I-R-CHOP ligama elichanekileyo lokudibanisa iziyobisi ezisetyenziswa ngokuqhelekileyo njengekhemotherapy kwezinye i-cancer, ezifana ne- non-Hodgkin lymphomas, okanye i-NHLs . Incwadi nganye kwi-R-CHOP imele izidakamizwa ezahlukileyo, kodwa isichazamazwi sinokudideka ekubeni esinye isilwanyana sininzi sinalo igama elilodwa:
R = Rituximab
C = Cyclophosphamide
H = Doxorubicin Hydrochloride (Hydroxydaunomycin)
O = iVincristine Sulfate (iOncovin)
P = iPrednisone
I-Rituximab yi-antibody ejoliswe kwi-anti-CD-antigen, iprotheni efumaneka kwi-lymphocytes ye-B yangaphambili ne-B. I-Rituximab ibangela ukuphendula komzimba kwisigulane malunga neeseli ze-CD20-positive.
I-Cyclophosphamide yaziwa ngokuba yi-agent e-alkylating kwaye ine-anti-cancer kunye ne-anti-immune activity. Esibindi, i-cyclophosphamide iguqulwa ibe yi-metabolites ebophezela kwi-DNA, ikhusela iiseli ekwenzeni iikopi ze-DNA, kwaye iqalise ukufa kweseli.
I-Hydroxydaunomycin ifomu eguquguqukileyo ye doxorubicin, eyaziwa njenge-antithracycline uhlobo lwe-antibiotic, kwaye inomsebenzi wokulwa nomhlaza.
I-Oncovin okanye i-vincristine ibophelela kwisakhiwo esincinane kwiiseli ezibizwa ngokuba yi-microtubules kwaye ziphazamisa ukukwazi ukwahlukana kweeseli.
I-Prednisone iyi-agent ye-steroid eneepropati ezichasayo, kwaye inokusetyenziswa ezininzi ezahlukeneyo kumachiza. Kwiintlobo ezithile zesifo somhlaza zesifo somhlaza, i-prednisone inokuvuselela ukufa kweselfini.
I-R-CHOP isetyenziswa kakhulu kwi-non-Hodgkin lymphoma. Ingasetyenziselwa yodwa, okanye ingasetyenziswa kunye nezinye iziyobisi okanye unyango, okanye ukunyanga ezinye iintlobo zomhlaza ngaphandle kwe-lymphoma. Ngokufanayo, izakhiwo ze-R-CHOP, ezifana ne-rituximab, zingasetyenziselwa zodwa kwezinye izigulane kunye nezigulane ezithile, ukukunceda ukulawula izifo.
Oku ngakumbi kwi-R-CHOP
Njengoko ulwazi lweentlobo ezahlukeneyo ze-lymphomas ziyaqhubeka, izazinzulu zifunda ukuba iincinci ezahlukeneyo zelinye i-lymphoma zingaphendula ngokwahlukileyo kwi-regimen enikwe. Izilingo zonyango zijonge ekusebenziseni amanye ama-agent, ngokudibanisa ne-R-CHOP, ngeentlobo ezininzi zeentlondi.
I-R-CHOP ithathwa njengonyango oluqhelekileyo lenye yeendidi eziqhelekileyo ze-NHL, isasaza i-B-cell lymphoma, okanye i- DLBCL . Xa ukhangela i-NHL ngokubanzi, i-DLBCL i-akhawunti engama-25 ukuya kuma-35 ekhulwini kuwo onke amatsha afundwayo kwihlabathi jikelele ngonyaka. I-R-CHOP ingasetyenziselwa kwezinye iimeko ze-follicular lymphoma, ngokwemihlahlandlela ka-2016 evela kwiNational Cancer Network Network.
Ngamaxesha amaninzi anikezelwa nguMmeli ngamnye?
Iinkcukacha ze-regimen yonke, kubandakanye na maxesha amaninzi ngamachiza anikezelwayo, ngaphaya kweliphi ixesha, kunye naluphi na ukulandelelana, kuyahluka ngokuxhomekeka kwimeko yokugula, isigulane sempendulo, kunye noogqirha okanye amaziko athatha inxaxheba.
- Olunye ulandelelwano lwamachiza lubizwa ngokuba ngumjikelo, ngoko unokuva oogqirha bexoxa malunga "zingaphi i-R-CHOP" ezicwangcisiweyo, umzekelo.
- Omnye umgaqo-nkqubo uquka ukulawulwa kwe-rituximab njenge-infusion kwiiyure ezimbalwa ngosuku lokuqala kunyango, ngelixa izidakamizwa ze-CHOP ziya kuqaliswa ngomhla olandelayo. Ikhosi yonke inokuphindwa rhoqo emva kweeveki ezintathu malunga no-6-8. Nangona kunjalo, iiklinikhi zanamhlanje zithetha "nge-CHIM-like regimens," kwaye, kukho iindidi ezahlukahlukeneyo zoogqirha zingalandela ukusetyenziswa kwezi zonyango.
Njengomzekelo wezinye iimeko ezivela ku-R-CHOP, into ebizwa ngokuthi "i-R-mini-CHOP" iyahlolwa. I-Groupe d'Etude des Lymphomes de l'Adulte (GELA) - iqela lophando elineliso eliqhelekileyo leFransi - lihlolisise umbuzo wokunciphisa utyhefu kubantu abano-DLBCL abaneminyaka eyi-80 ukuya ku-95. Bajolise ekuphandeni ukusebenza nokukhuseleka kokunciphisa umthamo we-CHOP (doxorubicin, cyclophosphamide, vincristine, kunye ne-prednisone) i-chemotherapy kunye ne-dose ye-rituximab-i-cell monoglonal targeting cell cells kunye ne-CD20 'tag' - kwizigulane ezisebekhulile nge-DLBCL.
Okwangoku, kwiminyaka emibili ephuma, iziphumo zikhuthaze; Kwakhona kugxininisa ukubaluleka kwemiba yezigulane ngamnye kweli qela leminyaka.
Xa kusetshenziswe i-regimen ye-dose ephantsi, okanye i-R- "miniCHOP", i-effectiveness yabonakala ifana ngokumalunga neminyaka emi-2 ukuya kumlinganiselo osemgangathweni, kodwa ngokuphindaphindiweyo kwee-hospitalization ezinxulumene ne-chemotherapy.
Iziphumo eziPhakathi
Bobabini i-rituximab kunye ne-CHOP banemiphumo emibi, kwaye uluhlu olupheleleyo lweziphumo ezinobungozi bungaphezulu kweli nqaku elikhoyo. Nazi ezinye ezimbalwa, khetha iziphumo ezichaphazelekayo, nangona kunjalo:
- Ngokuqhelekileyo ulahlekelwa zonke iinwele entloko yakho. Izinwele kwiimishiya kunye nezinye iindawo zingaphantsi okanye ziphume. Ukulahleka kweenwele ngokuqhelekileyo kuqala emva komjikelezo wokuqala okanye wesibini we-chemotherapy, kwaye phantse njalo ixeshana ukuba iinwele ziya kukhula emva kokuba i-chemotherapy iphelile.
- Isihlunu kunye nokuhlanza okanye ukugula kugqithisekile kwaye kunokuvela kwangoko emva kwonyango emva kweentsuku ezintathu emva kokunyanga.
- Ukugqithwa kungavela ngenxa ye-vincristine kunye namanye amayeza anokunikwa i-nausea nentlungu.
- Izilonda zomlomo zingabonakala emva kwexesha unyango, kwaye oku kunokukunceda ukuba ufumane intsholongwane emlonyeni wakho, ngoko ke ukunakekelwa komlomo kubalulekile.
- I-CHOP inokuchaphazela ukukwazi ukukhulelwa okanye ubaba umntwana.
- Unokuba lunyanzelekile ukusuleleka ngexesha lotyando lwe-CHOP, ngoko kuzama ukuphepha ukudibanisa nabantu abanomkhuhlane okanye umkhuhlane kunye nokuhlamba izandla rhoqo ukuze uncedise umngcipheko wokufumana intsholongwane okanye intsholongwane.
- I-R-CHOP inokunciphisa inani lamaplatelets anceda igazi ukuba livale, ngoko qiniseka ukuba uxelele ugqirha wakho ukuba unokwenyuka okanye ukuphaphaza awukwazi ukuchaza.
- I-Prednisone iyi-steroid kwaye ineempembelelo ezininzi ezinokubakho, kuquka ukuguquka kwemizwelo, ukufumana ubunzima, nokuvuvukala.
> Imithombo:
> Offer F, Samoilova O, Osmanov E, et al. I-Frontline rituximab, i-cyclophosphamide, i-doxorubicin, kunye ne-prednisone ne-bortezomib (i-VR-CAP) okanye i-vincristine (R-CHOP) yeyona engeyiyo iGCB DLBCL. Igazi . 2015; 126 (16): 1893-1901.
> Eyre TA, Clifford R, uRoberts C, et al. Isandla esisodwa sigaba se-NCRI isifundo se-CHOP ngokudibanisa ne-Ofatumumab ekufakweni nasekugcinweni kwezigulane ezine-syndrome ye-Richter. BMC Cancer. 2015; 15: 52.
> Bibas M, Castillo JJ. Ulwazi olukhoyo kwi-Plasmablastic Lymphoma echaphazelekayo ne-HIV. IMediterra J Hematol Dis 2014; 6 (1): e2014064.