Amatsha amasha akhulula iTrodiation Treatment More ngokuchanekileyo
Ukunyanga kwamayeza kubalulekile ekuphatheni iintlobo ezahlukeneyo zomhlaza. Iindidi ezahlukeneyo zemizi-mveliso zisetyenziselwa ukuzama ukujolisa iiseli ezihlambalayo kunye nezicubu. Ngokuqhelekileyo, ii- photons (x-ray) zisetyenziswe kwindlela ebizwa ngokuba yonyango lwe-radiation, okanye i-EBRT.
Kukho neendlela ezahlukeneyo zokwelashwa kweemitha zonyango, kwaye ezinye zazo zibonise isithembiso ngokubhekiselele ngokuthe ngempumelelo kwizicubu zomhlaza ngelixa zikhupha izakhiwo ezijikelezayo.
Iinkqubo ezintsha zibandakanya iiproton zeProteton kunye nokulinganisa kwe-4D
- I-PBT ibhekisela kwonyango lweproton ye-proton.
- I-EBRT ehambelanayo ne-3D ibhekisele ekubandakanyekeni kohlalutyo lweengcamango lwekhompyutha ukucwangcisa ukuhanjiswa kweqondo lombane ngokugqithiseleyo ekujoliswe kuyo.
- I-IMRT imele unyango olusisigxina lwe-radiation, kwaye yile enye inqubo eyenzelwe ukutshabalalisa izicubu zomhlaza kodwa ukugcina izicubu ezijikelezayo.
- I-IGRT imela unyango ochanekileyo we-radiation, kwaye ibandakanya ukusebenzisa i-imaging scans ngexesha lokunyanga kwamayeza, ukuhanjiswa kweemitha kwiinkqubo zokucwangcisa i-imaging ezaphuhliswa ngexesha lokucwangcisa unyango lweyeza.
- I-RMM ibhekisela kwiinkqubo zokulawula ukunyakaza kwimizila ye-radiotherapies eyenza ukuhamba kwindonga yesifuba, i-muscular diaphragm, kunye nezinye izakhiwo ezihamba ngexesha lokuphefumla ukuze i-radiation isifike kwindawo efanelekileyo nangona indawo ekujoliswe kuyo ihamba.
- I-4D CT ukulinganisa isebenzisa umgaqo ofanayo njengoko ku-RMM ekufuneni ukukhangela xa isigulane siphefumula, kwaye umthamo ojoliswe kuwo uqwalasela zonke izikhundla zesifo esiphambanweni kwisifundo sokucinga, ngokuhamba kwesikhathi.
Uphi unyango lweproton?
Amanye amaziko omhlaza sele aqala ukusebenzisa i-radiation matshini ehambisa iiproton emisebeni esikhundleni se-photons, okanye ii-ray-ray.
Iiprotho zeProton ngumlambo weengqungquthela ezichanekileyo ezinikezelwa amandla ngaphakathi kwithuba elincinane. Ngokwemfundiso, iiproton zifikelele kwiimathumba ezinzulu ngaphakathi emzimbeni ongenakonakaliswa kancinci kwizicubu eziseduze.
Imibutho efana neNational Cancer Network, okanye iNCCN, iqalile ukubandakanya unyango lweproton, okanye i-PBT, kwizikhokelo kunye neziphakamiso. Ngokomzekelo, ngokubhekiselele kwiimeko ezithile ze-T-cell lymphomas, i-NCCN radiotherapy compendium ibandakanya ukubhekisela kwiproston kunye nezinye iindlela zokwenza ukuba "... ukufezekisa [i] ukusabalalisa iqondo lokubaluleka okubaluleke kakhulu kwizigulane ezigulayo ezinokulindela ubomi obude. "U Ngamanye amagama, kukho ulindelo lokuba ukuhanjiswa kwemisebe kwindawo eqinisekisiweyo kunye nokukhusela izicubu ezizungezile kuya kubangela iziphumo ezingcono kunye neengxaki ezincinci zonyango lweyeza.
Ziziphi iingenelo ezinokuthi unyango lube njenge-PBT Offer?
Okwangoku, ukusetyenziswa rhoqo kwePBT akukhuthazwa kunyango lwe-lymphoma. Kodwa kwizigulane ezine-lymphoma, nangona kunjalo, inzululwazi njengokwelashwa kweprotoni ngolunye usuku ingathanda ukukhetha iiphoton kwiimeko ezithile kunye nezizathu ezahlukeneyo. Nangona iphumelele, i- chemotherapy esetyenziswa ekuphatheni i-lymphomas ingaba nobunobunzima kwintliziyo kunye nemiphunga.
Xa i-radiation yongezwa kwi-chemotherapy, izingozi ezinokwenyama ziyakunyuka, ekubeni iincuba ezisemngciphekweni zijongene nemiphumo ye-chemotherapy kunye ne-radiation.
I-Chemotherapy kunye ne-radiation zihlala zicetywa kunye kunye, kodwa zilawulwa ngokwahlukileyo, kwaye ngokuqhelekileyo, enye iya kulandela enye kwonyango lymphoma. Iprotro yonyango yenzelwe ukunciphisa ukuvezwa kwezicubu ezinempilo ezinokuthi zenzeke ekujoliseni ukugula. Izigulane ezininzi ezine-lymphoma zincinci xa zifumaniswe kwaye zihlala ubomi obude emva kokunyanga, ngoko zisengozini yokuphuhliswa kwexesha elifutshane, iimpembelelo ezide ezide ezixhomekeke kwizigulane eziqhelekileyo.
Ngokusekelwe kwinto eyaziwayo malunga nokwelashwa kweproton, abaninzi bakholelwa ukuba iziphumo zempembelelo ziya kuncitshiswa xa kuthelekiswa nonyango oluqhelekileyo. Oogqirha kunye nabaphandi basebenzela kwicandelo le-chemotherapy le-equation, ukuhlola ukusetyenziswa kwamagosa amasha kunye nemiphumo emibini, ukujonga kuyo nayiphi na impembelelo kwiziphumo zexesha elide kunye nemiphumo emibi emva kwexesha.
Izigulane ngeHodgkin lymphoma , ngokukodwa, zinamazinga aphezulu okunyanga, kodwa ziyakuthi ziphuhlise imiphumo emibi yonyango esuka kwi-chemotherapy kunye ne-radiation. Enyanisweni, abasindileyo be-Hodgkin i-lymphoma abasindileyo ngenye yeqela elisesichengeni sezinto ezinobungozi okanye ezinobungozi obuphila ubomi obungapheliyo, njengomhlaza wesibini okanye isifo senhliziyo . Ezi ngcipheko ezongeziweyo zikholelwa ngenxa yecandelo kwinxalenye kwimiphumo yokugqibela ye-chemotherapy kunye ne-radiotherapy.
Ngenxa yokuba unyango lweproton lusetyenziswe ukuba luchaneke ngakumbi ekuhambiseni i-radiation, ithemba kukuba isifo senhliziyo esincinci kunye neesibini zonyana ziza kuphuhlisa. Kuze kube ngoku, kwisifundo esinye, iziganeko zentsholongwane yesibini phakathi kwabo baphathwa ngeproton ne-photon radiation kubonakala zifana noko, kodwa idatha ingaphelelanga kwaye kufuneka uphando olungakumbi.
ILizwi
I-Oncologists exhasa ukusetyenziswa kwonyango ka-proton ye-Hodgkin lymphoma baye bachaza isenzo sokulinganisela esenziwayo, phakathi kokuphindaphinda ngenxa yonyango olungonelanga ngakwesinye icala kunye noxinzelelo olubi emva kwexesha lokusukela unyango olugqithisileyo kwenye.
Abanye bathi ukuba ukwandisa i-chemotherapy ukuba ukhutshwe ngenxa yokuba ungenalo unyango lwe-radiation, awuyi kuyenza nayiphi na inzuzo ngokwemiqathango yexesha elide. Ukongezelela, bacebisa ukuba inkululeko yesibini yokuphindaphinda kwe-lymphoma kuyisiphumo esibalulekileyo sokugcina iithebhu, njengoko abaphandi kwixesha elizayo bazama ukulungisa ingozi kunye neenzuzo zendlela ezintsha.
Ngokwoluhlolo lweHoppe kunye noogxa nabo, unyango lweproton lunikeze iqondo eliphantsi elingaphantsi kweemitha zentliziyo kwiintliziyo, imiphunga, amabele, isifo kunye nezinye izakhiwo kwinxalenye enkulu yabathathi-nxaxheba be-Hodgkin lymphoma. Ixesha kuphela liza kuxela ukuba unyango lweproton luya kuba luqhelekile.
> Imithombo:
> Chung CS, Yock TI, Nelson K, Xu Y, Keating Keet, Tarbell NJ. Isiganeko sesilumkiso sesibini phakathi kwezigulane eziphathwe ngeproton kunye ne-photon radiation. Int J Radiat Oncol Biol Phys. 2013; 87 (1): 46-52.
> Hoppe BS, Flampouri S, Su Z, et al. Ukunciphisa umthamo osebenzayo kwizakhiwo zentliziyo usebenzisa iiponon ukufaniswa ne-3DCRT kunye ne-IMRT kwi-Hodgkin lymphoma. Int J Radiat Oncol Biol Phys 2012; 84: 449-455.
> NCCN Ulwaphulo lweeNkcazo zonyango. 2017.