unyango lwemfuzo unyango umhlaza wemiphunga

Unyango lweeNguqu zeMfuzo kuMhlaza weMiphungaUkuqonda kunye nokuNyanga iiNguqu zeMfuzo kuMhlaza weMiphunga: Isikhokelo esiBanzi Umhlaza wamaphaphu sisifo esintsokothileyo, kwaye unyango lwaso luhlala luxhomekeke kutshintsho oluthile lwemfuza olukhoyo kwithumba. Esi sikhokelo sibonelela ngombono obanzi wendima yovavanyo lwemfuzo kumhlaza wemiphunga, utshintsho oluqhelekileyo, kunye nokhetho olukhoyo lonyango. Ijolise ekuxhobiseni izigulane kunye neentsapho zabo ngolwazi olufunekayo ukuhamba ngolu hambo lunzima. Siza kuphonononga unyango ekujoliswe kulo, unyango lwe-immunotherapy, kunye nezinye iindlela ezisetyenziswayo ngoku ekulawuleni umhlaza wemiphunga oqhutywa kukungaqhelekanga ngokwemfuza.

Uvavanyo lwemfuzo kuMhlaza weMiphunga

Ukubaluleka kweProfayili yeMolekyuli

Ngaphambi kokuqala unyango lwemfuzo unyango umhlaza wemiphunga, uvavanyo lwemfuza lubalulekile. Le nkqubo, edla ngokubizwa ngokuba yiprofayili yemolekyuli okanye uvavanyo lwebhayiloji, ichonga utshintsho oluthile lwemfuzo ngaphakathi kweeseli zethumba. Olu tshintsho lunokuthi lube nefuthe kwizigqibo zonyango kwaye luqikelele ukuba kunokwenzeka ukuphendulwa konyango. Ufuzo oluqhelekileyo oluvavanyiweyo lubandakanya i-EGFR, ALK, ROS1, BRAF, kunye ne-KRAS. Ukwazi utshintsho oluthile lwemfuza luvumela ii-oncologists ukuba zilungelelanise unyango kumhlaza wesigulana ngasinye. Iziphumo zovavanyo lwemfuzo zibalulekile ekumiseleni eyona ndlela ilungileyo yokwenza.

Iintlobo zovavanyo lwemfuzo

Zininzi iindlela ezikhoyo zovavanyo lwemfuza, nganye ineengenelo zayo kunye nokungalunganga. Ezi zibandakanya ukulandelelana kwesizukulwana esilandelayo (NGS), evumela ukuvavanywa kwangaxeshanye kwiimfuza ezininzi, kunye ne-polymerase chain reaction (PCR), indlela ejoliswe ngakumbi ejolise kuhlobo oluthile. Ukukhethwa kwendlela kuxhomekeke kwizinto ezifana nezibonelelo ezikhoyo kunye nemibuzo ethile yeklinikhi eshukuxwayo. I-oncologist yakho iya kukukhokela kolona khetho lubalaseleyo lovavanyo olusekwe kwimeko yakho.

Utshintsho lwemfuza oluqhelekileyo kuMhlaza weMiphunga kunye noNyango lwazo

Utshintsho lwe-EGFR

Ukuguqulwa kwe-EGFR kuxhaphake kumhlaza wemiphunga yeseli engeyiyo encinci (NSCLC), ngakumbi kwizigulana ezingazange zitshaye okanye zinembali yokutshaya kancinci. Iindlela zonyango ezijoliswe kuzo, ezifana ne-EGFR tyrosine kinase inhibitors (TKIs), zisebenza kakhulu kwizigulane ezinolu tshintsho. Ezi inhibitors zivimba umsebenzi weprotheyini ye-EGFR eguqukileyo, ithintela ukukhula kwethumba. Imizekelo ibandakanya i-gefitinib, i-erlotinib, kunye ne-afatinib. Nangona kunjalo, ukuxhathisa kula machiza kunokuvela ekuhambeni kwexesha.

ALK Rearrangements

Uhlengahlengiso lwe-ALK lolunye utshintsho olubalulekileyo lomqhubi kwi-NSCLC. Ngokufana neenguqu ze-EGFR, ukulungiswa kwakhona kwe-ALK kudla ngokujoliswa kwii-TKI ezithile. I-Criztinib kunye ne-alectinib yimizekelo ye-ALK inhibitors ebonise ukuba iyasebenza ekunyangeni izigulane ezinomdlavuza we-ALK-positive lung. Ukubeka iliso rhoqo kubalulekile ukuchonga nokulawula nakuphi na ukuxhathisa okunokuvela.

ROS1 Uhlengahlengiso

Ukulungiswa kwakhona kwe-ROS1 kuncinci kune-EGFR okanye i-ALK yokulungiswa kwakhona, kodwa babelana ngeendlela zonyango ezifanayo. Izigulane ezinomdlavuza wamaphaphu we-ROS1 zinokuzuza kwiindlela zonyango ezijoliswe kuzo, ezifana ne-crizotinib, i-lorlatinib, kunye ne-entrectinib. Ezi zonyango zibonise impumelelo ekwandiseni ixesha elide kunye nokuphucula umgangatho wobomi kwizigulane ezinolu tshintsho.

Ezinye Iinguqu

Uninzi lolunye utshintsho lwemfuzo lunokuba negalelo kuphuhliso lomhlaza wemiphunga, kubandakanya iBRAF, KRAS, kunye noguquko lweHER2. Ngelixa unyango olujoliswe kuyo lukhona kwezinye zezi nguquko, indawo yonyango ihlala iguquka, kunye nophando oluqhubekayo oluhlola iindlela ezintsha neziphuculweyo. Iziko loPhando ngoMhlaza laseShandong Baofa (https://www.baofahospital.com/) uphambili kolu phando, ehlala ephonononga iindlela ezintsha zonyango zomhlaza wemiphunga.

Amaqhinga Onyango NgaPhaya koNyango oluJolisiweyo

Immunotherapy

I-Immunotherapy ibamba amandla okhuselo lwesigulana ukulwa nomhlaza. I-Checkpoint inhibitors, njenge-pembrolizumab kunye ne-nivolumab, isetyenziswa kwi unyango lwemfuzo unyango umhlaza wemiphunga, ngamanye amaxesha ngokudibanisa nonyango olujoliswe kuyo okanye ichemotherapy. La machiza avala iindawo zokujonga amajoni omzimba, evumela amajoni omzimba ukuba abone ngcono kwaye ahlasele iiseli zomhlaza. I-Immunotherapy inokusebenza nakwiimeko apho unyango olujoliswe kuyo lunokuthi lungasebenzi.

Unyango ngamachiza

I-Chemotherapy ihlala iyinto ebalulekileyo yonyango lomhlaza wemiphunga, ngakumbi kwiimeko apho unyango olujoliswe kuyo okanye i-immunotherapy ayifanelekanga. Nangona kunjalo, ichemotherapy ayijoliswanga kangako kunonyango olutsha, kwaye inokuba neziphumo ezibi kakhulu.

Unyango ngemitha

Unyango lwemitha lunokusetyenziswa ukujolisa nokutshabalalisa iiseli zomhlaza. Ihlala isetyenziselwa ukunciphisa amathumba, ukunciphisa iintlungu, okanye ukunciphisa ezinye iimpawu. Isenokusetyenziswa yodwa okanye kudityaniswe nolunye unyango.

Ukujonga kuhambo loNyango

Uhlobo loNyango	Iingenelo	Iingxaki
Unyango ekujoliswe kulo	Ukusebenza okuphezulu kwiinguqu ezithile, imiphumo embalwa yecala kune-chemotherapy.	Ukuchasa kunokuphuhla, akusebenzi kuzo zonke iinguqu.
Immunotherapy	Iimpendulo ezihlala ixesha elide, zinokusebenza nangona zichasene nolunye unyango.	Okunokwenzeka kwiziganeko ezimbi ezinxulumene nomzimba.
Unyango ngamachiza	Isebenza kwiintlobo ezininzi zomhlaza, ezifumaneka ngokubanzi.	Imiphumo emibi ngakumbi kunonyango olujoliswe kuyo okanye i-immunotherapy, unyango olujoliswe ngaphantsi.

Ukukhetha okulungileyo unyango lwemfuzo unyango umhlaza wemiphunga yinkqubo entsonkothileyo efuna intsebenziswano esondeleyo phakathi kwesigulana, i-oncologist yabo, kunye nezinye iingcali zempilo. Kubalulekile ukubuza imibuzo, ukuqonda iindlela zonyango onokukhetha kuzo, kwaye uthathe inxaxheba ngokubonakalayo ekwenziweni kwezigqibo. Khumbula, inkqubela phambili yophando ihlala isulungekisa iindlela zonyango zomhlaza wemiphunga. Hlala unolwazi, kwaye ungathandabuzi ukufuna inkxaso kumaqela axhasa izigulane kunye nothungelwano lwenkxaso.I-Disclaimer: Le ngcaciso yenzelwe iinjongo zemfundo kuphela kwaye akufanele ithathwe njengengcebiso yezonyango. Soloko udibana nengcali yezempilo kuyo nayiphi na inkxalabo yezempilo okanye ngaphambi kokuba wenze naziphi na izigqibo ezinxulumene nempilo okanye unyango lwakho.