I-intraperitoneal chemotherapy yindlela yokulawula i- chemotherapy kwi-ovarian umdlavuza ngqo kwisigxina esiswini. Nangona ininzi i-chemotherapy i-intravenous, kwaye ezininzi iindlela ezintsha zokwelapha eziphilayo okanye ezijoliswe kuzo zizonyango, indlela yokwenza i-intraperitoneal yokukhupha i-chemotherapy enye yezilwanyana zokunyanga zokuqala ezicetywayo kubasetyhini abanomdlavuza wesiqendu se-III .
Isifundo esiPhambili
Ngo-2006, iziphumo ze-Gynecologic Group Clinic trial GOG 172 zapapashwa kwi-New England Journal of Medicine. Kule sifundo, abafazi babenelungelo lokunyanga xa benomdlavuza wesiqendu se-ovari okanye umhlaza wokuqala we-peritoneal kwaye ukuba babe ne-optoticuctive operesheni (oko kuthetha ukuba akukho ntsalela yesisindo esingaphaya kwe-1 cm eshiywe emva kokuhlinzwa).
Ulingo lwaluhlelwe ngolu hlobo, oku kuthetha ukuba izigulane zinikezelwa kwiqela lonyango ngeflip yekhompyutha. Kula mabhinqa angama-415 kwisifundo, isiqingatha safumana i-chemotherapy yendabuko yangokwamasiko kunye ne-cisplatin kunye ne-paclitaxel (i- Taxol ). Esinye isiqingatha samkela izidakamizwa ezifanayo, kodwa ngokudibanisa kwe-intravenous (paclitaxel) kunye ne-intraperitoneal (cisplatin ne-paclitaxel) yokuhanjiswa.
Oku akulona lonyango olulula ukuthatha, kwaye iziphumo zophando ziqinisekisile oko. Kuphela i-42% yabasetyhini kwiqela le-intraperitoneal liyakwazi ukufumana yonke imijikelezo yesithupha ye-intraperitoneal chemotherapy.
I-90% yabasetyhini kwiqela elixhamlileyo lafumana zonke iisithandathu. Abafazi abafumana i-intraperitoneal chemotherapy babenomthwalo obunzima okanye obuthathaka ubomi obunobungozi, intlungu, ukubala kwegazi eliphantsi kunye neempembelelo ze-neurologic side effects. Kwakhona kubalulekile ukuqaphela ukuba abasetyhini abasithoba bafa ngexesha le-chemotherapy - ezine kwiqela elixhamlayo kunye nehlanu kwiqela le-intraperitoneal.
Ukufa kwaba ngenxa yesifo.
Inzuzo Yokusinda
Olu phofu luka-2006 luye lwaba nomxholo, nangona inetyhefu yonyango, ngenxa yeziphumo zokusinda. Nangona kuphela i-42% yabasetyhini kwiqela le-intraperitoneal liyakwazi ukufumana zonke iintshukumo eziyisithupha zonyango, ukusinda okungaqhubekiyo kwintlalo (ixesha lokuphila ngaphambi kokuba umhlaza uphuthuke) yayingu-5 1/2 inyanga kwixesha elide kwiqela le-chemotherapy ye-intraperitoneal. Eyona nto ibangelisayo yinto yolondolozo jikelele. Abasetyhini abafumana i-intraperitoneal chemotherapy babenomsebenzi wokuphila okwakusondeleyo kweenyanga ezili-16 kunabesifazana abafumana i-chemotherapy yonyango kuphela - iinyanga ezingama-65.6 eziqhathaniswa neenyanga ezingama-49.7.
Ngokusekelwe kakhulu kwiziphumo zolu cwaningo, kunye nakwezinye izilingo ezimbini zesigaba se-III, iNational Cancer Institute yanikezela iSaziso seNtsholongwane esingavumelekanga sokukhuthaza ukuba ukusebenzisa i-intraperitoneal chemotherapy kufuneka kuqwalaselwa ngamandla kwizigulane ezifanelekileyo.
Ukuqwalasela ngokufanelekileyo
Ukufumana i-intraperitoneal chemotherapy akusiyo wonke umntu onomdlavuza we-ovarian, nangona kunjalo. Khumbula, ngokusekelwe kwisifundo esiqakathekileyo, siyazi kuphela ukuba inzuzo kwabasetyhini abanezifo zesigaba se-III abaye bafumana uphando olunzulu lwe-cytoreductive (akukho nkunkuma esele ishiywe ngaphezu kwe-1 cm eshiywe emva kokuhlinzwa).
Ukuze i-intraperitoneal chemotherapy ibe ne-intraperitoneal, i-cathteral intraperitoneal (port) kufuneka ibekwe eludongeni lwesisu nge-gynecologic oncologist. Ukuba ayifakwanga ngexesha lotyando lokuqala, ingasetwa kamva, kwindlela yokucwangcisa eyahlukileyo ngo-gynecologic oncologist okanye nge-radiologicalist intervention. Abahlengikazi abasebenzisa i-chemotherapy ngokusebenzisa le port kufuneka babe nezakhono kwaye bakhululekile ngendlela. I-catheter inokuvuza okanye ivalwe. Ulawulo lwemiphumo yecala ludinga i-oncologist yezonyango ezinokwazi okanye i-oncologist enamazinyo kulolu hlobo lonyango.
Ukulandela
Uphononongo olutshanje olwenziwa nguDkt. Wright kunye noogxa, olupapashwe kwiNcwadi ye-Clinical Oncology, lubonise ukuba akubona bonke abafazi abafanelekileyo ukufumana i-intraperitoneal chemotherapy. Iqela lakhe lafunda inani labasetyhini abali-823 ababenomgangatho we-III ovarian or fallopian tube okanye i-peritoneal carcinoma. La mabhinqa aphathwe kumaziko ahlukeneyo omhlaza ahlukeneyo angama-6 ayingxenye yeNational Comprehensive Cancer Network, kuquka neSixeko seThemba, iDana-Farber / Brigham kunye nabaseTyhini, iFox Chase, iYunivesithi yase-Ohio, iYunivesithi yaseTexas kunye neCancer Cancer Centre, kwaye kwiYunivesithi yaseMichigan.
Iqela likaDkt. Wright lafumanisa ukuba abafazi abangaphantsi kwe-50% abafanelekile ukufumana i-intraperitoneal chemotherapy bayifumene. Ukufunda kwabo kwaqinisekisa ukuba abafazi abafumana i-intraperitoneal chemotherapy bahlala ixesha elide kunabo bafumana i-chemotherapy kuphela.
Umyalezo weKhaya lokuThatha
I-chemotherapy ye-intraperitoneal ye-ovarian umdlavuza okanye umhlaza wesi-priitoneal isisitye esibalulekileyo ekunyangeni kwezi zifo, kunye neziphumo zokuphucula izigulane ezinokufumana le nyango. Nangona kunjalo, ingaba yinkathalo enzima kunye nemiphumo emibi kakhulu kunekhemotherapy yendalo. Ukuba usanda kutshatyalaliswa ngumhlaza wesifo somhlaza we-ovarian okanye umhlaza wokuqala we-peritoneal, kubalulekile ukuba nencoko kunye ne-oncologist yakho malunga nokuba le ndlela ikulungele wena.
> Imithombo:
> Armstrong DK, uBundy B, Wenzel L, et al. I-ntraperitoneal cisplatin kunye ne-paclitaxel kumdlavuza we-ovari. N Engl J Med . 2006; 354 (1): 34-43.
> ISaziso seKlinikhi ye-NCI , 2006. https://ctep.cancer.gov/highlights/docs/clin_annc_010506.pdf.
> Wright AA, uCronin A, uMilne DE, et al. Ukusetyenziswa kunye nokuphumelela kwe-chemotherapy ye-intraperitoneal kunyango lomhlaza we-ovari. J Clin Oncol . 2015 Aug 3. I-epub ngaphambi kokuprinta.