I-Chemotherapy kanye Nemiphumela Yayo emibi ku-Cancer

Amaphuzu avelele

I-Chemotherapy ingumgogodla wokwelashwa komdlavuza kanye nokwelashwa kokuqala komugqa ongakhethwa kumdlavuza omningi njengoba kusekelwa imihlahlandlela yomtholampilo nobufakazi. Kodwa-ke, yize kunentuthuko yezokwelapha nokuthuthuka kwenani labasinde kumdlavuza emashumini ambalwa edlule, imiphumela emibi yesikhathi esifushane kanye neyesikhathi eside ye-chemotherapy ihlala iyinto ebakhathaza kakhulu iziguli nabelaphi. Ukukhetha umsoco ofanele nezithako zokudla okunempilo kungasiza ekunciphiseni eminye yale miphumela engemihle.

Kuyini i-Chemotherapy?

I-Chemotherapy uhlobo lwe umdlavuza ukwelashwa okusebenzisa izidakamizwa ukucekela phansi amangqamuzana omdlavuza ahlukana ngokushesha. Kuphinde kube wumugqa wokuqala wokwelashwa okhethwayo kumakhensa amaningi njengoba kusekelwa imihlahlandlela yomtholampilo nobufakazi.

I-Chemotherapy ekuqaleni yayingahloselwe ukusetshenziswa kwayo njengamanje ekwelashweni komdlavuza. Eqinisweni, kwatholakala ngesikhathi seMpi Yezwe yesibili lapho abacwaningi bebona ukuthi igesi le-nitrogen lwesinaphi labulala inani elikhulu lamaseli amhlophe egazi. Lokhu kudale ukuthi kuqhutshekwe nocwaningo lokuthi kungamisa yini ukukhula kwamanye amaseli omdlavuza ahlukanisa ngokushesha futhi. Ngocwaningo oluthe xaxa, ukuhlolwa, nokuhlolwa kwemitholampilo, i-chemotherapy iguquke yaba yilokho namuhla.

Izidakamizwa ezahlukahlukene ze-chemotherapy zinezindlela ezihlukile zesenzo ezisetshenziselwa ukukhomba izinhlobo ezithile zomdlavuza. Le mithi yokwelashwa ngamakhemikhali ibekiwe:

• kungaba ngaphambi kokuhlinzwa ukunciphisa ubukhulu besimila esikhulu;
• ukwehlisa nje ukukhula kwamangqamuzana omdlavuza;
• ukwelapha umdlavuza osusakaze futhi wasabalala ezingxenyeni ezihlukene zomzimba; noma
• ukuqeda nokuhlanza wonke amangqamuzana omdlavuza ashintshiwe futhi akhula ngokushesha ukuvimbela ukubuyela emuva okuzayo esikhathini esizayo.

Namuhla, kunemithi yokwelapha ngamakhemikhali engaphezu kwekhulu evunyelwe futhi iyatholakala emakethe yezinhlobo ezahlukene zomdlavuza. Izigaba ezahlukahlukene zemithi yokwelapha ngamakhemikhali zifaka ama-alkylating agents, ama-antimetabolites, ama-alkaloids ezitshalo, ama-antitumor antibiotics kanye ne-topoisomerase inhibitors. I-oncologist ithatha isinqumo sokuthi imuphi umuthi wamakhemikhali ozosetshenziswa ekwelapheni isiguli esinomdlavuza ngokuya ngezici ezahlukahlukene. Lokhu kufaka phakathi:

• uhlobo nesigaba somdlavuza
• indawo yomdlavuza
• izimo zezokwelapha ezikhona zesiguli
• ubudala besiguli nempilo ejwayelekile

I-Chemotherapy Side-Imiphumela

Ngaphandle kwentuthuko yezokwelapha nokuthuthuka kwesibalo sabasindile bomdlavuza emashumini ambalwa edlule, imiphumela engemihle ye- elwa nomdlavuza i-chemotherapy ihlala ingumthombo omkhulu wokukhathazeka kuzo zombili iziguli nabonesi. Ngokuya ngohlobo nobungako bokwelashwa, i-chemotherapy ingadala imiphumela emibi emibi ebucayi. Le miphumela emibi ingathinta kakhulu ikhwalithi yempilo yesiguli esinomdlavuza.

Imiphumela Yesikhashana Yesikhashana

I-Chemotherapy ikakhulu ilimaza amaseli ahlukaniswa ngokushesha. Izingxenye ezahlukahlukene zomzimba wethu lapho amaseli ajwayelekile enempilo ahlukana kaningi kungenzeka athinteke kakhulu ngamakhemikhali. Izinwele, umlomo, isikhumba, amathumbu nomnkantsha wamathambo kuvame ukuthinteka yimithi yokwelapha ngamakhemikhali.

Imiphumela emibi yesikhashana esifushane yokwelashwa ngamakhemikhali ebonwa ezigulini ezinomdlavuza ifaka:

• ukulahlekelwa izinwele
• isicanucanu nokuhlanza
• ukulahlekelwa ukudla
• ukuqunjelwa noma uhudo
• ukukhathala
• ukuqwasha 
• inkathazo yokuphefumula
• izinguquko zesikhumba
• izimpawu ezinjengomkhuhlane
• Ubuhlungu
• i-esophagitis (ukuvuvukala komphimbo okuholela ekugwinyweni kobunzima)
• izilonda zomlomo
• izinkinga zezinso nesinye
• i-anemia (inani elincishisiwe lamaseli abomvu egazi)
• ukutheleleka
• izinkinga zokuvala igazi
• ukwanda kwegazi nokulimala
• i-neutropenia (isimo ngenxa yezinga eliphansi lama-neutrophils, uhlobo lwamaseli amhlophe egazi)

Le miphumela engemihle ingahluka kusuka komuntu kuya komuntu nokusuka ku-chemo kuye ku-chemo. Esigulini esifanayo, imiphumela engemihle ingahlukahluka phakathi nakho konke ukwelashwa ngamakhemikhali. Iningi lale miphumela emibi ithinta impilo yomzimba kanye nenhlalakahle yeziguli ezinomdlavuza. 

Imiphumela Yesikhathi Eside Yesikhathi Eside

Ngokusetshenziswa kabanzi kwemithi yokwelapha ngamakhemikhali emaqenjini ahlukene eziguli ezinomdlavuza, ubuthi obuhlobene nalawa ma-chemotherapies asungulwe kahle njenge amakhemikhali asekelwe eplatinamu qhubeka ukwanda. Ngakho-ke, yize kukhona intuthuko yezokwelapha, iningi labasindile kumdlavuza ligcina ngokubhekana nemiphumela emibi yesikhathi eside yalezi zindlela zokwelashwa ngamakhemikhali, noma ngabe sekudlule iminyaka eminingana belashwa. Ngokuya ngeNational Pediatric Cancer Foundation, kulinganiselwa ukuthi ngaphezu kuka-95% wabasindile bomdlavuza wezingane bayoba nenkinga ebalulekile ehlobene nempilo lapho beneminyaka engama-45 ubudala, okungaba umphumela wokwelashwa kwabo komdlavuza phambilini (https: //nationalpcf.org/facts-about-childhood-cancer/). 

Kwenziwe izifundo ezahlukahlukene zomtholampilo ezigulini ezinomdlavuza nakwabasinda ezinhlotsheni ezahlukahlukene zomdlavuza ezifana nomdlavuza webele, umdlavuza wesinye kanye ne-lymphoma ukuhlola ubungozi bemiphumela emibi yesikhathi eside yokwelashwa komdlavuza wabo. Izifundo zomtholampilo ezihlola le miphumela emibi yamakhemikhali kwabasindile kumdlavuza zifingqiwe ngezansi.

Izifundo zemiphumela emibi yesikhathi eside yeChemotherapy

Ubungozi Bomdlavuza Wesibili

Ngokwelashwa kwesimanje komdlavuza kusetshenziswa i-chemotherapy noma i-radiotherapy, yize amazinga okusinda kwamathumba aqinile esethuthukile, ingozi yokwelashwa komdlavuza wesibili (enye yemiphumela emibi ye-chemotherapy) nayo inyukile. Izifundo ezahlukahlukene zikhombisa ukuthi ukwelashwa ngokweqile ngamakhemikhali okwandisa ukwelashwa kuthuthukisa ingozi yokuthola umdlavuza wesibili ngemuva kokungenawo umdlavuza isikhashana. 

Ucwaningo olwenziwe yiNational Cancer Institute lucubungule kahle imininingwane ezigulini ezingaphezu kuka-700,000 ezinezicubu zomdlavuza eziqinile. Lezi ziguli ziqale zathola i-chemotherapy kusuka ngo-2000-2013 futhi zasinda okungenani unyaka owodwa ngemuva kokuxilongwa. Babeneminyaka ephakathi kuka-1 no-20. Abaphenyi bathole ukuthi ingozi yokwelashwa ihlobene ne-myelodysplastic syndrome (tMDS) kanye ne-acute myeloid leukemia (AML) “inyuke isuka ku-84-fold iya ngaphezu kwe-1.5 ephindwe ngama-10 kwezingu-22 izinhlobo zomdlavuza eziqinile eziphenyiwe” . (UMorton L et al, i-JAMA Oncology. UDisemba 20, 2018) 

Olunye ucwaningo lwenziwe muva nje ngabaphenyi abavela e-University of Minnesota Medical School kwabangaphezu kuka-20,000 21 abasinda emdlavuzweni wezingane. Laba abasindile baqala ukutholakala benomdlavuza beneminyaka engaphansi kwengama-1970 ubudala, phakathi kuka-1999-2.8 futhi baphathwa ngamakhemikhali / i-radiotherapy noma i-chemotherapy kanye ne-radiation therapy. Ucwaningo luveze ukuthi abasindile abelashwa ngamakhemikhali kuphela, ikakhulukazi labo abaphathwa ngemithamo ephezulu yokuqoqwa kweplathinamu kanye nama-alkylating agents, babe nengcuphe engu-2019 ephindwe kabili yokuba nomdlavuza obulalayo olandelayo uma kuqhathaniswa nabantu abaningi. (ITurcotte LM et al, J Clin Oncol., XNUMX) 

Olunye ucwaningo lwenziwa futhi lwashicilelwa ngo-2016 olwahlola idatha kusuka kwabangu-3,768 besifazane abanomdlavuza we-leukemia noma abasinda umdlavuza we-sarcoma ngaphandle komlando we-radiotherapy yesifuba. Abasinde kumdlavuza bake baphathwa ngemithamo ekhulayo ye-cyclophosphamide noma i-anthracyclines. Ucwaningo luthole ukuthi laba abasindile bahlotshaniswa kakhulu nengozi yokuba nomdlavuza webele. (UHenderson TO et al., J Clin Oncol., 2016)

Ocwaningweni oluhlukile, kutholakale ukuthi abantu abane-Hodgkin's Lymphoma basengozini enkulu yokuthola umdlavuza wesibili ngemuva kwe-radiotherapy. ILymphoma kaHodgkin ingumdlavuza wohlelo lwe-lymphatic oluyingxenye yamasosha omzimba. (UPetrakova K et al, Int J Clin Pract. 2018)

Futhi, ngenkathi kunezinga eliphakeme eliphakeme kakhulu lokuphumelela kwabesifazane abanomdlavuza webele, ingozi yokuthuthukisa ukwelashwa kwesibindi samathumba okuyisisekelo nayo inyuke kakhulu (Wei JL et al, Int J Clin Oncol. 2019).

Lezi zifundo ziveza ukuthi umdlavuza wezingane ophathwa ngemithamo ephezulu yokwenyuka kwamakhemikhali afana ne-cyclophosphamide noma i-anthracyclines ubhekene nengozi eyengeziwe yomphumela wesikhathi eside wokuthola umdlavuza olandelayo.  

Ubungozi Bezifo Zenhliziyo

Omunye umphumela ohlangothini lwe-chemotherapy isifo senhliziyo noma senhliziyo. Ucwaningo oluhlukile lukhombisa ukuthi kunengozi eyengeziwe yokwehluleka kwenhliziyo kwabasindile kumdlavuza webele, eminyakeni ngemuva kokutholakala nokwelashwa komdlavuza wabo wokuqala. Ukwehluleka kwenhliziyo ukuminyana yisimo esingalapheki esenzeka lapho inhliziyo ingakwazi ukumpompa igazi emzimbeni ngokufanele.

Ocwaningweni lwakamuva, abacwaningi baseKorea bahlole imvamisa yokwenzeka kanye nezici zobungozi ezihambisana nokuhluleka kwenhliziyo okuyi-congestive (CHF) ezigulini zomdlavuza webele ezasinda eminyakeni engaphezu kwengu-2 ngemuva kokuxilongwa komdlavuza. Lolu cwaningo lwenziwe kwiNational Health Information Database yaseNingizimu Korea futhi kwafakwa imininingwane evela kubantu abangu-91,227 abasinde kumdlavuza webele phakathi kuka-2007 no-2013. Abaphenyi bathole ukuthi:

• izingozi zokwehluleka kwenhliziyo yokucinana zaziphezulu kwabasindile kumdlavuza webele, ikakhulukazi kwabasindile abasebasha abaneminyaka engaphansi kwengu-50, kunokulawula. 
• Abasindile kumdlavuza ababelashwa ngaphambili ngamakhemikhali e-chemotherapy afana ne-anthracyclines (epirubicin noma i-doxorubicin) namatekisi (i-docetaxel noma i-paclitaxel) bakhombisa ingozi enkulu kakhulu yezifo zenhliziyo (U-Lee J et al, Umdlavuza, i-2020). 

Ocwaningweni oluhlukile olwenziwe yiPaulista State University (UNESP), eBrazil, abacwaningi bahlole izinto ezinobungozi ezihambisana nezinkinga zenhliziyo kwabasinde umdlavuza wamabele abasinde esikhathini sokuya esikhathini. Baqhathanisa idatha evela kwabasindile kumdlavuza webele we-postmenopausal abangama-96 ababeneminyaka engaphezu kwengu-45 nabesifazane abangu-192 be-postmenopausal ababengenawo umdlavuza webele. Ucwaningo luphethe ngokuthi abesifazane abangemva kokuya esikhathini nabasindile kumdlavuza webele babenobudlelwano obunamandla nezici eziyingozi zesifo senhliziyo nokwanda kokukhuluphala esiswini uma kuqhathaniswa nabesifazane be-postmenopausal abangenawo umlando wesifo somdlavuza webele (Buttros DAB et al, Menopause, 2019).

Ocwaningweni olushicilelwe nguDkt Carolyn Larsel nethimba laseMayo Clinic, e-United States, bahlaziye imininingwane evela kumdlavuza webele we-900 + noma kwiziguli ze-lymphoma ezivela e-Olmsted County, e-United States. Abaphenyi bathola ukuthi umdlavuza webele kanye neziguli ze-lymphoma zisengozini enkulu kakhulu yokuhluleka kwenhliziyo ngemuva konyaka wokuqala wokuxilongwa okwaqhubeka kwaze kwaba yiminyaka engama-20. Ucwaningo luphinde lwathola ukuthi iziguli ezelashwa nge-Doxorubicin zinengozi ephindwe kabili yokuhluleka kwenhliziyo uma kuqhathaniswa nezinye izindlela zokwelashwa. (UCarolyn Larsen et al, Ijenali yeAmerican College of Cardiology, Mashi 2018)

Lokhu okutholakele kufakazela iqiniso lokuthi ezinye izindlela zokwelashwa komdlavuza zingakhuphula ubungozi bemiphumela emibi yokuthuthuka kwezinkinga zenhliziyo kwabasindile bomdlavuza abahlukahlukene noma eminyakeni eminingana ngemuva kokuxilongwa nokwelashwa.

Ingozi Yezifo Zamaphaphu

Izifo zamaphaphu noma izinkinga zamaphaphu nazo ziyasungulwa njengomphumela omubi wesikhathi eside we-chemotherapy. Ucwaningo olwehlukile lukhombisa ukuthi abasinde kumdlavuza wezingane banezifo eziphezulu zamaphaphu / izinkinga ezifana nokukhwehlela okungamahlalakhona, isifuba somoya kanye nenyumoniya ephindaphindekayo njengabantu abadala futhi ingozi yayinkulu uma yelashwa ngemisebe esemncane.

Ocwaningweni olushicilelwe yi-American Cancer Society, abacwaningi bahlaziye imininingwane evela ku-Childhood Cancer Survivor Study eyahlola abantu abasinda okungenani eminyakeni emihlanu ngemuva kokutholakala kwengane yomdlavuza onjenge-leukemia, i-central nervous system malignancies kanye ne-neuroblastomas. Ngokuya ngemininingwane evela ezigulini ezingaphezu kwe-14,000, abacwaningi bathola ukuthi ngeminyaka engu-45, izehlakalo zokuqoqeka kwanoma yisiphi isimo se-pulmonary zazingama-29.6% kwabasindile kumdlavuza kanye no-26.5% wezingane zakubo. Baphethe ngokuthi izinkinga zamaphaphu / zamaphaphu zibaluleke kakhulu kubantu abadala abasinda umdlavuza wezingane futhi zingathinta imisebenzi yansuku zonke. (UDietz AC et al, Umdlavuza, 2016).

Kokunye ukutadisha okwenziwe ngabaphenyi baseColumbia University eNew York, benze ukuhlolwa okufanayo okususelwa kwimininingwane evela ezinganeni ezingama-61 ezathola imisebe yamaphaphu futhi zahlolwa umsebenzi wamaphaphu. Bathola ukuxhumana okuqondile okukhombisa ukuthi ukungasebenzi kahle kwamaphaphu / kwamaphaphu kudlangile phakathi kwabasindile bomdlavuza wezingane abathola imisebe eya emaphashini njengengxenye yemithi yabo yokwelashwa. Abaphenyi baphinde babona ukuthi kwakukhona ingozi enkulu yokukhubazeka kwamaphaphu / kwamaphaphu lapho ukwelashwa kwenziwa kusencane ngenxa yokungavuthwa kokukhula (UFatima Khan et al, Intuthuko Yemisebe Ye-Radiation Oncology, 2019).

Ukwazi izingozi zokwelashwa okunolaka njenge-chemotherapy, umphakathi wezokwelapha ungathuthukisa nokwelashwa komdlavuza ezinganeni ukugwema le miphumela engemihle ngokuzayo. Izimpawu zezinkinga zamaphaphu kufanele ziqashwe ngeso lokhozi futhi kufanele kuthathwe izinyathelo zokuzivimbela. 

Ubungozi Bokushaywa Unhlangothi Okulandelayo

Ukuhlolwa kwemininingwane evela ezifundweni eziningi ezizimele zomtholampilo kukhombisa ukuthi abasindile bomdlavuza abathole ukwelashwa ngemisebe noma imishanguzo yokwelashwa ngamakhemikhali bangaba nengozi eyengeziwe yemiphumela emibi yohlangothi olulandelayo. 

Ocwaningweni olwenziwe ngabaphenyi eSouth Korea, bahlole imininingwane yeziguli ezinomdlavuza ezingama-20,707 ezivela ku-Korean National Health Insurance Service National Sample Cohort database phakathi kuka-2002-2015. Bathole ukuhlangana okuhle ngengozi ephezulu yokushaywa yisifo sohlangothi ezigulini ezinomdlavuza uma kuqhathaniswa neziguli ezingelona umdlavuza. Ukwelashwa kwe-Chemotherapy kwakuhlotshaniswa ngokuzimela nengozi eyengeziwe yokushaywa unhlangothi. Ingozi yayiphezulu kwiziguli ezinomdlavuza wezitho zokugaya ukudla, umdlavuza wokuphefumula nezinye ezifana nomdlavuza webele kanye nomdlavuza wezitho zokuzala zabesilisa nabesifazane. Ucwaningo luphethe ngokuthi ingozi yokushaywa unhlangothi ezigulini ezinomdlavuza inyuke eminyakeni engu-3 ngemuva kokuxilongwa kanti le ngozi iqhubeke kwaze kwaba yiminyaka engu-7 yokulandelwa. (UJang HS et al, Ngaphambili. I-Neurol, 2019)

Ucwaningo olwenziwe yi-Xiangya School of Public Health, eCentral South University, eChina, lwenze ukuhlaziywa kwe-meta kwe-12 olwahlulwa ohlwini oluzimele lokuhlola olushicilelwe phakathi kuka-1990 kuya ku-2017, neziguli ezingama-57,881 eziphelele, ezelashwa ngemishanguzo yemisebe. Ukuhlaziywa kwembula ubungozi obuphakeme jikelele bokushaywa unhlangothi okwalandela abasindile bomdlavuza abanikezwa ukwelashwa ngemisebe uma kuqhathaniswa nalabo abangazange baphathwe ngemisebe. Bathola ukuthi ubungozi buphakeme kwiziguli ezelashwa nge-radiotherapy ezine-lymphoma kaHodgkin nekhanda, intamo, ubuchopho noma umdlavuza we-nasopharyngeal. Le nhlangano yokwelashwa ngemisebe kanye nesifo sohlangothi kwatholakala ukuthi iphakeme ezigulini ezingaphansi kweminyaka engama-40 uma kuqhathaniswa neziguli ezindala. (UHuang R, et al, Front Neurol., 2019).

Okutholakele kulezi zifundo zemitholampilo kuveze ingozi ephezulu yokushaywa unhlangothi okwalandela abasinde kumdlavuza abake baphathwa ngemisebe yokwelashwa ngemisebe noma ngamakhemikhali.

Ubungozi be-Osteoporosis

I-osteoporosis ingenye yemiphumela emibi yesikhathi eside ebonwa ezigulini zomdlavuza nakwabasindile abathole ukwelashwa okufana nokwelashwa ngamakhemikhali nokwelashwa kwamahomoni. I-osteoporosis yisimo sezokwelapha lapho kuncipha khona amathambo, okwenza ithambo libe buthakathaka futhi liphuke. Ucwaningo oluningi lukhombisa ukuthi iziguli nabasindile ezinhlotsheni zomdlavuza ezifana nomdlavuza webele, umdlavuza wendlala yesinye kanye ne-lymphoma basengozini enkulu yokwanda kwamathambo.

Ucwaningo oluholwa ngabaphenyi baseJohns Hopkins Bloomberg School of Public Health, eBaltimore, e-United States, luhlolisise izinga lezigameko zokulahleka kwamathambo njenge-osteoporosis kanye ne-osteopenia kwabangu-211 abasinde kumdlavuza webele. Laba abasinde kumdlavuza webele batholwe benomdlavuza beneminyaka yobudala engama-47. Abaphenyi baqhathanisa imininingwane evela kwabasinda kumdlavuza webele nabesifazane abangama-567 abangenawo umdlavuza. Ukuhlaziywa kutholakale ukuthi kune-68% engcupheni ephakeme ye-osteoporosis kulabo abasinde kumdlavuza webele uma kuqhathaniswa nabesifazane abangenawo umdlavuza.Imiphumela ibivelele kulabo abaphathwa ngama-aromatase inhibitors kuphela, noma inhlanganisela ye-chemotherapy kanye ne-aromatase inhibitors noma iTamoxifen. (UCody Ramin et al, Ucwaningo Lomdlavuza Webele, 2018)

Kwesinye isifundo somtholampilo, kwahlaziywa idatha evela ezigulini ezingama-2589 zaseDenmark ezitholwe zine-B-cell lymphoma enkulu noma i-follicular lymphoma. Iziguli ze-lymphoma zaziphathwa kakhulu ngama-steroids afana ne-prednisolone phakathi kuka-2000 no-2012. Imininingwane evela ezigulini zomdlavuza yaqhathaniswa nezihloko zokulawula eziyi-12,945 ukuhlola izehlakalo zezimo zokulahleka kwamathambo njengemicimbi ye-osteoporotic. Ukuhlaziywa kutholakale ukuthi iziguli ze-lymphoma zazinengozi eyengeziwe yezimo zokulahleka kwamathambo uma kuqhathaniswa nokulawulwa, nezingozi zeminyaka engu-5 kanye nezingu-10 zokuqongelela ezibikwe njenge-10.0% kanye ne-16.3% yeziguli ze-lymphoma uma kuqhathaniswa no-6.8% no-13.5% wokulawulwa. (UBaech J et al, uLeuk Lymphoma., 2020)

Lokhu okutholakele kusikisela ukuthi iziguli ezinomdlavuza nabasindile abathole imishanguzo efana ne-aromatase inhibitors, i-chemotherapy, i-hormone therapy efana neTamoxifen noma inhlanganisela yalokhu, basengozini enkulu yokulahleka kwamathambo.

Ukuphathwa kwe-Chemotherapy Side-Effects ngokukhetha Izithako Zokudla Okufanele / Izithasiselo Zokudla

Eminye imiphumela emibi ye-chemotherapy ingancishiswa ngempumelelo noma ilawulwe ngokuthatha i- okunomsoco / izithako zokudla okunempilo kanye nokwelashwa. Izithasiselo kanye ukudla, uma kukhethwe ngokwesayensi, kungathuthukisa izimpendulo zamakhemikhali futhi kunciphise nemiphumela engemihle ezigulini ezinomdlavuza. Noma kunjalo, ukukhetha okungahleliwe kokudla okunomsoco futhi izithasiselo zokudla okunempilo zingakwazi imiphumela emibi iba mibi kakhulu.

Izifundo / ubufakazi obuhlukahlukene bomtholampilo obusekele izinzuzo zokudla / isengezo esithile ekwehliseni umphumela othile we-chemo ohlangothini oluthile lomdlavuza kufingqwe ngezansi. 

1. Ucwaningo lwesigaba II somtholampilo olwenziwe ngabaphenyi eShandong Cancer Hospital and Institute eChina luphethe ngokuthi ukwengezelwa kwe-EGCG kunganciphisa ukugwinya ubunzima / i-esophagitis ngaphandle kokuthinta kabi ukusebenza kwe-chemoradiation noma i-radiation therapy emdlavuzeni wokuqina.UXiaoling Li et al, Ijenali Yokudla Kwemithi, i-2019)
2. Ucwaningo oluyimpumputhe olulodwa olwenziwe ezigulini zomdlavuza ekhanda nasentanyeni lukhombisile ukuthi uma kuqhathaniswa neqembu elilawulayo, cishe iziguli ezingama-30% azitholanga ibanga lesi-3 lomlomo womlomo (izilonda zomlomo) lapho zengezwa nge-royal jelly. (UMiyata Y et al, Int J Mol Sci., 2018).
3. Ucwaningo olwenziwe ngabaphenyi abavela eSyrekrekord University of Medical Sciences e-Iran luveze ukuthi i-lycopene ingasebenza ekunciphiseni izinkinga ngenxa ye-nephrotoxicity (izinkinga zezinso ezenziwa yi-cisplatin) ngokuthinta ezinye izimpawu zomsebenzi wezinso. (UMahmoodnia L et al, J Nephropathol., 2017)
4. Ucwaningo lomtholampilo oluvela e-Tanta University eGibhithe lukhombisile ukuthi ukusetshenziswa kwe Ubisi Thistle Silymarin esebenzayo kanye neDoxorubicin kusiza izingane ezine-acute lymphoblastic leukemia (ALL) ngokunciphisa i-cardiotoxicity eyenziwe nge-Doxorubicin. (UHagag AA et al, Infect Disord Drug Target., 2019)
5. Ucwaningo lwesikhungo esisodwa olwenziwe yisibhedlela iRigshospitalet kanye neHerlev, eDenmark ezigulini ezingama-78 luthole ukuthi ukusetshenziswa kweMannitol ezigulini ezinomdlavuza ekhanda nasentanyeni ezithola ukwelashwa kwe-cisplatin kunganciphisa ukulimala kwezinso okubangelwa yiCisplatin (UHagerstrom E, et al, iClin Med Insights Oncol., 2019).
6. Ucwaningo olwenziwe e-Alexandria University eGibhithe luthole ukuthi ukuthatha imbewu emnyama ecebile nge-Thymoquinone kanye nokwelashwa ngamakhemikhali kunganciphisa izehlakalo ze-febrile neutropenia (amaseli egazi amhlophe aphansi) ezinganeni ezinezicubu zobuchopho. (UMousa HFM et al, Ingqondo Yezingane Yezinzwa., 2017)

Isiphetho

Kafushane, ukwelashwa okunamandla nge-chemotherapy kungandisa ingozi yokuba nemiphumela emibi yesikhashana neyesikhathi eside ehlanganisa izinkinga zenhliziyo, izifo zamaphaphu, izimo zokulahlekelwa amathambo, okwesibili. zomdlavuza kanye nemivimbo ngisho neminyaka eminingana ngemva kokwelashwa. Ngakho-ke, ngaphambi kokuqala ukwelashwa, kubalulekile ukufundisa iziguli ezinomdlavuza ngemiphumela emibi okungenzeka lezi zindlela zokwelapha zibe nayo empilweni yazo yesikhathi esizayo kanye nekhwalithi yempilo. Ukuhlaziywa kwenzuzo yengozi yokwelashwa komdlavuza wezingane kanye nabantu abadala abasebasha kufanele kuthande ukwelapha nge kunciphisa imithamo ekhulayo yokwelashwa ngamakhemikhali nokucatshangelwa kwezinye izindlela zokwelashwa noma ezihlosiwe ukunciphisa ubungozi bemiphumela emibi kakhulu ngokuzayo. Ukukhetha umsoco ofanele nezithako zokudla okunempilo nakho kungasiza ekunciphiseni eminye yale miphumela engemihle.

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 imvamisa kufanele zibhekane nemiphumela ehlukile yamakhemikhali ethinta ikhwalithi yempilo yazo futhi ibheke ezinye izindlela zokwelapha umdlavuza. ukudla okunomsoco nezithasiselo ezisuselwa ekucabangeni kwesayensi (ukugwema ukuqagela nokukhetha okungahleliwe) yikhambi elingcono kakhulu lemvelo lomdlavuza nemiphumela emibi ehlobene nokwelashwa.

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