ukwelashwa komdlavuza wamaphaphu

Ukwelashwa komdlavuza wamaphaphu ihlanganisa izindlela eziningi, okuhlanganisa ukuhlinzwa, ichemotherapy, ukwelashwa ngemisebe, ukwelashwa okuhlosiwe, kanye ne-immunotherapy. Uhlelo lokwelapha olungcono kakhulu luncike ezicini ezifana nesigaba somdlavuza, impilo yesiguli iyonke, kanye nalokho umuntu akuthandayo. Lo mhlahlandlela uhlola lezi zinketho zokwelapha ngokuningiliziwe, unikeza ulwazi lokusiza iziguli nemindeni yazo ukuthi zihambe kulolu hambo oluyinkimbinkimbi.Ukuqonda Umdlavuza WamaphaphuUmdlavuza wamaphaphu yisifo lapho amangqamuzana ephaphu ekhula angalawuleki. Kunezinhlobo ezimbili eziyinhloko: iseli engeyona encane umdlavuza wamaphaphu (NSCLC) kanye neseli elincane umdlavuza wamaphaphu (SCLC). I-NSCLC ivame kakhulu futhi ihlanganisa izinhlobo ezincane ezifana ne-adenocarcinoma, i-squamous cell carcinoma, ne-cell carcinoma enkulu. I-SCLC ayijwayelekile kangako kodwa ijwayele ukukhula futhi isakazeke ngokushesha. Ukutholwa kusenesikhathi nokuxilongwa okunembile kubalulekile ukuze kuphumelele ukwelashwa komdlavuza wamaphaphu. I-Shandong Baofa Cancer Research Institute izinikele ekuthuthukiseni ucwaningo lomdlavuza kanye nezinketho zokwelapha.Izinketho Zokwelashwa Zomdlavuza WamaphaphuIzinketho zokwelashwa eziningi ziyatholakala umdlavuza wamaphaphu. Uhlelo oluthile lokwelapha luzofanelana nesiguli ngasinye kanye nezici zomdlavuza waso.UkuhlinzwaUkuhlinzwa kuvame ukuba inketho yokwelapha eyinhloko ye-NSCLC yesigaba sokuqala. Kubandakanya ukukhipha isimila kanye nama-lymph nodes aseduze. Izinhlobo ezahlukene zokuhlinzwa zihlanganisa: Ukususwa Kwe-Wedge: Ukususwa kwesiqephu sephaphu esincane, esimise okwe-wedge. I-Segmentectomy: Ukususwa kwengxenye enkulu yephaphu kunokukhishwa koweji. I-Lobectomy: Ukususwa kwe-lobe yonke yephaphu. I-Pneumonectomy: Ukususwa kwephaphu lonke.Ukufaneleka kokuhlinzwa kuncike kusayizi wesimila nendawo, kanye nempilo yesiguli iyonke. I-Baofa Cancer Research Institute inodokotela abahlinzayo abanolwazi lwezindlela zakamuva zokuhlinza.I-ChemotherapyI-Chemotherapy isebenzisa izidakamizwa ukubulala amangqamuzana omdlavuza. Ivamise ukusetshenziselwa kokubili i-NSCLC ne-SCLC, futhi inganikezwa ngaphambi kokuhlinzwa (i-neoadjuvant chemotherapy), ngemva kokuhlinzwa (i-adjuvant chemotherapy), noma njengokwelashwa okuyinhloko komdlavuza wesigaba esithuthukile. Imithi ejwayelekile ye-chemotherapy ye umdlavuza wamaphaphu zihlanganisa i-cisplatin, i-carboplatin, i-paclitaxel, i-docetaxel, ne-etoposide.I-Radiation TherapyRadiation therapy isebenzisa imisebe yamandla amakhulu ukubulala amangqamuzana omdlavuza. Ingalethwa ngaphandle (i-external beam radiation therapy) noma ngaphakathi (brachytherapy). Ukwelashwa ngemisebe kungasetshenziswa yodwa noma kuhlanganiswe nezinye izindlela zokwelapha ezifana ne-chemotherapy. 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 eqhumeni elincane, elichazwe kahle. I-Brachytherapy: Imbewu ekhipha imisebe noma izintambo zifakwa ngqo phakathi noma eduze kwesimila.Imithi yokwelapha ehlosiwe iqondise kuma-molecule athile (njengamaprotheni noma izakhi zofuzo) abandakanyeka ekukhuleni nasekusakazekeni kwamangqamuzana omdlavuza. Le mithi ivame ukusebenza kangcono kune-chemotherapy futhi inemiphumela emibi embalwa. Izindlela zokwelapha ezihlosiwe zisetshenziselwa ikakhulukazi i-NSCLC. Izibonelo zifaka: I-EGFR inhibitors: Okufana ne-gefitinib, i-erlotinib, i-afatinib, ne-osimertinib, esetshenziselwa umdlavuza onokuguquka kwe-EGFR. I-ALK inhibitors: Okufana ne-crizotinib, i-alectinib, i-ceritinib, i-brigatinib, ne-lorlatinib, esetshenziselwa umdlavuza ngokuhlelwa kabusha kwe-ALK. I-BRAF inhibitors: Njenge-dabrafenib ne-trametinib, esetshenziselwa umdlavuza onokuguquka kwe-BRAF. I-RET inhibitors: Okufana ne-selpercatinib ne-pralsetinib yomdlavuza ane-RET fusions.I-ImmunotherapyImmunotherapy isiza amasosha omzimba ukulwa nomdlavuza. Le mithi isebenza ngokuvimbela amaprotheni avimbela amasosha omzimba ekuhlaseleni amangqamuzana omdlavuza. Izidakamizwa ze-Immunotherapy zisetshenziselwa kokubili i-NSCLC ne-SCLC. Izibonelo zifaka: I-PD-1 inhibitors: Okufana ne-pembrolizumab, nivolumab, ne-cemiplimab. I-PD-L1 inhibitors: Njenge-atezolizumab, i-durvalumab, ne-avelumab. I-CTLA-4 inhibitors: Okufana ne-ipilimumab. Ukusetshenziswa kwe-immunotherapy ku ukwelashwa komdlavuza wamaphaphu ithuthukise kakhulu amazinga okusinda ezigulini eziningi. Ngokusho kwe I-American Cancer Society, i-immunotherapy ibonisa isithembiso ezigabeni ezihlukahlukene ze umdlavuza wamaphaphu. Izigaba zomdlavuza wamaphaphu kanye nokwelashwaIsigaba se umdlavuza wamaphaphu kuyisici esibalulekile ekunqumeni indlela yokwelapha engcono kakhulu.Isigaba 1 Umdlavuza WamaphaphuKulesi sigaba sokuqala, umdlavuza utholakala endaweni ethile emaphashini. Ukwelashwa ngokuvamile kuhilela ukuhlinzwa ukuze kukhishwe isimila. Ukwelashwa ngemisebe noma ukwelapha ngamakhemikhali kungase kusetshenziswe njenge-adjuvant therapy ukuze kubulawe noma imaphi amaseli omdlavuza asele.Isigaba sesi-2 nesesi-3 Umdlavuza WamaphaphuUmdlavuza ususabalele kuma-lymph node aseduze. Ukwelashwa ngokuvamile kuhilela inhlanganisela yokuhlinzwa, ukwelashwa ngamakhemikhali, kanye nokwelapha ngemisebe.Isigaba 4 Umdlavuza WamaphaphuUmdlavuza ususabalele ezithweni ezikude. Ukwelashwa kuhlose ukulawula ukukhula nokusabalala komdlavuza kanye nokuqeda izimpawu. Izinketho zifaka ukwelapha ngamakhemikhali, ukwelapha okuhlosiwe, i-immunotherapy, kanye nokwelashwa ngemisebe.Ukwelashwa komdlavuza wamaphaphu kungabangela imiphumela emibi. Imiphumela ethile engathandeki incike ohlotsheni lokwelashwa kanye nesiguli ngasinye. Imiphumela emibi evamile ihlanganisa: Ukukhathala Isicanucanu nokuhlanza Ukuqothuka kwezinwele Ukulahlekelwa ukudla Izilonda emlonyeni Ukusabela kwesikhumba Abahlinzeki bezempilo bangasiza ekulawuleni le miphumela engemihle ngemithi nezinye izinyathelo zokunakekela ezisekelayo. Iqembu ku I-Shandong Baofa Cancer Research Institute inikeza ukwesekwa okuphelele ezigulini kulo lonke uhambo lwazo lokwelashwa.Isivivinyo Semitholampilo Izivivinyo zezokwelapha izifundo zocwaningo ezivivinya ezintsha. ukwelashwa komdlavuza wamaphaphu izindlela. Ukubamba iqhaza ocwaningweni lomtholampilo kungase kunikeze iziguli ukufinyelela ekwelashweni kwesimanje okungakatholakali kabanzi. Iziguli zingaxoxa ngezinketho zesilingo somtholampilo nabahlinzeki bazo bezempilo.Amazinga Okusinda kanye NesibikezeloAmazinga okusinda umdlavuza wamaphaphu ziye zaba ngcono eminyakeni yamuva ngenxa yentuthuko yokwelapha. Kodwa-ke, ukubikezelwa kuyahlukahluka kuye ngokuthi umdlavuza utholakala kanjani, uhlobo lomdlavuza, kanye nempilo yesiguli iyonke. Ukutholwa kusenesikhathi nokwelashwa kubalulekile ukuze kuthuthukiswe amazinga okusinda. Izinga lokusinda leminyaka emihlanu lazo zonke izigaba ze umdlavuza wamaphaphu cishe ama-25%, ngokusho kwe- I-American Cancer Society. Intuthuko Entsha Ekwelapheni Umdlavuza WamaphaphuUmkhakha we ukwelashwa komdlavuza wamaphaphu ilokhu ivela njalo. Ukwelashwa okusha nobuchwepheshe kuthuthukiswa ngaso sonke isikhathi. Ezinye izindawo ezithembisayo zocwaningo zihlanganisa: I-Liquid biopsy: Ukuhlolwa kwegazi okungathola amaseli omdlavuza noma izingcezu ze-DNA. Umuthi womuntu siqu: Ukuhlanganisa ukwelashwa kwesiguli ngasinye ngokusekelwe ezicini zomdlavuza waso. Imithi emisha ye-immunotherapy: Ukuthuthukisa imithi emisha engakhuphula amandla amasosha omzimba okulwa nomdlavuza.Ukwenza Izinqumo EzinolwaziUkuzulazula ukwelashwa komdlavuza wamaphaphu kungaba inselele. Iziguli kanye nemindeni yazo kufanele basebenzisane eduze nabahlinzeki bazo bezempilo ukuze benze izinqumo ezinolwazi mayelana nokunakekelwa kwazo. Kubalulekile ukubuza imibuzo, ukuveza ukukhathazeka, nokuqonda zonke izindlela zokwelapha ezitholakalayo. Cabangela ukufuna umbono wesibili komunye uchwepheshe. Ulwazi lungamandla uma ubhekene umdlavuza wamaphaphu. Ithebula: Ukuqhathaniswa Kwezindlela Zokwelapha Ezivamile Zomdlavuza Wamaphaphu Ukwelapha Indlela Yokwelapha Okuvamile Imiphumela Eseceleni Efanelekayo Izigaba Zokuhlinzwa Ukususwa ngokomzimba kwezicubu ezinomdlavuza Ubuhlungu, ukutheleleka, ukopha Izigaba zakuqala (I-III) I-Chemotherapy Isebenzisa izidakamizwa ukubulala amangqamuzana ahlukana ngokushesha Isicanucanu, ukukhathala, ukuqothuka kwezinwele Zonke izigaba, ngokuvamile zihlangene ngokuhlangana kwe-Radiation Therapy, I-Radiation Cemotherapy ubunzima bokugwinya Umdlavuza wendawo, ukunakekelwa kwe-palliative Ukwelashwa Okuqondisiwe Kuqondiswe kuma-molecule athile abandakanyeka ekukhuleni komdlavuza Ukuqubuka kwesikhumba, isifo sohudo, izinkinga zesibindi Izigaba ezithuthukile ezinokuguqulwa okuthile I-Immunotherapy Iqinisa amasosha omzimba ukulwa nomdlavuza Ukukhathala, ukuqubuka kwesikhumba, ukuvuvukala Izigaba ezithuthukile, ezinye izigaba zokuqala