Iimpawu, Ukuxilongwa, kunye neNtuthuko kwiNyango
Umdlavuza womlenze uyaziwa ukuba usasazeke kwingqondo malunga nama-40 ekhulwini amatyala apho kwenzeka imetastasis. I-Metastasis ligama lezonyango elisetyenziselwa ukuchaza umhlaza osasaze ngaphaya kwe-tumor yokuqala ukuya kwinkqubo eyahlukileyo. Ngomdlavuza wamaphaphu, oku kuqwalaselwa kwisigaba 4 sesi sifo.
Sibanzi
Xa i-metastases iyenzeka kubantu abanomdlavuza wamaphaphu, ukusalalisa okwesibini akubheki "ngumhlaza wengqondo" kodwa kunoko "umhlaza wesifo somdlavuza kwingqondo" okanye "umdlavuza wamaphaphu kunye ne-brainstorms". Ngokwahlukileyo, isigama somhlaza wengqondo sisetyenziselwa ezo zicubu ezivela kwingqondo njengeyona nto ephambili, kunokuba isesibini .
Ngamanye amagama, ukuba uthabatha isampuli yamaseli omhlaza engqondweni, babeya kuba ngamaseli emiphunga emhlaza, kungekhona amangqamuzana ebuchopho bomhlaza.
Ngokudabukisayo, iintsholongwane zeemiphunga kunye ne-metastas to the brain have prognosis, kodwa oku kuguquka kwabanye abantu. Ngokungafani namachiza amaninzi e-chemotherapy, ezinye zezilwanyana ezijoliswe kumtsha ngomhlaza wamaphaphu ziyakwazi ukungena emngceleni we-brain-brain and can help fight the tumors tumors which spread to the brain. Kukho iinketho ezintsha ezitholakalayo kulabo abaneempawu ezincinci kuphela kwiingqondo (ngamanye amaxesha zichazwe njenge-oligometastases). A
Umlinganiselo wokuhlala ixesha kunye neengqondo ze-metastases zihlala zingaphantsi konyaka, kodwa xa kutholakala i-metastase (i-oligometastases) kuphela kwaye ingaphathwa, abangaphezu kwama-60 ekhulwini abantu bangaphila iminyaka emibini okanye ngaphezulu.
Ukuba unomdlavuza wemiphunga kunye nesifo sesibindi, unyango lwakho kunye nesifo sokugxekwa sisenokuthi sihluke kunomntu onomqathango ofanayo nje ngonyaka okanye emibini edlulileyo.
Kubalulekile ukuba ufunde konke onakho kwaye ube ngummeli wakho.
Iimpawu
I-Brainastases ye-Brain ingenzeka kunye nomdlavuza omncinci wamangqamuzana wesifo somhlaza okanye umhlaza wesifo somhlaza wesininzi . Umdlavuza omncinci wamancinci omninzi uhlala kunzima ukuxilonga kumanyathelo okuqala kwaye, ngenxa yoko, unokusasazeka kwingqondo ngaphambi kokufunyaniswa.
Amanqwelana amancinci amancinci angasasazeka kwingqondo kodwa athambekele ukwenza njalo emva kwesi sifo emva kokuba i-tumor yokuqala ifunyenwe.
Iimpawu ziyakwazi ukuhluka ngohlobo lomhlaza wamaphaphu kwaye apho kwindawo yengqondo i-metastases ivela khona. Ukuxhalabisayo, ininzi yesithathu kubo bonke abantu abanomdlavuza wesibili engqondweni abayi kuba nempawu. Ukuba zenzeke, ziquka:
- Intloko
- Ukukhathala
- Ukulahlekelwa kwe-balance
- Isihlunu kunye nokuhlanza
- Unzima ukuhamba
- Ukulahlekelwa kolawulo
- Iingxaki zokuthetha
- Umbono utshintsha, kuquka ukulahleka kombono okanye umbono obini
- Ubuthakathaka besiphelo (okuvela kwicala elinye lomzimba)
- Ukulahleka kwememori
- Utshintsho lwabantu
- Ukuxhamla
Ukuxilongwa
Ukuba ugqirha wakho uxolisa ukuba umhlaza wakho wamaphaphu usasazeke kwingqondo yakho, uya kulandelela iimvavanyo zokucinga njenge- computed tomography (CT scan) esebenzisa i-X-ray ukudala imifanekiso yokuxilonga okanye imifanekiso ye -resonance magnetic (MRI) eyenza efanayo namaza ombane. Nangona i-MRI ithathwa njengechanekile ngakumbi, ingasetyenziselwa abantu abanezixhobo ezithile zentsimbi (kubandakanywa nabakhuseli abazikhuselekile).
Olunye uhlobo lwesitofiso sokubhenca ngumpositron ukukhishwa kwe-tomography (i-PET scan) ekwazi ukuhlukanisa phakathi kwesigxina se-cell metabolism kunye nalabo abonakala bengasebenzi (njengama-cell cell).
Ukuba i-lesion esicangayo ifunyenwe kodwa ukuxilongwa akuqinisekanga, i-biopsy inokwenziwa ukuba ifumane isampuli yesisindo sokuhlola.
Unyango
Ukunyangwa kwengqondo ye-metastases kuxhomekeke kwizinto eziliqela kubandakanya ubuninzi bobuchopho obandakanyekayo kunye nempilo yakho yonke. Ukuba ubuchopho be-metastases buninzi, unyango lujoliswe ekulawuleni iimpawu kunye neengxaki ukuze kulungiswe umgangatho wobomi. Ukuba kukho imitha embalwa kuphela, unyango lwengingqi ekupheliseni i-metastase ngokupheleleyo luhlala luqhutywa.
I-Steroids njenge-Decadron (dexamethasone) ingasetyenziselwa ukulawula naluphi na ukuvuvukala kwengqondo, ngelixa iilanti ze-anticonvulsive (ukusetyenziswa kweziyobisi) zinokunciphisa iziganeko kunye nobuqili bokuthinjelwa.
Ezinye iindlela zonyango zingaphulwa zibe zonyango ngokubanzi kumgca wesi-4 umdlavuza wamaphaphu, unyango lwe-brainstorms, kunye nezokwelapha zendawo ye-oligometastases.
Iingonyango eziqhelekileyo zomhlaza naphi na apho zikhoyo zingabandakanya:
- I-Chemotherapy: Amachiza amaninzi e-chemotherapy ayiphumeli ekuphatheni ubuchopho be-brainstatic ngenxa yobungqina begazi-ingqondo, inethiwekhi enamandla yama-capillari enokugcina i-toxin (kuquka i-chemotherapy drugs) ngaphandle kwengqondo. Kodwa i-Chemotherapy inokunciphisa ubukhulu beemathunga emiphakeni kwaye ngoko ukunciphisa amandla abo ekusasazeni kwingqondo.
- Ulwaphulo olujoliswe kuko : Izilwanyana ezijoliswe kwiinguqulelo ze-EGFR, ukulungiswa kwe-ALK, ukulungiswa kwe-ROS1 kunye nokunye ngamanye amaxesha banako ukungena kwi-barrier-brain barrier. Ezinye zezilwanyana ezintsha zibonakala zisebenza ngakumbi xa zenza njalo. Njengokhemotherapy, ezi zi yobisi zilawula i-tumor yokuqala kwaye zinciphise amandla okusasazeka kwingqondo.
- I-Immunotherapy : Sekukhawuleza ukuba ukwazi okuningi (isicatshulwa sokuqala se-immunotherapy yomdlavuza wamaphaphu savunywa ngo-2015) kodwa amayeza amathathu e-immunotherapy avunyelwe umhlaza wemiphunga abonisa isithembiso ekunciphiseni i-metastases yengqondo. Kwabanye abantu, ezi zi yobisi ziye zaholela ekulawuleni zombini i-metastases kunye "nokuphendula okuqhubekayo" kumhlaza ngokubanzi.
Unyango olujoliswe ngqo kwiingxaki ze-metastases kodwa zenzelwe ukuphatha i-metastases ephakamileyo:
- I-radiotherapy yobuchopho bonke: Ukuba kukho iinjongo ezininzi zengqondo ezikhoyo (amaziko omhlaza ahluke ekuchazeni oku kunye nenani linokuba likhulu kunamathathu ukuya phezulu kune-20), i-radiotherapy yonke ingqondo ikhuthazwe ngokuqhelekileyo. Ubungakanani bentliziyo yengqondo lunokuba lukhethi olufanelekileyo kulabo abaneempawu ezinxulumene nengqondo yabo yeemastastases okanye abasemngciphekweni weengxaki (njenge-stroke). Ingasetyenziselwa emva kokuhlinzwa ukuze unciphise ukusasazeka komhlaza. Nangona kungenakucwangciswa ukuphilisa umdlavuza, ubuncinane ama-50 ekhulwini abantu abaphantsi kwengqondo-radiotherapy bonke baya kuqaphela ukuphuculwa kweempawu. Iziphumo eziqhelekileyo ziquka ukulahleka kwememori (ngokukodwa imemori yomlomo), ukugqithisa kwesikhumba kunye nokukhathala. I-radiation oncologists ihlala icetyisa imishanguzo ebonakala ibangela ukunciphisa ukungasebenzi kwengxaki enxulumene nale nyango.
Izinketho zonyango oluthile lweMetastasis ziquka:
- I-radiotherapy ye-stereotactic: Eyaziwa nangokuthi i- radiosurgery okanye i-SBRT njenge- stereotactic , lo luhlobo lwe-high-dose radiation enikwe indawo ethile yengqondo. Ekubeni i-radiation ijoliswe, imiphumo emibi iyancinci kwaye inika amazinga angcono okusinda kunokuba unyango opheleleyo. Olu hlobo lwe-radiotherapy luvame ukugcinwa kubantu abaneentlungu ezilathu okanye ezimbalwa, nangona abanye abantu baye bafumana unyango olufikelela kuma-tumors angama-20.
- Ukwelashwa kweproton: Ukwelashwa kweproton kusetyenziswa ngendlela efana ne-SBRT, kwaye kwenziwa kwimizamo yokuphelisa i-metastases ekhoyo.
- Ugqirha: Utyando lusetyenziselwa ngaphantsi kodwa lungaba lukhetho ukuba kukho enye okanye izibilini ezinokufikeleleka kalula, kwaye akukho zibonakaliso zomhlaza kwenye indawo. Utyando lunokubandakanya ukususwa ngokupheleleyo kwesisu okanye ukususwa ngokukhawuleza ukunciphisa iimpawu. I-radial yonke ingqondo isilandela. Ekubeni iimvumi ezincinci zithintela kwi-radiotherapy yedwa, utyando luvame ukusetyenziselwa ukususa amancinci amancinci esele.
Ukuba iinketho ezahlukeneyo zonyango zibonakalisa zingasebenzi, ukunyamekelwa ngentsholongwane kungasetyenziselwa ukubonelela ngoncedo kunye nokunciphisa uxinzelelo oluchaphazelekayo nokuxilongwa kwesigulane. Oku kungabandakanya ukusetyenziswa kweentlungu zonyango, ukunyangwa komzimba kunye nokunyanga, okanye unyango olongezelelweyo ukuphucula induduzo nokuphucula umgangatho wobomi.
ILizwi
I-Brain metastases ngenxa yomdlavuza wamaphaphu inokuyikrakra. Kodwa, njengothusayo njengoko kunokwenzeka, kubalulekile ukukhumbula ukuba akukho khosi ehleliweyo xa kufike kumhlaza. Iyakwazi ukuhluka kumntu kumntu, kwaye "i-median" okanye "imilinganiselo" ekulindelekileyo oyifunayo malunga nokuba ayifuni isicelo kuwe.
Ukuba ubhekene neengqondo zesifo sengqondo kumdlavuza wamaphaphu, sebenzisana noogqirha kunye nabathandekayo ukuba wenze ukhetho olunolwazi olusekelwe ngokupheleleyo kunye nokunyaniseka kweengcaciso. Ngokuqhelekileyo kuncedo ukufumana umbono wesibini kwelinye lamaziko amakhulu omhlaza asebenza ngokusemgangathweni kumdlavuza wamaphaphu. Nangona unyango luyefana, wena kunye nosapho lwakho unokuziva unethemba lokuba uyikho efanelekileyo.
Kubalulekile ukuvumela ukuba uzive oko uvakalelwa kwaye ufune inkxaso ukuze uncede uhambe olu hambo. Yithatha isinyathelo esinye ngelo xesha.
> Imithombo:
> Cohen, J., no H. Kluger. I-Immunotherapy echanekileyo yoNyango lweBraastases yeBongo. Imida kwi-Oncology . 2016. 6:49.
> Jimenez, R., Alexander, B., Mahadevan, A. et al. Impembelelo ye-Stereotactic Treatment Radiation Treatment I-Regimens for Brain Metastase kwi-Local Control and Toxicity. Ukuphucula kwi-Radiation Oncology . 2017. 2 (3): 391-397.
> Loganadane, G., Hendriks, L., Le Pechoux, C. et al. Inxaxheba yangoku ye-Brain Radiation Allrapy kwi-Non-Small Cell Lung Cancer Patients. Umbhalo we-Thoracic Oncology . 2017. 12 (10): 1467-1477.
> Zhu, Z., kunye neY. Chai. Ukuchaswa kweCrizotinib Ukunqotshwa yi-Ceritinib kwi-ALK-Positive Cell-Non-Small Cell Isifo sengculaza esiswini se-Brain Metasase: Ingxelo yeNgxelo. Amachiza (iBaltimore) . 2017. 96 (45): e8652.