ukwelashwa okusha okungewona amangqamuzana amancane omdlavuza wamaphaphu

Ukwelashwa Komdlavuza Omusha Ongewona Omncane Wengqamuzana Wamaphaphu

Lo mhlahlandlela ophelele uhlola intuthuko yakamuva ukwelashwa okusha okungezona okuncane komdlavuza wamaphaphu wamangqamuzana. Sizofaka izindlela zokwelapha ezahlukahlukene, okubandakanya izindlela zokwelapha ezihlosiwe, i-immunotherapy, kanye ne-chemotherapy, sinikeza imininingwane ngokusebenza kwazo, imiphumela engemihle, nokufaneleka kwamaphrofayili esiguli ahlukene. Funda mayelana nokuvela kwezwe lokwelashwa kwe-NSCLC nokuthi abacwaningi baqhubeka kanjani besebenzela izinketho ezisebenza kahle nezingenabo ubuthi obuncane.

Ukuqonda Umdlavuza Ongewona Owomncane Weseli Wamaphaphu (NSCLC)

Yini i-NSCLC?

Umdlavuza wamaphaphu ongewona omncane (i-NSCLC) ubala cishe ama-85% awo wonke umdlavuza wamaphaphu. Iqembu lomdlavuza okhula emaphashini futhi ubonakala ngokubonakala kwamaselula okuhlukile ngaphansi kwesibonakhulu. Ukuxilongwa kusenesikhathi kubalulekile ukuze kube nemiphumela yokwelashwa ethuthukisiwe. Isigaba somdlavuza ekuxilongweni sithinta kakhulu izinqumo zokwelashwa kanye ne-prognosis. I-Shandong Baofa Cancer Research Institute (https://www.baofahospital.com/) ungumholi kulo mkhakha, ohlinzeka ngokunakekelwa okuphelele kanye nocwaningo ku-NSCLC.

Isiteji kanye Nokuxilongwa kwe-NSCLC

Isiteji esinembayo sibalulekile ekunqumeni inkambo engcono kakhulu ukwelashwa okusha okungezona okuncane komdlavuza wamaphaphu wamangqamuzana. Lokhu kuhilela ukuhlola okuhlukahlukene, okuhlanganisa ama- imaging scans (CT, PET), ama- biopsies, nokuhlolwa kwegazi. Uhlelo lwesiteji lwe-TNM luvame ukusetshenziselwa ukuhlukanisa i-NSCLC ngokusekelwe kusayizi wesimila (T), ukubandakanyeka kwe-lymph node (N), kanye ne-metastasis (M). Ukutholwa kusenesikhathi, ngokuvamile ngokuhlolwa okuvamile kwabantu abasengozini enkulu, kuthuthukisa amathuba okwelashwa okuphumelelayo.

Izinketho Zokwelashwa ze-NSCLC

Ukwelapha Okuhlosiwe

Izindlela zokwelapha ezihlosiwe zigxile kuma-molecule athile ahilelekile ekukhuleni komdlavuza. Le mithi ingasebenza kangcono futhi ibe nemiphumela engemihle embalwa kune-chemotherapy yendabuko kwezinye iziguli. Izibonelo zifaka ama-EGFR inhibitors (njenge-gefitinib ne-erlotinib) nama-ALK inhibitors (njenge-crizotinib). Ukukhethwa kokwelashwa okuhlosiwe kuncike ekuguquguqukeni kofuzo okuthile okukhona kumaseli omdlavuza.

I-Immunotherapy

I-Immunotherapy ihlanganisa amandla amasosha omzimba ukulwa nomdlavuza. I-Checkpoint inhibitors, njenge-pembrolizumab ne-nivolumab, ivimba amaprotheni avimbela amasosha omzimba ekuhlaseleni amangqamuzana omdlavuza. Le mithi ibonise impumelelo emangalisayo ekwelapheni i-NSCLC, ikakhulukazi ezigulini ezinama-biomarker athile. I-Immunotherapy ingaba nemiphumela engemihle ehlukile kune-chemotherapy, edinga ukuqapha ngokucophelela ochwepheshe bezokwelapha.

I-Chemotherapy

I-Chemotherapy isebenzisa izidakamizwa ukubulala amangqamuzana omdlavuza. Ingasetshenziswa iyodwa noma ihlanganiswe nezinye izindlela zokwelapha. Kunezinhlobo ezahlukene zemithi yokwelapha ngamakhemikhali, eyenzelwe izidingo ezithile zesiguli kanye nesigaba somdlavuza waso. Izidakamizwa ezisetshenziswa kakhulu zifaka i-cisplatin, i-carboplatin, ne-paclitaxel. I-Chemotherapy ingaba nemiphumela engemihle emikhulu, futhi ukulawula le miphumela engemihle kuyingxenye ebalulekile yokwelashwa.

Ukwelapha Ngemisebe

Ukwelapha ngemisebe kusebenzisa imisebe enamandla amakhulu ukucekela phansi amangqamuzana omdlavuza. Ingasetshenziselwa ukunciphisa izimila, ukukhulula izimpawu, noma ukuvimbela ukuphindeka komdlavuza. Izinhlobo ezahlukene zokwelapha ngemisebe zikhona, okuhlanganisa imisebe yangaphandle ye-beam kanye ne-brachytherapy. Ukwelashwa ngemisebe nakho kungaba nemiphumela engemihle, kuye ngendawo elashwayo kanye nomthamo.

Ukwelashwa Okusafufusa Nocwaningo

Izilingo Zomtholampilo

Ukubamba iqhaza ezivivinyweni zomtholampilo kunganikeza ukufinyelela kokusungulayo ukwelashwa okusha okungezona okuncane komdlavuza wamaphaphu wamangqamuzana ngaphambi kokuba zitholakale kabanzi. Lezi zinhlolo zibhekwa ngokucophelela futhi zinikeza iziguli ithuba lokufaka isandla entuthukweni yezokwelashwa kuyilapho zithola ukunakekelwa kwesimanje. Abacwaningi e-Shandong Baofa Cancer Research Institute babambe iqhaza ngenkuthalo ezivivinyweni eziningi zemitholampilo ezihlola izindlela zokwelapha ezintsha ze-NSCLC.

I-Liquid Biopsy

I-Liquid biopsies iyindlela engavamile yokuthola nokuqapha umdlavuza. Kubandakanya ukuhlaziya amasampula egazi e-circulating tumor DNA (ctDNA), enganikeza imininingwane ebalulekile ekwakhekeni kofuzo lomdlavuza futhi iqondise izinqumo zokwelashwa. Lobu buchwepheshe obusha buvumela izindlela zokwelashwa eziqondene nomuntu siqu, ukuthuthukisa izinhlelo zokwelashwa ezisuselwe ezidingweni zesiguli ngasinye.

Ukukhetha Ukwelashwa Okulungile

Okungcono kakhulu ukwelashwa okusha okungezona okuncane komdlavuza wamaphaphu wamangqamuzana indlela yokubhekana nayo iyahlukahluka kuye ngezinto eziningana, okuhlanganisa isigaba somdlavuza, impilo yesiguli iyonke, kanye nokuba khona kwezinguquko ezithile zofuzo. Ithimba lezinhlaka eziningi lodokotela be-oncologists, odokotela abahlinzayo, nabanye ochwepheshe bezokunakekelwa kwezempilo bavame ukubamba iqhaza ekwakheni uhlelo lokwelapha lomuntu siqu. Ukuxhumana okuvulekile nomhlinzeki wakho wezempilo kubalulekile ukuze uqinisekise ukuthi uyaziqonda izinketho zakho futhi wenze izinqumo ezinolwazi.

Umshwana wokuzihlangula: Lolu lwazi luhloselwe izinjongo zokufundisa kuphela futhi akufanele luthathwe njengeseluleko sezokwelapha. Hlala uthintana nochwepheshe bezempilo abaqeqeshiwe ukuze uxilongwe futhi ulashwe noma yisiphi isimo sezempilo.