Kukho iintlobo ezingaphezu kwama-50 zeetalks eziphathekayo
Ama- sarcomas ahlambulukileyo anamaqela ahlukeneyo enomdlavuza ovela kwi-fat, muscle, tendon, i-cartilage, iiscupu ze-lymphoid, iimpahla kunye nokunye. Kukho iintlobo ezingaphezu kwama-50 ze-sarcoma zezicubu ezithambileyo. Nangona amaninzi amanqatha amathanga athambileyo, ngeendlela eziqhelekileyo, ama-sarcomas anokuchaphazela amathambo.
Ukuxilongwa kunye nokunyangwa kwama-sarcomas amancinci athatyathwayo kwaye kubandakanyeka ezininzi, kufuna i- oncologists , i-oncologists, ii-radiologists, ii-radiologists ezingenelelo kunye nokunye.
Utyando luquka ukuhlinzwa, i-radiotherapy kwaye, kwezinye iimeko, i-chemotherapy.
Ziziphi i-Soft Tissue Sarcomas?
Ama-sarcomas ahlambulukileyo ayinqabileyo ye-neoplasm kunye ne-akhawunti engaphantsi kwesinye seepesenti ze-khansa kubantu abadala. I-American Cancer Society iqikelela ukuba ama-12,310 amatyala amatsha e-softar sarcoma aya kufumaneka ngo-2016 (amacala angama-6,980 ngamadoda kunye namacala ama-5,330 kwabasetyhini). Kubantwana, ama-sarcomas athambileyo amele ama-15 ekhulwini.
Isizathu esona sithandwa se-tissue sarcomas asiyazi, kwaye ezi zilonda zihlala zingekho isizathu esicacileyo. Nangona kunjalo, kwezinye iimeko ze-sarcoma ezincinci, iinguqu ze-DNA ezifunyenwe emva kokuzalwa kwaye ezisekondari ukuya kwi-radiation okanye i-carcinogen exposure zingadlala indima kwi-pathogenesis.
Ama-sarcomas aqhelekileyo aqhelekileyo kwi- sarcoma yabantu abadala abaxhatshazwayo yi-sarcoma ye-pleomorphic (eyayibizwa ngokuba yi-hertiocytoma eyingozi), i- liposarcoma kunye neiomyosarcoma . I-Liposarcomas kunye nee-sarcomas ezingenasiphelo eziqhelekileyo zikhona kwimilenze, kwaye i-leiomyosarcomas yizona iisardi eziqhelekileyo zesisu.
Kubantwana, uhlobo oluqhelekileyo lwe-sarcoma yezicubu ezithambileyo yi-rhabdomyosarcoma, echaphazela isisu somzimba.
Iingqungquthela ezinomzimba ezinobungozi zingasongela ubomi, kunye neepesenti ezingama-50 ukuya kuma-60 kuphela abantu abaphila iminyaka emihlanu emva kokuba bafumene unyango okanye baphathwe okokuqala, umlinganiselo obizwa ngokuba ngumlinganiselo weminyaka emihlanu yokusinda. Phakathi kwalabo bantu abafa nge-sarcoma ye-tissue sarcoma, i-metastasis, okanye isasazeka, imiphunga iyona nto ibangela ukufa.
Kwimizuzu engama-80 yezigulane ezichaphazelekayo, ezi zingozi zokuphila ezisemngciphekweni zemiphunga zenzeka phakathi kweminyaka emibini nantathu emva kokuxilongwa.
Ukubonakaliswa kwezonyango zeSoft Tissue Sarcomas
Ngokuqhelekileyo, i-sarcoma ye-tissue ephathekayo ibonakala njengobunzima obungabangela iimpawu (oko kukuthi, i-asymptomatic). Ziyakwazi ukufana neepomomas, okanye eziphathekayo, ezingekho ezibulalayo izifunu ezenziwe ngamafutha. Enyanisweni, i-lipomas ziphindwe ngama-100 aqhelekileyo ngaphezu kwezicubu ezincinci kwaye kufuneka zibhekwe njengenxalenye yokuxilongwa ngokungafani. Ngamanye amagama, isikhumba sekhanda esisesandleni sakho okanye umlenze unakho amathuba okuba ngumlomo we-lipoma ongcono kunokuba i-sarcoma ye-tissue.
Malunga neyesibini kwisithathu se-tissue sarcomas ivela kwiingalo nasemilenzeni. Enye yesithathu ivela entloko, kwisisu, entanyeni, entanyeni, naku-retroperitoneum. I- retroperitoneum yindawo ekhoyo emva kwodonga lwesisu oluqulethe iintso kunye ne-pancrea kunye nenxalenye ye-aorta kunye ne-downena vena cava.
Ngenxa yokuba ama-sarcomas athambileyo akangabikho mpawu, zivame ukuba zibonwe kuphela emva kwesiganeko esibangela ukuba unyango lulethe umntu esibhedlele. Iingqungquthela ezincinci zee-distal extremities (iinxalenye zengalo nomlenze ode ngaphezu kwethambo) zihlala zincinci xa zifunyanwe.
Nangona, ama-sarcomas amancinci atholakala kwi-retroperitoneum okanye iindawo ezixhomekeke kwimida (ezo zifuphi kwimizi) zingakhula kakhulu ngaphambi kokuba zibonwe.
Ukuba i-sarcoma i-soft tissue iba enkulu ngokwaneleyo, inokubangela ukuba izakhiwo ezizungezile, ezifana neethambo, iintsholongwane kunye nemithambo yegazi, kwaye kubangele iimpawu, kuquka intlungu, ukuvuvukala kunye ne-edema. Ngokuxhomekeka kwendawo, ama-sarcomas amakhulu angakuphazamisa umzila wamathumbu kunye nokubangela iimpawu zesisu, ezifana ne-cramps, ukuqothulwa kunye nokulahleka kwesidlo. Iingqungquthela ezinkulu ziyakuchukumisa kunye neentlungu ze-pelvic ne-pelvic ezibangelwa iingxaki ze-neurological.
Ekugqibeleni, iingqungquthela ezisemaphethelweni (iingalo kunye nemilenze) zingabonakala njenge-thrombosis enzulu.
Ukuxilongwa kunye nokuThatyathwa kweSoft Tissue Sarcomas
Amancinci amancinci amancinci amasha, angaphakanyiswa, angaphantsi kwaye angaphantsi kweesentimitha amahlanu ubukhulu angabonwa ngunyango ongenakho unyango olusisiseko. Ukwandisa izihlwele ezinzulu okanye ezikhulu kunama-centimitha amahlanu zidinga ukukhutshwa ngokupheleleyo: imbali, ukucinga kunye ne- biopsy .
Ngaphambi kokuba i-biopsy, uvavanyo lokuxilonga lusetyenziswa ukuvavanya i-sarcoma ye-tissue. I-imagination resonance magnetic (MRI) ilona luncedo kakhulu xa kubonwa iisaricas eziphathekayo ezincinci ezisemaphethelweni. Ngokubhekiselele kwiimvumi ezithintekayo, i-intra-esiswini (ngaphakathi kwesisu) okanye i-truncal, i-computed tomography (CT) ibaluleke kakhulu. Ezinye iindlela zokuxilonga ezingabamba indima ekuxilongweni yi-positron ukukhishwa kwe-tomography (PET) kunye ne-ultrasound. Imifanekiso-mboleko (x-ray) ayiluncedo xa ufumanisa izicubu ezincinci.
Emva kokuvavanya uvavanyo, i-biopsy yenzelwa ukuhlolisisa i-anatomy microscopic ye-tumor. Ngokomlando, ii-biopsies ezivulekileyo ezivulekileyo , ezenziwa ngophando oludinga i-anesthesia jikelele, kuye kwaba ngumgangatho wegolide xa ufumana iisampuli ezaneleyo zesisombululo sokuxilonga kwakhe. Ngoku kutshanje, nangona kunjalo, i- biopsy yenaliti esemqoka , engabonakaliyo encinci kunye nekhuselekile, echanekileyo kunye neendleko ezinempumelelo, ibe yinto ekhethiweyo ye-biopsy. Enye-inaliti yentswelo yinto enye ye-biopsy. Ekugqibeleni, xa isilonda sincinci kwaye sisondele kumphezulu, i -biopsy yolwazi ingenziwa.
Nangona i-biopsy yezidumbu ezingaphezulu ziyakwenziwa kwisigulana okanye kwisithuba seofisi, izicubu ezinzulu kufuneka zifakwe kwiibhedlele ngeprologistri engenelelo esebenzisa i-ultrasound okanye i-CT ukuze ikhokelo.
Ukuhlolwa kwe-microscopic ye-tissue sarcomas yinkimbinkimbi, kwaye kunye neengcali ze-sarcoma pathologists azivumelani nokuxilongwa kwe-histologic kunye ne-tumor grade phakathi kwama-25 no-40 ekhulwini kwixesha. Nangona kunjalo, ukuxilongwa kwengqondo yakhe yinto ebaluleke kakhulu xa ugxininisa i-tumor kwaye uqikelele ulwaphulo lomzimba kunye nesigulane sokugulisa isigulane, okanye umphumo wekliniki. Ezinye izinto ezibaluleke kakhulu xa kuqikelelwe isiteyimu se-tumor ubukhulu nendawo. Isitrato sisetyenziswe ngumphathi ukucwangcisa unyango.
Ngama-sarcomas amancinci, i-metastase okanye isasazeka kwi-lymph nodes ayiyithandabu. Esikhundleni saloo ndawo, iimbala zihlala zisasazeka kwimiphunga. Ezinye iindawo zeemastastases ziquka ithambo, isibindi kunye nengqondo.
Unyango lwe-Soft Tissue Sarcoma
Ugqirha ukususa i-tumor iyona ndlela eqhelekileyo yokonyango kwiisarum. Ngamanye amaxesha, utyando lukho konke okufunekayo.
Ngesinye isikhathi, ukuxothwa kwakusenziwa rhoqo ukuphatha imida yeengalo nemilenze. Ngethamsanqa, namhlanje, ukutyunjwa kwesilungu kuninzi kakhulu.
Xa ususa i-sarcoma ye-tissue ye-tarue, ukugqithiswa kwendawo ephakamileyo kuyenziwa apho i-tumor kunye nezinye izicubu ezinobungozi, okanye umda, ususwe. Xa izibilini zisuswe entloko, intamo, isisu okanye i-trunk, i-oncologist yokugqirha izama ukukhawulela ubukhulu bemida kwaye igcine izicubu ezinempilo ezinokuthi zenzeke ngokusemandleni. Nangona kunjalo, akukho mbono ekuvunyelwene ngayo kukho ubungakanani bomgama "olungileyo".
Ukongeza kwindlela yokuhlinzwa, i-radiotherapy, esebenzisa i-ray-ray okanye iindidi zemizila, ingasetyenziselwa ukubulala iiseli zesisu okanye ukunciphisa ukukhula kwazo. I-Radiotherapy ivame ukuhlanganiswa nokuhlinzwa kwaye inokunikezwa phambi kokuhlinzwa (oko kukuthi, i-neoadjuvant therapy) ukunciphisa ubungakanani besisu okanye emva kokuhlinzwa (oko kukuthi, unyango oluxhasayo) ukunciphisa umngcipheko wokuphindaphinda umhlaza. Bobabini i-neoadjuvant kunye ne-adjuvant therapy banenzuzo kunye neengxaki zabo, kwaye kukho ukuphikisana malunga nexesha elifanelekileyo lokuphatha ama-sarcomas amancinci asebenzisa i-radiotherapy.
Iindidi ezimbini eziphambili ze-radiotherapy zonyango lwangaphandle kunye neyeza zangaphakathi . Ngonyango lwangaphandle lwamayeza, umatshini ongekho ngaphandle komzimba uhambisa i-radiation kwi-tumor. Ngonyango lwangaphakathi lwe-radiation, izinto ezinomfutho omsakazo zivalwe ngeencingo, iinaliti, i-catheters okanye imbewu zifakwa okanye zifakwe kwi-tumor.
Uhlobo olutsha lwe-radiotherapy luseburhulumenteni be-radiotherapy (IMRT). I-IMRT isebenzisa ikhompyutheni ukuba ithathe imifanekiso iphinde ibuye iphinde ivuselele ukuma kunye nobukhulu be-tumor. Iimitha zemizila ye-intensities ezihlukeneyo zijoliswe kwi-tumor ezivela kuma-angles ahlukahlukeneyo. Olu hlobo lolwaphulo lwe-radiation lubangela umonakalo omkhulu kumathambo aphilileyo kunye nokubeka isigulane esichengeni sengozi esingaphantsi kwemiphumo emibi, njengomlomo owomileyo, inkathazo yokugwinya kunye nomonakalo wesikhumba.
Ukongeza kwi-radiotherapy, i-chemotherapy ingasetyenziselwa ukubulala amangqamuzana omhlaza okanye ukuyeka ukukhula. I-Chemotherapy iquka ukulawulwa kwee-chemotherapeutic agents okanye iziyobisi ngomlomo okanye nge-vein okanye i-muscle (ulawulo lwe-parenteral). Ingqalelo, ukusetyenziswa kwe-chemotherapy ukunyanga ama-sarcomas amancinci.
Amachiza ahlukeneyo avunyelwe ukuphatha i-sarcoma ye-tissue ephathekayo kuquka oku kulandelayo:
- doxorubicin hydrochloride
- i-dactinomycin (i-Cosmegen)
- imatinib mesylate (Gleevec)
- eribulin mesylate (i-Halaven)
- olaratumab (Lartruvo)
- trabectedin
Ekugqibeleni, i-sarcoma ye-tissue ye-sarcoma ehlaziyileyo i-sarcoma ye-tissue ehambayo emva kokunyanga. Inokubuyela kwi-tissue efanayo okanye ithambo elithambileyo elisekwinye inxalenye yomzimba.
Okukwintsusa
Nceda ugcine ukhumbule ukuba ama-sarcomas athambileyo awanqabile. Yonke into ilinganayo, ithuba lokuba naluphi na ukubola okanye umquba emzimbeni wakho umhlaza uphantsi. Nangona kunjalo, ufanele uzive ukhululekile ukucwangcisa ukuqesha kunye nodokotela wakho ukuvavanya nayiphi na into ngokubhekiselele kwintonga okanye i-bump-ngakumbi ukuba ibangela intlungu, ubuthathaka okanye njalo.
Ukuba wena okanye othandekayo sele sele ufumene i-sarcoma ye-tissue sarcoma, nceda uthobele ngokuthobela ukhokelo lweengcali zakho. Nangona ubomi besongelo malunga nesiqingatha sazo zifunyanwe, ezininzi, iisargus eziphathekayo zincinci zingaphathwa.
Ekugqibeleni, unyango olutsha lwe-sarcoma ezifayo zivela. Ngokomzekelo, i -chemotherapy yendawo yengingqi , eyi-chemotherapy ejolise kwiindawo ezithile zomzimba njengezandla okanye imilenze, yindawo esebenzayo yophando. Wena okanye othandekayo unokufumana ilungelo lokuthatha inxaxheba kwilingo leklinikhi. Unokufumana iimvavanyo zekliniki ezixhaswe yiNational Cancer Institute (NCI) ezikufutshane nawe.
> Imithombo:
> I-Adult Soft Tissue Sarcoma Treatment (PDQ®). National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/clinical-trials/search.
> I-Cormer JN, iGronchi A, Pollock RE. I-Soft Tissue Sarcomas. Ku: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. I-Schwartz Iimigaqo zoPhando, 10e . New York, NY: McGraw-Hill; 2014.
> Hoefkens F, et al. I-sarcoma ye-tissue ye-sarcoma ekupheleni: imibuzo enemibuzo malunga nokuhlinzwa kunye ne-radiotherapy. I-Radiation Oncology. 2016; 11: 136.
> Sabel MS. Oncology. Ku: Doherty GM. eds. UKUPHATHWA KWESIFUNDO NOKUPHATHWA: Ukuhlinzwa, 14e . New York, NY: McGraw-Hill; 2015.