unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga

Umhlaza wemiphunga osemva kwexesha, ngelixa ucela umngeni, uveza uninzi unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga iinketho ezijolise ekwandiseni ubomi kunye nokuphucula umgangatho wobomi. Olu nyango lususela kunyango lwesintu olufana nechemotherapy kunye nemitha yemitha ukuya kwiindlela ekujoliswe kuzo ezinje ngonyango lwe-immunotherapy kunye nonyango olujoliswe kuyo, oluhlala lusetyenziswa ngokudibeneyo ukulwa esi sifo ngokufanelekileyo. Ukugqiba okulungileyo unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga Isicwangciso sifuna uhlolo olubanzi lweempawu ezithile zomhlaza kunye nempilo yesigulana iyonke.Ukuqonda Inqanaba Lamva Umhlaza Wemiphunga Ukuma komhlaza wemiphunga yinkqubo esetyenziswa ukuchaza ubungakanani bomhlaza emzimbeni. Umhlaza wemiphunga osemva kwexesha ubhekisa kwiSigaba sesi-III kunye neSigaba IV. Ukuqonda inqanaba lakho elithile kubalulekile ekuqinisekiseni elona lifanelekileyo unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga iqhinga.Inqanaba lesithathu loMhlaza weMiphungaInqanaba lesithathu lomhlaza wemiphunga lithetha ukuba umhlaza usasazeke kwiilymph nodes ezikufutshane, kodwa hayi kumalungu akude. Ngokuxhomekeke kubungakanani bokusasazeka ngaphakathi kwesifuba, kunokwenzeka ukuba kunokwenzeka ukususa umhlaza ngotyando, nangona oku kudla ngokudityaniswa nezinye. unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga Inqanaba IV Umhlaza WemiphungaInqanaba le-IV lomhlaza wemiphunga libonisa ukuba umhlaza wemiphunga ubonisa ukuba umhlaza unwenwele kumalungu akude, anjengobuchopho, amathambo, isibindi, okanye amadlala eadrenal. Ngelixa unyango lunqabile kweli nqanaba, unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga igxile ekulawuleni ukukhula komhlaza, ekudambiseni iimpawu, nasekuphuculeni umgangatho wobomi. NONE unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga iinketho ezikhoyo zokulawula ukusasazeka kunye nokuphucula imeko yesigulane. Iziko loPhando ngoMhlaza laseShandong Baofa (https://baofahospital.com) inikezelwe ekuqhubeleni phambili uphando lomhlaza kunye neendlela zonyango. Ngokwemveli Unyango lwenqanaba lasemva koNyango loMhlaza wemiphunga OptionsChemotherapyChemotherapy isebenzisa amayeza ukubulala iiseli zomhlaza kuwo wonke umzimba. Ihlala isetyenziswa njengomgca wokuqala unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga kumhlaza wemiphunga osemva kwexesha. Amachiza aqhelekileyo echemotherapy yomhlaza wemiphunga aquka amachiza asekwe kwiplatinam (i-cisplatin okanye i-carboplatin) edityaniswe nezinye ii-arhente ezifana ne-pemetrexed, i-gemcitabine, okanye i-docetaxel.Iziphumo ebezingalindelekanga: Iziphumo ebezingalindelekanga eziqhelekileyo zibandakanya isicaphucaphu, ukuhlanza, ukudinwa, ukulahleka kweenwele, kunye nomngcipheko wokosuleleka. Ezi ziphumo zecala zihlala zilawulwa ngamayeza axhasayo.Unyango lweRadiation TherapyRadiation isebenzisa imiqadi yamandla aphezulu ekujoliseni nasekubulaleni iiseli zomhlaza kwindawo ethile. Ingasetyenziselwa ukucutha amathumba, ukuthomalalisa iintlungu, okanye ukulawula ukusasazeka komhlaza ebuchotsheni okanye emathanjeni.Iziphumo ebezingalindelekanga: Imiphumo emibi ixhomekeke kwindawo ephathwayo kwaye inokubandakanya ukukhathala, ukucaphuka kwesikhumba, kunye nobunzima bokugwinya. Unyango lwemitha ye-stereotactic body radiation (SBRT) luhlobo oluchane ngakumbi lwemitha yemitha enikezela ngeedosi eziphezulu kwiiseshini ezimbalwa, ukunciphisa umonakalo kwiithishu ezingqongileyo. Unyango ekuJoliswe kulo Unyango lwenqanaba lasemva koNyango loMhlaza wemiphungaAmachiza onyango ekujoliswe kuwo ajolise ngokukodwa kwizinto ezingaqhelekanga kwiiseli zomhlaza ezivumela ukuba zikhule kwaye zisasazeke. Ezi zonyango zihlala zisebenza kunye nemiphumo emibi embalwa kune-chemotherapy yendabuko, kodwa zifuna uvavanyo oluthile lwemfuza ukuchonga ukuba iiseli zomhlaza zineenjongo ezifanelekileyo. Ezi zidla ngokuba kudidi lokuqala unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga ukhetho lwezigulane ezinolu tshintsho.Iziphumo ebezingalindelekanga: Iziphumo eziqhelekileyo ezichaphazelekayo ziquka i-rash, isifo sohudo, kunye nesikhumba esomileyo.ALK InhibitorsAnaplastic lymphoma kinase (ALK) inhibitors, ezifana ne-crizotinib, i-ceritinib, i-alectinib, i-brigatinib, kunye ne-lorlatinib, i-target ALK gene rearrangements, enye inguqu yomqhubi oqhelekileyo kwi-NSCLC.Iziphumo ebezingalindelekanga: Imiphumo emibi iyahluka ngokuxhomekeke kwiyeza elithile kodwa inokubandakanya utshintsho lombono, isicaphucaphu, ukudinwa, kunye neengxaki zesibindi. Iqela elizinikeleyo e-Shandong Baofa Cancer Research Institute lizibophelele ekuphuculeni iziphumo zesigulana.Olunye unyango oluJolisiweyoOlunye unyango olujoliswe kuyo lujolise kwiinguqulelo ezithile, ezifana neROS1, BRAF, MET, kunye neRET. Uvavanyo kolu tshintsho lubalulekile ukuchonga izigulane ezinokuxhamla kolu nyango.Immunotherapy for Unyango lwenqanaba lasemva koNyango loMhlaza wemiphungaI-Immunotherapy idibanisa amandla e-immune system yokulwa nomhlaza. La machiza anceda amajoni omzimba abone kwaye ahlasele iiseli zomhlaza. Immunotherapy iye yatshintsha indlela unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga ezininzi zomhlaza, kubandakanywa nomhlaza wemiphunga.PD-1/PD-L1 InhibitorsPD-1 kunye nePD-L1 inhibitors, ezifana ne-pembrolizumab, nivolumab, atezolizumab, kunye ne-durvalumab, vimba ukusebenzisana phakathi kwe-PD-1 (iprotheni kwiiseli zomzimba) kunye ne-PD-L1 (iprotheni kwiiseli zomhlaza). Olu thintelo lukhupha 'iziqhoboshi' kwisixokelelwano sokhuselo lomzimba, siluvumela ukuba luhlasele iiseli zomhlaza ngempumelelo ngakumbi. I-Pembrolizumab isoloko isetyenziswa njengomgca wokuqala unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga ukhetho kwizigulane ezine-PD-L1 yokubonisa.Iziphumo ebezingalindelekanga: Iziphumo ebezingalindelekanga zinokubandakanya ukudinwa, irhashalala, urhudo, ipneumonitis (ukudumba kwemiphunga), kunye neengxaki zedlala lengqula. Ezi ziphumo zecala zihlala zilawuleka kunye ne-corticosteroids okanye ezinye i-immunosuppressants.CTLA-4 InhibitorsCTLA-4 inhibitors, njenge-ipilimumab, isebenza ngeendlela ezahlukeneyo zokuvula amajoni omzimba. Ngamanye amaxesha zisetyenziswa ngokudibeneyo kunye ne-PD-1 inhibitors.Iziphumo ebezingalindelekanga: Iziphumo ebezingalindelekanga ziyafana nezo ze-PD-1 inhibitors kodwa zinokuba qatha ngakumbi.Uvavanyo lweClinical Ulingo lwezonyango lunika izigulane ukufikelela kwizinto ezintsha nezintsha. unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga iinketho ezingekafumaneki ngokubanzi. Ukuthatha inxaxheba kwiimvavanyo zeklinikhi kunokubonelela ngeenzuzo ezinokubakho kunye negalelo ekuqhubeleni phambili uphando lomhlaza. I-oncologist yakho inokukunceda ukuba ubone ukuba ngaba uvavanyo lweklinikhi luyinto efanelekileyo kuwe. Ukhathalelo lwePalliative CarePalliative lugxile ekudambiseni iimpawu kunye nokuphucula umgangatho wobomi kwizigulana ezinezigulo ezimandundu, ezinjengomhlaza wemiphunga osemva kwexesha. Inokubonelelwa kunye nezinye unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga kwaye kubandakanya ukulawula intlungu, ukuphefumula okufutshane, ukukhathala, kunye nezinye iimpawu. Ukhathalelo lwePalliative lukwajongana neemfuno zomphefumlo nezomoya zezigulane kunye neentsapho zazo. unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga ifuna indlela ebandakanya izinto ezininzi ezibandakanya iqela leengcaphephe, kubandakanywa iingcali zeoncologists zonyango, ii-oncologists ngemitha, i-pulmonologists, oogqirha botyando, iingcali ngemitha, kunye neengcali zokhathalelo lokuthomalalisa. Eli qela lisebenza kunye ukuphuhlisa umntu unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga isicwangciso esisekelwe kwiimfuno kunye neenjongo zesigulana ngasinye. IiNgqwalasela zendlela yokuphila Ukugcina indlela yokuphila esempilweni kunokudlala indima ebalulekileyo ekulawuleni umhlaza wemiphunga osemva kwexesha. Oku kuquka:Isondlo: Ukutya ukutya okunokulinganisela kunokunceda ukugcina amandla kunye namanqanaba amandla.Umthambo: Ukuzilolonga okuphakathi kunokuphucula isimo sengqondo, ukunciphisa ukudinwa, kunye nokuphucula impilo yonke.Ukuyeka Ukutshaya: Ukuyeka ukutshaya kubalulekile, nangona sele kusemva kwexesha, ukuphucula ukusebenza kwemiphunga kunye nokuphendula unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga.Inkxaso yoMvakalelo: Ukufuna inkxaso ngokweemvakalelo kusapho, izihlobo, amaqela enkxaso, okanye abanyangi kunokunceda ukumelana nemingeni yeemvakalelo yomhlaza wemiphunga. unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga iinketho ziyafumaneka ukwandisa ubomi kunye nokuphucula umgangatho wobomi. A eyenzelwe wena unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga isicwangciso, esiphuhliswe ngokubonisana neqela leengcaphephe eziphuma kwiinkalo ngeendidi, siyimfuneko ekwandiseni iziphumo. Uphando oluqhubekayo kunye nezinto ezintsha zikhokelela kunyango olutsha nolusebenzayo ngakumbi unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga yonke imihla. Iingcali ezizinikeleyo eShandong Baofa Cancer Research Institute ziphambili kulo mlo. Ukuthelekiswa koKuqhelekileyo Unyango lwenqanaba lasemva koNyango loMhlaza wemiphunga Iinketho Unyango lwenqanaba lasemva koNyango loMhlaza wemiphunga I-Mechanism I-Mechanism ye-Side Effects I-Chemotherapy Ibulala iiseli ezahlula ngokukhawuleza I-nausea, ukudinwa, ukulahleka kweNwele Unyango lwe-Radiation Therapy Ukulimala kwe-DNA yeeseli zomhlaza Ukukhathala, ukucaphuka kwe-Skin EGFR Inhibitors Blocks EGFR signaling Rash, Diarrhea PD-1 / PD-L1 Inhibitors Ikhupha i-immune system 'i-PD-L1 Inhibitors Ikhupha ulwazi lwe-immune' iinjongo zemfundo kuphela kwaye akufanele zithathwe njengengcebiso yezonyango. Soloko udibana nomboneleli wakho wezempilo ukuze uxilongwe kwaye unyango kwinqanaba emva kwexesha unyango umhlaza wemiphunga iinketho.