ukwelashwa komdlavuza wamaphaphu omkhulu

Umdlavuza wamaphaphu omkhulu (LCLC) iwuhlobo oluncane olunolaka lomdlavuza wamaphaphu ongewona omncane (NSCLC). Izinketho zokwelapha zihlukene futhi zincike esigabeni somdlavuza, impilo yonke, kanye nezinketho zesiguli. Izindlela ezijwayelekile zihlanganisa ukuhlinzwa, ukwelashwa ngemisebe, i-chemotherapy, ukwelashwa okuhlosiwe, kanye ne-immunotherapy. Ukuhlanganisa imithi yokwelapha kuvame ukuveza imiphumela engcono kakhulu.Ukuqonda Umdlavuza Wengqamuzana ElikhuluUyini Umdlavuza Weseli Elikhulu Wamaphaphu?Umdlavuza wamaphaphu omkhulu (LCLC) ibonakala ngamaseli amakhulu, angajwayelekile uma ibukwa ngesibonakhulu. Ibalelwa cishe ku-5-10% wawo wonke umdlavuza wamaphaphu. Ngenxa yemvelo yayo enolaka, ukutholakala kusenesikhathi nokwelashwa kubalulekile. Iwuhlobo oluncane lwe-NSCLC, okusho ukuthi iziphatha ngendlela ehlukile futhi yelashwa ngendlela ehlukile kunomdlavuza wamaphaphu wamangqamuzana amancane (SCLC).Izinhlobo Zomdlavuza Weseli Elikhulu LamaphaphuNgenkathi zihlukaniswa kabanzi njenge I-LCLC, ukuthayipha okwengeziwe kungenziwa ukuze kuqondiswe kangcono amasu okwelapha. Lokhu kubandakanya: I-Large cell neuroendocrine carcinoma (LCNEC): Le subtype yabelana ngezici nazo zombili umdlavuza wamaphaphu omkhulu kanye nomdlavuza wamaphaphu amancane. I-basaloid carcinoma: I-subtype engavamile futhi enolaka. I-Lymphoepithelioma-like carcinoma: Kuvame kakhulu kubantu bozalo lwase-Asia futhi kuvame ukuhlotshaniswa nokutheleleka ngegciwane le-Epstein-Barr. Sula i-cell carcinoma: Ibonakala ngamaseli anokubukeka okucacile noma okungenalutho ngaphansi kwesibonakhulu.Ukuxilongwa Komdlavuza Weseli Elikhulu WamaphaphuUkuxilonga umdlavuza wamaphaphu omkhulu ngokuvamile kubandakanya inhlanganisela yokuhlolwa kwezithombe nama-biopsies. Ukuhlolwa Kwezithombe: I-X-ray yesifuba: Imvamisa ukuhlolwa kokuqala kwesithombe kwenziwa ukuze kutholwe ukungahambi kahle emaphashini. I-CT Scan (i-Computed Tomography): Inikeza izithombe ezinemininingwane eminingi yamaphaphu nezakhiwo ezizungezile, okusiza ukunquma usayizi nendawo yesimila. I-PET Scan (i-Positron Emission Tomography): Ithola amangqamuzana asebenzayo e-metabolic, esiza ekuboneni izicubu ezinomdlavuza futhi inqume ukuthi umdlavuza usabalele yini. I-MRI (i-Magnetic Resonance Imaging): Ingase isetshenziselwe ukuhlola ukusabalala komdlavuza ebuchosheni noma emgogodleni. I-Biopsy: Isampula lesicubu sithathwa ukuze sihlolwe ngaphansi kwesibonakhulu. Izindlela ze-Biopsy zihlanganisa: I-Bronchoscopy: Ishubhu elincanyana, eligobekayo elinekhamera lishutheka ngekhala noma ngomlomo emaphashini ukuze libone ngeso lengqondo futhi liqoqe amasampula ezicubu. I-Needle Biopsy: Inaliti ifakwa obondeni lwesifuba ukuze kuqoqwe isampula yethishu esimila. Lokhu kungaqondiswa yi-CT ukuze uthole ukunemba okwengeziwe. I-Biopsy Yokuhlinzwa: Kwezinye izimo, kungase kudingeke ukuhlinzwa ukuze kutholwe isampula yethishu eyanele. Izinketho Zokwelapha Umdlavuza Weseli ElikhuluOkungcono kakhulu ukwelashwa komdlavuza wamaphaphu omkhulu kuncike ezicini eziningana, okuhlanganisa isigaba somdlavuza, impilo yesiguli iyonke, nalokho esikuthandayo. Izinketho zokwelapha zingasetshenziswa zodwa noma zihlanganiswe.UkuhlinzwaUkuhlinzwa kuvame ukuba yindlela yokwelapha ekhethwayo uma kusenesikhathi umdlavuza wamaphaphu omkhulu lapho isimila sitholakala endaweni futhi singasuswa ngokuphelele. Izinketho zokuhlinzwa zihlanganisa: Ukususwa Kwe-Wedge: Ukususwa kwengxenye encane yephaphu emise okwentshinyela equkethe isimila. I-Segmentectomy: Ukususwa kwengxenye enkulu yephaphu kunokukhishwa koweji. I-Lobectomy: Ukususwa kwe-lobe yonke yephaphu. I-Pneumonectomy: Ukususwa kwephaphu lonke.Uzakwethu, I-Shandong Baofa Cancer Research Institute, kwe baofahospital.com, igxile ezindleleni ezintsha zokuhlinza zomdlavuza wamaphaphu.I-Radiation TherapyRadiation therapy isebenzisa imisebe enamandla amakhulu ukubulala amangqamuzana omdlavuza. Ingasetshenziswa njengendlela yokwelapha eyinhloko umdlavuza wamaphaphu omkhulu lapho ukuhlinzwa kungeyona inketho, noma kungasetshenziswa ngemva kokuhlinzwa ukubulala noma imaphi amangqamuzana omdlavuza asele. Izinhlobo zokwelashwa ngemisebe zihlanganisa: I-Beam Radiation Therapy yangaphandle (EBRT): Imisebe ihanjiswa emshinini ongaphandle komzimba. I-Stereotactic Body Radiation Therapy (SBRT): Iletha imithamo ephezulu yemisebe endaweni encane, eqondiswe kahle. I-Brachytherapy (I-Internal Radiation Therapy): Imbewu ekhipha imisebe noma izintambo zifakwa ngqo phakathi noma eduze kwalesi simila.I-ChemotherapyI-Chemotherapy isebenzisa imithi ukuze ibulale amangqamuzana omdlavuza. Ivame ukusetshenziselwa umdlavuza wamaphaphu omkhulu esesabalale ngale kwephaphu noma lapho ukuhlinzwa kungenzeki. Imithi yokwelapha ngamakhemikhali ivamise ukulawulwa ngomthambo (ngokusebenzisa umthambo) noma ngomlomo.Imithi yokwelapha ehlosiwe iqondise kuma-molecule athile ahilelekile ekukhuleni nasekuphileni kwamaseli omdlavuza. Le mithi iphumelela kakhulu lapho amangqamuzana omdlavuza anezinguquko ezithile zofuzo. Okuhlosiwe okujwayelekile kuhlanganisa: I-EGFR (I-Epidermal Growth Factor Receptor): Ukuguqulwa kwezinguquko ku-EGFR kuvame kakhulu kubantu abathile. I-ALK (Anaplastic Lymphoma Kinase): I-ALK inhibitors ingasebenza kahle kakhulu ezigulini ezine-ALK-positive umdlavuza wamaphaphu omkhulu. I-ROS1: I-ROS1 inhibitor isetshenziselwa izimila ezine-ROS1. Ukuhlolwa kwalokhu kuguqulwa kubalulekile ukuze kutholakale ukuthi ingabe ukwelashwa okuhlosiwe kufanelekile. ukwelashwa komdlavuza wamaphaphu omkhulu.ImmunotherapyImmunotherapy isiza amasosha omzimba ukulwa nomdlavuza. Le mithi isebenza ngokuvimbela amaprotheni avimbela amasosha omzimba ekuhlaseleni amangqamuzana omdlavuza. Izidakamizwa ze-Immunotherapy zivame ukusetshenziselwa i-Advanced umdlavuza wamaphaphu omkhulu.Ukwelashwa ngeSitejiIsiteji se umdlavuza wamaphaphu omkhulu ithonya kakhulu indlela yokwelapha. Ukwelashwa Okujwayelekile Kwesigaba Kusondela Isigaba I & II (Isigaba Sokuqala) Ukuhlinzwa (i-lobectomy noma i-wedge resection) okulandelwa ukwelapha ngamakhemikhali uma kunesidingo. Ukwelashwa ngemisebe kungase kucatshangelwe uma ukuhlinzwa kungeyona inketho. Isigaba III (Esithuthukisiwe Endaweni) Inhlanganisela yokwelapha ngamakhemikhali kanye nokwelashwa ngemisebe. Ukuhlinzwa kungase kucatshangelwe ezimweni ezikhethiwe. I-Immunotherapy ingasetshenziswa ngemuva kwe-chemoradiation. I-Stage IV (Metastatic) Chemotherapy, ukwelashwa okuhlosiwe (uma kukhona izinguquko ezifanele), kanye ne-immunotherapy. Ukwelashwa ngemisebe kungase kusetshenziswe ukuze kudambise izimpawu. I-Clinical TrialsIzinhlolo zocwaningo ziyizifundo zocwaningo ezihlola ezintsha ukwelashwa komdlavuza wamaphaphu omkhulu ongakhetha kukho. Ukubamba iqhaza esivivinyweni somtholampilo kungase kunikeze ukufinyelela kumakhambi asezingeni eliphezulu futhi kube nomthelela entuthukweni yokwelashwa komdlavuza.Isibikezelo umdlavuza wamaphaphu omkhulu kuyahlukahluka kuye ngesigaba somdlavuza ekuxilongweni nasekuphathweni okutholiwe. Ukutholwa kusenesikhathi kanye nokwelashwa okunolaka kungathuthukisa imiphumela. Ukuqokwa kokulandelela njalo kubalulekile ukuze kuqashwe ukuphindeka.Ukuphila Nomdlavuza Wamaphaphu Weseli ElikhuluA umdlavuza wamaphaphu omkhulu ukuxilongwa kungaba nzima. Amaqembu okusekela, ukwelulekwa, nokuguqulwa kwendlela yokuphila (njengokuyeka ukubhema nokugcina ukudla okunempilo) kungasiza iziguli zibhekane nezinselele ezingokomzimba nezingokomzwelo zalesi sifo.Umshwana wokuzihlangula: Lolu lwazi ololwazi olujwayelekile kanye nezinjongo zolwazi kuphela, futhi aluhlanganisi iseluleko sezokwelapha. Kubalulekile ukubonisana nochwepheshe bezempilo abaqeqeshiwe nganoma yikuphi ukukhathazeka ngezempilo noma ngaphambi kokwenza noma yiziphi izinqumo ezihlobene nempilo noma ukwelashwa kwakho. Izinketho zokwelashwa kufanele zinqunywe uchwepheshe wezokunakekelwa kwempilo ngokusekelwe ezintweni zesiguli ngasinye.Izithenjwa: I-American Cancer Society: https://www.cancer.org/ I-National Cancer Institute: https://www.cancer.gov/