ukwelashwa okusha komdlavuza wamaphaphu

Intuthuko yakamuva ku ukwelashwa okusha komdlavuza wamaphaphu zinikeza amazinga okusinda athuthukisiwe kanye nezinga lempilo leziguli. Lokhu kuhlanganisa izindlela zokwelapha ezihlosiwe, ama-immunotherapies, namasu okuhlinza athuthukile. Ukuqonda lezi zinketho kunganika iziguli amandla nemindeni yazo ukuthi zenze izinqumo ezinolwazi kanye nabahlinzeki bazo bezempilo. Lesi sihloko sinikeza umbono wentuthuko yakamuva nezindlela zokwelapha ezitholakalayo.Ukuqonda Umdlavuza Wamaphaphu kanye Nesidingo Sokwelashwa Okusha Umdlavuza wamaphaphu usalokhu uyinselele yezempilo enkulu emhlabeni wonke. Kubalulekile ukuqonda izinhlobo ezahlukene zomdlavuza wamaphaphu kanye nezici ezinomthelela ekukhuleni kwawo. Ukwelashwa kwendabuko okufana nokwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe kunemikhawulo, okugcizelela isidingo esiphuthumayo salokho ukwelashwa okusha komdlavuza wamaphaphu amasu.Izinhlobo Zomdlavuza WamaphaphuIzinhlobo ezimbili eziyinhloko yilezi: Umdlavuza Ongewona Owomncane Weseli Wamaphaphu (NSCLC): Lolu wuhlobo oluvame kakhulu, olubalelwa ku-80-85% amacala omdlavuza wamaphaphu. Izinhlobo ezincane zihlanganisa i-adenocarcinoma, i-squamous cell carcinoma, kanye ne-cell carcinoma enkulu. Umdlavuza Wengqamuzana Encane (SCLC): Lolu hlobo aluvamile futhi luvame ukukhula futhi lusakazeke ngokushesha kune-NSCLC.Ukwephulwa Kokwelashwa Okuhlosiwe Komdlavuza WamaphaphuUkwelashwa okuhlosiwe kuyi- ukwelashwa okusha komdlavuza wamaphaphu egxile kuma-molecule athile ahilelekile ekukhuleni kwamangqamuzana omdlavuza nasekuphileni kwawo. Ngokungafani ne-chemotherapy, ehlasela wonke amangqamuzana ahlukana ngokushesha, izindlela zokwelapha ezihlosiwe zihlose ukubulala amangqamuzana omdlavuza ngenkathi zisindisa anempilo. Lokhu kuvame ukuholela emiphumeleni engemihle embalwa.Izindlela Zokwelapha Eziqondiwe Ezivamile kanye Nezinjongo ZazoIzindlela zokwelapha ezimbalwa eziqondiwe manje sezigunyazwe ukusetshenziswa ezinhlotsheni ezithile ze-NSCLC. Lezi zindlela zokwelapha zivame ukukhomba ukuguqulwa kofuzo njenge-EGFR, ALK, ROS1, BRAF, MET, kanye ne-NTRK. Isibonelo Esiqondiwe Somuthi othize we-NSCLC Uhlobo lwe-EGFR Osimertinib (Tagrisso) NSCLC enezinguquko ze-EGFR ALK Alectinib (Alecensa) NSCLC enokuhlelwa kabusha kwe-ALK nge-ROS1 Entrectinib (Rozlytrek) NSCLC enokuhlelwa kabusha kwe-ROS1 Umthombo: I-American Cancer SocietyIqhaza Lokuhlola I-BiomarkerNgaphambi kokuqala ukwelashwa okuhlosiwe, ukuhlolwa kwe-biomarker kubalulekile. Lokhu kuhlola kuhilela ukuhlaziya isampula yesimila sesiguli ukuze kutholakale ukuguqulwa kofuzo okuthile noma ukungavamile kwamaprotheni. Imiphumela yokuhlolwa kwe-biomarker isiza odokotela ukuthi banqume ukuthi isiguli kungenzeka yini sizuze ekwelashweni okuqondiwe okuthile. I I-Shandong Baofa Cancer Research Institute igcizelela ukubaluleka kokuxilongwa okunembile ukuze kutholakale ukwelashwa okuphumelelayo.I-Immunotherapy: Ukubophela Amasosha omzimba Ukuze Alwe Nomdlavuza WamaphaphuImmunotherapy imelela enye intuthuko ebalulekile ukwelashwa okusha komdlavuza wamaphaphu. Le ndlela isebenza ngokushukumisa amasosha omzimba esiguli ukuba abone futhi ahlasele amangqamuzana omdlavuza. Izidakamizwa ze-Immunotherapy, njenge-checkpoint inhibitors, zivimba amaprotheni avimbela amasosha omzimba ukuthi ahlasele amangqamuzana omdlavuza.Izinhlobo Zezidakamizwa Ezivikela Umzimba Zomdlavuza WamaphaphuIzidakamizwa ezivamile zokuzivikela ezisetshenziswa ekwelapheni umdlavuza wamaphaphu zihlanganisa: I-PD-1 inhibitors: I-Pembrolizumab (Keytruda), i-Nivolumab (Opdivo) I-PD-L1 inhibitors: I-Atezolizumab (Tecentriq), i-Durvalumab (Imfinzi) I-CTLA-4 inhibitors: I-Ipilimumab (Yervoy) (evame ukusetshenziswa ngokuhlanganiswa ne-PD-1 inhibitor)Ubani Odinga I-Immunotherapy?Isinqumo sokusebenzisa i-immunotherapy sincike ezicini eziningana, okuhlanganisa uhlobo nesigaba somdlavuza wamaphaphu, impilo yesiguli iyonke, kanye nezinga lokubonakaliswa kwe-PD-L1 kumaseli wesimila. I-PD-L1 iphrotheni engasiza amangqamuzana omdlavuza ukuba agweme amasosha omzimba. Iziguli ezinenkulumo ephezulu ye-PD-L1 cishe zisabela ku-immunotherapy. Udokotela oncologist uzohlola ngokucophelela isiguli ngasinye ukuze athole ukuthi ukwelashwa komzimba kufanele yini.Izindlela Zokuhlinza Ezithuthukisiwe Ekwelashweni Komdlavuza WamaphaphuUkuhlinzwa kuseyingxenye ebalulekile ukwelashwa okusha komdlavuza wamaphaphu, ikakhulukazi ye-NSCLC yasekuqaleni. Ukuthuthuka kwezindlela zokuhlinza kuholele ekucushweni okuncane kanye nemiphumela ethuthukisiwe.Ukuhlinzwa Okungenasidingo KancaneIzindlela ezihlaselayo ezincane, njengokuhlinzwa kwe-thoracoscopic okusizwa ngevidiyo (i-VATS) nokuhlinzwa kwe-robotic, kuvumela odokotela abahlinzayo ukuthi basuse izimila ngokusebenzisa izimbotshana ezincane. Lezi zindlela zokwelapha zinikeza izinzuzo ezimbalwa kunokuhlinzwa okujwayelekile okujwayelekile, okuhlanganisa ubuhlungu obuncane, ukuhlala isikhathi esifushane esibhedlela, kanye nezikhathi zokululama ngokushesha.I-Stereotactic Body Radiotherapy (SBRT)Nakuba ingahlinzwa ngokuqinile, i-SBRT iwuhlobo olunembe kakhulu lokwelapha ngemisebe engasetshenziswa ukwelapha umdlavuza wamaphaphu osaqala ezigulini ezingafaneleki ukuba zihlinzwe. I-SBRT iletha imithamo ephezulu yemisebe esigangeni kuyilapho inciphisa ukuchayeka esicutshini esinempilo esizungezile.Ukuhlanganisa Ukwelashwa Kwemiphumela ElungileEzimweni eziningi, indlela ephumelela kakhulu ukwelashwa okusha komdlavuza wamaphaphu kuhilela ukuhlanganisa izindlela zokwelapha ezihlukahlukene. Isibonelo, iziguli zingathola ukwelashwa ngamakhemikhali okulandelwa ukuhlinzwa, noma ukwelashwa okuhlosiwe kuhlanganiswe ne-immunotherapy. Inhlanganisela ethize yokwelashwa izoncika esimweni sesiguli ngasinye.Ukubaluleka Kwezilingo Zomtholampilo Ukuhlolwa kwezokwelapha kudlala indima ebalulekile ekuthuthukisweni kwezifo. ukwelashwa okusha komdlavuza wamaphaphu amasu. Lezi zinhlolo zihlola ukuphepha nokusebenza kwemithi emisha nezindlela zokwelapha. Iziguli ezibamba iqhaza ezivivinyweni zomtholampilo zingase zibe nokufinyelela ekwelashweni okuphambili okungakatholakali kabanzi. Cabangela ukuxoxa ngezinketho zesilingo somtholampilo nodokotela wakho we-oncologist. Ulwazi mayelana nemizila yomtholampilo ehlobene nocwaningo lomdlavuza lungatholakala ku- I-Shandong Baofa Cancer Research Institute iwebhusayithi.Ukuphila Nomdlavuza Wamaphaphu: Ukusekela kanye NezinsizaUkuxilongwa komdlavuza wamaphaphu kungaba nzima kakhulu. Kubalulekile ukufuna ukwesekwa ochwepheshe bezokunakekelwa kwempilo, umndeni, abangani, namaqembu okusekela. Izinhlangano eziningi zinikeza izinsiza kanye nezinsizakalo ukusiza iziguli kanye nemindeni yazo ukubhekana nezinselele zokuphila nomdlavuza wamaphaphu.IsiphethoInqubekelaphambili enkulu yenziwe ukwelashwa okusha komdlavuza wamaphaphu eminyakeni yamuva. Izindlela zokwelapha ezihlosiwe, ama-immunotherapies, kanye namasu okuhlinza athuthukile kunikeza ithemba elisha ezigulini ezinomdlavuza wamaphaphu. Ngokuhlala unolwazi mayelana nentuthuko yakamuva nokusebenzisana eduze nethimba lazo lokunakekelwa kwezempilo, iziguli zingenza izinqumo ezinolwazi futhi zithuthukise amathuba azo okusinda kanye nezinga lempilo.