Iimbalasane
Uhlalutyo lweemeta olwenziwe kuwo onke amanqanaba olingo lwe-3 lwezonyango isifo somhlaza esihambele phambili okanye semastatic bafumanise ukuba kukho izigulane ezingaphezu kwe-125,000 ezibhalise kwizifundo ezingazange zihlole umgangatho weziphumo zobomi. Unxulumano phakathi kwesiphelo esixeliweyo sokuqhubela phambili kokusinda, umlinganiselo wexesha apho umhlaza khange uqhubele phambili, kwaye umgangatho wobomi obuphuculweyo, ubuphantsi. Olu hlalutyo lubonisa ukuba i-surrogate endpoints echazwe kwiimvavanyo zeklinikhi ayiyona imilinganiselo efanelekileyo ye-metric ebalulekileyo yomgangatho wovavanyo lobomi kwizigulane.
Nokuba umntu ufunyaniswe ngokucacileyo ukuba unalo umhlaza, isigulane kunye nosapho lwaso aluyi kukhawuleza luqalise i-chemotherapy ngosuku olulandelayo kuba ngokuqhelekileyo kufuneka bahlole ngokupheleleyo zonke iinketho zabo kuqala. Kwaye inxalenye ebalulekileyo yaloo nto kukubona ukuba unyango olunokubakho luya kuwuchaphazela njani umgangatho wobomi bomntu. Ukuvuma ukuqalisa kunye nokunyamezela inkqubo yechemotherapy sisigqibo esikhulu, ikakhulu kwizigulana esele zikhulile, kuba kufuneka bathathe isigqibo sokuba bangaphi na ubunzima bomzimba abanokuthi bakulungele ukunyamezela ukuze bangabinamhlaza. Ukuba iziphumo ebezingalindelekanga zeyeza elithile ziqatha kangangokuba zibangela ukuba umntu angabi nabomi nangayiphi na indlela, ekhumbula ukuba akukho nyango luqinisekileyo ngokuphathelele ukuchacha, ngaba bekuya kuba yingenelo ukuba umguli azibeke kuloo meko?
Eyona nto iphambili kukuba abaguli kunye neentsapho zabo kufanele ukuba bazenze ngokwabo izigqibo eziguqula ubomi kwaye banolwazi olupheleleyo malunga nokuba unyango oluthile luya kubandakanya ntoni. Nangona kunjalo, iimvavanyo zeklinikhi zihlala zisilela ekunikeni ingxelo efanelekileyo yokuba ichiza elithile liya kuwuchaphazela njani umgangatho wobomi bezigulana, nolona lwazi lubalulekileyo lwabasebenzisi beziyobisi.
Ukutya okuTyiwa emva kokuChongwa koMhlaza!
Akukho mhlaza mibini ifanayo. Yiya ngaphaya kwezikhokelo zesondlo esiqhelekileyo kuwo wonke umntu kwaye wenze izigqibo ezizezakho malunga nokutya kunye nezongezo ngokuzithemba.
Umgangatho woVavanyo loBomi
Ngo-2018, bekukho uphando olwenziwa ngabaphandi abavela kwiSikolo sezoNyango saseHarvard eBoston ngomanyano phakathi umhlaza ukuqhubela phambili kwesigulane ukusinda simahla kunye nomgangatho wabo wobomi. Ngokusisiseko, umgangatho ofanelekileyo wokulinganisa ukusebenza kovavanyo lweklinikhi uya kuba kukulinganisa umlinganiselo wokusinda xa uwonke (OS) kodwa oko kunokuthatha ixesha elide ukufumana iziphumo, ke kukho ezinye iziphelo ezisetyenzisiweyo endaweni efana nenqanaba lokusinda simahla (PFS). ). I-PFS ilinganisa izinga lezigulane eziye zasinda ngaphandle kokuba i-tumor iqhubele phambili. Nangona kunjalo, inani elandayo lezilingo zeklinikhi kumachiza echemo anokubakho asebenzisa i-PFS njengebambela ledatha kumgangatho wobomi (QoL) wezigulane ngokunjalo. Kuzo zonke izigaba ze-3 zolingo lwezonyango zomhlaza ophambili okanye we-metastatic athe abaphandi baphonononga, “Iitotali yezigulane ezingama-125,962 zabhaliswa kwizifundo ezisweleyo okanye ezingaxeliyo umgangatho weziphumo zobomi. Phakathi kwezilingo eziye zachaza umgangatho weziphumo zobomi, i-67% ibike ukuba akukho siphumo, i-26% ichaze umphumo omuhle kwaye i-7% ichaze isiphumo esibi sonyango kumgangatho wobomi behlabathi jikelele bezigulane. Okubalulekileyo, ukuhambelana phakathi kwe-PFS kunye nokuphuculwa komgangatho wobomi kwakuphantsi, kunye ne-coefficient coefficient kunye ne-AUC yexabiso le-0.34 kunye ne-0.72, ngokulandelanayo "(IHwang TJ kunye neGyawali B, Int J Cancer. 2019).
Oko kuboniswa ngokucacileyo sesi sifundo kukuba amanye ama-surrogate awunguye umlinganiso olungileyo wokuvavanywa kobomi kuvavanyo lweklinikhi. Ulwazi kufuneka luziswe ngokwahlukeneyo malunga nokuba ichiza linokuwuchaphazela njani umgangatho wobomi besigulana kuba ngokungafaniyo nokuba sisibalo esithe nkqo njengeenyanga ze-PFS zinechiza, umgangatho wolwazi lobomi uyimfuneko kubo bobabini abaguli kunye noogqirha ukwenza izigqibo ezinolwazi malunga ikamva.
Kukuphi ukutya okutyayo kwaye okuncedisayo kukuthatha sisigqibo osithathayo. Isigqibo sakho kufuneka sibandakanye ukuthathelwa ingqalelo kotshintsho lomhlaza kuhlobo lomhlaza, unyango oluqhubekayo kunye nezongezelelo, nakuphi na ukwaliwa, ulwazi ngobomi bakho, ubunzima, ukuphakama kunye nemikhwa.
Isicwangciso sesondlo somhlaza esivela kwi-addon asisekelwanga kukhangelo lwe-Intanethi. Isebenza ngokuzenzekelayo ukwenza izigqibo zakho kusekwe kwisayensi yemolekyuli ephunyezwe ngoososayensi kunye neenjineli zesoftware. Nokuba ukhathalele na ukuqonda iindlela ezisisiseko seemolekyuli okanye hayi - zokucwangciswa kwesondlo somhlaza ukuqonda kuyafuneka.
Qalisa NGOKU ngokucwangciswa kwesondlo ngokuphendula imibuzo ngegama lomhlaza, uguquko kwimfuza, unyango oluqhubekayo kunye nezincedisi, nakuphi na ukwaliwa, imikhwa, indlela yokuphila, iqela lobudala kunye nesini.
ISondlo esiSiqu soMhlaza!
Umhlaza uyatshintsha ngokuhamba kwexesha. Yenza ngokwezifiso kwaye uguqule isondlo sakho ngokusekwe kwisalathiso somhlaza, unyango, indlela yokuphila, ukhetho lokutya, i-allergies kunye nezinye izinto.
Izigulana ezinomhlaza zihlala zisebenza ngeendlela ezahlukeneyo iziphumo ebezingalindelekanga ezichaphazela umgangatho wobomi babo kwaye bajonge ezinye iindlela zonyango lomhlaza. Ukuthatha isondlo esifanelekileyo kunye nezongezelelo ezisekwe kuqwalaselo lwenzululwazi (ukuphepha ukuqagela kunye nokukhetha okungakhethiyo) lolona nyango lulungileyo lwendalo umhlaza kunye neziphumo ebezingalindelekanga ezinxulumene nonyango.