Unyango lwe-Brain Metastases Kusuka kwiCanscer Breast
Yintoni eyenzekayo xa umdlavuza wakho webele usasazeka kwingqondo yakho? Ngamanye amaxesha, i-brainast metastases ifunyenwe xa isifo somhlaza wesifuba sifunyanwa kuqala, kodwa ininzi yexesha, ubuchopho be-brainstatic bubonakala njengento ephindaphindiweyo yomdlavuza webele owawusaphathwa ngaphambili. Ziziphi iimpawu ezinokuthi zenzeke, kwaye zeziphi iindlela zokwelapha ezikhoyo xa umdlavuza wakho webele usasazeka kwiqondo lakho?
Ngokubanzi, ubuchopho be-metastases buba ngama-15 ukuya kuma-24 ekhulwini kwabasetyhini abanomdlavuza webele. Njengoko ukuphucula kuphuculwe, kunjalo, eli nani lilindeleke landa.
Inkcazo kunye noBume
Ingqondo ingenye yeendawo eziqhelekileyo apho umdlavuza webele usasazeka , kunye namathambo , imiphunga kunye nesibindi . Xa umdlavuza webele usasazeka kwingqondo, uthathwa njengesigaba 4 okanye umdlavuza webele we-metastatic. Nangona kungasayi kuphulukiswa ngeli nqanaba, lonyango, kwaye unyango lunokuphucula iimpawu, luncedo ngobunjani bobomi, kwaye ngamanye amaxesha ludla ubomi.
Xa umdlavuza webele udibanisa ingqondo, usengumdlavuza webele. Ukuba ubuza kuthatha isampuli yobunzima okanye ubuninzi emzimbeni, babeza kuba neeseli zesifuba zesifo somhlaza, kungekhona amangqamuzana engqondo. I-Brain metastases ayibizwa ngokuthi "umdlavuza wengqondo" kodwa kunoko "isifo somhlaza wesifuba esiswini" okanye "umdlavuza wesifuba kunye nesifo sengqondo." Ngenxa yoko, unyango lusetyenziselwa umhlaza wesifuba esiphezulu, kungekhona ezo zisetyenziselwa umhlaza wengqondo.
Kwixesha elidlulileyo, ubuchopho be-metastase babesoloko becingwa njengesilumkiso sokunyanzelisa kwaye injongo yonyango "yayilula," oku kuthetha ukulawula iimpawu kodwa ungazami ukuphilisa i-tumor. Kwiminyaka yakutshanje, imbono "ye-oligometastases" iye yaqwalaselwa. Okokuthi, xa umntu enomzimba omnye okanye ezimbalwa, kwaye akukho ziphumo ezinqamlekileyo kwezinye iindawo zomzimba, indlela yokwelapha yokuphelisa i-metastases ingazama.
Ngamanye amagama, ngelixa unyango luhlala luhlala lugxininisa, ngakumbi kulabo abanamathotholo amaninzi okanye aphezulu, kwabanye abantu, unyango olusenokwenzeka ukuba lunokukhetha.
Iimpawu
Kukho inani leempawu ezahlukileyo ezingachaza ubukho bobuchopho. Ngamanye amaxesha akukho zibonakaliso, kwaye ezi ziphumo zifunyenwe kuphela xa uvavanyo lweemifanekiso, olufana nokuhlolwa kwe-PET okanye i-MRI yengqondo. Xa iimpawu zikhoyo zingabandakanya:
- Intloko: Inwele ngenxa yengqondo ye-metastases ingafana neentloko zentsholongwane okanye i-migraine ikhanda, kodwa inokuhamba kunye nezinye iimpawu ze-neurological (kunye nezantsi). Kwisifundo esinye, iintloko zazikho kwiipesenti ezingama-35 zabantu xa i-brainstatic i-metastases ifunyenwe. Intloko ezinxulumene nobuchopho be-metastase ziba nzima ngakumbi ngokulala, zibi kakhulu kusasa okanye emva kokulahlwa, kwaye zibi ngakumbi ngokukhwehlela, ukunyunyuza okanye ukunyathela ukunyakaza. Oko kwathiwa, kunokuba nzima ukuhlukanisa phakathi "eziqhelekileyo" iintloko kunye nalabo ngenxa yeemastastases ngaphandle kokufunda izifundo.
- Ukutshabalalisa: Ukuvuthwa (okanye ngaphandle kwesicathulo) kwakungowesibini uphawu oluqhelekileyo lwengqondo ye-metastase kwisifundo esinye. Kungenzeka ngokukhawuleza ngaphandle kokunyamezela kwangaphambili kwaye kudla kakubi emva kokulala phantsi nangomso. Ukutshabalalisa ngenxa yengqondo ye-metastases iyancipha ngakumbi kwaye iphindwe rhoqo kwixesha.
- Ubuthakathaka kwelinye icala lomzimba, ukuphazamiseka, okanye ukubetha emacaleni: I-Hemiparesis, ubuthathaka okanye ukukhubazeka kwelinye icala lomzimba, kwakungowesithathu uphawu oluqhelekileyo lweengqondo ze-brainast metastases kwisifundo esinye.
- Umbono utshintsho : iingxaki ezifana nombono ombini, umbono obonakalayo, ukubona ukukhanya kokukhanya, okanye ukulahleka kombono kunokwenzeka.
- Ukuxoshwa: Ukuxhatshazwa kunokuthi kube yi-tonic-clonic (inkulu mal) apho umzimba wonke uphazamisa kwaye umntu ulahlekelwa ingqalelo, ukuxhatshazwa kwincinci, apho inxalenye, njengengalo yokugubha, okanye ezinye iintlobo zokuthintela, umzekelo, abo umntu ubonakala ejonge kwindawo engabonakaliyo.
- Ukulahlekelwa ukulinganisela: Ukulahleka kokulinganisela kunokuqala kubonakale kukuxhamla, ngokusebenza kwiibalithi okanye kwi-benders njengempawu.
- Izinguqu zengqondo: Utshintsho lomntu, utshintsho lwendlela yokuziphatha, utshintsho lweemeko, okanye isigwebo esingafanelekanga.
Izinto Zingozi / Iingxaki
Akukho mntu oqinisekileyo ukuba kutheni abanye abantu behlakulela ingqondo ye-metastases kunye nabanye abayithandi. Siyazi ngeminye yemingcipheko, nangona kunjalo, oko kuqikelelwe ukuba abantu kunye neziphi na izicubu ezinokuthi zisasazeka kwiingqondo. I-Brain metastase inokwenzeka kakhulu kubasetyhini abaselula abanomdlavuza wesibeleko , kwaye iziganeko ziphezulu kakhulu kulabo bafunyanwe ngaphambi kokuba baneminyaka engama-35. Izidumbu ezinokuthi zisasazeke kwingqondo ziquka abo banezinga eliphezulu le- tumor , abo ba-HER2 positive kunye ne-estrogen receptor engafanelekanga, kunye nezo zinto zingekho ezintathu.
I-Brain metastase iyakwazi ukuba yenzeke kulabo abanezikhumba ezininzi (ngaphezu kwe-2 cm ububanzi), kunye nabantu abanesifo se-lymph nodes ngexesha lokuqala ukuxilongwa. Ixesha elincinci phakathi komhlaza wesantya sokuqala kunye nokuphindaphinda kudibaniswa nomngcipheko omkhulu wobuchopho beengqondo.
Ukuxilongwa
Iingcamango zokucinga ezisoloko zibona ubuchopho be-brainstas ziquka i-MRIs yengqondo kunye ne-PET. Iingcingo ze-CT zentloko zingasetyenziselwa abo abangenako ukufumana i-MRI eyenziwa (umzekelo, abo banezikhungululi), kodwa ii-CT izicatshulwa zingasebenzi kangangoko ekunqumeni ubukho be-metastases. Ukuxilongwa ngokuqhelekileyo kwenziwa ngokusekelwe ekufunyanweni kweengcamango kunye nembali yomhlaza wesifuba, kodwa i-biopsy ingadinga. Ekubeni isimo se-receptor sinokutshintsha (nokuba i-tumor is receptor receptor, i-progesterone receptor, okanye i-HER2 positive) kunye ne-metastase, i-biopsy inokufuneka ukuba ukhethe iindlela ezifanelekileyo zokunyango.
Iindawo eziqhelekileyo zengqondo ye-metastases yi-cerebellum (inxalenye yengqondo elawula ukulinganisela) kunye ne -lobes yangaphambili . Ubuncinane isiqingatha sabantu abasifumene neengqondo zesifo sengqondo esivela emdlalweni wesibeleko sebele kuya kuba ne-metastases ezininzi ezikhoyo.
Unyango
Izinyango zokwelapha iingqondo zengqondo zingaphulwa zibe yonyango lwenkqubo, abo baphatha umdlavuza naphi na apho emzimbeni, kunye nezokwelapha, ezo zijongene ngqo neengqondo zokuhlaziya. Ukongezelela kwonyango olusetyenziselwa ukulungisa umhlaza ngokwawo, i-steroids isetyenziselwa ukunciphisa ukukhukhumeza kwengqondo, kwaye ngamanye amaxesha inganciphisa kakhulu imiphumo emibi.
Enye ingxaki ebalulekileyo ekuphatheni ubuchopho be-brainstatic kukuba ezininzi iziyobisi azikwazi ukungena kwi-barrier brain-barrier. Umqobo we-brain-brain is a network tight of capillaries eyenzelwe ukugcina i-toxins ngaphandle kwengqondo. Ngelishwa, kusebenza kakhulu ekugcineni iziyobisi zamakhemikhali, kunye neminye imithi ephuma engqondweni. Izifundo ngoku zijonge iindlela zokunyusa ukutshabalalisa kweengcambu zegazi.
Ukongeza kwi-steroids kunye neenkqubo zonyango okanye iingingqi zengqondo ye-metastase, kubalulekile ukujongana nezinye iimpawu ezinxulumene nomdlavuza we-metastatic, ukhathala okunjalo, ukulahleka kwesidlo, ukuxinezeleka, nokunye. I-oncologist yakho ingancoma ukuba unxibelelwano lwentsebenziswano , kwaye oku kuya kunkwantya ukuba awukwazi kakuhle intsimi. Ukunyamekela okuqhelekileyo akufani ne-hospice, kodwa yindlela yokwelapha esetyenziselwa ukuphatha iimpawu zenyama, iimvakalelo kunye nezomoya ezihamba kunye nokuxilongwa komhlaza. Ukunyamekela okuluncedo kunokuba luncedo nangona kudla kakhulu.
Khetha iindlela
Izinyathelo zokonyango eziqhelekileyo yilezo ezisetyenziselwa ukujongana nomhlaza wakho webele kungakhathaliseki ukuba ziphi emzimbeni wakho. Ingaba unayo okanye unayo unyango lwengingqi kwingqondo yakho yesifo, i-mainstay yonyango ngokuqhelekileyo le yonyango. Ukwelashwa okwenkqubo yesifo somhlaza wesifo semitha kungabandakanya:
Chemotherapy
I-Chemotherapy isoloko isetyenziselwa umdlavuza webele we-metastatic, ngokuqhelekileyo usebenzisa iziyobisi ezahlukileyo kunokuba unayo ukuba unayo i-chemotherapy ngaphambili. Kukho iindlela ezininzi ezahlukeneyo okanye "imigca" yonyango engasetyenziswa. Njengoko kuphawuliwe, amaninzi ama-agents e-chemotherapy ayangena ngaphakathi kwinqanaba legazi, kodwa ngokuthe rhoqo ukuhlaziywa kwezinye iindawo zikhoyo kunye neengqondo ze-metastases. Inokukunceda ekunciphiseni umngcipheko weemastastas eziqhubekayo kwingqondo.
Unyango lweHormonal
Ukunyangwa kwe-hormonal ye-metastatic cancer yomhlaza kunokunconywa ukuba i-tumor yakho i-estrogen receptor. Ukusetyenziswa kwezi zi yobisi kunokuxhomekeke ekubeni unobonyango be-hormone ngaphambili, kwaye ukuba kunjalo, yiyiphi imithi owayithatha. Xa umdlavuza webele udibanisa ukuba awuqhelekanga ukuba isimo samukeli sitshintshe, umz. Ngokuqhelekileyo kucinga ukuba ukuba unesifo esithile se-hormonal xa umhlaza wakho unqabile, ukuba i-tumor ayimelana naloo mziyo. Ngokungafani neendlela ezininzi zokonyango, i-tamoxifen kunye ne- aromatase inhibitors zibonakala ziwela i-barrier-brain brain
Iimpawu zokwelapha ezijoliswe
Izinyango zokwelapha kwi- metastatic HER2 isifo somhlaza wesifuba esifanelekileyo sincike kwiyiphi na, ukuba kukho na, unyango oye wahlala ngalo xa i-tumor yakho idibene. Njengoko i-estrogen receptor status, isimo se-HER2 sinokutshintsha, ukwenzela ukuba i-tumor eyayi-HER positive ngaphambili ingaba yi-HER2 engalunganga xa isasazeka kwingqondo kunye nangona kunjalo. Kulabo abangazange bafumane i-H3 ngaphambili, unyango kunye no-Herceptin (trastuzumab) okanye iPerjecta (pertuzumab) lunokuphucula ukuphila. Ukuba ubuchopho be-metastases buphuhliswa ngelixa umntu ethatha i-Herceptin (okanye kwiinyanga ezili-12 zokumisa isilwanyana), isilwanyana se-T-DM1 (trastuzumab emtansine) sifunyenwe kukuphucula kakhulu ukuphila. Ngelishwa, i-HER2 ekujoliswe kuyo imithi ayisoloko iwela umqobo wegazi.
Ukuhlanganiswa kweTykerb (lapatinib) kunye neXeloda (capecitabine) ingasetyenziselwa, kodwa ibonakala ibangela ukuphuculwa okuthobekileyo kunye nobutywala obukhulu (nangona ezi ziyobisi zibonakala ziwela i-blood-brain barrier). Kubonakala ukuba iTykerb inokusebenza bhetele xa idibene neXeloda kunokuba isetyenziswe yodwa.
Uvavanyo lwezonyango
Ukuhlanganiswa kwezi zonyango ezilapha ngentla, kunye neendidi ezitsha zamachiza ezifana nezidakamizwa ze- immunotherapy kunye nee-inhibitors ze-PARP, zifundiswa kwizilingo zekliniki kwisigaba 4 somhlaza wesifuba
Izinketho zendawo
Ionyango zendawo zenzelwe ukunyanga ingqondo ye-metastases ngokukhethekileyo kwaye zidla ngokucetyiswa ukuba ubuchopho be-metastases bubangela iimpawu ezibalulekileyo, okanye ukuba zikhona kuphela iimastastases ezikhoyo ngenjongo yokuphelisa i-metastases. Xa kuninzi lweemastastases zikhoyo, injongo kukunciphisa impawu (i-palliative). Ngeempawu ezimbalwa kuphela, ukupheliswa kweemastastases kunokuzama ukuphucula ukusukela (kunye nenjongo yokuguga). Ngokubanzi, uvakalelwa kukuba unyango oluninzi lwezengingqi (njenge-SBRT kunye ne-metastasectomy) kufuneka luqwalaselwe ngokukodwa kubantu abo kulindeleke ukuba baphile kwiinyanga ezili-6 ukuya kwezi-12.
Ubungqina bobuchopho be-Radiotherapy (WBRT)
Ingqondo yonke i-radiotherapy ayikho into eyenziwa yiminyaka yamuva ngenxa yemiphumo emibi. Kuqhelekileyo kunconywa ngoku kubantu abanokuba nobuchopho be-metastases ezibangele iziganeko ezibalulekileyo. Izinguqu ezinokwenkcazo, ezifana neengxaki zememori, ukukhumbula ngokukhawuleza kunye nokuthetha ngokucacileyo ziqhelekileyo, kwaye ziyakhathaza ngabo bafanele bajamelane nale mpawu. Ekubeni umgangatho obalulekileyo wobomi kudla ngokuba yinjongo ebaluleke kakhulu ekuphatheni umdlavuza webele we-metastatic, ukusetyenziswa kwe-WBRT kufuneka kuhlolwe ngokucokisekileyo malunga neenzuzo kunye nobungozi. Kungekudala, ukusetyenziswa kweNamenda (mementine) kunye ne-WBRT kuye kwafunyanwa ukunciphisa ukuncipha kwengqondo ngokubonakalayo.
Utyando (i-Metastasectomy)
Ugqirha ukususa enye okanye i-metastase embalwa (ebizwa ngokuba yi-metastasectomy) isetyenziswe kwiminyaka yamuva kwaye inokuphucula ukuphila xa isetyenziselwa abantu abachanekileyo abafanelekileyo kwinkqubo (baneempawu ezimbalwa zeemastastas kwaye banempilo enempilo). Utyando lunokuba lukhetho olungcono (ngaphandle kwe-SBRT ngaphantsi) kwiimitha ezisisiseko ezinkulu (ngaphezu ko-3 cm ububanzi). Ngokungafani ne-SBRT, utyando luneziphumo ezikhawuleza ezinokunciphisa ukukhukhumeza kwengqondo. Noko ke, kukho umngcipheko omkhulu wokulimala kwegazi, kunye nomngcipheko we-"spill tumill" (ukusasaza iiseli zomhlaza kwi-brain) ngokuhlinzwa.
I-Stereotactic Body Radiotherapy (SBRT)
Kwakhona kuthiwa "i-Cyberknife" okanye "i-gamma knife," umzimba we-stereotactic radiotherapy okanye i- SBRT isebenzisa umthamo ophezulu wemisebe kwindawo encinci yesikhumba ukuze uzame ukuphelisa i-metastases. Ngokuqhelekileyo kusetyenziswe xa kusekho iimitha ezithintekayo kuphela, kodwa amanye amaziko awaphatha abantu ngama-10 e-metastase ngexesha. Le nkqubo inokuphinda iphinde iphinde iphathwe ngeemastastase ezongezelelweyo ezikhoyo okanye ezenzeka emva kwexesha. I-SBRT ingaba yindlela engcono kunokuba utyunjelwe kwiimitha zesistim ezinzulu kwingqondo, okanye kwiindawo ezibucayi apho utyando luya kubangela umonakalo omkhulu kumatshini obuchopho obuchopho. Eyona ndlela iphumelele kakhulu kunye ne-metastases encinci, kwaye ukuhlinzwa kungabakho ukhetho olungcono kwi-metastases engaphezu kwe-3 cm ububanzi. Kukho ukwehla kwengqondo engapheliyo ebonwayo nge-SBRT kunokuba ubuchopho be-radiotherapy obupheleleyo, nangona ezinye iziphumo ezibi, ezifana ne-radiation necrosis, zenzeka.
Ezinye iindlela ezinokwenzeka
Olunye unyango olusenokuba luncedo lweengcambu zengqondo ezingazange zenziwe ngokucacileyo ziquka ukuphuma kwe-radiofrequency (RFA) kunye ne-hyperthermia.
I-Metastases kwiNgaphezulu kweNgingqi enye
Ngexesha elidlulileyo, unyango lwengingqi lwama-metastases luye lucingelwa ukuba kwakungekho nezinye ii-sites of metastasis, abanye bakholelwa ukuba unyango lwe-oligometastases kwisayithi ezingaphezu kwesinye lunokubangela ukuphucula ukuphucula. Ezi zonyango, ezibhekiselwe "njengamayeza omlilo" kwi-oligometastatic umdlavuza webele, ngoku zivavanywa kwizilingo zonyango. Ngaloo ndlela, kucingelwa ukuba, kubantu abakhethiweyo, ixesha elide lokuqhubekayo lokusasazeka kunye nobutyhefu obungancinci kunokwenzeka ukuba abanye abantu abaneemastastasi ezimbalwa kwiindawo ezahlukeneyo ezibandakanya ingqondo, imiphunga, amathambo kunye nesibindi.
Prognosis
Isibhengezo sesigaba se-4 somhlaza wesifuba esasasazeka kwingqondo ayikho into esinokuyinqwenela ngayo, ingakumbi ukuba ikhona i-metastases ekhoyo. Oko kwathiwa, ubuchopho be-metastases ngenxa yesifo somhlaza wesifuba sinomdla ongcono kunokuba i-metastases yengqondo ngenxa yezinye iindiza ezinomhlaza.
Ngokomlando, ukusinda kunye nobuchopho be-metastases bekuphela kweenyanga ezili-6 kodwa oku kuguquka. Ucwaningo olwenziwa ngo-2017 lubone ukuba ukusinda komdlavuza wesibeleko kunye nobuchopho be-metastase (zonke iintlobo ezidibeneyo) kwakuyiminyaka emibini engaphezulu kweminyaka emi-2, enomdla wokuphila iminyaka emi-3 kulabo abane-tumor ye-H2 positive. Kungekudala ukuba ukwazi ukuba oku kuya kutshintsha njani unyango olunjenge-SBRT kunye ne-metastasectomy, kodwa izifundo zokuqala zithembisa. Kwakhona kubalulekile ukuba uqaphele ukuba kukho abantu abasinde ixesha elide, kunye nama-15 ekhulwini abantu abanomdlavuza webele we-metastatic bahlala ubuncinane iminyaka eyi-10.
Ukujamelana
Ukujongana neengxaki ze-brainstatic ingaba ngumngeni kumbono wokuba nomdlavuza webele we-metastatic, kunye neempawu ezingabangela. I-oncology iyatshintsha ngokukhawuleza, kwaye kunceda ukufunda konke okusemandleni akho ngesifo sakho ukuze ukwazi ukudlala indima ebalulekileyo ekunyamekeleni kwakho. Buza imibuzo eninzi. Thatha isikhashana ufunde indlela yokuphanda umhlaza wakho . Buza malunga naziphi na iimvavanyo zeclini ezinokufumaneka. Kukho iinkonzo zeklinikhi ezifanisana neenkonzo ezifumanekayo apho abahlengikazi abahamba ngeemoto banokukunceda ukuba ufumane (mahhala) ukuba kukho naziphi na iimvavanyo zonyango naphina kwihlabathi elingasetyenziswa kumhlaza wakho. Njengoko kuphawuliwe ngasentla, ezinye iifundo zifumanisa ukuba ukusinda kwexesha elide kunokwenzeka nakwiimastastases, kodwa ezininzi iindlela ezintsha zijongwa njengoluvavanyo. Kubalulekile ukuba ngummeli wakho ekunyamekelweni komhlaza wakho.
Kubalulekile ukunyamekela ngokwasemzimbeni. Cela uncedo, kwaye uvumele abantu ukuba bancede. Akukho mntu unokujamelana nomdlavuza weemetastatic kuphela. Cinga ukuthatha inxaxheba kwiqela leenkxaso okanye ujoyine enye ye-intanethi yesifo somdlavuza webele . Abantu abaninzi abanomdlavuza webele we-metastatic bafumana uncedo ekufumaneni amaqela agxile ngokubhekiselele kumdlavuza wemetastatic, kunokuba abo baquka abantu abanezigaba zonke zomhlaza wesisu. Kulabo bajongene nomdlavuza webele we-metastatic nabantwana abancinci, gcinani engqondweni ukuba kukho amaqela enkxaso (kunye neenkampu kunye nokuhlaziya) kubantwana abanomzali ohlala nomhlaza.
Ngamanye amaxesha ubuchopho be-metastase bububanzi okanye buhamba kunye neendawo ezininzi zeemastastases kwezinye iindawo. Nangona ukhathaza umdlavuza wakho webele akusenzi kakuhle, ukunyamekela ukunyamekela iimpawu zakho kwaye kukunikeze umgangatho wobomi obunono kakhulu ngexesha oshiyekileyo kubaluleke kakhulu. Siye sifunde ukuba iingxoxo zijongene nokuphela kwezinto ezichaphazelekayo ngokuphathelele umdlavuza webele we-metastatic. Ngelishwa, abantu abanomdlavuza ophezulu kunye nabanonophelo babo bentsapho badla ukuba baqalise ezi ngxoxo.
Ukukhetha ukumisa unyango akuthethi ukuba ushiyayo. Endaweni yoko, kuthetha ukuba ukhetha ukuba nomgangatho obalulekileyo wokuphila ekupheleni kohambo lwakho. Ukuba ungumthandi wakho onomdlavuza webele, ukuthatha umzuzwana ukufunda ngokunyamekela umthandayo ngomhlaza webele we-metastatic kunokukwenza ukuba kube lula ukuhamba ngeentsuku.
ILizwi
Ukuba uye wafumanisa ukuba unesifo se-brainstatic, mhlawumbi unesivalo kwaye udidekile. I-Brainastas ye-Brain idla ngokuphindaphindiweyo njengokuphindaphinda kude emva komhlaza wesifuba. Ukuva ukuba umdlavuza wakho ubuye kwaye awusayi kuphulukiswa.
Zomibini zonyango kunye neendawo zendawo zifumaneka ukuphatha iingqondo ze-brain. Xa zikhona nje ezimbalwa zeemastastas ezikhoyo kwaye ukuba impilo yakho yonke imilungile, unyango lwe-metastases kunye neenkqubo ezifana neSBRT okanye ukuhlinzwa kunokuphucula ukusinda. Ukuba i-metastases zakho zibanzi, kusekho izinto ezininzi ezinokwenziwa ukuphucula umgangatho wobomi nanini na ixesha oshiye.
Uhambo lomntu wonke luhlukile, kwaye yintoni elungileyo kuwe akumele kube yinto ekhethwa ngayo enye. Qinisekisa ukuba uyazihlonela zakho iiminqweno kwizigqibo ozenzayo. Yamkele igalelo kwabanye, kodwa khumbula ukuba lo luhambo lwakho .
> Imithombo:
> Brown, P., Jaeckle, K., Ballman, K. et al. Impembelelo ye-Radiosurgery Alone vs Radiosurgery Ne-Brain Radiation Yonke Ingqondo Ngomsebenzi Wengqondo kwizigulane ezine-1 ukuya kwi-3 Brain Metastases. Uvavanyo lweNzululwazi oluLungisiweyo. JAMA . 2016. 316 (4): 401-409.
> Polivka, J., Kralickova, M., Polivka, J. et al. Isifihla se-Brain Metastatic Disease kwizigulane ze-Breast Cancer: I-Improved Statification Stratification, Izibikezelo zeZifo kunye nokuThinjwa okujoliswe kuLungelo? . Journal EPMA . 2017. 8 (2): 119-127.
> Rostami, R., Mittal, S., Rostami, P., Tavassoli, F., no B. Jabbari. I-Brain Metastasis kwiCanscer Breast: Ukuhlaziywa kweeNcwadi eziPhezulu. Journal of Neurooncology . 2016. 127 (3): 407-14.
> Trovo, M., Furlan, C., Polesel, J. et al. Ukunyanga kwamayeza omnxeba kwi-Oligometastatic Breast Cancer: Iziphumo zovavanyo lweSigaba sesiPhulo sesiBini. Radiotherapy kunye ne-Oncology . 2018. 126 (1): 177-180.
> Ilayibrari yeSizwe ka-US yamayeza. Medline Plus. Xa unyango lwakho lomhlaza luyeka ukusebenza. Ukuhlaziywa 08/15/16. https://medlineplus.gov/ency/patientinstructions/000851.htm