isigaba 3b sokwelashwa komdlavuza wamaphaphu

Isigaba 3B Ukwelashwa Komdlavuza Wamaphaphu: Umhlahlandlela OpheleleUkuqonda izinketho zakho isigaba 3b sokwelashwa komdlavuza wamaphaphu kubalulekile. Lo mhlahlandlela uhlinzeka ngemininingwane ebanzi yezindlela zokwelapha ezitholakalayo, ukusebenza kahle kwazo, imiphumela engemihle engaba khona, kanye nokucatshangelwa kokuthatha izinqumo unolwazi. Sizohlola izinketho zokuhlinzwa, i-chemotherapy, ukwelashwa ngemisebe, ukwelashwa okuhlosiwe, kanye ne-immunotherapy, sigqamisa intuthuko yakamuva kulo mkhakha.

Ukuqonda Isigaba 3B Umdlavuza Wamaphaphu

Isigaba 3b somdlavuza wamaphaphu kusho ukuthi umdlavuza ususabalele kuma-lymph nodes esifubeni, kodwa hhayi ngale. Lesi sigaba siphinde sihlukaniswe sibe yi-3B1 kanye ne-3B2, ngokuya ngezinga lokubandakanyeka kwe-lymph node. Isiteji esinembayo sibalulekile ekunqumeni isu lokwelapha elifaneleka kakhulu. Uhlelo oluthile lokwelapha luzoncika ezintweni ezihlukahlukene ezihlanganisa impilo yesiguli iyonke, uhlobo lomdlavuza wamaphaphu (ingqamuzana elincane uma liqhathaniswa neseli elingelona elincane), indawo nobukhulu besimila, kanye nokuba khona kwanoma yiziphi ezinye izimo zezokwelapha. Ukuxilongwa kusenesikhathi nokunembile kubalulekile ekuphatheni ngempumelelo isigaba 3b somdlavuza wamaphaphu. Ukubonisana nama-oncologists anolwazi kubaluleke kakhulu ekuzuleni lolu hambo oluyinkimbinkimbi.

Izinketho Zokwelashwa ZeSigaba 3B Umdlavuza Wamaphaphu

Ukuhlinzwa

Ukuhlinzwa kungase kube inketho kwezinye iziguli ezine isigaba 3b somdlavuza wamaphaphu, ikakhulukazi labo abanesifo sendawo kanye nempilo enhle iyonke. Izinqubo zokuhlinzwa zingase zihilele i-lobectomy (ukususwa kwe-lobe yamaphaphu), i-pneumonectomy (ukususwa kwephaphu lonke), noma i-segmentectomy (ukususwa kwengxenye yephaphu). Isinqumo sokuqhubeka nokuhlinzwa sizoncika ekutheni kungenzeka yini ukususwa ngokuphelele kwesimila kanye nezingozi ezihlobene. I-Shandong Baofa Cancer Research Institute (https://www.baofahospital.com/) ihlinzeka ngezinsizakalo ezibanzi ze-oncology yokuhlinzwa.

I-Chemotherapy

I-Chemotherapy isetshenziswa kaningi ekwelapheni isigaba 3b somdlavuza wamaphaphu, ngaphambi kokuhlinzwa (i-neoadjuvant chemotherapy) ukuze kuncishiswe isimila noma ngemva kokuhlinzwa (i-adjuvant chemotherapy) ukuze kuncishiswe ingozi yokuphinda. Izidakamizwa ze-Chemotherapy zisebenza ngokukhomba futhi zibulale amangqamuzana omdlavuza ahlukanisa ngokushesha. Ama-chemotherapeutic agents asetshenziswa ngokuvamile ahlanganisa izidakamizwa ezisekelwe ku-platinum (i-cisplatin, i-carboplatin) nezinye. Uhlu lwemithi ethile luzofanelana nezidingo zesiguli ngasinye kanye nokusabela ekwelashweni. Imiphumela engemihle yokwelashwa ngamakhemikhali ingahluka, kodwa ngokuvamile ihlanganisa isicanucanu, ukukhathala, ukuqothuka kwezinwele, nokuncipha kwezibalo zamangqamuzana egazi.

Ukwelapha Ngemisebe

Ukwelapha ngemisebe kusebenzisa imisebe enamandla amakhulu ukubulala amangqamuzana omdlavuza. Ingasetshenziswa yodwa noma ihlanganiswe ne-chemotherapy. Ukwelashwa ngemisebe kungalethwa ngaphandle (ukwelashwa ngemisebe yangaphandle) noma ngaphakathi (i-brachytherapy). I-stereotactic body radiation therapy (SBRT) iwuhlobo olunembe kakhulu lokwelapha ngemisebe oluletha imithamo ephezulu yemisebe esimila kuyilapho kunciphisa umonakalo ezicutshini ezinempilo ezizungezile. Lena indlela yokwelapha ephumelela kakhulu ezigulini ezikhethiwe. Ukukhethwa kokwelashwa ngemisebe kuzoncika ezintweni ezimbalwa njengendawo yesimila, usayizi, kanye nempilo iyonke yesiguli.

Ukwelapha Okuhlosiwe

Ukwelapha okuhlosiwe kusebenzisa izidakamizwa eziqondise amangqamuzana omdlavuza ngaphandle kokulimaza amaseli avamile. Lezi zindlela zokwelapha zisebenza ngempumelelo ezinhlotsheni ezithile zomdlavuza wamaphaphu ezinokuguquguquka okuthile kofuzo. Izibonelo zifaka ama-EGFR inhibitors, ama-ALK inhibitors, nama-ROS1 inhibitors. Ngaphambi kokwelashwa, ukuhlolwa kofuzo kuvame ukwenziwa ukuze kuhlolwe ukuthi umdlavuza wamaphaphu wesiguli unokuguquguquka kofuzo okufanelekile yini.

I-Immunotherapy

I-Immunotherapy ihlanganisa amasosha omzimba ukuze alwe namaseli omdlavuza. Ama-Checkpoint inhibitors, njenge-nivolumab ne-pembrolizumab, avame ukusetshenziswa ekwelapheni isigaba 3b somdlavuza wamaphaphu. Basebenza ngokuvimbela amaprotheni avimbela amasosha omzimba ekuhlaseleni amangqamuzana omdlavuza. I-Immunotherapy ngezinye izikhathi ingaholela emiphumeleni ebalulekile efana nezenzakalo ezimbi ezihlobene nokuzivikela komzimba. Uhlelo lokwelapha kufanele luklanywe ngokucophelela futhi lulandelwe eduze ngochwepheshe bezokwelapha.

Ukwenza Izinqumo Ezinolwazi

Ukukhetha ukwelashwa okufanele isigaba 3b somdlavuza wamaphaphu kudinga ukucatshangelwa ngokucophelela kwezici ezihlukahlukene. Kubalulekile ukuba nezingxoxo ezivulekile nezithembekile nodokotela wakho we-oncologist ukuze uqonde izinzuzo nezingozi ezingaba khona zenketho ngayinye yokwelashwa. Le ndlela yokusebenzisana, esekelwe ezimweni zakho ezithile kanye nezintandokazi zakho, ibalulekile ekuzuzeni umphumela omuhle kakhulu. Cabangela ukufuna imibono yesibili nokuhlanganyela emaqenjini okusekela ukuze uzulazule kangcono kulolu hambo oluyinselele. Ukuqokwa kokulandelela njalo kanye nezifundo zezithombe kubalulekile ukuze kuqashwe ukusabela kokwelashwa kanye nokuthola noma yikuphi ukuphindeka.

Ukuhlaziywa Okuqhathaniswayo Kwezinketho Zokwelashwa

Qaphela: Lolu lwazi luhloselwe izinjongo zokufundisa kuphela futhi aluhlanganisi iseluleko sezokwelapha. Hlala uthintana nochwepheshe bezempilo abaqeqeshiwe ukuze uxilongwe futhi ulashwe noma yisiphi isimo sezempilo.