Izikhokelo kunye neNgcebiso
Ukuhlinzwa akukwenziwa ngokuqhelekileyo kumdlavuza omncinci wamangqamuzana wesifo somhlaza njengomdlavuza omninzi wesifo samaphaphu, kwaye abaninzi abantu bayazibuza ukuba kutheni. Makhe sithethe malunga nokuba kunokwenzeka nini, kwaye izizathu zokuba i-chemotherapy kunye neyeza zonyango zihlala zikhethwa kangcono kunonyango.
Ngaba Unokwenziwa?
Kwixesha elidlulileyo, utyando lomdlavuza omncinci wamangqamuzana wesifo somdlavuza awuthatyathwa nje ngolu hlobo.
Ngokuqhelekileyo, xa umdlavuza omncinci wamangqamuzana wesifo semfuyo ufunyenwe, sele sele usasazeka kwiindawo ezingaphaya kwemiphunga (i-metastasized) okanye ikhona kwimimiselo yomibini. Kuzo zicwangciso, i-chemotherapy kunye neyeza zonyango zikhethwa ngonyango olungcono.
Kodwa oogqirha baphinde bakhangele i-subset encinci yabantu abanokuzuza, kwaye bahlala ixesha elide, emva kokuhlinzwa ngokuphumelelayo kwintsholongwane yomhlaza wesifo somnxeba.
Xa Utyando Lungakhuthazwa
Amanqaku omhlaza wesifo somhlaza wamaphaphu angama-15 ekhulwini lomdlavuza wamaphaphu. Iphule phantsi zibe zigaba ezimbini: isigaba esilinganiselwe kunye nesigaba esiphezulu. Ukuba umntu unesicathulo esincinci somhlaza wesifo samangqamuzana (ekhoyo malunga neepesenti ezingama-70 zabantu ngexesha lokuxilongwa), ukuhlinzwa akuphuculanga ixesha lokuphila. Ngomlinganiselo omncinci wesifo somhlaza wesifo somnxeba, ukudibanisa i-chemotherapy kunye neyeza zonyango kunokusebenza kakuhle, ubuncinane ekuqaleni. Ukuba ukuhlinzwa kwakufuneka kwenziwe oko kungekuphela kuphela kodwa kungaphazamisa unyango olwenza uncedo.
Xa Utyando Lwenokuba Ngempumelelo
Utyando lunokunika ithuba lokuphila ixesha elide kwabanye abantu abanomdlavuza omncinci wesikomnci omncinci apho:
- Umhlaza ukhona kumphunga omnye kuphela.
- Umhlaza awubandakanyi i-lymph nodes okanye ukhona kuphela kwii-lymph nodes eziseduze. (Ngamanye amazwi, ukuhlinzwa akuyona inketho enhle kubantu abanesifo se-N2 kwi- TNM yomhlaza wesifo somdlavuza , okubhekisela kwii-lymph nodes ezinomdlavuza kwindawo phakathi kwemiphunga (i-lymph nodes).
- Uphando luyakwazi ukuba lukhetho ukuba umhlaza ungxenyeni yangaphandle yemiphunga.
Iintlobo zoBucholo
Kukho iintlobo ezi-4 eziphambili zokuhlinzwa ezenziwa ngomhlaza wemiphunga:
- Pneumonectomy. I- pneumonectomy yindlela yokuhlinzwa eyenza ukususwa komphefumlo wonke. Abanye abantu bayamangaliswa kukuba lo uphando luyakwenzeka, kodwa kubantu abanomsebenzi ontle, abantu abaninzi baye banyamezela le nkqubo ngokufanelekileyo.
- Lobectomy. I- lobectomy yinkqubo apho i-lobe yomphunga isuswa khona. Ilungelo lempompo linama-3 lobes kunye nomphunga wesobunxele unesi-2.
- Ukwandisa i-resection okanye i-segmentectomy. Ukuthengiswa kwemigodi yindlela yokuhlinzwa apho i-tumor kunye nommandla omeleleko weentlobo ezijikelezayo zisuswe. Oku kubangela ukuba izicubu ezincinci zilahleke ngaphandle kwelobectomy, kodwa zinokuthi zithwale ingozi ephezulu yokuphindaphinda.
- Ukuthengiswa kweSleeve.
Kule ndawo, i-lobectomy ibonakala ibe nezona ziphumo ezibalaseleyo kubantu abanomdlavuza omncinci wamangqamuzana.
Ngaphambi koPhando
Ukuba kuthethwa ngonyango, ukuhlolwa okucokisekileyo kuyakufuneka kwenziwe, kuquka i- mediastinoscopy (inkqubo ekhangele umdlavuza kwindawo emiphakeni), ukuqinisekisa ukuba umhlaza awuzange usasaze kwi-lymph nodes kule ndawo (i-lymph n2 nodes). I-PET / CT ingaba yinto ehlukile kwi-mediastinoscopy kubantu abathile.
Iimvavanyo zomsebenzi wepulmonari ziya kwenziwa kwakhona ukuqinisekisa ukuba umntu uya kunyamezela ukuhlinzwa kwaye abe nomsebenzi okwaneleyo wamaphaphu emva kokuhlinzwa.
Ekubeni ukusinda ekutyathweni komdlavuza omncinci wamangqamuzana omncuba kubonakala kuwungcono kumaziko omhlaza okwenza ukuba lukhulu kakhulu lwale misebenzi yokuhlinzwa, kubalulekile ukuphanda umhlaza wakho ngaphambi kokuhlinzwa kwaye ucinge ukufumana umbono wesibini kwisikhululo somhlaza .
Emva kokuPiliswa
Ukuba utyando luyenziwe, kubalulekile ukuba i-chemotherapy kwaye ininzi ityhutyana isetyenziswa emva kokuhlinzwa, kuba oku kuphucula ukuqhubeka.
I-prophylactic irradiation irradiation (PCI) , uhlobo lombane owenzelwe ukukhusela ukusasazeka komhlaza kwingqondo, ingasetyenziselwa ukunciphisa umngcipheko womhlaza osasazeka kwingqondo emva kokuhlinzwa.
Umngcipheko wobuchopho be-brainstage obonakala emva kweminyaka emithathu emva kokuhlinzwa kukhula kunye nesigaba se-tumor, kwaye uphando oluthile lufumene le mngcipheko ube yi-9,7 ekhulwini kwi-stage 1, i-18.5 yepesenti kwisigaba sesi-2, kunye ne-35.4 ekhulwini kwisigaba se-3.
Prognosis
Uphononongo lubonisa ukuba abantu abanomdla wokuqala (isigaba esincinci) amancinci amancinci omnxeba wamaphaphu (T1 okanye i-T2), ukuhlinzwa kuphucula izinga lokusinda. Ekuhlaziyweni okukhulu, kwafunyaniswa ukuba ukusinda kubantu abanezifo zengingqi kunye neengingqi kuye kwaphuculwa ngokuhlinzwa.
Kwalabo abanezifo ezikulo ndawo ababenomdla we-lobectomy, izinga lokusinda kwamanzi lalingamawaka angama-65 kwaye i-5-year-old survival rate yaba ngaphezu kwama-52 ekhulwini. La manani angabonakala eyikisayo aze awathelekise kwizinga lokusinda kwabantu abangenalo utyando olubandakanya izinga lokusinda eliphakathi kweenyanga ezingama-25 kunye nomyinge we-5% we-survival rate of years.
Ingqalelo kukuba unyango lwengqondo ye-metastases ngenxa yomdlavuza wamaphaphu litshintshile, kwaye ezinye iimeko abantu abanomzimba kuphela ("i-oligometastase") banokuphathwa ngeenjongo zokunyanga kunye ne- radiotherapy yomzimba (stereotactic body radiotherapy) (SBRT) okanye unyango lweproton .
Okukwintsusa
Kwixesha elidlulileyo, utyando aluzange lubhekwe njengento yokunyanga umhlaza wesifo somhlaza wamangqamuzana. Oku kubonakala ngathi iyatshintsha njengezifundo ezintsha zifumene inzuzo kwabanye abantu abanesifo. Ngokukodwa, abantu abanomdlavuza omncinci womdlavuza wamaphaphu banomlinganiselo ongcono kakhulu weminyaka engama-5 yokusinda kunye nokuhlinzwa kunokusebenzisa i-chemotherapy kunye neyeza zonyango kuphela. Kweenkqubo ezahlukeneyo ezikhoyo, i-lobectomy ineziphumo eziphambili.
Kubalulekile ukugcina engqondweni ukuba wonke umntu uhlukile. Amanye amanyathelo okuqala (isigaba esincinci) amancinci amancinci amancinci amancinci angaba nzima okanye angenakwenzeka ukunyanga ngokuhlinzwa ngenxa yendawo yokuhlambalaza. Ubukho bezinye iimeko zonyango zingakhokelela kumngcipheko wokuhlinzwa ngokugqithiseleyo inzuzo.
Ukuba uhlala nomdlavuza wamaphaphu kubalulekile ukuba ube ngummeli wakho ekunyamekeleni kwakho. Izinyathelo zokonyango zomhlaza wesifo somhlaza wamaphaphu ziphucula kwaye unyango olutsha luvavanywa kwizilingo zeclini. Ezinye zezo zonyango, njengalezo ezisebenzisa izilwanyana zamachiza omtsha zinika isithembiso seziphumo eziphuculweyo kakhulu kwixesha elizayo. Ngelixa abantu abaninzi besaba ukuhlolwa kweeklinikhi, kubalulekile ukukhumbula ukuba yonke imveliso esele ikhoyo ngoku ibe yinxalenye yesilingo sekliniki.
> Imithombo:
> Ngokugqibeleleyo, C. Impembelelo yevolontiyiti yokuvota kwinkqubo yokukhethwa kwindlela yokutyunjwa komhlaza wesifo somhlaza. I-Journal ye-Thoracic ne-Cardiovascular Surgery . 2016. 151 (4): 1219.
> IKoletsis, E., Prokakis, C., iKaranikolas, M., Apostolakis, E., noD. D. Dougenis. Inxaxheba yangoku yokuhlinzwa yincinci ye-cell lung carcinoma. Umbhalo weCardiothoracic Surgery . 2009. 4:30.
> INational Cancer Institute. Ukwelashwa kweNcinci yeCatal Lung Cancer (PDQ). Ukuhlaziywa 11/09/17.
> Schreiber, D., Rineer, J., Weedon, J. et al. Iziphumo zokusinda kunye nokusetyenziswa kotyando kumgangatho omncinci wesifo somhlaza wamaphaphu: ngaba kufuneka inxaxheba yayo ihlolisiswe kwakhona? Cancer . 116 (5): 1350-7.
> Zhu, J., Bi. Y., Han A. et al. Imiba yengozi ye-metastases yengqondo ephandle ngokupheleleyo umdlavuza omncinci wamangqamu omnxeba: ukuphononongwa ngokuphindaphindiweyo ukufumanisa izigulane ezinokuthi zizuze kwi-prophylactic iraniation ye-cranial irradiation. I-Radiation Oncology . 2014. 9: 216.