ukwelashwa okungekona okuncane komdlavuza wamaphaphu

Ukwelashwa komdlavuza wamaphaphu ongewona omncane (NSCLC) izinketho zihlukahlukene futhi zincike esiteji, uhlobo oluncane, kanye nezici zesiguli ngasinye. Ukwelashwa okuvamile kuhlanganisa ukuhlinzwa, ukwelapha ngemisebe, ukwelashwa ngamakhemikhali, ukwelashwa okuhlosiwe, kanye ne-immunotherapy, evame ukusetshenziswa ngokuhlanganiswa. Lo mhlahlandlela uhlola inketho ngayinye ngokuningiliziwe, ikusiza ukuthi uqonde okungenzeka futhi wenze izinqumo ezinolwazi ngokubonisana nethimba lakho lezokunakekelwa kwezempilo.Ukuqonda Umdlavuza Ongewona Owomncane Wengqamuzana Wamaphaphu (NSCLC)Iyini i-NSCLC?Umdlavuza wamaphaphu weseli ongewona omncane (NSCLC) wuhlobo oluvame kakhulu lomdlavuza wamaphaphu, olubalelwa ku-80-85% wawo wonke amacala omdlavuza wamaphaphu. Kuyitemu lesambulela elihlanganisa izinhlobo ezimbalwa ezincane, ezivame kakhulu i-adenocarcinoma, i-squamous cell carcinoma, kanye ne-cell carcinoma enkulu.I-NSCLC StagingIsigaba se-NSCLC sibalulekile ekunqumeni indlela yokwelapha engcono kakhulu. Isiteji sinqunywa ubukhulu kanye nendawo yesimila, ukuthi sesabalale kuma-lymph nodes aseduze, nokuthi ingabe sesimetastasized ezithweni ezikude.Izinketho Zokwelapha ze-NSCLCSUkuhlinzwaUkuhlinzwa kuvame ukuba ukwelapha okuyinhloko kwe-NSCLC yesigaba sasekuqaleni. Umgomo uwukukhipha isimila nanoma yimaphi ama-lymph nodes aseduze angase abe namaseli omdlavuza. I-Lobectomy: Ukususwa kwe-lobe yonke yephaphu. I-Pneumonectomy: Ukususwa kwephaphu lonke. Ukususwa Kwe-Wedge: Ukususwa kwesiqephu sephaphu esincane, esimise okwe-wedge. I-Segmentectomy: Ukususwa kwengxenye yephaphu, enkulu kunokukhishwa koweji kodwa incane kune-lobectomy.Qaphela: Ukuhlinzwa kungase kungabi yindlela yokuzikhethela ezigulini ezine-NSCLC ethuthukisiwe noma lezo ezinezinye izimo zempilo ezenza ukuhlinzwa kube yingozi kakhulu.Ukwelashwa NgeRadiationRadiation therapy isebenzisa imisebe enamandla amakhulu ukubulala amangqamuzana omdlavuza. Ingasetshenziswa ukwelapha i-NSCLC ngezindlela eziningana: I-Beam Radiation Therapy yangaphandle (EBRT): Imisebe ihanjiswa emshinini ongaphandle komzimba. I-Stereotactic Body Radiation Therapy (SBRT): Uhlobo olunembe kakhulu lwe-EBRT oluletha umthamo omkhulu wemisebe endaweni encane. Ivamise ukusetshenziselwa umdlavuza wamaphaphu osesigabeni sokuqala lapho ukuhlinzwa kungenakwenziwa. I-Brachytherapy: Izinto ezikhipha imisebe zifakwa ngqo ngaphakathi noma eduze kwethumba.Ukwelashwa ngemisebe kungasetshenziswa iyodwa noma kuhlanganiswe nezinye izindlela zokwelapha, ezifana nokwelapha ngamakhemikhali. Thina at I-Shandong Baofa Cancer Research Institute qonda ukubaluleka kokuhlanganisa ukwelashwa ukuze uthole imiphumela engcono kakhulu. U-Baofa ungumholi ekunakekelweni komdlavuza okudidiyelwe.I-ChemotherapyI-Chemotherapy isebenzisa izidakamizwa ukubulala amangqamuzana omdlavuza emzimbeni wonke. Ivame ukusetshenziselwa ukwelapha i-NSCLC ethuthukisiwe noma ukuvimbela umdlavuza ukuthi ungaphinde uvele ngemva kokuhlinzwa. Imithi ejwayelekile ye-chemotherapy ye-NSCLC ihlanganisa: I-Cisplatin Carboplatin Pemetrexed Docetaxel PaclitaxelChemotherapy ngokuvamile inikezwa ngemijikelezo, nezikhathi zokwelashwa ezilandelwa yizikhathi zokuphumula. Imiphumela engemihle ingahluka kuye ngemithi esetshenziswayo kanye nesiguli ngasinye.I-Targeted TherapyTargeted therapy isebenzisa izidakamizwa eziqondise ama-molecule athile ahilelekile ekukhuleni kwamangqamuzana omdlavuza kanye nokuphila. Le mithi ivamise ukusebenza ngempumelelo futhi inemiphumela engemihle embalwa kune-chemotherapy. Izindlela zokwelapha ezihlosiwe ngokuvamile ezeziguli ezinezinguquko ezithile zofuzo. Okuhlosiwe okujwayelekile kuhlanganisa: I-EGFR: I-Epidermal Growth Factor Receptor I-ALK: I-Anaplastic Lymphoma Kinase I-ROS1: I-ROS1 Proto-Oncogene Receptor Tyrosine Kinase I-BRAF: I-B-Raf Proto-Oncogene, i-Serine/Threonine Kinase I-NTRK: I-Neurotrophic Tyrosine Receptor KinaseIzibonelo zemithi yokwelapha ehlosiwe esetshenziselwa i-NSCLC zifaka: I-Gefitinib (Iressa) i-Erlotinib (Tarceva) i-Afatinib (Gilotrif) i-Osimertinib (Tagrisso) i-Crizotinib (Xalkori) i-Ceritinib (i-Zykadia) i-Alectinib ehlosiwe ejwayelekile i-Alectinib eqala ukwelashwa) ukuhlolwa kofuzo ukuze kutholakale ukuthi banalo yini uguquko oluqondiswe kubo.ImmunotherapyImmunotherapy isebenzisa imithi ukusiza amasosha omzimba ukulwa nomdlavuza. Le mithi ingavimba amaprotheni avimbela amasosha omzimba ukuba ahlasele amangqamuzana omdlavuza. Imithi evamile yokwelapha amasosha omzimba ye-NSCLC ihlanganisa: I-Pembrolizumab (Keytruda) Nivolumab (Opdivo) I-Atezolizumab (Tecentriq) Durvalumab (Imfinzi)Immunotherapy ingasetshenziswa yodwa noma ihlanganiswe ne-chemotherapy noma ezinye izindlela zokwelapha. Imiphumela engemihle ingase ihlanganise ukukhathala, ukuqubuka kwesikhumba, nokuvuvukala kwezitho ezihlukahlukene.I-NSCLC Ukwelashwa nge-StageStage I I-NSCLCSurgery ngokuvamile iwukwelashwa okuyinhloko kwe-Stage I NSCLC. I-SBRT ingase icatshangelwe uma isiguli singeyena umuntu ozohlinzwa.Isigaba II I-NSCLCTUkwelashwa kweSigaba II NSCLC ngokuvamile kuhilela ukuhlinzwa okulandelwa ukwelapha ngamakhemikhali. Ukwelapha ngemisebe kungase futhi kusetshenziswe.I-NSCLCT ye-Stage III ye-NSCLC iyinkimbinkimbi kakhulu futhi ingase ihlanganise inhlanganisela yokuhlinzwa, ukwelapha ngamakhemikhali, nokwelashwa ngemisebe. I-Immunotherapy ingase isetshenziswe ngemva kwe-chemoradiation kwezinye izimo.Isigaba IV I-NSCLCTUkwelashwa Kwesigaba IV I-NSCLC igxile ekulawuleni ukukhula komdlavuza kanye nokukhulula izimpawu. Izinketho zingabandakanya ukwelashwa ngamakhemikhali, ukwelashwa okuhlosiwe, i-immunotherapy, nokwelashwa ngemisebe. Ukukhethwa kwendlela yokwelashwa kuncike ezicini ezithile zomdlavuza kanye nempilo yesiguli iyonke.Isivivinyo SemitholampiloIzivivinyo zezokwelapha izifundo zocwaningo ezihlola izindlela zokwelapha ezintsha zomdlavuza. Iziguli ezine-NSCLC zingase zifaneleke ukubamba iqhaza ezivivinyweni zomtholampilo. Khuluma nodokotela wakho ukuze ufunde kabanzi mayelana nezinhlolo zomtholampilo nokuthi ingabe zikulungele yini. I-Shandong Baofa Cancer Research Institute's ukuzibophezela ocwaningweni kusho ukuthi sihlale onqenqemeni lwezinketho ezintsha zokwelapha, ngezinye izikhathi ngokuhlolwa komtholampilo.Ukwenza Izinqumo ZokwelashwaUkukhetha ukwelashwa okufanele kwe-NSCLC kuyisinqumo esiyinkimbinkimbi okufanele sithathwe ngokubonisana nethimba lakho lezempilo. Izinto okufanele zicatshangelwe zihlanganisa isigaba nohlobo oluncane lomdlavuza, impilo yesiguli iyonke, kanye nezinto ezikhethwayo. Ungangabazi ukubuza imibuzo futhi ufune umbono wesibili uma kudingeka.Amazinga Okubikezela kanye NokusindaAmazinga okusinda e-NSCLC ayahlukahluka kuye ngesigaba somdlavuza, ukwelashwa okutholiwe, nezinye izici. Ukutholwa kusenesikhathi kanye nokwelashwa kungathuthukisa amathuba okusinda. Isigaba 5-Iminyaka Yokusinda Isigaba I 68-92% Isigaba II 53-60% Isigaba III 13-36% Isigaba IV Ngaphansi kuka-10% *Umthombo: I-American Cancer Society (www.cancer.org)Ukuphila ne-NSCLCUkuphila ne-NSCLC kungase kube inselele, kodwa kunezinsiza eziningi ezitholakalayo zokusiza iziguli kanye nemindeni yazo ukuba zibhekane nesimo. Lezi zinsiza zifaka amaqembu osekelo, izinsiza zokweluleka, nezinhlelo zokusiza ngezezimali.