ukwelashwa umdlavuza wamaphaphu omkhulu

I-Large cell lung cancer (LCLC) iwuhlobo olungaphansi olunolaka lomdlavuza wamaphaphu ongewona omncane (NSCLC). Izindlela zokwelapha ngokuvamile zihlanganisa inhlanganisela yokuhlinzwa, i-chemotherapy, ukwelapha ngemisebe, ukwelashwa okuhlosiwe, kanye ne-immunotherapy, eklanyelwe isigaba sesiguli ngasinye, impilo iyonke, kanye nezici ezithile zesimila. Intuthuko yakamuva ekuhlonzweni kwamangqamuzana kanye nemithi yomuntu siqu yenza ngcono imiphumela yalabo abatholakala bene-LCLC.Ukuqonda Umdlavuza Weseli Elikhulu WamaphaphuUyini Umdlavuza Weseli Elikhulu Lamaphaphu?Ukwelashwa komdlavuza wamaphaphu omkhulu (LCLC) wuhlobo lomdlavuza wamaphaphu ongewona omncane. Ithola igama layo kumaseli amakhulu, abukeka ngendlela engavamile abonwa ngaphansi kwesibonakhulu. I-LCLC ijwayele ukukhula futhi isabalale ngokushesha, okwenza ukuxilonga kusenesikhathi nokwelashwa kubaluleke kakhulu. Nakuba kungavamile kakhulu kunezinye izinhlobo ze-NSCLC, ukuqonda izici zayo kubalulekile ekulawuleni okuphumelelayo.Izici Eziyingozi NokuvimbelaNgokufana nezinye izinhlobo zomdlavuza wamaphaphu, ukubhema kuyisici esiyingozi esihamba phambili se-LCLC. Ezinye izici eziyingozi zihlanganisa ukuchayeka entuthuni kagwayi, i-radon, i-asbestos, nezinye izinto zasembonini. Ukuyeka ugwayi, ukugwema ukuchayeka emagciwaneni aziwayo, nokugcina indlela yokuphila enempilo kuyizinyathelo ezingcono kakhulu zokuvimbela. Ukuhlolwa njalo kanye nokuhlolwa komdlavuza wamaphaphu kubantu abasengozini enkulu nakho kungasiza ekutholakaleni kusenesikhathi futhi kube ngcono. ukwelashwa komdlavuza wamaphaphu omkhulu imiphumela.Izinketho Zokwelashwa Zomdlavuza Weseli Elikhulu UkuhlinzwaUkuhlinzwa kuvame ukuba umugqa wokuqala wokwelapha we-LCLC yesigaba sangaphambi kwesikhathi, lapho isimila senziwe sasendaweni futhi singakasabaleli ezindaweni ezikude. Inqubo yokuhlinzwa ingase ihilele ukukhipha ingxenye yephaphu (ukususwa kwe-wedge noma i-segmentectomy), i-lobe yonke (lobectomy), noma ngisho nephaphu lonke (i-pneumonectomy). Ukukhethwa kokuhlinzwa kuncike kusayizi nendawo yesimila, kanye nomsebenzi wamaphaphu jikelele wesiguli. Amathimba okuhlinza e-Shandong Baofa Cancer Research Institute anolwazi oluningi kulezi zinqubo.I-ChemotherapyI-Chemotherapy yindlela yokwelapha ehlelekile esebenzisa imithi ukubulala amangqamuzana omdlavuza emzimbeni wonke. Ivamise ukusetshenziswa ekuhlanganisweni nokuhlinzwa noma ukwelashwa ngemisebe, noma njengokwelashwa okuyinhloko kwe-LCLC yezinga eliphezulu. Imithi ejwayelekile yokwelapha ngamakhemikhali ye-LCLC ihlanganisa izidakamizwa ezisekelwe ku-platinum (njenge-cisplatin noma i-carboplatin) ehlanganiswe namanye ama-chemotherapy agents. Imiphumela engemihle yokwelashwa ngamakhemikhali ingase ihlanganise isicanucanu, ukukhathala, ukuqothuka kwezinwele, kanye nengozi eyengeziwe yokutheleleka.Ukwelashwa ngemisebeUkwelashwa ngeRadiation kusebenzisa imisebe enamandla amakhulu ukuze kuqondiswe futhi kubhubhise amangqamuzana omdlavuza. Ingasetshenziselwa ukwelapha i-LCLC ngezindlela eziningana: njengendlela yokwelapha eyinhloko ezigulini ezingazohlinzwa, njenge-adjuvant yokwelapha ngemva kokuhlinzwa ukuze kubulawe noma yimaphi amangqamuzana omdlavuza asele, noma ukukhulula izimpawu ezinjengobuhlungu noma ukuphelelwa umoya ezifweni ezisezingeni eliphezulu. Izinhlobo zokwelapha ngemisebe ezisetshenziswa ku-LCLC zifaka ukwelapha ngeradiation ye-beam yangaphandle (EBRT) kanye ne-stereotactic body radiation therapy (SBRT).Imithi yokwelapha ehlosiwe iqondise ngokukhethekile ama-molecule athile noma izindlela ezihileleke ekukhuleni kweseli lomdlavuza kanye nokuphila. Lezi zindlela zokwelapha zisebenza kakhulu ezigulini ezinokuguquguquka okuthile kofuzo kumathumba azo. Okuhlosiwe okujwayelekile ku-LCLC kufaka i-EGFR, ALK, ROS1, kanye ne-BRAF. Ngaphambi kokuqala ukwelashwa okuhlosiwe, iziguli ngokuvamile zihlolwa amangqamuzana ukuze kutholwe ukuthi izimila zazo anazo yini zalezi zinguquko ezingenzeka. Uma udinga usizo oluthile, i-Baofa Cancer Research Institute ingahlinzeka ngezinsizakalo zokuhlola izakhi zofuzo.I-ImmunotherapyImmunotherapy ihlanganisa amandla amasosha omzimba okulwa nomdlavuza. Ama-immune checkpoint inhibitors, njenge-pembrolizumab, nivolumab, ne-atezolizumab, awuhlobo lwe-immunotherapy oluvimba amaprotheni avimbela amasosha omzimba ekuhlaseleni amangqamuzana omdlavuza. I-Immunotherapy ibonise imiphumela ethembisayo ekwelapheni i-LCLC, ikakhulukazi ezigulini ezinezimila eziveza amazinga aphezulu e-PD-L1. Ingasetshenziswa njengendlela yokwelapha yomugqa wokuqala ye-LCLC yesigaba esithuthukisiwe noma ngemva kokuba ukwelapha ngamakhemikhali kuhlulekile.Intuthuko Enkulumweni Yeseli Enkulu Yamaphaphu Ukwelashwa KomdlavuzaI-Molecular ProfilingIphrofayili yemolekyuli ihilela ukuhlaziya izicubu zesimila sesiguli ukuze kutholakale ukuguqulwa okuthile kofuzo noma ezinye izinguquko zamangqamuzana ezingase ziqhubekise ukukhula komdlavuza. Lolu lwazi lungasiza odokotela bakhethe ukwelashwa okuhlosiwe okufanele kakhulu noma i-immunotherapy yesiguli ngasinye. I-Next-generation sequencing (NGS) iyindlela evamile esetshenziselwa ukwenza iphrofayili yamangqamuzana, evumela ukutholakala ngesikhathi esisodwa kofuzo oluningi. ukwelashwa komdlavuza wamaphaphu omkhulu esigulini ngasinye ngokusekelwe kuphrofayili yengqamuzana yesimila, impilo iyonke, kanye nalokho abakuthandayo. Le ndlela ihlose ukukhulisa ukusebenza kahle kokwelashwa kuyilapho kunciphisa imiphumela emibi. Umuthi oqondene nawe uya ngokuya ubaluleke kakhulu ekuphathweni kwe-LCLC, njengoba uvumela odokotela ukuthi bakhethe isu lokwelapha elifaneleka kakhulu esigulini ngasinye.Isivivinyo SemitholampiloIzinhlolo zocwaningo zocwaningo ezihlola izindlela zokwelapha ezintsha noma izinhlanganisela zokwelapha ze-LCLC. Ukubamba iqhaza ocwaningweni lomtholampilo kunganikeza iziguli ukufinyelela ekwelashweni kwesimanjemanje okungakatholakali kabanzi. Izivivinyo zemitholampilo ziyingxenye ebalulekile yokuthuthukisa ukunakekelwa komdlavuza, futhi iziguli kufanele zixoxisane nodokotela bazo ukuthi ukuhlanganyela esivivinyweni somtholampilo kuyinketho enhle kubo.Amazinga Okubikezela kanye NokusindaUkubikezela kwe-LCLC kuyahlukahluka kuye ngezinto eziningana, okuhlanganisa isigaba somdlavuza ekuxilongweni, impilo yesiguli iyonke, kanye nokusabela ekwelashweni. I-LCLC yesigaba sangaphambi kwesikhathi eselashwa ngokuhlinzwa ine-prognosis engcono kune-LCLC yesiteji esithuthukile esisabalele kumasayithi akude. Intuthuko ekwelashweni, njengokwelashwa okuhlosiwe kanye ne-immunotherapy, ithuthukise amazinga okusinda ezigulini ezine-LCLC eminyakeni yamuva. Izilinganiso Zokusinda Zeminyaka Emi-5 Yomdlavuza Ongewona Owomncane Wengqamuzana Wamaphaphu (NSCLC) Ngesigaba 1 Isigaba Sokusinda Seminyaka Emi-5 Enziwe Yasendaweni 63% Isifunda 36% Ekude 8% Zonke Izigaba Ze-SEER 26% *Qaphela: Lawa mazinga okusinda asekelwe kudatha evela ku-National Cancer Institute's Surveillance, I-EndLide ye-EndLide ye-EndLide kanye nohlelo lwe-Epide ye-EndLide. Umdlavuza WamaphaphuUkuphila ne-LCLC kungaba inselele, kodwa kunezinsiza ezitholakalayo zokusiza iziguli nemindeni yazo ukuba zibhekane nemiphumela engokomzimba nengokomzwelo yalesi sifo. Amaqembu okusekela, ukwelulekwa, kanye nokunakekelwa kwe-palliative kunganikeza usizo olubalulekile. Ukugcina indlela yokuphila enempilo, kuhlanganise nokudla okulinganiselayo nokuzivocavoca njalo, kungathuthukisa izinga lempilo. Ukuxoxa ngezinto ezikukhathazayo nemibuzo nethimba lakho lokunakekelwa kwezempilo kubalulekile ekuphatheni i-LCLC ngempumelelo.Ukuthola Ukusekela NezinsizaIzinhlangano eziningi zinikeza ukwesekwa nezinsiza kubantu abatholakala bene-LCLC nemindeni yabo. Lezi zinsiza zihlanganisa izinto zokufunda, amaqembu osekelo, izinhlelo zosizo lwezezimali, nemizamo yokumela. Ukuxhumana nalezi zinsiza kunganikeza ukwesekwa okubalulekile nesiqondiso kulo lonke uhambo lomdlavuza.Izithenjwa: I-American Society of Clinical Oncology (ASCO): Umdlavuza Wamaphaphu - Iseli Elingelona Elincane: Izibalo.