Amaphuzu avelele
Ucwaningo lomtholampilo lukhombisile ukuthi kuphephile ukusebenzisa isengezo se-soy isoflavone Genistein kanye nenhlanganisela ye-chemotherapy FOLFOX ekwelapheni iziguli ezinomdlavuza we-metastatic colorectal. Ukuhlanganisa ukugcwaliswa kokungezelelwa kwe-Genistein ne-chemotherapy kunamandla okuthuthukisa imiphumela yokwelashwa ngamakhemikhali e-FOLFOX ezigulini ezinomdlavuza we-metastatic colorectal.
I-Metastatic Colorectal Cancer
I-Metastatic Colorectal Cancer (mCRC) ine-prognosis embi lapho ukusinda kweminyaka emi-2 kungaphansi kwama-40% kanye nokusinda kweminyaka emi-5 kungaphansi kuka-10%, naphezu kwezinketho zokwelashwa ezihlanganisiwe ezinonya kakhulu. (I-AJCC Cancer Staging Handbook, 8th Edn).
I-Metastatic Colorectal Cancer Chemotherapy Regimens
Imithi yomdlavuza we-Metastatic Colorectal ihlanganisa i-5-Fluorouracil kanye nesidakamizwa seplatinamu i-Oxaliplatin, ene-antiangiogenic noma ngaphandle kwayo (evimbela ukwakheka kwemithambo yegazi esimila) umenzeli i-Bevacizumab (Avastin). Imithi emisha ehlanganisa i-FOLFIRI (i-fluorouracil, i-leucovorin, i-irinotecan), i-FOLFOX (5-Fuorouracil, i-oxaliplatin), i-CAPOX (i-capecitabine, i-oxaliplatin) kanye ne-FOLFOXIRI (i-fluorouracil, i-oxaliplatin, i-leucovorin, imiphumela ye-irinotecan ye-proCmisi).
Lapha, sizoxoxa ngezinhlobo zemithi ze-mCRC ezivelele ezisezivivinyweni zomtholampilo futhi ezibhekwa njengezisebenzayo ngokumelene ne-Metastatic Colorectal Cancer (mCRC).
Ukusebenza kwe-FOLFOXIRI ku-Metastatic Colorectal Cancer Patients
Ucwaningo oluningi lugxile ku-metastatic colorectal ehlukene umdlavuza Imithi kanye nokusebenza kwayo ezigulini ze-mCRC. I-FOLFOXIRI iyinhlanganisela yokwelapha yomugqa wokuqala i-mCRC ehlanganisa i-fluorouracil, i-oxaliplatin, i-leucovorin nezinhlanganisela zezidakamizwa ze-irinotecan. Ovivinyweni lwe-TRIBE, olusanda kushicilelwa ngo-2020, ukwethulwa kabusha kwe-FOLFOXIRI ene-bevacizumab kuholele emiphumeleni engcono kakhulu kune-FOLFIRI kanye ne-bevacizumab kodwa nethuba lokuba nobuthi obuphezulu njengoba kwakudingeka isikhathi eside sokwelashwa ngamakhemikhali futhi kwabonwa imiphumela emibi eminingana ezigulini ezinjalo. (U-Glynne-Jones R, et al. I-Lancet Oncology, 2020). Leli su lokuhlanganisa izidakamizwa ezisebenzayo kodwa eziyi-cytotoxic nezidakamizwa ezilwa ne-angiogenic liye laphakamisa ukukhathazeka okuthile kuma-oncologists maqondana nokuphepha nobuthi.
Imininingwane yokuhlaziywa kwe-Meta: I-XELOX vs. FOLFOX ku-Metastatic Colorectal Cancer
Ucwaningo ngo-2016 lukaGuo Y, et al. kuqhathaniswa ukusebenza kahle kwe-capecitabine ne-fluorouracil, ngayinye ehlanganiswe ne-oxaliplatin, ezigulini ze-mCRC ngokuhambisana ne-chemotherapy (Guo, Yu et al. Uphenyo lomdlavuza, 2016).
- Izilingo eziyisishiyagalombili ezilawulwa ngokungahleliwe (RCTs) zasetshenziselwa ukuhlaziywa okubandakanya iziguli ze-4,363 sezizonke.
- Isiphetho esiyinhloko socwaningo kwakuwukuhlola ukuphepha nokusebenza kwemithi ye-chemotherapy i-XELOX (capecitabine plus oxaliplatin) vs. FOLFOX (i-fluorouracil plus oxaliplatin) ezigulini zomdlavuza we-metastatic colorectal.
- Iziguli ezingu-2,194 seziphelele zelashwe ngohlelo lwe-XELOX kuyilapho iziguli ezingu-2,169 zelashwa ngohlelo lwe-FOLFOX.
Imiphumela yokuhlaziywa kwe-Meta: I-XELOX vs. FOLFOX ku-Metastatic Colorectal Cancer
- Iqembu le-XELOX lalinezehlakalo eziphakeme ze-hand-foot syndrome, isifo sohudo kanye ne-thrombocytopenia kuyilapho iqembu le-FOLFOX lalinezehlakalo eziphakeme ze-neutropenia kuphela.
- Amaphrofayili wobuthi atholwe ekuhlaziyeni okuhlanganisiwe kwawo womabili amaqembu abehlukene kodwa ucwaningo olwengeziwe ngalolu daba luyadingeka.
- Ukusebenza kwe-XELOX ezigulini ze-mCRC kufana nokusebenza kwe-FOLFOX.
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.
Izithako zeGenistein zomdlavuza
I-Genistein iyi-isoflavone ngokwemvelo etholakala ekudleni okufana nesoya nemikhiqizo kabhontshisi wesoya. IGenistein ibuye itholakale ngendlela yezithako zokudla futhi iyaziwa ukuthi inezinzuzo eziningi zezempilo ngenxa yezakhiwo zayo ze-antioxidant, anti-inflammatory kanye ne-anti-cancer. Ezinye zezinye izinzuzo ezijwayelekile zezempilo zezithako ze-genistein (ngaphezu kwezakhiwo zokulwa nomdlavuza) zihlanganisa:
- Kungasiza ukunciphisa amazinga kashukela egazini
- Kungasiza ukunciphisa izimpawu zokunqamuka kokuya esikhathini
- Kungasiza ekuthuthukiseni impilo yenhliziyo
- Kwangathi kungakhuthaza impilo yamathambo nobuchopho
Kule bhulogi sizoxoxa ngokuthi ukusetshenziswa kwe-Genistein supplement kunezinzuzo ku-metastatic colorectal umdlavuza iziguli.
Ukusetshenziswa Kwe-Genistein Supplement kuColorectal Cancer
Ucwaningo oluningi lukhombisile ukuhlangana kwengozi engezansi yomdlavuza onamabala empumalanga yabantu base-Asia abadla ukudla okunothile kweSoy. Kunezifundo eziningi zokuhlolwa kwangaphambi kokuhlolwa okukhombise izakhiwo ezilwa nomdlavuza ze-soy isoflavone Genistein, kanye namandla ayo okunciphisa ukumelana namakhemikhali kumaseli womdlavuza. Ngakho-ke, abacwaningi e-Icahn School of Medicine eNtabeni iSinayi, eNew York, bahlole ukuphepha nokusebenza kokusebenzisa i-soy isoflavone Genistein kanye nezinga elijwayelekile lokuhlanganiswa kokunakekelwa kwamakhemikhali esifundweni somtholampilo esizoba sezigulini zomdlavuza ezi-colorectal. (NCT01985763) (UPintova S et al, iCancer Chemotherapy & Pharmacol., 2019)
Imininingwane Yesifundo Somtholampilo ekusetshenzisweni kweGenistein Supplement kuColorectal Cancer
- Kube neziguli eziyi-13 ezine-mCRC ezingazange zelashwe ngaphambili ezalashwa ngenhlanganisela ye-FOLFOX ne-Genistein (N=10) kanye ne-FOLFOX + Bevacizumab + Genistein (N=3).
- Ukuphela okuyisisekelo kocwaningo bekuwukuhlola ukuphepha nokubekezelela ukusebenzisa uGenistein ngenhlanganisela yamakhemikhali. Iphoyinti lokugcina lesibili bekungukuhlola impendulo enhle kunazo zonke (i-BOR) ngemuva kwemijikelezo eyisithupha ye-chemotherapy.
- UGenistein ngomthamo wama-60 mg / ngosuku, unikezwe ngomlomo izinsuku eziyi-7 njalo emavikini ama-2, ukuqala ezinsukwini ezi-4 ngaphambi kwe-chemo nokuqhubeka ngezinsuku eziyi-1-3 zokufakwa kwe-chemo. Lokhu kuvumele abacwaningi ukuthi bahlole imiphumela engemihle noGenistein yedwa naphambi kwe-chemo.
Imiphumela Yesifundo Somtholampilo ekusetshenzisweni kweGenistein Supplement kuColorectal Cancer
- Ukuhlanganiswa kweGenistein ne chemotherapy kutholakale kuphephile futhi kubekezeleleka.
- Izehlakalo ezimbi ezibikwe noGenistein kuphela bezimnene kakhulu, njengokuphathwa yikhanda, isicanucanu nokushisa okushisayo.
- Izehlakalo ezimbi ezibikwe lapho uGenistein enikezwa kanye ne-chemotherapy bezihlobene nemiphumela emibi ye-chemotherapy, efana ne-neuropathy, ukukhathala, isifo sohudo, noma kunjalo, asikho nesisodwa seziguli esathola isigameko esibi kakhulu sebanga lesi-4.
- Kube nokuthuthuka ekuphenduleni okungcono kakhulu jikelele (BOR) kulezi ziguli ze-mCRC ezithatha i-chemotherapy kanye noGenistein, uma kuqhathaniswa nalabo ababikwe ukwelashwa ngamakhemikhali bodwa ezifundweni zangaphambili. I-BOR yayingu-61.5% kulolu cwaningo kuqhathaniswa ne-38-49% ezifundweni ezedlule ezinemithi efanayo yokwelashwa ngamakhemikhali. (USaltz LB et al, J Clin Oncol, 2008)
- Ngisho ne-metric yokusinda yamahhala yokusinda, ekhombisa isikhathi lapho isimila singakaqhubeki nokwelashwa, bekuyinyanga elinganiselwe yezinyanga eziyi-11.5 ngokuhlanganiswa kweGenistein kuqhathaniswa nezinyanga eziyi-8 zokwelashwa ngamakhemikhali kuphela kususelwa ocwaningweni lwangaphambilini. (USaltz LB et al, J Clin Oncol., 2008)
Isiphetho
Lolu cwaningo, noma lusesibalweni esincane kakhulu seziguli, lukhombisa ukuthi ukusebenzisa isoy isoflavone Genistein ukwengeza kanye ne-chemotherapy ehlanganisiwe kwakuphephile futhi akuzange kwandise ubuthi be-chemotherapy kuColorectal Cancer. Ngaphezu kwalokho, ukusebenzisa uGenistein ngokuhambisana ne-FOLFOX kunamandla okwenza ngcono ukwelashwa futhi futhi kunciphise nemiphumela emibi yekhemotherapy. Lokhu okutholakele, yize kuthembisa, kuzodingeka kuhlolwe futhi kuqinisekiswe ezifundweni ezinkulu zemitholampilo.
Ikuphi ukudla okudlayo, nokuthi yiziphi izithasiselo ozithathayo kuyisinqumo osithathayo. Isinqumo sakho kufanele sibandakanye ukucutshungulwa kwezakhi zofuzo zomdlavuza, yimuphi umdlavuza, ukwelashwa okuqhubekayo nezithasiselo, noma yikuphi ukungezwani komzimba nezinto ezithile, ulwazi lwendlela yokuphila, isisindo, ubude nemikhuba.
Ukuhlelwa kokudla okunomsoco ovela ku-addon akusekelwe ekusesheni kwe-inthanethi. Izenzela wena izinqumo ngokusekelwe kusayensi yamangqamuzana esetshenziswa ososayensi bethu nonjiniyela bezinhlelo zokusebenza. Kungakhathalekile ukuthi uyakhathalela yini ukuqonda izindlela zamangqamuzana e-biochemical noma cha - ekuhleleleni umsoco womdlavuza lokho kuqonda kuyadingeka.
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.
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.
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.
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.