ukwelashwa okusha komdlavuza wamaphaphu isigaba 4

Isigaba 4 somdlavuza wamaphaphu, owaziwa nangokuthi umdlavuza wamaphaphu we-metastatic, uletha izinselelo ezinkulu. Kodwa-ke, ucwaningo oluqhubekayo nokuthuthuka kwezinketho zokwelapha kunikeza ithemba kanye nezinga lempilo elithuthukisiwe. Lesi sihloko sihlola okwakamuva ukwelashwa okusha komdlavuza wamaphaphu isigaba 4, ehlanganisa izindlela zokwelapha eziqondiwe, amasosha omzimba, izivivinyo zemitholampilo, kanye namasu okunakekela asekelayo.Ukuqonda Isigaba 4 Umdlavuza WamaphaphuSiyini Isigaba 4 Umdlavuza Wamaphaphu?Isigaba 4 umdlavuza wamaphaphu sisho ukuthi umdlavuza ususabalele (umetastasized) usuka ephashini uye kwezinye izingxenye zomzimba, njengobuchopho, amathambo, isibindi, noma izindlala ze-adrenal. Lesi sigaba sidinga indlela yokwelapha ebanzi yokulawula lesi sifo nezimpawu zaso. Ukuze uthole ulwazi olwengeziwe nokuthuthuka kocwaningo, vakashela I-Shandong Baofa Cancer Research Institute.Izimpawu EzivamileIzimpawu zesigaba sesi-4 somdlavuza wamaphaphu ziyahlukahluka kuye ngendawo lapho i-metastase itholakala khona, kodwa ingase ihlanganise: Ukukhwehlela okungapheli Ubuhlungu besifuba Ukuphelelwa umoya Ukuncipha kwesisindo Ubuhlungu bethambo Izinhlungu zekhanda noma ukuquleka. Ukwelashwa Okusha Komdlavuza Wamaphaphu Isigaba 4Imithi yokwelapha eqondisiweImithi yokwelapha eqondisiwe yizidakamizwa ezikhomba izakhi zofuzo ezithile, amaprotheni, noma indawo yethishu enomthelela ekukhuleni nasekuphileni komdlavuza. Lezi zindlela zokwelapha zenzelwe ukuhlasela ngokuqondile amangqamuzana omdlavuza, kuncishiswe umonakalo kumaseli avamile.Izibonelo zihlanganisa: I-EGFR Inhibitors: Isetshenziselwa umdlavuza wamaphaphu ngokuguqulwa kwe-EGFR. Izidakamizwa ezivamile zihlanganisa i-erlotinib, i-gefitinib, i-afatinib, ne-osimertinib. I-ALK Inhibitors: Isetshenziselwa umdlavuza wamaphaphu ngokuhlelwa kabusha kofuzo lwe-ALK. Izibonelo zifaka i-crizotinib, i-alectinib, i-ceritinib, ne-brigatinib. I-BRAF Inhibitors: I-Dabrafenib ne-trametinib zisetshenziselwa umdlavuza wamaphaphu ngokuguquguquka kwe-BRAF V600E. I-RET Inhibitors: I-Selpercatinib ne-pralsetinib zisetshenziselwa umdlavuza wamaphaphu nge-RET fusions.Ukukhethwa kokwelashwa okuhlosiwe kuncike ekuguquguqukeni kofuzo okuqondile okukhonjwe ku-tumor yesiguli ngokuhlolwa kwamangqamuzana. Ukwelashwa okusha komdlavuza wamaphaphu isigaba 4 ziyaqhubeka nokuvela ngocwaningo oluqhubekayo oluvela ezikhungweni ezifana ne-Shandong Baofa Cancer Research Institute.I-ImmunotherapyImmunotherapy ithuthukisa ukuzivikela kwemvelo komzimba ukulwa nomdlavuza. Isebenza ngokushukumisa amasosha omzimba ukuze abone futhi ahlasele amangqamuzana omdlavuza.Izinhlobo ezivamile ze-immunotherapy ezisetshenziselwa isigaba sesi-4 somdlavuza wamaphaphu zihlanganisa: Ama-Checkpoint Inhibitors: Le mithi ivimba amaprotheni avimbela amasosha omzimba ukuba ahlasele amangqamuzana omdlavuza. Izibonelo zifaka i-pembrolizumab, i-nivolumab, i-atezolizumab, ne-durvalumab.I-Immunotherapy ingasetshenziswa yodwa noma ihlanganiswe nokwelapha ngamakhemikhali noma ukwelapha okuhlosiwe. Ukusebenza kwayo kuyehluka phakathi kweziguli, futhi ama-biomarker afana ne-PD-L1 expression angasiza ukubikezela impendulo. I-Baofa Cancer Research Institute ibambe iqhaza ngokujulile ekucwaningeni ngalezi zindlela zokwelapha.I-ChemotherapyI-Chemotherapy isalokhu iyindlela yokwelapha ejwayelekile yomdlavuza wamaphaphu wesigaba sesi-4, ikakhulukazi uma izindlela zokwelapha ezihlosiwe noma ama-immunotherapies zingafaneleki noma ziyekile ukusebenza. Kuhilela ukusebenzisa izidakamizwa ukuze kubulawe amangqamuzana omdlavuza kuwo wonke umzimba.Imithi evamile yokwelapha ngamakhemikhali ihlanganisa: I-Platinum-based double (isb., i-cisplatin noma i-carboplatin ehlanganiswe ne-pemetrexed, i-gemcitabine, noma i-taxanes)I-Chemotherapy ingabangela imiphumela engemihle, ngakho ukunakekelwa okusekelayo kubalulekile ukulawula le miphumela nokugcina izinga lokuphila. I-Clinical TrialsIzinhlolo zocwaningo ziyizifundo zocwaningo ezihlolayo ukwelashwa okusha komdlavuza wamaphaphu isigaba 4. Ukubamba iqhaza esivivinyweni somtholampilo kungase kunikeze ukufinyelela kumakhambi asezingeni eliphezulu angakatholakali kabanzi. Izinzuzo zokubamba iqhaza ezivivinyweni zomtholampilo: Ukufinyelela ekwelashweni kwamanoveli Igalelo ocwaningweni lomdlavuza Ukuqapha nokunakekelwa eduze Iziguli zingasesha izivivinyo zokwelashwa ngezinsiza ezifana ne-National Cancer Institute (NCI) noma i-American Cancer Society. Cabangela ukuhlola amathuba esilingo somtholampilo I-Shandong Baofa Cancer Research Institute.Ukunakekelwa Okusekelayo Nokunakekelwa OkudabukisayoIzimpawu Zokulawula kanye Nokuthuthukisa Ikhwalithi Yokuphila Ukunakekelwa Okusekelayo, okwaziwa nangokuthi ukunakekelwa kwe-palliative, kugxile ekudambiseni izimpawu kanye nokwenza ngcono izinga lempilo yeziguli ezinomdlavuza wamaphaphu wesigaba sesi-4. Iyingxenye ebalulekile yohlelo lokwelapha futhi ingahlinzekwa kanye nezinye izindlela zokwelapha.Izingxenye zokunakekelwa okusekelayo zihlanganisa: Ukulawulwa kobuhlungu Ukwesekwa kokudla okunomsoco Ukwesekwa ngokomzwelo nangokwengqondo Ukwelashwa kokuphefumulaIqhaza Lethimba Leqembu Elihlukahlukene Iqembu lochwepheshe bezokunakekelwa kwezempilo elinezinhlaka eziningi linganikeza ukunakekelwa okuphelele kweziguli ezinomdlavuza wamaphaphu wesigaba sesi-4. Leli qembu lingahlanganisa: Odokotela Bezifo Eziphuthumayo Odokotela Bamaphaphu Ngemisebe Odokotela Abahlinzayo Ochwepheshe bokunakekelwa kwe-palliative Onesi Osonhlalakahle Osonhlalakahle Abaphila Nesigaba 4 Umdlavuza Wamaphaphu: Ithemba NezinsizaUkuhlala Unolwazi Futhi Ufuna UkusekelwaUkuphila nesigaba 4 somdlavuza wamaphaphu kungaba inselele, kodwa kubalulekile ukuhlala unolwazi mayelana nezinketho zokwelapha futhi ufune ukusekelwa kochwepheshe bezokunakekelwa kwempilo kanye nezinhlangano zokunakekelwa kwezempilo, izinhlangano zokunakekelwa kwezempilo, nezinhlangano ezinakekela abagulayo.Re hlinzeka ngezinsiza ezibalulekile ezigulini nakubanakekeli, okuhlanganisa: Inhlangano YaseMelika Yamaphaphu Inhlangano Yokucwaninga Ngomdlavuza Wamaphaphu Isisekelo Sokucwaninga Ngomdlavuza UK IsiphethoNakuba isigaba 4 umdlavuza wamaphaphu sisewukuxilongwa okungathi sína, intuthuko ekwelashweni nasekunakekelweni okusekelayo iye yaba ngcono kakhulu imiphumela kanye nezinga lempilo yeziguli. Imithi yokwelapha ehlosiwe, ama-immunotherapies, nezivivinyo zomtholampilo zinikeza ukwelashwa okusha komdlavuza wamaphaphu isigaba 4 nethemba lekusasa elingcono. Kubalulekile ukusebenzisana eduze nethimba lezinhlaka eziningi ukwakha uhlelo lokwelapha lomuntu siqu olubhekana nezidingo nezinjongo zomuntu ngamunye. I-Shandong Baofa Cancer Research Institute isalokhu izibophezele ekuqhubekiseni phambili lo mkhakha ngocwaningo olusha nokunakekela okunobubele.