isigaba 3b unyango lomhlaza wemiphunga

Inqanaba 3B Unyango loMhlaza weMiphuphu: IsiKhokelo esiBanziUkuqonda iinketho zakho isigaba 3b unyango lomhlaza wemiphunga ibalulekile. Esi sikhokelo sibonelela ngenkcazo ebanzi yonyango olukhoyo, ukusebenza kwalo, iziphumo ebezingalindelekanga ezinokubakhona, kunye nengqwalasela yokwenza izigqibo ezizizo. Siza kuphonononga ukhetho lotyando, ichemotherapy, unyango lweradiation, unyango ekujoliswe kulo, kunye ne-immunotherapy, siqaqambisa inkqubela phambili ebaleni.

Ukuqonda iNqanaba 3B Umhlaza wemiphunga

Inqanaba 3b umhlaza wemiphunga ibonisa ukuba umhlaza usasazeke kwii-lymph nodes esifubeni, kodwa kungekhona ngaphaya. Eli nqanaba liphinde lahlulahlulwe kwi-3B1 kunye ne-3B2, ngokusekelwe kubungakanani bokubandakanyeka kwe-lymph node. Iqonga elichanekileyo libalulekile ekumiseleni esona sicwangciso sifanelekileyo sonyango. Isicwangciso sonyango oluthile luya kuxhomekeka kwizinto ezahlukeneyo ezibandakanya impilo yesigulana iyonke, uhlobo lomhlaza wemiphunga (iseli encinci vs. iseli engeyiyo encinci), indawo kunye nobungakanani bethumba, kunye nobukho bezinye iimeko zonyango. Ukuxilongwa kwangaphambili kunye nokuchanekileyo kubalulekile kulawulo oluyimpumelelo isigaba 3b somhlaza wemiphunga. Uthethwano kunye neengcali ze-oncologists ezinamava zibaluleke kakhulu ekuhambeni kolu hambo lunzima.

IiNdlela zoNyango lweSigaba 3B soMhlaza weMiphunga

Utyando

Utyando lunokuba lukhetho kwezinye izigulane ezine isigaba 3b somhlaza wemiphunga, ngakumbi abo banesifo sendawo kunye nempilo entle iyonke. Iinkqubo zotyando zinokubandakanya i-lobectomy (ukususwa kwe-lung lobe), i-pneumonectomy (ukususwa komphunga wonke), okanye i-segmentectomy (ukususwa kwecandelo lomphunga). Isigqibo sokuqhubeka notyando siya kuxhomekeka ekubeni kunokwenzeka ukususwa ngokupheleleyo kwethumba kunye neengozi ezinxulumene noko. Iziko loPhando ngoMhlaza laseShandong Baofa (https://www.baofahospital.com/) ibonelela ngeenkonzo ezibanzi zotyando lwe-oncology.

Unyango ngamachiza

I-Chemotherapy isetyenziswa rhoqo kunyango lwe isigaba 3b somhlaza wemiphunga, nokuba ngaphambi kotyando (neoadjuvant chemotherapy) ukunciphisa ithumba okanye emva kotyando (i-adjuvant chemotherapy) ukunciphisa umngcipheko wokuphinda. Amachiza eChemotherapy asebenza ngokujolisa kwaye abulale iiseli zomhlaza ezahlulahlula ngokukhawuleza. Ii-chemotherapeutic agents ezisetyenziswa ngokuqhelekileyo ziquka izidakamizwa ezisekelwe kwiplatinam (cisplatin, carboplatin) kunye nabanye. Irejimeni ethile iya kulungiselelwa iimfuno zesigulana ngasinye kunye nempendulo kunyango. Imiphumo emibi ye-chemotherapy inokwahluka, kodwa ngokuqhelekileyo ibandakanya isicaphucaphu, ukudinwa, ukulahleka kweenwele, kunye nokuncipha kweeseli zegazi.

Unyango ngemitha

Unyango ngemitha lusebenzisa imitha yamandla aphezulu ukubulala iiseli zomhlaza. Ingasetyenziswa yodwa okanye idityaniswe nechemotherapy. Unyango lwe-radiation lunokuhanjiswa ngaphandle (unyango lwe-radiation yangaphandle) okanye ngaphakathi (i-brachytherapy). Unyango lwemitha ye-Stereotactic body radiation (SBRT) luhlobo oluchaneke kakhulu lonyango lwemitha olunikezela ngeedosi eziphezulu zemitha kwithumba ngelixa unciphisa umonakalo kwizihlunu ezisempilweni ezingqongileyo. Olu lukhetho olusebenzayo kakhulu lonyango kwizigulane ezikhethiweyo. Ukhetho lonyango lwemitha luya kuxhomekeka kwizinto ezininzi ezinjengendawo yethumba, ubungakanani, kunye nempilo yonke yesigulana.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo lusebenzisa amachiza ajolise ngokukodwa kwiiseli zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Olu nyango lusebenza ngokuchasene neendidi ezithile zomhlaza wemiphunga ezinotshintsho oluthile lwemfuza. Imizekelo ibandakanya i-EGFR inhibitors, i-ALK inhibitors, kunye ne-ROS1 inhibitors. Ngaphambi konyango, uvavanyo lwemfuzo luhlala lwenziwa ukuvavanya ukuba umhlaza wemiphunga wesigulana unoguquko olufanelekileyo lwemfuza.

Immunotherapy

I-Immunotherapy idibanisa amajoni omzimba ukuze alwe neeseli zomhlaza. I-Checkpoint inhibitors, njenge-nivolumab kunye ne-pembrolizumab, isetyenziswa ngokuqhelekileyo kunyango lwe. isigaba 3b somhlaza wemiphunga. Basebenza ngokuthintela iiproteni ezithintela amajoni omzimba ekuhlaseleni iiseli zomhlaza. I-Immunotherapy ngamanye amaxesha inokukhokelela kwiziphumo ezibi ezibalulekileyo ezifana neziganeko ezimbi ezinxulumene nomzimba. Isicwangciso sonyango kufuneka senziwe ngononophelo kwaye silandelwe ngokusondeleyo ngabasebenzi bezonyango.

Ukwenza Izigqibo Ezinolwazi

Ukukhetha unyango olululo isigaba 3b somhlaza wemiphunga kufuna ukuba kuqwalaselwe ngenyameko iinkalo ezahlukahlukeneyo. Kubalulekile ukuba neengxoxo ezivulelekileyo nezinyanisekileyo kunye ne-oncologist yakho ukuqonda iingenelo ezinokubakho kunye nobungozi bokhetho ngalunye lonyango. Le ndlela yokubambisana, ngokusekelwe kwiimeko zakho ezithile kunye nezinto ozikhethayo, kubaluleke kakhulu ekufezekiseni umphumo ongcono kakhulu. Cinga ngokufuna izimvo zesibini kwaye uzibandakanye kumaqela enkxaso ukuze uhambe kakuhle kolu hambo lucelomngeni. Ukuqeshwa okulandelwa rhoqo kunye nezifundo zokucinga zibalulekile ekubekeni iliso impendulo yonyango kunye nokufumanisa nakuphi na ukuphindaphinda.

Uhlahlelo oluthelekisayo loKhetho loNyango

Qaphela: Olu lwazi lulungiselelwe iinjongo zemfundo kuphela kwaye aluquki iingcebiso zonyango. Soloko udibana nengcali yokhathalelo lwempilo olufanelekileyo ukuze uxilongwe kunye nonyango lwaso nasiphi na isimo sonyango.