Ukunyuka kweemitha zomhlaza wesibeleko kubonakala ngathi yintoni-into "encinane" yezaziso zombane ezinikwe emva kweeseshoni eziqhelekileyo zemizila epheleleyo. Makhe sihlolisise le nqubo kwisifo somhlaza webele, kubandakanywa nophando emva kokusebenza kwayo, kunye nemiphumo yaso emibi.
Inkcazo ye-Radiation Boost
Umdlavuza wesifuba uvame ukuphathwa ngokuhlinzwa, mhlawumbi i- lumpectomy okanye i- mastectomy .
Ukongeza kwindlela yokuhlinzwa, ezinye iindlela zonyango ziyakunikwa, njengonyango lwe-radiation , elona unyango olunemizila ephezulu yamandla okanye amaqhekeza abulala amaseli omhlaza. Uhlobo oluqhelekileyo lwenyango ye-radiation enikwe emva kwe-lumpectomy (ebizwa ngokuba yi-breast-conserving operation) yi-radium yangaphandle yomlambo welibele lonke (elibizwa ngokuba yi-breast full irradiation).
Emva kokuba iiseshoni zakho zonyango zonyango zonke zizaliswe, ukunyuka kweemitha kuqhutywe, njengendlela yokuthintela ukuphindaphinda (umhlaza wesifuba ubuya).
Ngokukodwa, ukunyuka kweemitha kubandakanya enye okanye ezininzi ezongezelelweyo zonyango ezijoliswe kwisibhedlele se-tumor, esiyindawo encinane yeengxube zesifuba apho umhlaza wesiqalo wasuswa khona. Ibhedi yecala lijoliswe kuba yindawo ebonakalayo apho umdlavuza webele uya kubuya khona.
Le nzosi ekujoliswe kuyo ikhutshwe, isebenzisa umshini ofanayo kunye naleyo isetyenziselwa ukugqithisa isifuba sonke, kodwa usebenzisa ixabiso elincinci lemitha.
Kubalulekile ukukhankanya ukuba ibhedi ye-tumor ibona ichanekileyo ngexesha le-lumpectomy yowesifazane. Yingakho iziqephu zokuvuthwa zingafakwa ngexesha lokuhlinzwa, njengoko ezi ziqhotyoshelweyo zinceda iqela lakho le-oncology ligxininisa umbane.
Impembelelo ye-Radiation Boost on Breast Cancer Recurrence and Survival
Uphando lubonise ukuba abafazi abafumana ukunyuka kwamayeza banomdlavuza omncinci wesikhokelo sendawo, xa kuthelekiswa nabasetyhini abangenakukhuthaza.
Ukongezelela, ukunciphisa ukuphindaphinda kubaluleke kakhulu kwabasetyhini abaneminyaka engama-50 okanye abatsha abafumana ukuba bane- ductal carcinoma in situ (DCIS).
Oko kwathiwa, nangona ukunyuka kwamayeza okunciphisa kakhulu umngcipheko wokuphindaphinda umdlavuza wesikhumba (obizwa ngokuba yinzuzo ekulawuleni kwendawo), akubonakali ukuba naso nasiphumo ekusindeni jikelele (ukufikelela kwiminyaka engama-20 emva kwonyango).
Iimiphumo eziPhakathi zeXesha elifutshane kunye nexesha elide
Ukuxhaswa kwemisebe ngokuqhelekileyo kunyamezeleke kakuhle, kuthwala imiphumo efanayo kunye nokusabalalisa kwebele, njengokukhathala, ukuvuvukala kwebele, kunye nokuguquka kwesikhumba, njengobomvu, ukuguqulwa, kunye nokukhwabanisa, kunye nokukhanyeka kwesikhumba.
Oko kwathiwa, ngokwemiphumo yangexesha elide, i- fibrosis ye- radiation yebele iya kwenzeka. Enyanisweni, uphando oluthile lufumanisa ukuba xa kuthelekiswa nabasetyhini abangazange bathuthunyiswe ngama-radiation, abo benzayo babenomngcipheko okhulayo wokuphuhlisa i-fibrosis.
Umgca apha apha kukuba ukubonakala kwenyama kunokuba nzima nakwabasetyhini abafumana ukunyuka kwemitha ngokungahambisani nalabo abangenayo-nangona, uphando oluxhasa ukufumana oku alukho lukhulu.
ILizwi
Isishwankathelo, kubasetyhini abasetyenziswa ngokuvuthwa kwebele ngokulandelwa yi-irradiation yonke ye-breast, ukukhutshwa komlilo kulungiselelwe ukukhusela umdlavuza wesibeleko kwi-site yomzimba.
Le dose yokukhulisa ithetha ukuba i-dose eyongezelelweyo yemirhumo inikwe kwi-site yokuqala ye-tumor, apho i-microscopic (engabonakaliyo kwamehlo abuze) iiseli zomhlaza zingase zifihliwe.
Nangona ukukhutshwa kweemitha kungekufunyanwanga ukuphucula ngokubanzi ukusasazeka kwabafazi abanomdlavuza webele, kunciphisa umngcipheko wokuphindaphinda, ngenzuzo enkulu kunazo zonke ezibonwa kwabasetyhini abaselula.
> Imithombo:
> Bartelink H et al. Isilumkiso sesifuba esipheleleyo kunye okanye esingenakho ukunyusa izigulane ezithathwa ngophando olulondolozwayo lwebele lomhlaza wesifuba sokuqala: ulandelelwano lweminyaka engama-20 yolu vavanyo lwesigaba esingama-3. Lancet Oncol . 2015 Jan; 16 (1): 47-56.
> Franco, P., Cante, D., Sciacero, P. et al. I-Bedor Bed Boost Integration ngexesha lonke le-Breast Radiotherapy: Ukuhlaziywa koBungqina Boku. Unakekelo lwebele . 2015. 10 (1): 44-9.
> Uhlobo lwam, iLaenen A, i-Depuydt T, i-Weltens C, i-bedor stimulation radiotherapy kubasetyhini emva kokulondolozwa kwebele. Cochrane Databse Syst Rev. Ngo-2017 Novemba 6; 11: CD011987.
> Moran, M., Schnitt, S., Giuliano, A. et al. Umbutho we-Oncology-American Society for Radiation Oncology inqamaniso yokubambisana kwimigca yolondolozo lwebele olusisigxina kwizinyathelo I no-II zihlasela umdlavuza webele, iAnals of Oncology . 2014. 21 (3): 704-16.
> Vrieling C et al. Iziganeko zokuxela ukulawulwa kwendawo emdlalweni wesibeleko sesifuba emva kokulandela ixesha elide kwi-EORTC Boost no-Trial No Boost Trial: Uvavanyo lweNzululwazi olungalindelekanga. JAMA Oncol . 2017 Jan 1; 3 (1): 42-48.