Ukuqonda iiNzuzo kunye neengozi ze-Proton Beam Therapy
Ukuba ugqirha wakho uphakamise unyango lweproton ngomhlaza wakho, mhlawumbi uxhalabele kwaye udideke. Ngokungafani nonyango lwezonyango, unyango lweproton ye-proton olutsha kummandla kwaye ulwazi oluncinci lukhoyo. Makhe sijonge ukuba lolu hlobo lonyango lusebenza njani, inzuzo kunye nokuphazamiseka okunxulumene nolunye unyango lomhlaza, kunye nemiphumo engabonakaliyo ongayifumana.
Ngelixa unyango lweproton lusetshanje "luthatyathwa" kunye nezimbalwa ezimbalwa zezakhiwo ezibonelela le nkonzo, ubuchule buye bujikeleze kwezinye izibhedlele e-United States ukususela ngo-1990.
Usebenza njani Ngonyango lweProton?
Intsingiselo emfutshane malunga nendlela yokwenza unyango lweprotro isebenza ngayo-efana neyonyango ye-radiation-isebenzisa amandla ukulimaza okanye ukutshabalalisa iiseli zomhlaza.
Kulabo bafuna ukuqonda indlela yokwenza unyango ngokubanzi, utyando lweproton lusebenza ngokukhawulezisa iiponononi (iindidi ezintle) kummandla ophezulu wamandla nge-accelerator. Umoya ophezulu wamandla uvumela iiponononi ukuba zihambe ngeengxube ngqo kwi-tumor; kubangelwa ibhobholo yeendawo ezikhoyo kwi-tumor.
Iiproston zihlawuliswa ngokuqinisekileyo kwaye ngoko zitsala iintlawulo ezingekho phantsi. Xa iproton isungulwe kufuphi ne-molecule efana ne-DNA, iindawo ezichaswe kakubi ze-molecule ziya kutsalwa kwiproton, ngaloo ndlela ziphazamise ukuba iimolekyu eziqhelekileyo ziqhelanise kunye nomsebenzi.
Isiphumo sale nkqubo ekugqibeleni kukufa kweeseli zomhlaza.
Ukwahlukahlukana Phakathi kohlobo "oluqhelekileyo" Ulwaphulo lwe-Radiation kunye noTyton Therapy
Ulwaphulo lweproton kunye neyeza eziqhelekileyo zonyango zichazwe zii-radiation oncologists. Enye yezinto ezahluke kakhulu kwiindawo zonyango. Iprotro unyango lujolise ngokuchanekileyo kwiindawo ezithile, ezinokubangela umonakalo omncinci kumathambo ajikelezileyo.
Ulwaphulo oluqhelekileyo lwamayeza alujoliswe kancinci, kwaye ezinye iiseli "eziqhelekileyo" kummandla wesifo sinokonakaliswa.
Ulwaphulo lwe-proton lwentambo alukho uhlobo olulodwa lonyango, kodwa kunokuba kukho iintlobo ezahlukeneyo kunye neendlela. Iindidi ezintsha zonyango lweproton ezifana nophenyo lwepencil ucingwa ukwenza le ngonyango ibekezeleleke ngakumbi.
Ziziphi iidrakes ezenziwa Ngonyango lweProton?
Ukwelashwa kweprotram ngokuqhelekileyo kusetyenziswa izidumbu zendawo (isigaba I, II, okanye III) kwaye isetyenziswe ngokungaqhelekanga kwisigxina se-4 (iiswini eziye zasasazeka kwezinye iindawo zomzimba). Ezinye iintlobo zomhlaza apho unyango lweproton lungasetyenziswa luquka:
- Umhlaza womlenze: Ngomdlavuza wamaphaphu, unyango lweproton lungasetyenziselwa umhlaza wesifo somhlaza ongasayi kunyangwa ngokuhlinzwa, okanye ukuphindaphinda xa unyango lwamayeza oluqhelekileyo selunikwe.
- Umdlavuza wobunongo: Indawo echanekileyo yokunikezelwa ngonyango lweproton ingaba luncedo kwiimvumi zengqondo apho kunye nemiphumo encinci yomonakalo kwizicubu eziqhelekileyo ezinokuthi zibe nemiphumo emibi.
- Iingcingo zomntwana: I- proton ye-britry treatment, njengoko ichaziwe ngasentla, ingenza umonakalo ongaphantsi kwimizimba eqhelekileyo. Ekubeni umonakalo we-DNA kwiiseli eziqhelekileyo kunokukhokelela ekliniki yesibini, kucingelwa ukuba le nonyango ingaba yindlela engcono kumaxesha athile kubantwana.
- Intloko neentamo zomhlaza
- Umhlaza wesifo
- Umhlaza weGallbladder
- Umhlaza we-Esophageal
- Umhlaza wesisu
- Umhlaza weprostate
Iingenelelo kunye neNzuzo yeCandelo leProton Beam
Zininzi unyango olutsha lomhlaza oye wavela kwiminyaka emashumi edlulileyo, kwaye oku kuyamangalisa. Ngexesha elifanayo, nangona kunjalo, xa kukho iindlela ezahlukeneyo zonyango, wena kunye ne-oncologist yakho kuya kufuneka wenze isigqibo malunga nonyango ophilileyo kuwe.
Abanye abantu balula uluhlu lwezonyango kwaye banokulinganisela ukhetho olusekelwe kwindlela olufanelekileyo ngayo unyango kunye nemiphumo emihle (nokuba ziphi iziphumo ezizeleyo eziza kubonwa ukuba zincinci kakhulu).
Ukubhala uluhlu kunye nenkunkuma yonyango lweproton kunganceda kule nkqubo.
Iinkqubo zonyango lweproton ziquka:
Ukwelashwa kwe-proton kwenyusa umonakalo kwindawo echanekileyo yeethambo. Oku kunokuba luhle kakhulu kwiimvumi ezikufutshane nezakhiwo ezibalulekileyo, ezifana nezicubu zeengqondo , okanye iimfompho zamaphaphu ezisondele entliziyweni. Intloko kunye neentamo zomhlaza, ngakumbi ezo zihlobene ne- papillomavirus yabantu (HPV), zinomlinganiselo omkhulu wokusinda kunezifo ezingekho nge-HPV, oku kuthetha ukuba abantu baya kudla ukujamelana nemiphumela emibi yexesha elide kwiminyaka emininzi. Kule meko, unyango lweproton ye-proton lunokuba luncedo kwiimitha eziqhelekileyo.
Ngenxa yokunikezelwa kweeponononi ezichanekileyo, i-dose ephezulu ye-radiation iyakwazi ukuhanjiswa kwi-tumor kunye neyeza leproton.
Indawo echanekileyo yokuhanjiswa kweemitha ngepropytha yonyango yeproton ingabangela umonakalo omncinci kwiimpawu ezijikelezayo. Akunjalo kuphela oku kunciphisa imiphumo emibi (ngenxa yokungonakaliswa kancinci kumathishini anempilo) kodwa kunokunciphisa amathuba okuphucula umdlavuza wesibili (iisomhlaza ezibangelwa unyango lwezonyango ezifana nokunyanga kwamayeza kunye ne- chemotherapy ). Kucingelwa ukuba umngcipheko weekliniki zesibini ziza kuba ziphantsi kwonyango lweproton kune-radiation yonyango, okwenza ingqalelo ikakhulu kubantu abatsha abanomdlavuza.
Iiplanga zeProteton zilula ukulawula ngaphezu kwemizila eqhelekileyo. Ukongezelela, xa i-boram ifinyelela kwi-tumor, iyayeka, kunokuba ibangele ukusabalalisa nokugqithisa.
I-proton yonyango yexilongo ngokuqhelekileyo ixhomekeke kakuhle kunye nemiphumo emibini ngaphandle kweyonyango ye-radiation.
Ukwelashwa kweproton (kunye ne- stereotactic body body radiotherapy okanye i-SBRT) ingasetyenziselwa i-cancer ye-early in theory ifanele isebenze, kodwa ibonakala ingenakusebenza ngenxa yendawo yayo kufuphi nezakhiwo ezibalulekileyo okanye umntu akayena umviwa ofanelekileyo wokuhlinzwa.
Ubume bonyango lweproton lungabandakanya:
Ngenxa yendawo echanekileyo yokuhanjiswa kwee-radiation, unyango lweproton lungaphuthelwa indawo ezincinci zeeseli zomhlaza kunye nezisifo ezisondeleyo kodwa ngaphandle kwimizila ye-radiation.
Ngethuba langoku, unyango lweproton ye-proton lugqithisa ngokuphindwe kabili njengonyango oluqhelekileyo lwe-radiation ngenxa yeendleko eziphezulu (unyango lweproton ludinga ukukhawuleza okukhulu). Okwangoku iindleko ezingaphezu kwezigidi ezingama-200 zeedola ukwenza isibonelelo.
Iingxaki zibandakanya ukuphathwa kohambo kunye neenguqu kwi-anatomy ezenzeka ngaphambi nangonyango.
Ekubeni amaziko amachiza athile okanye amaninzi aseproton asekhona eUnited States, abantu bangadinga ukuhamba ngokude ukufumana le nyango.
Eminye indlela eya kuTyton Beam
Nangona unyango oluqhelekileyo lwe-radiation lugqithiseleyo kwaye lubandakanya "ukusabalalisa" kunokuba unyango lweproton, iindlela zokutshabalalisa ngokutsha zibonelela ngokugqithiseleyo ukuhanjiswa kwemitha.
Omnye umzekelo ngumzimba we-stereotactic radiotherapy (SBRT). Nge-SBRT, amanani aphakamileyo emirhumo ayaziswa kwiindawo ezichanekileyo. I-SBRT ingasetyenziselwa injongo yokukhusela iimvumi ezingenakucinywa ngenxa yendawo yazo, okanye ukunyanga "i-oligometastase" (enye okanye imitha embalwa kuphela kwiingqondo, isibindi, okanye imiphunga ezivela emathunjini aqinileyo).
Ngo-2017 ukuphononongwa kwezifundo ngokuthelekisa unyango lweproton kunye ne-SBRT, abaphandi abafumananga naluphi na ulwahlulo oluxabisekileyo kule mpahla ezimbini zokunyanga komhlaza wesifo somhlaza ongaselula.
Iimpembelelo ezingasetyenziswayo zonyango lweProteton Beam
Njengoko unyango oluninzi lomhlaza, unyango lweproton lungenza iziphumo zecala ngokunjalo. Nangona unyango lweproton lugqithiselwa kwindawo echanekileyo, umonakalo kwiiseli eziqhelekileyo kufuphi ne-tumor zingenzeka. Uninzi lwemiphumo emibi ifana nemiphumo emibi yonyango oluqhelekileyo, kodwa ngenxa yengqwalaselo echanekileyo yomonakalo, ingaba nzima kakhulu.
Iziphumo eziqhelekileyo ziquka:
- Ukukhathala: Njengoko unyango oluqhelekileyo lonyango, ukukhathala ngenye yeempawu eziqhelekileyo zonyango. Olu ludaka luba nzima kakhulu ekuhambeni kwonyango oyiyo.
- Ubomvu besikhumba (i-radiation dermatitis): Ngokuqhelekileyo, ukuphuphuma kwesikhumba kunye nokuchithwa kwesikhumba kunokwenzeka ngonyango lweproton.
- Ukulahleka kweenwele: Ukulahleka kweenwele kungenzeka kwindawo apho unyango lweproton lwenziwa khona, umzekelo xa ikhanda xa lisetyenziselwa umhlaza wengqondo okanye isifuba xa sisetyenziselwa umhlaza wemiphunga. Ngokungafani nokulahleka kweenwele ezinxulumene ne-chemotherapy, ukulahleka kweenwele ezinxulumene nopilisi lwe-proton ye-pro
- Ukuvuvukala kwemiphunga: Ukuqhaqha kwamanzi okubhekiselele kuthiwa yi- radiation pneumonitis ingenzeka xa unyango lweproton lusetyenziselwa esifubeni. Ukubaluleka kwe-radiation pneumonitis kukuba kufuneka ibonwe kwaye iphathwe ukwenzela ukunciphisa umngcipheko wokuphuhlisa i- pulmonary fibrosis (ukunqanda imiphunga).
Uphi iTransil Beam Eyatholakala?
Kukho inani elingaphantsi kwamaziko emhlaza e-United States nakwihlabathi jikelele elibonelela ngonyango lweproton beam. Imephu yamaziko enyango ka-proton angakubonisa ukuba le nonyango inikelwa kufuphi nendawo yakho.
Ukulungiselela i-Proton Beam Therapy
Ngaphambi kokuba uqale unyango ngeyeza leprotram, uza kudibana ne- radiation oncologist oza kuxubusha into onokuyilindela, kunye neenzuzo kunye neengozi zenkqubo. Uya kuba ne-CT scan ukwenzela ukuba ubalaphule ummandla womzimba wakho ukuba uphathwe kwaye uza kufakwa kwisixhobo sokuchithwa (njengokuba unyango oluqhelekileyo). Esi sikhokelo siya kufakwa phezu kwengxenye yomzimba wakho ukufumana imitha yonyango ngexesha lonyango.
Efana nemirhumo eqhelekileyo, unyango lweproton bonyango luhlala lwenziwa rhoqo ngeveki nganye kwiseshoni ezingama-20 ukuya kwe-40. Ngoxa i-parts yangempela yemitha yokutyelela ithatha umzuzu okanye ezimbini, ukuqeshwa kwabaninzi kuza kudlula imizuzu engama-30 ukuya kwe-45.
Iprotro yokwelapha ayibuhlungu, kwaye akukho ne-anesthesia efunekayo (ngaphandle kwabantwana abangadinga ukuba i-sedation isekho ngexesha lonyango).
ILizwi
Ulwaphulo lwe-proton lwesigxina linikeza enye indlela yokunyanga umdlavuza. Ngenxa yokukwazi ukugxininisa ngokucacileyo ukukhanya kwemitha emdlalweni, umdlalo owona mbambiso awunakuphelisa umdlavuza kodwa kunciphisa umngcipheko wemiphumo emibi echaphazelekayo kunyango. Ngaloo ndlela, inokuba yinto efanelekileyo yokuxhamla izibonda ezikufutshane nezakhiwo ezibalulekileyo kunye nabantu abatsha abanokuba nomngcipheko omncinci weekliniki zesibini kunye neyeza leproton nge-radiation eziqhelekileyo.
Ingasetyenziselwa iimvumi ezaziye zaphathwa ngonxibelelwano oluqhelekileyo kodwa zaphindaphinda. Indawo echanekileyo yonyango inokuvumela ukuba imirhumo iwanikwe kumlinganiselo ophezulu kuneemitha eziqhelekileyo.
Kukho ukuphikisana ngokukhawuleza kwamkelwa kunye nokuphuhliswa kwamaziko anika olu lwaluphi unyango njengamanye amaxesha okanye i-radiation eqhelekileyo okanye inkqubo efana ne-SBRT inokusebenza ngokufanelekileyo kodwa ingabizi. Ngenxa yokuba unyango lweproton lusemtsha, asinalo iiphononongo eziza kukuxhasa ngokupheleleyo iingenelelo zonyango lweproton ngaphezu kwamanye unyango. Xoxa ngale ndlela kunye nomboneleli wakho ukuze ubone ukuba kulungile kuwe.
> Imithombo:
> Diwangi, T., Mohindra, P., Vyfhuis, M. et al. Uphuhliso lwee-Radiotherapy Techniques kunye nokuhanjiswa kweNcinci ye-Lung ye-Cell engeyona encinci: IiNzuzo zoPhulo lweMitha yoLwabiwo-mandla, i-Proton Therapy, ne-Body Stereotactic Radiation. Uphando lweLung Cancer Research . 2017. 6 (2): 131-147.
> Mohan, R., noD. Grosshans. Iprotro Therapy- Ekhoyo kunye neKamva. UkuPhathwa kweziMveliso eziPhambili . 2017. 109: 26-44.