Malunga neepesenti ezili-1 zazo zonke izigulane zibandakanya i-thyroid, kwaye umdlavuza we-thyroid unamaxesha aphindwe kathathu kubafazi. Emazweni aseNtshona aphethe amanqanaba afanelekileyo e-iodine kwimithombo yokutya, uninzi oluphawulekayo lwama-khansa luhlobo lomdlavuza we-thyroid obizwa ngokuba yi- papillary thyroid carcinoma . Ngethamsanqa, kubantu abadala abane-papillary thyroid carcinoma, i-metastase ede kakhulu ayiqhelekanga.
Nangona kunjalo, i-metastases ezide-ezithatha uhambo olujikelezayo (ukusasazeka kwegazi) kunye nokuzingela phantsi kwiindawo ze-anatomic ezifana ne-lung kunye ne-bone-ziqhelekileyo kunye nomnye uhlobo lomhlaza we-thyroid obizwa ngokuba yi- follicular thyroid carcinoma . Uloyiko, loo mizobo ingabonakalisa impawu! Ngelishwa, abanye balaba bantu abane-carlicoma ye-thyroid ye-follicular bayakwazi ukuphendula kwi-radiotherapy (i-radioiodine) emva kokususwa kwe-thyroid. Ngenxa yokuba isigulane sabantu abanomdlavuza, behluke umhlaza we-thyroid, i-lenvatinib yezilwanyana (Lenvima) inokunceda. Inqaku, lenvatinib ifika kwifomsule ifomu.
Okungakumbi Ngomdlavuza we-Thyroid
Zombili i-papillary and follicular thyroid carcinoma ivela kwii-cellist epithelial cells kwi-thyroid. Ziyabonwa ngokuba yizohlukeneyo zezakhiwo kunye nenyukliya. Amaphesenti angamashumi anesithoba anesihlanu ama-cancer e-thyroid aqhelekanga ngaphandle kwelifa lentsapho.
Imisebe yangaphandle yodwa yingozi yomdlavuza we-thyroid kunye nomdlavuza we-thyroid ngokubanzi-ngokuthe ngqo umdlavuza we-thyroid, nangona kunjalo, i-iodine ngokweqile okanye ukungabikho kwangegalelo inokudlala indima.
Ngomdlavuza we-thyroid, i-thyroid i-nodules okanye "i-lumps" yimiqondiso ebonakalayo ebonakalayo . Ngenxa yokuba ii-nodules eziqhelekileyo "zibandayo" kwi-scan ye-thyroid, i-good nucleus aspiration (uhlobo lwe-biopsy) yindlela efanelekileyo yokufumanisa ezi zicubu.
Umdlavuza we-thyroid uhlukeneyo uqala ukuphathwa ngonyango, ubukhulu becala okanye obuthathaka-buphikisanayo kwaye kuxhomekeke ekubandakanyekeni kwe-thyroid kunye ne-lymph nodes. Kwiimeko zesifo somhlaza we-thyroid (invastve), yonke i-thyroid kufuneka isuswe ukuze i-radioiodine ithathe.
Ingqalelo, umdlavuza we-thyroid ulandelelana kakhulu kubantu abakwi-50s kunye no-60, kwaye emva kokuba ulungelelanisa, izinga lokusinda iminyaka eli-10 li-10 ekhulwini. (Ngokubanzi, ngo-2014, abantu aba-1 890 eUnited States babulawa ngumdlavuza we-thyroid.) Ngaphezu koko, i-chemotherapy ayifanele iqinisekiswe ngempumelelo kulabo abane-thyroid carcinoma.
Ngakumbi malunga neLenvatinib
Ngaphandle kokwenza okuthe ngqo, i-lenvatinib yi-inhibitor ye-multitargeting tyrosine kinase evimbela iindlela zamathambo ezibandakanya ukukhula kwe-tumor nokugcinwa. Ngamanye amagama, i-lenvatinib inqanda ukukhula kweeseli zesisu ezide kude ne-thyroid eziye zanyanzelisa unyango nge-iodine yama-radioactive.
NgoFebruwari 2015 emva kokuphonononga iziphumo ezivela kuvavanyo lweSigaba sesi-3, i-FDA ivunyelwe lenvatinib. Abaphandi bavavanye abantu abangama-392 abanomdlavuza we-thyroid eyahlukileyo. Ngokukodwa, i-lenvatinib yalawulwa kwabathathi-nxaxheba abangama-261 ngelixa abathathi-nxaxheba abangu-131 bafumana indawo ye-placebo.
Okubalulekileyo, olu pho nonongo luye lwenzelwe nge-crossover eyenza abantu banenkqubela yokugula ukusuka kwindawo ye-placebo ukuya lenvatinib. Ngenxa ye-crossover enjalo, abaphandi babengenakukwazi ukukrazula ukuba i-lenvatinib yanda ngokubanzi ixesha lokusinda.
Nangona kunjalo, abaphandi banako ukubonisa ukuba ukuqhubeka kokuphila okungafaniyo kwinyanga ezili-18.3 kwiqela lokulinga okanye abo bafumana i-lenvatinib ngokumalunga neenyanga ezi-3.6 kulabo abakwiqela lokulawula abafumana i-placebo.
Amaphesenti angama-40 abathathi-nxaxheba bathatha i-lenvatinib babenemiphumo emibi ekuthi, kwiimeko ezininzi, belawulwa ngokulungiswa kwemilinganiselo yeziyobisi.
Nangona kunjalo, i-14.2 ekhulwini yabathathi-nxaxheba bathatha i-lenvatinib yashiywe ngaphandle kwesi sifundo, kunye nokufa kwe-6 kwabangama-20 okwenzeka ngexesha lokufunda kweenyanga ezili-14 kwakucatshangwa kubangelwa yiziyobisi.
Ngokukodwa, nantsi ezinye zeempembelelo ze-lenvatinib:
- Uxinzelelo oluphezulu (67.8 ekhulwini lwabathathi-nxaxheba)
- uhudo (iipesenti ezingama-59.4 zabathathi-nxaxheba)
- ukukhathala (ama-59 ekhulwini abathathi-nxaxheba)
- kunciphise ukutya (50.2 ekhulwini yabathathi-nxaxheba)
- ukwehla kwesisindo (ama-46.4 ekhulwini abathathi-nxaxheba)
- isicupunu (amaphesenti angama-41.0 abathathi-nxaxheba)
Ngokubanzi, iziphumo ezivela kulolu vavanyo zibonisa ukuba kulabo abanomdlavuza we-thyroid olwahlukileyo olwahlukileyo kwi-radiotherapy, i-lenvatinib inokuyeka ukukhula komhlaza. Ukuba wena okanye othandekayo unesifo esibulalayo, ukufunyaniswa kwesi sifundo kuyakhuthaza. Nangona kunjalo, uphando olongezelelweyo lufuneka luyenze ukwenzela ukuba lubone ngokuchanekileyo ngubani ofuna iilisi, ukuba yiyiphi imilinganiselo ephumelele kakhulu, kwaye nokuba ukuyeka ukuqhubela phambili kukukhokelela kumgangatho wobomi obubhetele. Emva kwakho konke, unyango olungakumbi luyinto encinci ukuba umgangatho wakho wobomi uyabethusa.
Imithombo:
Isahluko seNcwadi esithi "Ukuhlukana kwe-thyroid carcinoma" ngu-O. Gimm no-H. Dralle kwi- Treatment Treatment: Ubufakazi obusekelwe kunye neNgxaki-Echazwe ngo-2001.
Isiqendu esithi "uLenvatinib sithuthukisa ukusinda kumdlavuza we-thyroid" ngu-S Mayer evela kwi -Lancet epapashwe ngo-2015.
I-athikili ebizwa ngokuthi "Umthamo woBugqirha weNtsholongwane yeChroid ye-Thyroid: Isikhokelo esinconywayo" nguGar Rahman waseOman Medical Journal eshicilelwe ngo-2011.
I-Article ebizwa ngokuthi "Lenvatinib ngokumelene ne-Placebo kwi-Radioiodine Refractory Cancer Cancer" ngu-M Shlumberger kunye nabalobi be- NEJM epapashwe ngo-2015.