unyango amayeza amatsha kumhlaza wemiphunga isigaba 4

Inqanaba lesi-4 lomhlaza wemiphunga, nokwaziwa ngokuba ngumhlaza wemiphunga we-metastatic, lithetha ukuba umhlaza usasazeke kwamanye amalungu omzimba. Nangona ukuxilongwa kwesigaba sesi-4 somhlaza wemiphunga kunokuba nzima, kubalulekile ukwazi ukuba ukuqhubela phambili kuphando lwezonyango kuye kwakhokelela kwiindidi ezahlukeneyo. unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 iinketho ezinokunceda ukulawula isifo, ukuphucula umgangatho wobomi, kunye nokwandisa ukusinda. Ezi unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 zibandakanya unyango olujoliswe kuyo, i-immunotherapies, i-chemotherapy, unyango lwe-radiation, kunye nokunakekelwa kwenkxaso. Eyona ilungileyo unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 indlela yokufikelela kuxhomekeke kuhlobo oluthile lomhlaza wemiphunga, ukuguqulwa kofuzo, impilo jikelele, kunye nokukhethwa komntu ngamnye.Ukuqonda iNqanaba lesi-4 lomhlaza wemiphungaInqanaba lesi-4 lomhlaza wemiphunga libonisa ukuba esi sifo siye sasasazeka, oku kuthetha ukuba sisasazeke ngaphaya kwemiphunga siye kwezinye iindawo zomzimba. Iindawo eziqhelekileyo ze-metastasis ziquka ingqondo, amathambo, isibindi, kunye namadlala e-adrenal. Kubalulekile ukuchonga ngokuchanekileyo uhlobo lomhlaza wemiphunga (umhlaza wemiphunga ongeyonxalenye encinci yeseli okanye umhlaza wemiphunga omncinci weseli) kunye naluphi na utshintsho oluthile lwemfuza, njengoko olu lwazi luchaphazela kakhulu. unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 izigqibo.Iintlobo zoMhlaza wemiphungaZimbini iindidi eziphambili zomhlaza wemiphunga zezi: Umhlaza weMiphunga yeSeli engeNcinane (NSCLC): Olona hlobo luqhelekileyo, lubalelwa malunga ne-80-85% yeemeko zomhlaza wemiphunga. Iintlobo ezincinci ziquka i-adenocarcinoma, i-squamous cell carcinoma, kunye ne-cell carcinoma enkulu. Umhlaza weMiphunga yeSeli encinci (SCLC): Olona hlobo lundlongo-ndlongo lomhlaza wemiphunga othanda ukusasazeka ngokukhawuleza. Idla ngokunxulunyaniswa nokutshaya.Ukubaluleka kovavanyo lweGenetic TestingGenetic, ekwaziwa ngokuba luvavanyo lwe-biomarker, lubalulekile kwizigulane ezine-NSCLC. Ichonga utshintsho oluthile kwiiseli zomhlaza ezinokujoliswa ngokuthe ngqo unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. Iinguqu eziqhelekileyo ziquka i-EGFR, ALK, ROS1, BRAF, kunye nePD-L1. Ukuchonga olu tshintsho kuvula umnyango kunyango lomntu.Unyango Unyango olutsha loMhlaza weMiphunga inqanaba lesi-4 Iinketho ezininzi unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 ziyafumaneka kwinqanaba lesi-4 lomhlaza wemiphunga, zihlala zisetyenziswa xa kudityaniswa: Unyango ekujoliswe kulo Amachiza onyango ekujoliswe kuwo ajolise ngokukodwa kwiiseli zomhlaza ezinotshintsho oluthile lwemfuza, ukunciphisa umonakalo kwiiseli eziphilileyo. Olu nyango ludla ngokusetyenziswa ngomlomo. I-EGFR Inhibitors: Isetyenziselwa izigulane ze-NSCLC ezineenguqu ze-EGFR. Imizekelo ibandakanya i-erlotinib, i-gefitinib, i-afatinib, kunye ne-osimertinib. I-Osimertinib isoloko isetyenziswa njengomgca wokuqala unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. I-ALK Inhibitors: Isetyenziselwa izigulane ze-NSCLC ezine-ALK rearrangements. Imizekelo ibandakanya i-crizotinib, i-alectinib, i-ceritinib, i-brigatinib, kunye ne-lorlatinib. I-ROS1 Inhibitors: Isetyenziselwa izigulana ze-NSCLC ezine-ROS1 rearrangements. Imizekelo ibandakanya i-crizotinib kunye ne-entrectinib. I-BRAF Inhibitors: Isetyenziselwa izigulane ze-NSCLC ezineenguqu ze-BRAF V600E. Imizekelo ibandakanya i-dabrafenib kunye ne-trametinib (ehlala isetyenziswa xa idityanisiwe). Thetha nogqirha wakho ukujonga ezi unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 ilungiselelwe iprofayile yakho yemfuzo ethile. Unokufumana kwakhona ulwazi oluxabisekileyo kwizixhobo ezifana ne Iwebhusayithi ye-American Cancer Society.ImmunotherapyImmunotherapy amayeza anceda amajoni omzimba aqaphele kwaye ahlasele iiseli zomhlaza. Basebenza ngokuthintela iiproteni ezithintela amajoni omzimba ekuhlaseleni iiseli zomhlaza. PD-1/PD-L1 Inhibitors: La machiza avala indlela yePD-1/PD-L1, enceda iiseli zomhlaza ukuba zibaleke amajoni omzimba. Imizekelo ibandakanya i-pembrolizumab, i-nivolumab, i-atezolizumab, kunye ne-durvalumab. I-Pembrolizumab ngamanye amaxesha isetyenziswa njengomgca wokuqala unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 kwizigulane ezine-PD-L1 ibonakaliso ephezulu. I-CTLA-4 Inhibitors: La machiza avala iprotein ye-CTLA-4, ekwanceda ukulawula amajoni omzimba. Ipilimumab ngumzekelo. I-Immunotherapy ibonise isithembiso esibalulekileyo ekuphuculeni iziphumo kwezinye izigulane ezinenqanaba lesi-4 lomhlaza wemiphunga. Nceda ukhumbule ukuba iShandong Baofa Cancer Research Institute izibophelele ekuqhubeleni phambili uphando lomhlaza.IChemotherapy Amachiza onyango lweChemotherapy abulala iiseli zomhlaza kuwo wonke umzimba. Ihlala isetyenziswa ngokudibeneyo nezinye unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. I-Platinum-based Chemotherapy: Iirejimeni zechemotherapy ezisetyenziswa ngokuqhelekileyo ziquka i-cisplatin okanye i-carboplatin edibene namanye amachiza afana ne-pemetrexed, i-gemcitabine, okanye i-taxanes.Unyango lwe-Radiation TherapyRadiation therapy isebenzisa imitha ephezulu yamandla ukubulala iiseli zomhlaza. Ingasetyenziselwa ukunciphisa amathumba, ukukhulula iimpawu, kunye nokuphucula umgangatho wobomi. Unyango lweBeam yangaphandle: Ihambisa imitha kumatshini ongaphandle komzimba. Unyango lweRadiation Body Stereotactic (SBRT): Uhlobo oluchanekileyo lonyango ngemitha olunikezela ngeedosi eziphezulu zokusasazeka kwemitha kwindawo encinci. unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 ukhetho, kodwa kunokuqwalaselwa kwiimeko ezithile ukususa i-metastasis enye okanye ukunciphisa iimpawu.Ukhathalelo oluXhasayoUnonophelo oluxhasayo lugxile ekulawuleni iimpawu kunye neziphumo ebezingalindelekanga zomhlaza kunye neziphumo zayo. unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. Ibandakanya ulawulo lweentlungu, inkxaso yesondlo, kunye nenkxaso yengqondo.Izilingo zeClinicalIzilingo zeClinical zizifundo zophando ezivavanya amatsha. unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. Banikezela izigulane ukufikelela kwiindlela zonyango ezinokuthi zingafumaneki ngenye indlela. Cinga ngokuxoxa ngeendlela zolingo lwezonyango kunye nogqirha wakho. Ulwazi malunga nolingo lwezonyango lunokufumaneka iwebhusayithi yeZiko loMhlaza leSizwe.I-Prognosis kunye ne-Survival RatesI-prognosis yenqanaba lesi-4 lomhlaza wemiphunga iyahluka ngokuxhomekeke kwizinto ezininzi, kubandakanywa uhlobo lomhlaza wemiphunga, utshintsho lwemfuzo, impilo yonke, kunye nokuphendula unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. Amazinga okusinda aphuculwe kakhulu kwiminyaka yakutshanje ngenxa yenkqubela phambili unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. Kubalulekile ukuba nolindelo oluyinyani kunye nokugxila ekwandiseni umgangatho wobomi. Inqanaba le-5-Yeminyaka Yokusinda (NSCLC) Inqanaba lesi-4 Ngokumalunga ne-10% * Umthombo: I-American Cancer Society. La manani aluqikelelo kwaye anokwahluka.Ukuphucula uMgangatho woBomiUkuphila kunye nenqanaba lesi-4 lomhlaza wemiphunga kunokuba ngumngeni, kodwa zininzi izinto ezinokwenziwa ukuphucula umgangatho wobomi: Lawula iimpawu: Sebenza neqela lakho lezempilo ukulawula iintlungu, ukudinwa, ukuphefumla, kunye nezinye iimpawu. Gcina indlela yokuphila esempilweni: Yitya ukutya okusempilweni, wenze umthambo rhoqo, kwaye ulale ngokwaneleyo. Funa iNkxaso yeMvakalelo: Thetha nonyango, umcebisi, okanye iqela lenkxaso. Hlala uQhagamshelwe: Chitha ixesha nabantu obathandayo kwaye uthathe inxaxheba kwimisebenzi oyithandayo. Indima yeShandong Baofa Cancer Research InstituteIziko loPhando ngoMhlaza iShandong Baofa lizinikele ekuqhubeleni phambili uphando lomhlaza nokuphuhlisa unyango amayeza amatsha kumhlaza wemiphunga isigaba 4. Iqela lethu leengcali ze-oncologists kunye nabaphandi bazibophelele ekuboneleleni izigulane ngononophelo olungcono kakhulu. Sithatha inxaxheba ngokukhutheleyo kulingo lwezonyango kwaye sizame ukubonelela ngezinto ezintsha unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 IsipheloUkuphila nenqanaba lesi-4 lomhlaza wemiphunga kuzisa imingeni, kodwa mininzi unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 kunye nezicwangciso ezikhoyo zokulawula isifo, ukuphucula umgangatho wobomi, kunye nokwandisa ubomi obude. Ngokusebenzisana ngokusondeleyo neqela lakho lezempilo, ukuhlola unyango amayeza amatsha kumhlaza wemiphunga isigaba 4 iinketho, kunye nokubeka phambili impilo-ntle yakho iyonke, unokuhamba kolu hambo ngamandla amakhulu kunye nokomelela.