isigaba sokwelashwa 3 Ukwelashwa komdlavuza wamaphaphu okungewona omncane

Izinketho Zokwelapha ZeSigaba 3 Umdlavuza Wamaphaphu Ongewona Amancane Amaseli

Isigaba sesi-3 somdlavuza wamaphaphu ongewona omncane (NSCLC) siletha izinselelo eziyingqayizivele, ezidinga indlela yokwelashwa ehlukahlukene. Lo mhlahlandlela obanzi uhlola izindlela zokwelashwa ezahlukahlukene, uveza ukusebenza kahle kwazo, imiphumela engemihle engaba khona, nokufaneleka kuye ngezici zesiguli ngasinye. Ukuqonda lezi zinketho kubalulekile ukuze wenze izinqumo ezinolwazi eceleni kwe-oncologist yakho.

Ukuqonda Isigaba 3 NSCLC

Isigaba sesi-3 se-NSCLC sihlukaniswe ngeSigaba IIIA kanye ne-IIIB, okubonisa izinga lokusabalala komdlavuza. Isigaba IIIA sibandakanya umdlavuza osusabalele kuma-lymph nodes aseduze, kuyilapho iSigaba IIIB sihlanganisa ukubandakanyeka okubanzi kwama-lymph node kanye/noma ukusabalala ezakhiweni eziseduze. Isiteji esinembile ngokuthwebula (ama-CT scan, ama-PET scans) kanye nama-biopsies kubalulekile ekunqumeni okufanele kakhulu isigaba sokwelashwa 3 Ukwelashwa komdlavuza wamaphaphu ongewona omncane uhlelo.

Izindlela Zokwelapha ZeSigaba 3 NSCLC

Ukuhlinzwa

Ukuhlinzwa kungase kube inketho yeziguli ezikhethiwe zeSigaba IIIA ezinokubandakanyeka okulinganiselwe kwe-nodal kanye nempilo enhle iyonke. Lokhu kungase kuhlanganise i-lobectomy (ukususwa kwe-lung lobe) noma i-pneumonectomy (ukususwa kwephaphu lonke). Ukuhlinzwa kabusha kuvame ukulandelwa ukwelashwa kwe-adjuvant (i-chemotherapy noma imisebe) ukunciphisa ingozi yokuphinda. Isinqumo sokuqhubeka nokuhlinzwa sincike ezicini eziningana, okuhlanganisa indawo nobukhulu besimila, impilo yesiguli iyonke, kanye nezinga lokubandakanyeka kwe-lymph node. I-Shandong Baofa Cancer Research Institute inikeza ubuchwepheshe obuphelele bokuhlinza umdlavuza wamaphaphu.

I-Chemotherapy

Ukwelashwa ngamakhemikhali, ukusebenzisa izidakamizwa ezinamandla ukubulala amangqamuzana omdlavuza, kuyinto evamile isigaba sokwelashwa 3 Ukwelashwa komdlavuza wamaphaphu ongewona omncane Yesigaba IIIA kanye ne-IIB NSCLC. Imithi iyahlukahluka kuye ngezinto ezingazodwana, futhi ingase ihlanganise izidakamizwa ezisekelwe ku-platinum (i-cisplatin noma i-carboplatin) ehlanganiswe namanye ama-ejenti afana ne-pemetrexed noma i-docetaxel. I-Chemotherapy ingenziwa ngaphambi kokuhlinzwa (i-neoadjuvant) ukuze kuncishiswe isimila, ngemva kokuhlinzwa (i-adjuvant) ukuze kuqedwe amangqamuzana omdlavuza asele, noma njengokwelashwa okuyinhloko. Imiphumela emibi ivamile futhi ingabandakanya isicanucanu, ukukhathala, nokulahlekelwa izinwele; nokho, lezi zivame ukulawuleka ngokunakekelwa okusekelayo.

Ukwelapha Ngemisebe

Ukwelapha ngemisebe kusebenzisa imisebe enamandla amakhulu ukucekela phansi amangqamuzana omdlavuza. Ingasetshenziswa yodwa noma ihlanganiswe ne-chemotherapy. Ukwelashwa ngemisebe kungasetshenziswa ngaphambi kokuhlinzwa (i-neoadjuvant) ukuze kuncishiswe isimila, ngemva kokuhlinzwa (i-adjuvant) ukuze kukhonjwe noma yimaphi amangqamuzana omdlavuza asele, noma njengokwelashwa okuyinhloko, ikakhulukazi ezigulini ezingazohlinzwa. I-Stereotactic body radiation therapy (SBRT) iwuhlobo olunembile lwemisebe eletha imithamo ephezulu yemisebe esimila ngenkathi isindisa izicubu ezizungezile ezinempilo. Uhlobo oluthile kanye nesilinganiso sokwelashwa ngemisebe kuncike esimweni somuntu.

Ukwelapha Okuhlosiwe

Ukwelapha okuhlosiwe kusebenzisa izidakamizwa eziqondise ngokuqondile amangqamuzana omdlavuza ngokusekelwe ekuguquguqukeni kwawo kofuzo. Ukuguqulwa okuthile kofuzo (okufana ne-EGFR, ALK, ROS1 mutations) kuvamile ku-NSCLC futhi kungase kubikezele ukusabela ekwelapheni okuqondile okuqondisiwe. Uma ukuguqulwa okunjalo kukhonjwa, ukwelashwa okuhlosiwe kungase kube isisekelo isigaba sokwelashwa 3 Ukwelashwa komdlavuza wamaphaphu ongewona omncane, okungenzeka inikeze imiphumela ethuthukisiwe kanye nemiphumela engemihle embalwa uma iqhathaniswa nokwelapha ngamakhemikhali okuvamile. I-oncologist yakho izohlola izakhi zofuzo ukuze inqume ukuthi ukwelashwa okuhlosiwe kukulungele yini.

I-Immunotherapy

I-Immunotherapy ihlanganisa amandla amasosha omzimba okulwa nomdlavuza. Ama-immune checkpoint inhibitors, njenge-nivolumab noma i-pembrolizumab, asetshenziselwa ukuvimba amaprotheni avimbela amasosha omzimba ekuhlaseleni amangqamuzana omdlavuza. I-Immunotherapy ivame ukusetshenziswa ngokuhambisana nokwelashwa ngamakhemikhali futhi ingase ibe inketho ezigulini ezinamaphrofayili athile ofuzo noma lezo ezingazange zisabele kahle kwezinye izindlela zokwelapha. Imiphumela engemihle ingenzeka futhi iyahlukahluka kuye ngomuthi othile.

Ukukhetha Uhlelo Lokwelapha Olulungile

Okulungile isigaba sokwelashwa 3 Ukwelashwa komdlavuza wamaphaphu ongewona omncane isu lincike ezicini eziningana, okuhlanganisa isigaba somdlavuza, impilo yesiguli iyonke, kanye nokuba khona kwezinguquko ezithile zofuzo. Ithimba lemikhakha eminingi yodokotela be-oncologists, odokotela abahlinzayo, nabelaphi bemisebe bazosebenza ngokubambisana ukuze lenze uhlelo lokwelapha lomuntu siqu. Ukuxhumana okuvulekile nomhlinzeki wakho wokunakekelwa kwezempilo kubalulekile ukuze uqonde izinketho zakho futhi wenze izinqumo ezinolwazi mayelana nokunakekelwa kwakho.

Lolu lwazi ngelezinjongo zokufundisa kuphela futhi akufanele luthathwe njengeseluleko sezokwelapha. Hlala uthintana nomhlinzeki wakho wokunakekelwa kwezempilo ukuze uxilongwe futhi ulashwe noma yisiphi isimo sezempilo.

Umshwana wokuzihlangula: Lolu lwazi luhloselwe ulwazi olujwayelekile kanye nezinjongo zolwazi kuphela, futhi aluhlanganisi iseluleko sezokwelapha. Kubalulekile ukubonisana nochwepheshe bezempilo abaqeqeshiwe nganoma yikuphi ukukhathazeka ngezempilo noma ngaphambi kokwenza noma yiziphi izinqumo ezihlobene nempilo noma ukwelashwa kwakho. Ulwazi olunikezwe lapha akufanele luthathwe njengoluthatha indawo yeseluleko sezokwelapha esichwepheshile, ukuxilonga, noma ukwelashwa.