unyango lomhlaza wemiphunga ongatshayiyo

Umhlaza wemiphunga kubantu abangazange batshaye unikezela ngemingeni ekhethekileyo kunye neendlela zonyango. Nangona ukutshaya kuyinto eyaziwayo yomngcipheko, inxalenye enkulu yeemeko zomhlaza wemiphunga zenzeka kubantu abangenayo imbali yokusetyenziswa kwecuba. Eli nqaku liphonononga imiba eyahlukileyo ye unyango lomhlaza wemiphunga ongatshayiyo, kubandakanywa ukuxilongwa, ukhetho lonyango, kunye nophando oluqhubekayo.Uxilongo kunye neentlobo zoMhlaza weMiphunga kubantu abangaze batshayeUkuxilonga umhlaza wemiphunga kubantu abangazange batshaye kudla ngokubonakala ngendlela eyahlukileyo kunabo batshayayo. Kubalulekile ukuqonda ama-nuances okubhaqwa kunye neentlobo ezithile zomhlaza wemiphunga oxhaphakileyo kolu luntu.Imingeni yokuFumana kwangethuba Ngenxa yokuba umhlaza wemiphunga uhlala unxulunyaniswa nokutshaya, unokungajongwa ngokukhawuleza ukuba ungaze utshaye, okukhokelela ekuxilongeni ukulibaziseka. Iimpawu zingacacanga okanye zibalelwa kwezinye iimeko. Izicwangciso zokufumanisa kwangethuba ezifana nokuhlolwa komhlaza wemiphunga kusetyenziswa idosi ephantsi ye-CT scans ngokuqhelekileyo ayikhuthazwa kubantu ngokubanzi abangakhe batshaye, ngakumbi ukwenza nzima ukuxilongwa kwangethuba.Iintlobo zoMhlaza weMiphuphu oQhelekileyo kwi-Ungaze utshayeNgelixa abatshayayo besengozini ngakumbi kwi-squamous cell carcinoma kunye nomhlaza weseli emiphunga encinci, abakhe batshaya basengozini enkulu yokuba ne-adenocarcinoma. I-Adenocarcinoma ihlala ivela kwimimandla engaphandle yemiphunga, iyenza ukuba ifunyanwe ngaphambi kokuba isasazeke. Ezinye, iintlobo ezinqabileyo nazo zingenzeka.IZiko loPhando ngoMhlaza laseShandong Baofa (https://baofahospital.com) luzinikele ekuqhubeleni phambili ukuqonda kwethu iintlobo ngeentlobo zomhlaza wemiphunga kunye nokuphucula iindlela zokuxilonga.Ukhetho loNyango lwabangatshayiyo umhlaza wemiphunga.Indlela zonyango zomhlaza wemiphunga ekubeni ungatshayiyo zidla ngokulungelelaniswa nohlobo oluthile kunye nenqanaba lomhlaza, ngokunjalo nempilo yomntu wonke. Ubuchwephesha obuncinci obuncinci njengotyando lwe-thoracoscopic oluncediswa yividiyo (i-VATS) luye lwasetyenziswa ngakumbi ukunciphisa ixesha lokubuyisela kunye nokuphucula iziphumo.Unyango lwe-Radiation TherapyRadiation therapy isebenzisa imisebe ephezulu yamandla ukubulala iiseli zomhlaza. Ingasetyenziswa njengonyango oluphambili kwizigulana ezingafanelekanga utyando, okanye njengonyango lwe-adjuvant emva kotyando ukuphelisa naziphi na iiseli zomhlaza eziseleyo. Ubuchwephesha obufana nonyango lweradiation ye-stereotactic body radiation (SBRT) luhambisa ngemitha egxininise kakhulu kwithumba ngelixa kuncitshiswa umonakalo kwizihlunu ezingqongileyo ezisempilweni.IChemotherapyChemotherapy ibandakanya ukusetyenziswa kwamachiza ukubulala iiseli zomhlaza kuwo wonke umzimba. Ihlala isetyenziselwa amanqanaba aphezulu omhlaza wemiphunga okanye kudityaniswe noqhaqho okanye unyango ngemitha. Iirejimeni ezithile ze-chemotherapy ziyahluka ngokuxhomekeke kuhlobo lomhlaza wemiphunga kunye nempilo yesigulane iyonke.I-Targeted TherapyTargeted therapy igxile kwiimolekyuli ezithile okanye iindlela ezibandakanyekayo ekukhuleni komhlaza kunye nokusasazeka. Abaninzi abakhe batshaya abaneadenocarcinoma babe neenguqu zemfuza, ezifana neEGFR, ALK, ROS1, okanye BRAF. Ukuchonga olu tshintsho luvumela oogqirha ukuba bachaze unyango olujoliswe kuyo oluthintela ngokukodwa umsebenzi wezi proteni ezitshintshileyo, ezikhokelela ekuphuculweni kweziphumo.ImmunotherapyImmunotherapy yomeleza amajoni omzimba ukulwa nomhlaza. I-Checkpoint inhibitors, efana ne-PD-1 kunye ne-PD-L1 inhibitors, luhlobo lwe-immunotherapy olubonise isithembiso ekunyangeni iintlobo ezithile zomhlaza wemiphunga, kubandakanywa nezo zifunyenwe kwi-ngakaze itshaye. Ukusebenza konyango lokugonyela umzimba kuxhomekeke kwizinto ezahlukeneyo, kubandakanywa ubukho beempawu ezithile zebhayoloji. Ukubaluleka koVavanyo lwemfuza kuMntu ongatshayiyo Umhlaza wemiphunga Uvavanyo lweGenetic lubalulekile kulawulo umhlaza wemiphunga ongatshayiyo. Ukuchonga utshintsho oluthile lwemfuza luvumela oogqirha ukuba bazenzele izicwangciso zonyango kwaye bakhethe iindlela zonyango ezijoliswe kuzo okanye i-immunotherapies.Ukuguqulwa kwemfuza okuqhelekileyoUtshintsho lwemfuza oluqhelekileyo lufumaneka kumhlaza wemiphunga kumhlaza ongazange utshaye, kubandakanywa: EGFR (Epidermal Growth Factor Receptor) mutationsALK (I-Anaplastic Lyfusionma KiAFnase i-mutationsBRD ukusetyenziswa kweendlela zonyango ezijoliswe kuzo ezithintela ngokukodwa umsebenzi weeprotheni eziguquguqukayo, ezikhokelela kwiziphumo eziphuculweyo kunye nokuphila ixesha elide.Iinzuzo zoNyango loMntuUnyango olusekelwe kuvavanyo lwemfuza luvumela indlela echanekileyo nesebenzayo yokunyamekela umhlaza. Ngokujolisa kubaqhubi abathile beemolekyuli zomhlaza, oogqirha banokunciphisa iziphumo ezibi kunye nokuphucula umgangatho wobomi bezigulane. I IZiko loPhando ngoMhlaza laseShandong Baofa Ugxininisa amayeza omntu ngamnye kunyango lomhlaza. Iimvavanyo zeClinical kunye noPhando oluQhubekekayo Ulingo lwezonyango ludlala indima ebalulekileyo ekuqhubeleni phambili unyango. umhlaza wemiphunga ongatshayiyo. Ezi zifundo zivavanya iindlela zonyango olutsha, iindibaniselwano zonyango, kunye nobuchule bokuxilonga.Ukufumana iiMvavanyo zeKlinikhiIzigulane ezinomdla wokuthatha inxaxheba kwiimvavanyo zeklinikhi zinokukhangela izilingo ngemithombo ehloniphekileyo, efana ne: National Cancer Institute (NCI): https://www.cancer.gov/about-cancer/treatment/clinical-trialsClinicalTrials.gov: https://clinicaltrials.gov/Imimandla yoPhandoIinzame zophando zangoku zijolise ekuphuhliseni amayeza ekujoliswe kuwo otshintsho lwemfuza ethileUkuphucula ukusebenza kakuhle kwe-immunotherapyUkuchonga ii-biomarkers ezintsha zokubhaqwa kwangethuba kunye nempendulo yonyangoUkuqonda ibhayoloji eyodwa yomhlaza wemiphunga kwimiphunga yokungatshayiIingqikelelo kunye namazinga okusinda. unyango lomhlaza wemiphunga ongatshayiyo iyahluka ngokuxhomekeke kwinqanaba lomhlaza ekuxilongeni, uhlobo oluthile lomhlaza, kunye nempilo yomntu jikelele. Ngokubanzi, ungaze abantu abatshayayo abanomhlaza wemiphunga badla ngokuba ne-prognosis engcono kunabatshayayo, ngakumbi ukuba banamathumba anokuguqulwa kwemfuza okujoliswe kuko.Izinto ezichaphazela iPrognosisIzinto ezinokuphembelela ukuxilonga zibandakanya:Inqanaba lomhlaza ekuxilongeniUhlobo lomhlaza wemiphungaUbukho botshintsho lwemfuzo ekujoliswe kuloImpilo yonke kunye nokuba sempilweniIimpendulo kunyango Uphononongo lwango-2020 olupapashwe kwi-Journal of Thoracic Oncology* lwafumanisa ukuba abantu abangazange batshaya abane-adenocarcinoma kunye notshintsho lwe-EGFR babenokuphila okuphakathi kweenyanga ezingama-38.6 ngonyango olujoliswe kuyo, xa kuthelekiswa neenyanga ezingama-26.7 zabantu abatshayayo abaneenguqu ezifanayo eziphathwe ngechemotherapy. I-1 Group Treatment Median Overall Survival (Iinyanga) Ungaze utshaye nge-EGFR+ Advanced Adenocarcinoma Targeted Therapy 38.6 Abatshayayo nge-EGFR+ Advanced Adenocarcinoma Chemotherapy 26.7 Umthombo: 1. Ijenali yeThoracic Oncology, 2020UkuqukumbelaUnyango lomhlaza wemiphunga ongatshayiyo yinkalo ekhulayo enamathuba akhulayo onyango olulolwakho nolusebenzayo. Ukuqonda iimpawu ezithile zomhlaza wemiphunga kwabo bangatshayiyo, kubandakanya neentlobo zomhlaza kunye notshintsho lwemfuza oluqhelekileyo, kubalulekile ekwandiseni iziphumo zonyango. Uphando oluqhubekayo kunye nolingo lwezonyango lubalulekile ekuqhubeleni phambili ukhathalelo lwabantu abafunyaniswa benomhlaza wemiphunga abangazange batshaye. Ukufuna iingcebiso zengcali zonyango kunye nokuhlola iindlela zonyango ezikhoyo ngamanyathelo abalulekileyo ekulawuleni le meko.