isigaba 1b sokwelashwa komdlavuza wamaphaphu

Isigaba 1B isigaba 1b sokwelashwa komdlavuza wamaphaphu ngokuvamile kuhilela ukuhlinzwa ukuze kukhishwe isimila. I-Adjuvant chemotherapy ingase inconywe ngemva kokuhlinzwa ukuze kuncishiswe ingozi yokuphinda. Ukwelapha ngemisebe ngezinye izikhathi kusetshenziswa uma ukuhlinzwa kungeyona inketho noma uma isimila singakwazi ukususwa ngokuphelele. Ukuqonda lezi zinketho kubalulekile ukuze wenze izinqumo ezinolwazi nethimba lakho lezempilo. I-Shandong Baofa Cancer Research Institute izibophezele ekunikezeni ulwazi oluphelele kanye nokweseka iziguli nemindeni yazo.Ukuqonda Isigaba 1B Umdlavuza WamaphaphuSiyini Isigaba 1B Umdlavuza Wamaphaphu?Isigaba 1b somdlavuza wamaphaphu wuhlobo lomdlavuza wamaphaphu ongewona omncane (NSCLC). Kusho ukuthi umdlavuza ususabalele ngaphesheya komugqa wamaphaphu kodwa usatholakala endaweni. Ngokuqondile, isimila sikhulu kuno-3 cm kodwa asikho ngaphezu kuka-4 cm. Kulesi sigaba, umdlavuza awukasabaleli kuma-lymph nodes aseduze noma ezindaweni ezikude. Ukutholwa kusenesikhathi nokwelashwa ngokushesha kubalulekile ukuze kube nemiphumela engcono. Ukuze uthole imininingwane eyengeziwe kanye nemininingwane yocwaningo, ungavakashela I-Shandong Baofa Cancer Research Institute.Ukuxilongwa Kwesigaba 1B Umdlavuza WamaphaphuUkuhlola isigaba 1b somdlavuza wamaphaphu ngokuvamile kubandakanya inhlanganisela yokuhlolwa kwezithombe nama-biopsies. Izinqubo zokuxilonga ezivamile zihlanganisa:I-X-ray yesifuba: Ngokuvamile ukuhlolwa kokuqala kwesithombe ukuze kutholwe okungavamile emaphashini.I-CT Scan: Inikeza izithombe ezinemininingwane eminingi yamaphaphu nezakhiwo eziwazungezile.I-PET Scan: Ingasiza ekuboneni izindawo zokukhula komsebenzi we-metabolic, okubonisa umdlavuza.I-Bronchoscopy: Inqubo lapho ishubhu elincanyana nelithambile elinekhamera lishuthekwa emzileni womoya ukuze kubonakale amaphaphu ngeso lengqondo futhi kuqoqwe amasampula ezicubu.I-Biopsy: Isampula yezicubu zamaphaphu iyathathwa futhi ihlolwe ngaphansi kwesibonakhulu ukuze kuqinisekiswe ukuba khona kwamangqamuzana omdlavuza. Lokhu kungenziwa nge-bronchoscopy, i-need biopsy, noma ukuhlinzwa.Izinketho Zokwelashwa Zesigaba 1B Umdlavuza WamaphaphuUkuhlinzwaUkuhlinzwa kuwukwelapha okuyinhloko isigaba 1b somdlavuza wamaphaphu lapho isiguli siphile saka ngokwanele ukuba silandele inqubo. Umgomo uwukukhipha sonke isimila kanye nomkhawulo wezicubu ezinempilo. Izinqubo zokuhlinzwa ezivamile zihlanganisa:I-Lobectomy: Ukususwa kwayo yonke i-lobe yephaphu lapho isimila sikhona.Ukususwa Kwemikhono: Ukususwa kwengxenye yomzila womoya (i-bronchus) kanye nesimila.Ukususwa kwe-Wedge/Segmentectomy: Ukususwa kwengxenye encane yephaphu. Lezi azivamile kangako isigaba 1b somdlavuza wamaphaphu kodwa kungase kucatshangelwe uma isiguli sinezinye izinkinga zempilo ezenza i-lobectomy ibe yingozi kakhulu.I-Pneumonectomy: Ukususwa kwephaphu lonke. Lokhu akuvamile kudingekile ukuze isigaba 1b somdlavuza wamaphaphu.I-Adjuvant Chemotherapy I-Adjuvant chemotherapy ngokuvamile iyatuswa ngemva kokuhlinzwa ukuze kubulawe noma yimaphi amangqamuzana omdlavuza asele okungenzeka angabonakali kuzikena. Lokhu kunciphisa ingozi yokuphinda. Imithi ethile yokwelapha ngamakhemikhali izoncika ezintweni eziningana, okuhlanganisa uhlobo lomdlavuza wamaphaphu, impilo yesiguli iyonke, kanye nesincomo sikadokotela ohlinzayo. Imithi ejwayelekile yokwelapha ngamakhemikhali esetshenziselwa i-NSCLC ihlanganisa i-cisplatin, i-carboplatin, i-paclitaxel, i-docetaxel, ne-gemcitabine.I-Radiation TherapyRadiation therapy isebenzisa imisebe yamandla aphezulu ukubulala amangqamuzana omdlavuza. Ingase isetshenziswe ezimweni ezithile, njengalezi:Uma isiguli singeyena umuntu olungele ukuhlinzwa.Uma isimila singakwazi ukususwa ngokuphelele ngesikhathi sokuhlinzwa.Njengokunakekelwa kwe-palliative ukuze kudambise izimpawu.Izinhlobo zokwelashwa ngemisebe zihlanganisa:I-Beam Radiation Therapy yangaphandle (EBRT): Imisebe ihanjiswa emshinini ongaphandle komzimba.I-Stereotactic Body Radiation Therapy (SBRT): Uhlobo olunembe kakhudlwana lokwelapha ngemisebe oluletha imithamo ephezulu yemisebe endaweni encane.Imithi yokwelapha ehlosiwe yokwelapha ehlosiwe iqondise ukungavamile okuthile kumaseli omdlavuza. Le mithi ayisebenzi kuzo zonke iziguli ezine isigaba 1b somdlavuza wamaphaphu, kodwa angase abe inketho uma amangqamuzana omdlavuza enezinguquko ezithile. Okuhlosiwe okujwayelekile kufaka i-EGFR, ALK, ne-ROS1. Kudingeka ukuhlolwa ukuze kutholakale ukuthi umdlavuza unazo yini lezi zinguquko. Xhumana nethimba ku I-Shandong Baofa Cancer Research Institute ukuhlola izinketho zokwelapha. Imithi ye-ImmunotherapyImmunotherapy isiza amasosha omzimba ukulwa nomdlavuza. Le mithi ingase ibe inketho yezinye iziguli ezine isigaba 1b somdlavuza wamaphaphu, ikakhulukazi uma umdlavuza unamazinga aphezulu e-PD-L1. Imithi ejwayelekile ye-immunotherapy ihlanganisa i-pembrolizumab, i-nivolumab, ne-atezolizumab.Izibikezelo kanye Nezilinganiso Zokusinda Zesigaba 1B Umdlavuza WamaphaphuIsibikezelo se isigaba 1b somdlavuza wamaphaphu ngokuvamile kuhle, ikakhulukazi uma isimila sisuswe ngokuphelele ngokuhlinzwa. Izinga lokusinda leminyaka engu-5 isigaba 1b somdlavuza wamaphaphu cishe 60-70%. Lokhu kusho ukuthi 60-70% abantu abane isigaba 1b somdlavuza wamaphaphu basaphila iminyaka emi-5 ngemva kokuxilongwa.Izici eziningana zingathinta ukubikezelwa, okuhlanganisa:Impilo yesiguli iyonkeUbukhulu nendawo yesimilaUkuthi umdlavuza ususabalele kuma-lymph node aseduzeUhlobo lomdlavuza wamaphaphuUkwelashwa okutholiweImiphumela Emibi YokwelashwaKonke ukwelapha umdlavuza kungabangela imiphumela engemihle. Imiphumela ethile engemihle izoncika ohlotsheni lokwelashwa, umthamo, kanye nempilo yonke yesiguli. Imiphumela emibi evamile yokuhlinzwa ihlanganisa ubuhlungu, ukutheleleka, nokopha. Imiphumela emibi evamile ye-chemotherapy ihlanganisa isicanucanu, ukuhlanza, ukukhathala, nokulahlekelwa izinwele. Imiphumela engemihle evamile yokwelashwa ngemisebe ihlanganisa ukucasuka kwesikhumba, ukukhathala, kanye nobunzima bokugwinya.Izilingo Zomtholampilo Zesigaba 1B Umdlavuza WamaphaphuIzivivinyo zezokwelapha ezihlola ukwelapha okusha noma izindlela ezintsha zokusebenzisa izindlela zokwelapha ezikhona. Iziguli nge isigaba 1b somdlavuza wamaphaphu angase athande ukucabangela ukuhlanganyela ocwaningweni lomtholampilo. Izivivinyo zemitholampilo zinganikeza ukufinyelela ekwelashweni okuphambili okungakatholakali kabanzi. Ukuze uthole ulwazi olwengeziwe mayelana nokuhlolwa komtholampilo, khuluma nodokotela wakho noma vakashela iwebhusayithi ye-National Cancer Institute.Ukuphila Nesigaba 1B Umdlavuza Wamaphaphu isigaba 1b somdlavuza wamaphaphu kungaba yinselele, ngokomzimba nangokomzwelo. Kubalulekile ukuthi kube nohlelo oluqinile lokusekela. Lokhu kungase kuhlanganise amalungu omndeni, abangani, amaqembu osekelo, nabasebenzi bezempilo. Nawa amanye amathiphu okuphila nawo isigaba 1b somdlavuza wamaphaphu:Yidla ukudla okunempilo.Zivocavoce njalo.Lala ngokwanele.Lawula ukucindezeleka.Joyina iqembu lokusekela.Khuluma nodokotela wakho mayelana nanoma yikuphi okukukhathazayo.Ukunakekelwa KokulandelelaNgemva kokwelashwa isigaba 1b somdlavuza wamaphaphu, kubalulekile ukuba nezikhathi zokulandelela njalo nodokotela wakho. Lawa ma-aphoyintimenti angabandakanya ukuhlolwa ngokomzimba, ukuhlolwa kwezithombe, nokuhlolwa kwegazi. Inhloso yokunakekelwa kokulandelela iwukuqapha noma yiziphi izimpawu zokuphinda futhi ulawule noma yimiphi imiphumela emibi yesikhathi eside yokwelashwa.Izinto Ezibalulekile Nemibuzo Ekufanele Uyibuze Udokotela WakhoUma uxoxa isigaba 1b sokwelashwa komdlavuza wamaphaphu ongakhetha kukho nodokotela wakho, cabanga ukubuza le mibuzo ebalulekile: Yiziphi izinzuzo nezingozi zokhetho ngalunye lokwelashwa?Iyini imiphumela emibi engase ibe khona yokwelashwa ngakunye?Uyini umphumela olindelekile wokwelashwa ngakunye?Ukwelashwa kuzolithinta kanjani izinga lami lempilo?Iluphi uhlelo lokunakekelwa kokulandelela ngemva kokwelashwa?Zikhona yini izivivinyo zomtholampilo okufanele ngizicabangele?Ukwenza izinqumo ezinolwazi mayelana nokwelashwa kwakho? isigaba 1b sokwelashwa komdlavuza wamaphaphu kudinga ukucatshangelwa ngokucophelela kanye nokuxhumana okuvulekile nethimba lakho lezempilo. Ulwazi olunikezwe lapha kuhloswe ngalo njengesiqondiso esivamile futhi akufanele kuthathelwe indawo iseluleko sezokwelapha esichwepheshile. I-Shandong Baofa Cancer Research Institute inikeza izinsiza ezingakusiza.Ithebula Lokuqhathaniswa Kwezinga Lokusinda Isigaba Seminyaka emihlanu Yokusinda Isigaba 1A Umdlavuza Wamaphaphu Cishe ku-70-90% Isigaba 1B Umdlavuza Wamaphaphu Cishe ku-60-70% Isigaba 2 Umdlavuza Wamaphaphu Cishe ku-40-60% Qaphela: Amazinga okusinda ayahlawumbisela futhi angahluka ngokuya ngezinto ezingazodwana.