Amaphuzu avelele
Umdlavuza webele we-Metastatic, owaziwa nangokuthi umdlavuza webele wesigaba IV, uwuhlobo oluthuthukile lwesifo lapho umdlavuza ususabalele kwezinye izingxenye zomzimba, njengamathambo, amaphaphu, isibindi, noma ubuchopho. Iphesenti elincane kuphela (6%) labesifazane abaqala ukutholakala benebele le-metastatic umdlavuza, nezimo eziningi ezenzeka ngenxa yokubuyela emuva ngemva kokwelashwa kwangaphambili kanye nesikhathi sokuxolelwa.
Kunomehluko omkhulu phakathi komdlavuza wamabele kanye nomdlavuza webele we-metastatic; umdlavuza webele yigama lesambulela lazo zonke izinhlobo nezigaba ze-carcinoma ezisuka ezicutshini zebele. Ngakolunye uhlangothi, i-National Cancer Institute (NCI) iphinde inikeze ulwazi mayelana nomdlavuza webele we-metastatic kanye nezigaba ezahlukene zomdlavuza webele, okuhlanganisa nencazelo yomdlavuza webele we-metastatic njengesigaba IV sesifo, lapho amangqamuzana omdlavuza asakazekele kwezinye izingxenye zomzimba. .
Nakuba umdlavuza webele we-metastatic uvame ukutholakala kwabesifazane, uthinta nenani elincane lamadoda. Ngokombiko we-American Cancer Society's Cancer Facts and Figures kusuka ngo-2019, izinga lokusinda leminyaka engu-5 kumdlavuza webele we-metastatic lingaphansi kwama-30%.
Segar, Jennifer M et al. "Isifundo seSigaba II se-Irinotecan ne-Etoposide njengokwelashwa kwe-Refractory Metastatic Breast Cancer." I-oncologist ivolumu. 24,12 (2019): 1512-e1267. doi:10.1634/theoncologist.2019-0516
Ukuhlolwa Komtholampilo (NCT00693719): I-Irinotecan ne-Etoposide ku-Metastatic Breast Cancer
- Kwakunabesifazane abangama-31 ababhalise kule ngalo eyodwa, isivivinyo somtholampilo wesigaba II, phakathi kweminyaka yobudala engama-36-84.
- Ama-64% alaba besifazane abene-hormone positive kanye no-HER2 ongemuhle womdlavuza webele.
- Laba besifazane babelashwe ngomuthi ophakathi noma okungenani wezinqubo zokwelashwa ezi-5 zangaphambilini futhi base bevele bemelana nokwelashwa kwangaphambili kwe-anthracycline, taxane kanye ne-capecitabine.
Ukudla Okufanele Ukudla Ngemuva Kokuxilongwa Komdlavuza!
Akukho mdlavuza owodwa ofanayo. Dlulela ngale kwemihlahlandlela ejwayelekile yokudla kuwo wonke umuntu futhi wenze izinqumo ezenziwe ngezifiso ngokudla nezithasiselo ngokuzethemba.
Isizathu Sesayensi Yesifundo
- Isizathu sokuqulwa kwecala bekuwukuzama isethi entsha yemithi yokwelapha ngamakhemikhali ebikhombise umsebenzi obhaliwe ezigulini zomdlavuza webele futhi inhlanganisela iqinisekiswe kahle.
- Kokubili i-Irinotecan ne-Etoposide kungokwemvelo, izakhi ezivela kwizitshalo ezingaba modulators be-topoisomerase (TOP) enzyme isoforms. Ama-enzyme aphezulu ayadingeka ekuphindaphindeni kwe-DNA nokubhalwa, zombili izinqubo ezibucayi zeseli lomdlavuza elikhula ngokushesha. Ukuphazamisa isenzo se-TOP kubangela ukuphuka kwemicu ye-DNA, ukulimala kwe-DNA futhi kubangele ukufa kweseli.
- I-Irinotecan yi-TOP1 ne-Etoposide modulator ye-TOP2. Isizathu sokuhlanganisa zombili i-TOP1 kanye ne-TOP2 inhibitors ukubhekana nokusebenza kokunxeshezelwa kwesinye isoform lapho enye ye-isoform icindezelwe.
Imiphumela Yesivivinyo Somtholampilo
- Kwakuneziguli ezingama-24 ezingahlolwa ukuthi zisebenza ngempumelelo yini le nhlanganisela yemithi ye-Irinotecan ne-Etoposide. U-17% ube nempendulo engaphelele kanti u-38% ubenezifo ezizinzile.
- Zonke iziguli ezingama-31 zahlolwa ukuthi zinobuthi yini kanti ezingama-22 kwezingama-31 (71%) zathola imicimbi emibi ehlobene nokwelashwa ebangeni lesi-3 nele-4. Ubuthi obuvame kakhulu bekuyi-neutropenia, okuwukuba khona kwamazinga aphansi ngokungajwayelekile ama-neutrophils egazini angakhuphula ukuthambekela kwezifo.
- Ukutadisha kunqanyulwe kusenesikhathi ngoba umthwalo wobuthi ubunzima futhi weqa ukusebenza kwenhlanganisela.
Izimpawu Zomdlavuza Webele We-Metastatic
- Ubuhlungu bethambo noma ukuzwela: Kungasakazeka emathanjeni, kubangele ubuhlungu noma ububele ezindaweni ezithintekile.
- Ukukhathala: Ukwelashwa komdlavuza nomdlavuza kungabangela ukukhathala, okungase kube nzima futhi kuphikelele.
- Ukuphefumula: Umdlavuza usakazekela emaphashini ungabangela ukuphefumula.
- Izimpawu ze-Neurological: Umdlavuza osusabalele ebuchosheni ungabangela izimpawu zemizwa ezifana nokuphathwa yikhanda, ukuquleka, noma izinguquko ekusebenzeni kwengqondo.
- Ukulahlekelwa ukudla nokuncipha kwesisindo: Ukwelashwa komdlavuza nomdlavuza kungabangela ukulahlekelwa ukudla nokuncipha kwesisindo.
- Ijaundice noma ukuvuvukala esiswini lapho umdlavuza ususabalele esibindini.
Iminyaka yokuphila yomuntu onomdlavuza webele we-metastatic ingahluka kuye ngezinto ezimbalwa njengendawo nokusabalala kwesimila.
Ngokocwaningo, izinga lokusinda leminyaka emi-5 liyisilinganiso sokuthi bangaki abantu abanalolu hlobo umdlavuza basaphila eminyakeni emihlanu edlule ngemuva kokutholakala komdlavuza. Ivezwa njengephesenti, okusho inani labantu kwabangu-5 abaphila ngemva kweminyaka emi-100. Ngokusho kwe-American Cancer Society, izinga lokusinda leminyaka engu-5 kwabesifazane abanomdlavuza webele we-metastatic lingama-5%, kanti izinga lokusinda leminyaka emihlanu kwabesilisa lingama-29%. Kubalulekile ukuqaphela ukuthi lezi izibalo ezijwayelekile futhi amacala ngamanye angahluka.
Ukwelashwa Komdlavuza Webele Wesibeletho
Ukwelashwa kuyinkimbinkimbi kodwa inhlanganisela yokwelapha ngamakhemikhali nemithi ethile ye-chemo inezinzuzo ezithile ekulawuleni umdlavuza. Ngeke isetshenziswe kakhulu futhi isikhathi eside ngenxa yephrofayili yayo yobuthi obunzima kanye nomthelela wekhwalithi yempilo esigulini. Ukwelashwa kwe-immunotherapy kungenye indlela engacatshangelwa ezigulini ezinomdlavuza webele we-metastatic; le ndlela yokwelapha ingasiza amasosha omzimba abone futhi ahlasele amangqamuzana omdlavuza.
Ukuhlola iphrofayili yokuguqulwa kwesimila se-metastatic nakho kungasiza ekuhlonzeni inhlanganisela yezindlela zokwelapha eziqondiswe kakhulu ezinemiphumela engemihle ephansi. Ingozi yokusebenzisa inhlanganisela ethize ye-topoisomerase inhibitors i-Irinotecan ne-Etoposide idlule izinzuzo futhi ingase ingasetshenziswa ekwelapheni ibele le-metastatic. zomdlavuza.
Njengoba wonke umdlavuza webele we-metastatic uhlukile ngesethi yawo yokuhlukahluka kwe-genomic, izinketho zokwelashwa zenziwe ngezifiso ngodokotela be-oncologists. Kusenomsebenzi okufanele wenziwe ekutholeni izindlela zokwelashwa ezithuthukisiwe neziphephile zayo. Minyaka yonke, mhla ziyi-13 kuMfumfu, kugujwa usuku lokuqwashisa ngomdlavuza webele we-metastatic ukuze kuhlinzekwe ukwesekwa kwalabo abathintwe yilesi sifo futhi kuqoqwe izimali zokucwaninga ukuze kuthuthukiswe izindlela zokwelapha ezithuthukisiwe.
Ukudla okudlayo nokuthi yikuphi okunezelayo okwenzayo yisinqumo osithathayo. Isinqumo sakho kufanele sifake ukucutshungulwa kwezakhi zofuzo zomdlavuza, okuwumdlavuza, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imininingwane yokuphila, isisindo, ubude nemikhuba.
Ukuhlelela okunomsoco komdlavuza kusuka ku-addon akususelwa ekusesheni kwe-inthanethi. Kwenzela wena ukuthathela izinqumo ngokuya ngesayensi yamangqamuzana eyenziwe ososayensi bethu nonjiniyela be-software. Kungakhathalekile ukuthi ngabe uyakukhathalela ukuqonda okuyisisekelo kwamakhemikhali amakhemikhali noma cha - wokuhlelela umsoco ukuhlela lokho kudinga ukuqonda.
Qalisa MANJE ngokuhlela kwakho okunomsoco ngokuphendula imibuzo egameni lomdlavuza, ukuguquka kwezakhi zofuzo, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imikhuba, indlela yokuphila, iqembu lobudala nobulili.
Iziguli ezinomdlavuza ngokuvamile kufanele zibhekane nokuhlukile imiphumela emibi ye-chemotherapy okuthinta ikhwalithi yempilo yabo futhi babheke ezinye izindlela zokwelapha umdlavuza. Ukuthatha ukudla okunomsoco nezithasiselo ezisuselwa ekucabangeni kwesayensi (ukugwema ukuqagela nokukhetha okungahleliwe) yikhambi elingcono kakhulu lemvelo lomdlavuza nemiphumela emibi ehlobene nokwelashwa.
References:
- Cancer.net (2022). Umdlavuza Webele - I-Metastatic: Izibalo.
- I-National Cancer Institute. (nd). Umdlavuza Webele.
- I-American Cancer Society. (2021). I-Metastatic Breast Cancer.
- I-National Cancer Institute. (2021). I-Metastatic Breast Cancer.
- Cancer.net. (2022). Umdlavuza Webele - I-Metastatic: Izibalo.
Ukudla Okungokwakho Komdlavuza!
Umdlavuza uyashintsha ngokuhamba kwesikhathi. Enza ngendlela oyifisayo futhi uguqule umsoco wakho ngokusekelwe kunkomba yomdlavuza, ukwelashwa, indlela yokuphila, okuncamelayo kokudla, izinto ezingakuphathi kahle nezinye izici.