lokuqala umhlaza we-metastatic prostate.Unyango ngamachiza amachiza abandakanya ukusetyenziswa kwamachiza okubulala iiseli zomhlaza. Ihlala isetyenziswa xa unyango lwe-hormone lungasasebenzi (umhlaza we-prostate-resistant-castration-CRPC). Amachiza aqhelekileyo e-chemotherapy asetyenziselwa umhlaza we-prostate aquka i-docetaxel kunye ne-cabazitaxel. Iziphumo ebezingalindelekanga zinokubandakanya isicaphucaphu, ukuhlanza, ukulahleka kweenwele, ukudinwa, kunye nokwanda komngcipheko wosulelo. I-Shandong Baofa Cancer Research Institute igxininisa ukulawula iziphumo ebezingalindelekanga ukuphucula umgangatho wobomi.Unyango lweRadiation TherapyRadiation lisebenzisa imitha yamandla aphezulu okanye amasuntswana okubulala iiseli zomhlaza. Ingasetyenziselwa ukunyanga idlala lengqula ngokwalo (unyango lwemitha yangaphandle okanye ibrachytherapy) okanye ukujolisa kwiziza zemetastatic emathanjeni (unyango lwangaphandle lwemitha). Unyango lweradiation lunokunceda ukunciphisa intlungu kunye nokuphucula umgangatho wobomi. Iziphumo ebezingalindelekanga zixhomekeke kwindawo ephathwayo kodwa zinokubandakanya ukudinwa, ukucaphuka kwesikhumba, kunye neengxaki zamathumbu. umhlaza we-metastatic prostate. Nangona kunjalo, inokuqwalaselwa kwiimeko ezithile, ezinjengokususa ithumba eliphambili ukunciphisa iimpawu okanye kudityaniswe nolunye unyango. Ukususwa ngotyando lwezilonda zemetastatic akufane kwenzeke.Unyango olutsha kunye nolwaPhumayoPhanda kwizinto ezintsha iindlela zonyango zomhlaza we-metastatic prostate ihlala iguquka, inika ithemba kwiziphumo eziphuculweyo kunye nomgangatho ongcono wobomi. Nazi ezinye zeendlela ezintsha:IRadiopharmaceuticalsIRadiopharmaceuticals ngamachiza ahambisa imitha ngokuthe ngqo kwiiseli zomhlaza. I-Radium-223 dichloride (Xofigo) i-radiopharmaceutical esetyenziselwa ukunyanga i-bone metastases kwizigulane ezine-CRPC. I-Lutetium-177 PSMA-617 yenye i-radiopharmaceutical ejolise kwi-prostate-specific membrane antigen (PSMA), iprotheni efumaneka kumphezulu weeseli zomhlaza we-prostate. Imiphumo emibi ingabandakanya ukunyanzeliswa kwamathambo kunye nokukhathala.I-ImmunotherapyImmunotherapy idibanisa amandla omzimba wokulwa nomhlaza. I-Sipuleucel-T (i-Provenge) lunyango lwe-immunotherapy oluvunyiweyo lwe-CRPC engabonakaliyo okanye encinci ye-CRPC. Ibandakanya ukuqokelela iiseli zomzimba zesigulana, ukuziguqula ukuze ziqaphele iiseli zomhlaza wedlala lesinyi, kwaye emva koko uzibuyisele kwisigulana. I-Pembrolizumab, i-checkpoint inhibitor, ingaba yindlela yokukhetha izigulane ezineenguqu ezithile zofuzo okanye ukungazinzi kwe-microsatellite ephezulu (MSI-H) .I-PARP InhibitorsPARP inhibitors ziziyobisi ezivimba i-enzymes ze-PARP, ezibandakanyekayo ekulungiseni i-DNA. La machiza anokusebenza kwizigulane ezineenguqu ezithile zofuzo, ezifana nokuguqulwa kwe-BRCA1 / 2. I-Olaparib kunye ne-rucaparib yi-PARP inhibitors evunyiweyo kunyango lwe-CRPC. Iziphumo ebezingalindelekanga eziqhelekileyo ziquka i-anemia, ukudinwa, kunye nesicaphucaphu. I-Shandong Baofa Cancer Research Institute ibandakanyeka ngokubonakalayo kuphando lokuhlola ukusetyenziswa kwe-PARP inhibitors ngokudibanisa nolunye unyango. Unokufunda ngakumbi malunga ne-PARP inhibitors kwi Iwebhusayithi yeNational Cancer Institute.I-TherapyTargeted therapy isebenzisa iziyobisi ezijolise ngokukodwa kwiimolekyuli ezithile ezibandakanyekayo ekukhuleni kweeseli zomhlaza kunye nokuphila. Imizekelo ibandakanya iziyobisi ezinqanda iindlela zokubonisa njenge-PI3K/AKT/mTOR indlela. Olu nyango ludla ngokusetyenziswa kulingo lwezonyango kwaye lusaphandwa ukusebenza kwalo ekunyangeni umhlaza we-metastatic prostate.Amacebo oNyango aSekelwe kwiSigaba seSifo kunye neMiba yoMngciphekoUkhetho lonyango luxhomekeke kwizinto ezininzi, kubandakanywa ubungakanani besifo, impilo yesigulana iyonke, kunye nonyango lwangaphambili. Le theyibhile ilandelayo ishwankathela iindlela zonyango jikelele: Inqanaba/uMngcipheko oKhethekileyo woNyango loKhetho lweHormone-sensitive metastatic prostate cancer ADT + androgen receptor inhibitors (umzekelo, abiraterone, enzalutamide), ichemotherapy, okanye uvavanyo lwezonyango. I-Castration-resistant metastatic cancer cancer (CRPC) I-Chemotherapy, i-androgen receptor inhibitors, i-radiopharmaceuticals, i-immunotherapy, i-PARP inhibitors (ukuba ikhona), okanye ulingo lwezonyango. I-Bone Metastases Unyango lwe-radiation, i-radiopharmaceuticals, i-bisphosphonates okanye i-denosumab (ii-agent zokuqinisa amathambo). Iimvavanyo zeklinikhi kunye neFuture DirectionsUlingo lwezonyango lubalulekile ekuphuhliseni unyango olutsha noluphuculweyo lwe umhlaza we-metastatic prostate. Izigulane zinokucinga ngokuthatha inxaxheba kwiimvavanyo zeklinikhi ukufikelela kunyango oluphambili kunye negalelo kuphando lwezonyango. Uphando oluqhubekayo lujolise ekuphuhliseni unyango olujoliswe ngakumbi olusebenzayo, i-immunotherapies, kunye nonyango oludibeneyo. I-Shandong Baofa Cancer Research Institute idlala indima ebalulekileyo ekuqhubeni ulingo lwezonyango kunye nokuqhubela phambili intsimi yonyango lomhlaza wedlala lesinyi. Ungaqhagamshelana IZiko loPhando ngoMhlaza laseShandong Baofa ngolwazi malunga nolingo lwangoku lwezonyango kunye nokhetho lonyango.Ukuphila ngeMetastatic Prostate CancerUkuhlala ne umhlaza we-metastatic prostate inokuzisa imingeni ebalulekileyo. Ukulawula iimpawu, ukumelana neziphumo ebezingalindelekanga, kunye nokugcina umgangatho wobomi yimiba ebalulekileyo yokhathalelo. Amaqela enkxaso, iingcebiso, kunye neenkonzo zokhathalelo lokuthomalalisa zinokubonelela ngoncedo oluxabisekileyo. Unxibelelwano oluvulekileyo kunye nabanikezeli bezempilo lubalulekile ekwenzeni izigqibo ezizisiweyo kunye nokufumana olona khathalelo lungcono umhlaza we-metastatic prostate yimeko enzima, iindlela ezininzi zonyango ziyafumaneka ukunceda ukulawula isifo, ukuphucula umgangatho wobomi, kunye nokwandisa ubomi. Ukuhlala unolwazi malunga nenkqubela phambili yamva nje kunyango kunye nokusebenza ngokusondeleyo neqela leengcali ezininzi zonyango kubalulekile ukwenza izigqibo ezinolwazi kunye nokufumana ukhathalelo olungcono kakhulu. I-Shandong Baofa Cancer Research Institute izibophelele ekuboneleleni ngokhathalelo olubanzi kunye nokuqhubela phambili icandelo lophando kunye nonyango lomhlaza wedlala lesinyi.