unyango olungelulo oluncinci lomhlaza wemiphunga weseli

Umhlaza wemiphunga weseli engeyiyo encinci (NSCLC) luhlobo oluqhelekileyo lomhlaza wemiphunga. Ukhetho lonyango lwe-NSCLC lwahluka kwaye luxhomekeke kwizinto ezininzi, kubandakanya inqanaba lomhlaza, impilo yesigulana iyonke, kunye nokuguqulwa kofuzo oluthile ngaphakathi kwethumba. Esi sikhokelo sibonelela ngombono weendlela eziphambili zonyango ze-NSCLC, ukusuka kuqhaqho kunye nonyango lwe-radiation ukuya kunyango olujoliswe kuyo kunye ne-immunotherapy, ukuxhobisa izigulane kunye nabakhathaleli ngolwazi lokwenza izigqibo ezinolwazi.Umhlaza wemiphunga weseli engeyiyo encinci (NSCLC) liqela lomhlaza wemiphunga eliziphatha ngendlela efanayo. Iindidi eziphambili ze-NSCLC ziquka i-adenocarcinoma, i-squamous cell carcinoma, kunye ne-cell carcinoma enkulu. Ukuxilongwa ngokuchanekileyo, kubandakanywa ukulinganisa kunye novavanyo lwe-molecular, kubalulekile ekumiseleni isicwangciso sonyango esisebenzayo. I-Shandong Baofa Cancer Research Institute izinikele kuphando lomhlaza kunye nophuhliso lweendlela ezintsha zonyango, funda ngakumbi kwi https://baofahospital.com.Ukubekwa kwe-NSCLCNSCLC kusetyenziswe inkqubo ye-TNM (iTumor, Node, Metastasis). Isigaba sichaza ubungakanani kunye nendawo ye-tumor ephambili (T), nokuba umhlaza usasazeke kwii-lymph nodes ezikufutshane (N), kwaye ingaba umhlaza uye we-metastasized kwiindawo ezikude (M). Amanqanaba ukusuka kwi-I (inqanaba lokuqala) ukuya kwi-IV (inqanaba eliphezulu) .Uvavanyo lwe-Molecular ye-NSCLCUvavanyo lweMolekyuli luchonga ukuguqulwa kofuzo oluthile okanye ukungahambi kakuhle kweeprotheni ngaphakathi kweeseli zethumba. Ezi biomarkers zinokunceda ukugqiba ukuba isigulane singumviwa wonyango olujoliswe kuyo. Iinguqu eziqhelekileyo ziquka i-EGFR, ALK, ROS1, BRAF, kunye nabanye. Iziphumo zovavanyo lweemolekyuli zinefuthe kakhulu kwizigqibo zonyango.Umgangatho Unyango lwe-NSCLCUtyandoUtyando luhlala lunyango lodidi lokuqala lwenqanaba lokuqala le-NSCLC (inqanaba I ne-II). Injongo kukususa i-tumor kunye naziphi na ii-lymph nodes ezikufutshane. Iindidi zotyando ziquka: Ukususwa kweWedge: Ukususwa kweqhekeza elincinane lemiphunga emiphunga. Segmentectomy: Ukususwa kwenxalenye enkulu yomphunga kune-wedge resection. Lobectomy: Ukususwa kwelobe yonke yomphunga. Le yeyona nkqubo ixhaphakileyo yotyando ye-NSCLC. Inyumoniya: Ukususwa komphunga wonke. Oku akuqhelekanga kwaye kugcinelwe amathumba abanzi ngakumbi.Unyango lweRadiation TherapyRadiation isebenzisa imitha yamandla aphezulu ukubulala iiseli zomhlaza. Ingasetyenziswa njengonyango lokuqala, emva kotyando lokubulala naziphi na iiseli zomhlaza eziseleyo, okanye ukuthomalalisa iimpawu (i-palliative radiation). Iindidi ezahlukeneyo zonyango lwemitha ziquka: Unyango lweBeam Radiation yangaphandle (EBRT): Imitha ihanjiswa kumatshini ongaphandle komzimba. Unyango lweRadiation Body Stereotactic (SBRT): Ihambisa iidosi eziphezulu zokusasazeka kwemitha kwindawo encinci, ekujoliswe kuyo ngokuchanekileyo. Idla ngokusetyenziswa kwi-NSCLC yangethuba xa utyando ingelokhetho. Unyango lweBrachytherapy (Unyango lwangaphakathi lokusasazeka): Imathiriyeli ye-radioactive ibekwe ngokuthe ngqo ngaphakathi kwithumba okanye kufutshane nalo.I-ChemotherapyI-Chemotherapy isebenzisa amayeza ukubulala iiseli zomhlaza kuwo wonke umzimba. Ihlala isetyenziswa ngokudityaniswa noqhaqho okanye unyango lweradiation, okanye njengonyango oluphambili lwenqanaba eliphezulu NSCLC. Amachiza aqhelekileyo e-chemotherapy e-NSCLC abandakanya i-cisplatin, i-carboplatin, i-paclitaxel, i-docetaxel, i-pemetrexed, kunye ne-gemcitabine. Unyango lwe-NSCLCUnyango ekujoliswe kulo ngamachiza ajolise kwiimolekyuli ezithile ezibandakanyekayo ekukhuleni kweeseli zomhlaza kunye nokuphila. Ezi zonyango zisebenza kuphela ukuba ithumba linokuguqulwa kwemfuzo ethile okanye ukungaqhelekanga kweprotheni.EGFR InhibitorsEGFR (epidermal growth factor receptor) inhibitors isetyenziselwa ukunyanga. NSCLC kunye neenguqu ze-EGFR. La machiza avimba iprotein ye-EGFR, enceda iiseli zomhlaza zikhule. Imizekelo ibandakanya: Gefitinib (Iressa) Erlotinib (Tarceva) Afatinib (Gilotrif) Osimertinib (Tagrisso)ALK InhibitorsALK (anaplastic lymphoma kinase) inhibitors zisetyenziselwa ukunyanga NSCLC ngohlengahlengiso lwemfuza ye-ALK. La machiza avimba iprotheni ye-ALK, enceda iiseli zomhlaza zikhule. Imizekelo ibandakanya: Crizotinib (Xalkori) Ceritinib (Zykadia) Alectinib (Alecensa) Brigatinib (Alunbrig) Lorlatinib (Lorbrena)ROS1 InhibitorsROS1 inhibitors zisetyenziselwa ukunyanga NSCLC kunye nohlengahlengiso lwemfuza ye-ROS1. La machiza avimba iprotheyini ye-ROS1, enceda iiseli zomhlaza ukuba zikhule. Imizekelo iquka: Crizotinib (Xalkori) Entrectinib (Rozlytrek)BRAF InhibitorsBRAF inhibitors are used to treating NSCLC ngotshintsho lweBRAF V600E. La machiza avimba iprotein ye-BRAF. Imizekelo ibandakanya: I-Dabrafenib (i-Tafinlar) i-Trametinib (i-Mekinist) (isetyenziswe ngokudibeneyo ne-Dabrafenib)Olunye unyango oluJolisiweyoOlunye unyango olujoliswe kuyo lunokusetyenziswa ngokuxhomekeke kutshintsho oluthile olukhoyo kwithumba. Imizekelo ibandakanya i-RET inhibitors (ye-RET fusions) kunye ne-MET inhibitors (ye-MET exon 14 skipping mutations). Unyango lwe-NSCLCAmachiza e-Immunotherapy anceda amajoni omzimba ukulwa nomhlaza. Basebenza ngokuthintela iiproteni ezithintela amajoni omzimba ekuhlaseleni iiseli zomhlaza. Ezi zisetyenziswa rhoqo kwi NSCLC unyango.PD-1 / PD-L1 InhibitorsPD-1 (iprotheni yokufa kwe-cell ecwangcisiweyo ye-1) kunye ne-PD-L1 (i-programmed death-ligand 1) inhibitors ivimba indlela ye-PD-1 / PD-L1, enceda iiseli zomhlaza ukuba ziphephe amajoni omzimba. Imizekelo ibandakanya: Pembrolizumab (Keytruda) Nivolumab (Opdivo) Atezolizumab (Tecentriq) Durvalumab (Imfinzi) Cemiplimab (Libtayo)CTLA-4 InhibitorsCTLA-4 (cytotoxic T-lymphocyte-enxulumene neprotein 4) inceda i-CTLA inhibitors kwi-immune system inhibitors, i-CTLA-inhibitors ye-immune system. Umzekelo yi-Ipilimumab (Yervoy), edla ngokusetyenziswa ngokudibanisa ne-PD-1 inhibitors.Ukudibanisa unyango rhoqo, NSCLC unyango zibandakanya indibaniselwano yonyango olwahlukeneyo. Ngokomzekelo, utyando lunokulandelwa yichemotherapy okanye unyango lweradiation. Unyango olujoliswe kuyo okanye i-immunotherapy inokudibaniswa nechemotherapy. Inhlanganisela ethile iya kuxhomekeka kwimeko yesigulane ngasinye. Ukufumana ngakumbi malunga nophando lomhlaza ndwendwela IZiko loPhando ngoMhlaza laseShandong Baofa.Uvavanyo lweClinical Ulingo lwezonyango luphononongo lophando oluvavanya unyango olutsha okanye indibaniselwano yonyango. Izigulane ezine NSCLC inokucinga ngokuthatha inxaxheba kulingo lwezonyango ukufikelela kunyango oluphambili. Ulwazi malunga nolingo lwezonyango lunokufumaneka kwiwebhusayithi yeNational Cancer Institute kunye neminye imithombo ethembekileyo. NSCLC unyango kunokubangela iziphumo ebezingalindelekanga. Kubalulekile ukuxoxa ngeziphumo ebezingalindelekanga kunye nogqirha wakho kwaye ufunde indlela yokulawula. Ukunyamekelwa kwenkxaso, njengokulawulwa kweentlungu kunye nenkxaso yesondlo, kunokunceda ukuphucula umgangatho wobomi ngexesha lonyango.I-Prognosis kunye ne-Care-Up CareThe prognosis for NSCLC kuxhomekeke kwinqanaba lomhlaza, impilo yesigulana iyonke, kunye nendlela umhlaza osabela ngayo kunyango. Ukuqeshwa okulandelwa rhoqo kubalulekile ukubeka iliso ukuphindaphinda kunye nokulawula nayiphi na imiphumo emibi yexesha elide yonyango.Ukuziphendulela: Eli nqaku libonelela ngolwazi ngokubanzi malunga unyango olungelulo oluncinci lwe-cell lung cancer (NSCLC). kwaye akufanele ithathwe njengengcebiso yezonyango. Soloko udibana nogqirha wakho okanye ingcali yezempilo eqeqeshiweyo ukuze ufumane iingcebiso zomntu malunga nemeko yakho yonyango.