ukwelashwa komdlavuza wamaphaphu ongabhemi

Umdlavuza wamaphaphu kubantu abangakaze babheme uletha izinselelo eziyingqayizivele nezindlela zokwelashwa. Nakuba ukubhema kuyisici esiyingozi esaziwayo, ingxenye enkulu yezigameko zomdlavuza wamaphaphu zenzeka kubantu abangenawo umlando wokusebenzisa ugwayi. Lesi sihloko sihlola izici ezihlukile ze ukwelashwa komdlavuza wamaphaphu ongabhemi, okuhlanganisa ukuxilongwa, izinketho zokwelashwa, kanye nocwaningo oluqhubekayo.Ukuxilongwa Nezinhlobo Zomdlavuza Wamaphaphu Kwabangabhemi Ukuxilonga umdlavuza wamaphaphu kwabangakaze babheme kuvame ukuvela ngendlela ehlukile kunakwababhemayo. Kubalulekile ukuqonda izici ezihlukahlukene zokutholwa kanye nezinhlobo ezithile zomdlavuza wamaphaphu odlange kulesi sibalo. Ngenxa yokuthi umdlavuza wamaphaphu uvame ukuhlotshaniswa nokubhema, ungase ungabhekwa njengovamile kubantu abangabhemi, okuholela ekuxilongweni okubambezelekile. Izimpawu zingase zingacaci noma zifakwe kwezinye izimo. Amasu okuhlonza kusenesikhathi njengokuhlola umdlavuza wamaphaphu kusetshenziswa ama-CT scans anedosi ephansi ngokuvamile awanconywa kubantu abavamile abangabhemi, okwenza kube nzima ukuxilongwa kusenesikhathi. Izinhlobo Zomdlavuza Wamaphaphu Ezivamile Kongabhemi Nakuba ababhemayo bethambekele kakhulu ku-squamous cell carcinoma kanye nomdlavuza wamaphaphu amancane, ababhemi basengozini enkulu yokuba ne-adenocarcinoma. I-Adenocarcinoma ivame ukuvela ezindaweni ezingaphandle zamaphaphu, okwenza kube lula ukutholakala ngaphambi kokuba isakazeke. Ezinye izinhlobo eziyivelakancane nazo zingenzeka.I-Shandong Baofa Cancer Research Institute (https://baofahospital.com) sizinikele ekuthuthukiseni ukuqonda kwethu izinhlobo ezihlukahlukene zomdlavuza wamaphaphu kanye nokuthuthukisa izindlela zokuxilonga.Izinketho Zokwelapha Zomdlavuza Wamaphaphu OngabhemiIzindlela zokwelapha umdlavuza wamaphaphu kubantu abangabhemi ngokuvamile zifanelana nohlobo oluthile kanye nesigaba somdlavuza, kanye nempilo yomuntu jikelele. Izindlela ezincane ezihlaselayo ezifana nokuhlinzwa kwethoracoscopic okusizwa ngevidiyo (i-VATS) ziya ngokuya zisetshenziswa ukuze kuncishiswe isikhathi sokululama futhi kuthuthukiswe imiphumela.Ukwelashwa ngemisebeUkwelashwa ngeRadiation kusebenzisa imisebe yamandla amakhulu ukubulala amangqamuzana omdlavuza. Ingasetshenziswa njengokwelashwa okuyinhloko kweziguli ezingafanele ukuhlinzwa, noma njenge-adjuvant therapy ngemva kokuhlinzwa ukuze kuqedwe noma yimaphi amaseli omdlavuza asele. Amasu afana ne-stereotactic body radiation therapy (SBRT) aletha imisebe egxile kakhulu esimila kuyilapho enciphisa umonakalo esicutshini esizungezile esinempilo.I-ChemotherapyI-Chemotherapy ihilela ukusetshenziswa kwezidakamizwa ukubulala amangqamuzana omdlavuza kuwo wonke umzimba. Ivamise ukusetshenziselwa izigaba ezithuthuke kakhulu zomdlavuza wamaphaphu noma kuhlanganiswe nokuhlinzwa noma ukwelapha ngemisebe. Imithi ethile yokwelapha ngamakhemikhali iyahlukahluka kuye ngohlobo lomdlavuza wamaphaphu kanye nempilo yesiguli iyonke.I-Targeted TherapyTargeted therapy igxile kuma-molecule athile noma izindlela ezihilelekile ekukhuleni nasekusakazekeni komdlavuza. Abaningi abalokothi ababhemayo abane-adenocarcinoma babe nezinguquko zofuzo, njenge-EGFR, ALK, ROS1, noma i-BRAF. Ukuhlonza lezi zinguquko kuvumela odokotela ukuba banikeze imithi yokwelapha ehlosiwe evimbela ngokuqondile ukusebenza kwala maprotheni aguquliwe, okuholela emiphumeleni ethuthukisiwe.I-ImmunotherapyImmunotherapy ithuthukisa amasosha omzimba ukuze alwe nomdlavuza. Ama-Checkpoint inhibitors, njenge-PD-1 kanye ne-PD-L1 inhibitors, awuhlobo lwe-immunotherapy olubonise isithembiso ekwelapheni izinhlobo ezithile zomdlavuza wamaphaphu, kuhlanganise nalezo ezitholakala kubantu abangabhemi. Ukusebenza kwe-immunotherapy kuncike ezicini ezihlukahlukene, kuhlanganise nokuba khona kwezimpawu ezithile zezinto eziphilayo.Ukubaluleka Kokuhlolwa Kofuzo Kongabhemi Umdlavuza Wamaphaphu Ukuhlolwa kofuzo kubalulekile ekulawuleni umdlavuza wamaphaphu ongabhemi. Ukuhlonza uguquko oluthile lwezakhi zofuzo kuvumela odokotela ukuba benze izinhlelo zokwelapha zibe ngokwakho futhi bakhethe izindlela zokwelapha ezihlosiwe ezisebenza kahle kakhulu noma ama-immunotherapies.Izinguquko Zofuzo EzivamileIzinguquko eziningana zofuzo zivame ukutholakala kumdlavuza wamaphaphu kubantu abangabhemi, okuhlanganisa:I-EGFR (Epidermal Growth Factor Receptor) mutationsALK (Anaplastic Lymphoma KiAFnase) ivumela ukuguqulwa kwezinguquko ze-Lymphoma KiAFnase. ukusetshenziswa kwezindlela zokwelapha ezihlosiwe ezivimbela ngokuqondile umsebenzi wamaprotheni aguquliwe, okuholela emiphumeleni ethuthukisiwe nokuphila isikhathi eside.Izinzuzo Zokwelashwa Okuqondene NakhoUkwelashwa komuntu siqu okusekelwe ekuhloleni izakhi zofuzo kuvumela indlela enembayo nephumelelayo yokunakekelwa komdlavuza. Ngokuqondisa abashayeli abathile bamangqamuzana omdlavuza, odokotela banganciphisa imiphumela engemihle futhi bathuthukise ikhwalithi yempilo yonke yeziguli. I I-Shandong Baofa Cancer Research Institute igcizelela umuthi womuntu siqu ekwelapheni umdlavuza.Izilingo Zomtholampilo kanye Nocwaningo Oluqhubekayo Izivivinyo zezokwelapha zidlala indima ebalulekile ekuthuthukiseni ukwelashwa umdlavuza wamaphaphu ongabhemi. Lezi zifundo zihlola izindlela zokwelapha ezintsha, inhlanganisela yokwelapha, nezindlela zokuxilonga.Ukuthola Izivivinyo ZomtholampiloIziguli ezinentshisekelo yokubamba iqhaza ezivivinyweni zomtholampilo zingasesha izivivinyo ngemithombo ehloniphekile, njenge:National Cancer Institute (NCI): https://www.cancer.gov/about-cancer/treatment/clinical-trialsClinicalTrials.gov: https://clinicaltrials.gov/Izindawo ZokucwaningaImizamo yamanje yocwaningo igxile:Ukuthuthukisa izindlela zokwelapha ezintsha ezihlosiwe zokuguqulwa kwezakhi zofuzo ezithizeUkuthuthukisa ukusebenza kahle kwe-immunotherapyUkubona izimpawu zezinto eziphilayo ezintsha ukuze zitholakale kusenesikhathi kanye nokusabela kokwelashwaUkuqonda ngebhayoloji eyingqayizivele yomdlavuza wamaphaphu kubantu abangabhemi Ukubikezela kanye Namazinga Okusinda ukwelashwa komdlavuza wamaphaphu ongabhemi kuyahlukahluka kuye ngesigaba somdlavuza ekuxilongweni kwawo, uhlobo oluthile lomdlavuza, kanye nempilo yomuntu iyonke. Ngokuvamile, ababhemi ababhemayo abanomdlavuza wamaphaphu bavame ukuba nesibikezelo esingcono kunalabo ababhemayo, ikakhulukazi uma benezimila ezinokuguquguquka kofuzo okuqondiwe.Izinto Ezithinta UkubikezelaIzinto ezingaba nomthelela ekubikezeleni zihlanganisa:Isigaba somdlavuza ekuxilongweniUhlobo lomdlavuza wamaphaphuUkuba khona koguquko lwezakhi zofuzo okuqondiweIyonke impilo kanye nokuqinaImpendulo ekwelapheni Ukulinganisa Ukusinda Komdlavuza ziyahlukahluka ezifundweni zonkana, ucwaningo lwango-2020 olwanyatheliswa ku- *Journal of Thoracic Oncology* lwathola ukuthi abakaze ababhemayo abane-adenocarcinoma ethuthukisiwe nezinguquko ze-EGFR babe nokuphila okumaphakathi kwezinyanga ezingama-38.6 ngokwelashwa okuhlosiwe, uma kuqhathaniswa nezinyanga ezingama-26.7 kwababhemayo abanezinguquko ezifanayo zelashwa nge-chemotherapy. Iqembu Eli-1 Lokwelashwa Kwamaphakathi Ukusinda Kokuphelele (Izinyanga) Abangabhemi Nge-EGFR+ Advanced Adenocarcinoma Targeted Therapy 38.6 Ababhemayo abane-EGFR+ Advanced Adenocarcinoma Chemotherapy 26.7 Umthombo: 1. Ijenali ye-Thoracic Oncology, 2020IsiphethoUkwelashwa komdlavuza wamaphaphu ongabhemi iwumkhakha othuthukayo onamathuba andayo ezindlela zokwelapha eziqondene nawe nezisebenzayo. Ukuqonda izici ezithile zomdlavuza wamaphaphu kubantu abangabhemi, okuhlanganisa izinhlobo zomdlavuza kanye nokuguqulwa kofuzo okuvamile, kubalulekile ukuze kuthuthukiswe imiphumela yokwelashwa. Ucwaningo oluqhubekayo nezivivinyo zomtholampilo zibalulekile ekuqhubekiseleni phambili ukunakekelwa kwabantu abatholakala benomdlavuza wamaphaphu abangakaze babheme. Ukufuna izeluleko zezokwelapha ezingochwepheshe kanye nokuhlola izindlela zokwelapha ezitholakalayo kuyizinyathelo ezibalulekile ekulawuleni lesi simo.