Kuthiwayo ukuba ingqondo yinto yokuqala yemfazwe. Isibingelelo esifanayo sinokuthi sibe yinxalenye yemfazwe yonke imfazwe nomdlavuza, uninzi lwamachiza asetyenziswa ukubulala umdlavuza luye lukhuphe iingqondo zethu kwaye luphazamise iingxaki ezithumela ulwazi kwingqondo yethu.
Kwakhona njengemfazwe, akusoloko kulula ukuxelela umngane kwiintshaba. Ngaba uphawu oluthile ngenxa yomhlaza, okanye iziyobisi ezinikwe ukulwa nomhlaza?
Okanye ngaba ngenxa yento enye?
Kukho iindlela ezininzi ezahlukahlukeneyo ezinokuthi zonakalise inkqubo yeentlanzi. Oku kulandelayo akude kuphelele, kodwa unikezela ngolu hlobo lweendlela zokwenza i-chemotherapy lonakalise inkqubo ye-nervous.
Iingxaki ezinokuthi zenzeke ngokukhawuleza okanye kamva
Nangona ezinye iziphumo zeengxaki ze-chemotherapy zenzeka ngokukhawuleza, abanye bangathatha iminyaka ukukhula. I-Busulfan, umzekelo, isetyenziswa rhoqo ukulungiselela izigulane zokutshintshela i-stem cell kodwa ixhaphake ngokuqhelekileyo kunye nokuthinjelwa ngexesha lokulawula. Ngenxa yalesi sizathu, iyeza zokulwa ne-antiepileptic ezifana ne-phenytoin zingasetyenziswa ngelixa zinikezelwa ukwenzela ukuthintela ukuthintela. Nangona kunjalo, umngcipheko wokubanjwa kwegazi ulunge xa iyeza lisafumaneki.
I-Cytarabine ngamanye amaxesha isetyenziselwa ukwelapha i- leukemia kunye ne-lymphomas , kwaye ingakhokelela ekubambeni emva kwexesha lokulawula. Ngokomzekelo, kunokukhokelela ekudidekeni nasekukhuliseni, kunye nokufumanisa i-cerebellar njenge-clumsiness ( ataxia ).
Amachiza kufuneka ayeke ukukhawuleza ukuba oko kwenzeka. Ezinye izigulane zilula, kodwa ezinye izigulane aziyi. I-Cytarabine inokuthi ijowe nge- intrathecally , kodwa oku kunokubangela ukuba ngezinye izihlandlo kubangele ukubethelwa kwemilenze kunye nokukhubazeka komlenze kunye nokungasebenzi kwe-sphincter. Kwakhona, amayeza kufuneka anqunywe ngokukhawuleza ukuba oko kwenzeka.
Umonakalo ongasemva kwe-cytarabine udla ngokusisigxina.
I-Methotrexate ingasetyenziselwa ukunyanga uluhlu oluninzi lwee-cancer, kwaye luyabangela ezininzi iziphumo ezinobungozi, ezinye zazo ezinokuthi zenzeke kusasa kunye nabanye. Ngokomzekelo, kungenza i- aseptic meningitis eyenzeka phantse ngokukhawuleza xa isilwanyana sinikezwa nge-intrathecally. I-meningitis ye-Aseptic ivame ukulandela ukulawulwa kwe-intrathecal kwaye ivela kwi-10 ukuya kuma-50 ekhulwini yezigulane ezitholayo iziza ngale ndlela. Iimpawu ziquka intloko kunye nentamo elukhuni kunye nesicefe, ukuhlanza kunye nomkhuhlane. Unyango aluyidingi njengoko iimpawu zizodwa.
Ngokuphambene nale nkxalabo enzima, i-methotrexate nayo ibangela i-leukoencephalopathy, echaza intsingiselo ye-cerebral ngenxa yenguqu kwimimandla e-myelinated yengqondo, enokuthi ivele kwiminyaka emva kokuba izidakamizwa ziyeke. Oku kubaluleke kakhulu xa i-methotrexate isetyenziselwa ukuphathisa izifo zabantu abatsha, njenge-leukemia yobuntwaneni. Iziphumo ezichaphazelekayo zinokusukela kwiinkcukacha zokukhubazeka ezincinci kwi-mental dementia. KwiMRI, izilonda zesimo ziyabonakala.
Utshintsho lweCognitive
Utshintsho olunzulu lweengcamango ezifana ne-methotrexate leukoencephalopathy alunakuphela kweso sonyango kuphela.
Enyanisweni, utshintsho lweengqondo luxhaphake kakhulu kwi-chemotherapy ukuba igama elithi "chemofog," liye laqulunqwa ukuchaza le nto. I-Chemofog ibandakanya uluhlu olubanzi lwemiphumo engcamango edlalwa rhoqo kunye neyeza zamakhemikhali, kunye neempawu ezivela ekudidekeni kancinci ukuya ekudemeni komzimba. Ukusisigxina kwezi zinguqu kuyahluka.
Ukuba i-Ifosfamide, umzekelo, i-agent isetyenziswe ukuphatha izicubu ezinzulu. Isibilini ngamanye amaxesha sinokubangela i-encephalopathy, kodwa oku kudla ukufumana emva nje kokuba i-agent ishiyiwe. Ezinye i-encephalopathies, ezinjenge-leukoencephalopathy ye-methotrexate, inokubangela ukulahleka kwexesha.
I-PRES) enye ingxaki enokuthi yenzeke yinkqubo ye-chemotherapeutic agents, ngakumbi i-cyclosporine kunye ne-tacrolimus. La mayeza aqhelekileyo asetyenziselwa ukulungiselela abantu ukuguqulwa kwamalungu. Iimpawu zingabandakanya intloko, ukudideka, ukuthinteka , okanye ukulahlekelwa kweengxaki zegazi. Kwi-MRI, u-intensification-like-intensive-like-intensification ingabonakala ukuba kaninzi ibonakala ngasemva kwengqondo. Amachiza kufuneka ayeke okanye atshintshwe ukuba i-PRES ikhona.
Izibetho
I-cancer isoloko ibangela ukuba oogqirha babize i-hypercoagulable state, oko kuthetha ukuba i-clots yegazi iyakwazi ukufometha amaxesha angafanelekanga kunye neendawo. Ngokomzekelo, i-clot inokuyifaka engqondweni, kubangela ukubetha . Ngelishwa, ezinye i-chemotherapies nazo zingabangela izibetha, ezifana ne-methotrexate, i-cisplatin, i-imatinib kunye nokunye.
Amanye amanxusa, afana ne-bevacizumab kunye ne-sunitinib, ekujoliswe kuyo kwimigudu yegazi kuba izidumbu zihlala zidala izitya ezintsha zokuthumela izondlo ekukhuleni okungavamile. Ngelishwa, imiphumo emibi ingabandakanya ukubola okanye imivimbo yesichemicic. Njengomnye umzekelo, i-L-asparaginase isetyenziselwa ukuphatha i-lymphoblastic leukemia (BONKE) kwaye ngamanye amaxesha ibangele i-sinus thrombosis ukuba ifake ngisho nakubantwana. Oku kudla ngokusombulula ngekhefu kwi-regimen yeyeza. Ukuba igazi elincinci lilawulwa, ngamanye amaxesha amayeza angabuye aqaliswe.
Neerpheral Neuropathies
I-peripheral neuropathies yinto echaphazelekayo yecandelo le-chemotherapy, ngokukodwa kwi-agents e-platinum equkethe i-cisplatin kunye ne-oxaliplatin. I-peripheral neuropathy eyabangelwa yi-cisplatin ibangela i-numbness and paresthesias eqhubekayo eqala emacaleni eminwe kunye neenzwane kwaye isasaza ngaphakathi. Nangona uvakalelo lomzimba esikhaleni lonakaliswe, uvakalelo lwentlungu kunye nobushushu buhlala lusindiswa, okuhlukana ne-cisplatin neuropathy kwiintsholongwane ezininzi ezinokubangelwa ngumhlaza ngokwawo. Ubungozi bokunciphisa umthamo okanye ukutshintshela kwi-ejenti ye-neurotoxic efana ne-carboplatin kufuneka ilinganiswe malunga neenzuzo zokuqhubela unyango lwe-cisplatin. I-neuropathy ingaba yingozi ngakumbi okanye iqale iinyanga emva kokuba i-cisplatin ishiyiwe.
I-Oxaliplatin inxulumene nokuqala ngokukhawuleza kwee-paresthesias esandleni, iinyawo, kunye nomlomo, zonke ezo zibuhlungu kakhulu kubanda. Ingabangela ukuba ne-neuropathy efanayo ebangelwa yi-cisplatin, nangona i-oxaliplatin ye-neuropathy ibuyeke lula.
Ezinye i-chemotherapeutics ezinxulumene ne-peripheral neuropathy ziquka i-docetaxel, i-vincristine, kunye ne-paclitaxel, phakathi kwamanye amaninzi.
Ukulimala kweNeromuscular
Umonakalo we-neuromuscular awuqhelekanga ngaphezu kwe-peripheral neuropathy, kodwa usenokwenzeka ngenxa ye-chemotherapy. I-Doxorubicin, i-cisplatin, i-etoposide, kunye nabanye ingabangela ukuba impawu zifane ne- myasthenia gravis . I-Imatinib esetyenziselwa ukunyanga iindidi ze-leukemia, zingenza i-muscle cramping kunye ne-myalgias, kodwa ezi ziqhelekile zize ziphendule kumachiza afana ne-calcium okanye i-magnesium.
Akukho mfihlo yokuba i-chemotherapy yinyango enamandla kakhulu eneengozi eziphezulu zemiphumo emibi. Into endiyibhalileyo apha yinkcazo ebanzi kakhulu. Kukho isizathu sokuba la mayeza ahlala egcinwe kwizifo ezinzulu njengomdlavuza, apho iingeniso zokuthatha ukungalingani kwamachiza kunye neengozi ezinkulu. Injongo yale nqaku ayiyikubagxotha abo bafuna le myeza ukuba bathathe, kodwa ukuqinisekisa ukuba abantu bayazi iziphumo ezichaphazelekayo ukwenzela ukuba bahambe kakuhle kwiinkathazo zonyango lomhlaza.
Imithombo:
EQ Lee, IC Arrillaga-Romany, PY Wen. Iingxaki ze-Neurologic ze-Cancer Medical Therapies. Ukuqhubeka kweeNkalo zokuFunda konke ngeNeurol 2012; 18 (2): 355-365.
EQ Lee, PY Wen. Iingxaki ze-neurologic ye-platinum-based chemotherapy Ku: DMF Savarese, Ed
EQ Lee, PY Wen. Iingxaki ze-neurologic ye-cancer ye-platinum ye-chemotherapy. Ku: DMF Savarese, Ed UpToDate.