Ukwelapha I-Metastatic Stage IV I-Melanoma Inikeza Ithemba
I-Interleukin-2 ye-melanoma ye-metastatic ingenye yezinketho ezimbili zokwelashwa ezivunyelwe lesi sifo. I-melanoma esakaze ngaphezu kwesikhumba kuya ezithombeni ezikude ibizwa ngokuthi "metastatic" (noma isigaba IV ) i-melanoma. Nakuba ukwelashwa okwamanje kunciphile kakhulu, abanye abantu basinda kule nkinga enkulu kakhulu yesifo. Kukhona ucwaningo oluningi oluqhubekayo kule ndawo kodwa kuze kube manje, kuphela ukwelashwa okubili kuphela okuvunyelwe: i- interferon-alfa2b kanye ne-activator system interleukin-2 (i-IL-2).
Uma i-oncologist yakho iphakanyisile i-IL-2, lokhu kubuka konke kuzokuqinisa ngolwazi olubucayi oludingayo ukuze uluqonde ukuthi lusebenza kanjani, ukusebenza kwalo nemiphumela yaso emibi.
I-Interleukin-2
Futhi okuthiwa i-Proleukin ne-aldesleukin, i-IL-2 yamukelwa yi-Food and Drug Administration (FDA) yokwelashwa kwe-melanoma yemethamo ngonyaka ka-1998. (Ngeshwa, akekho omunye umuthi we-melanoma oye wamukelwa kusukela.)
I-IL-2 ihlukile kunomuthi we-chemotherapy - empeleni iyinxenye yemvelo yesimiso somzimba wakho womzimba. Luhlobo lomlayezo wezithunywa obizwa ngokuthi "i-cytokine" efihliwe kusuka kwamangqamuzana athile ukuze aqaphele amanye amaseli mayelana nomhlaseli othelelekayo. Kunezinhlobo ezingaba ngu-15 zama-interleukin ezitholakale kusukela ngawo-1970: IL-2 yaziwa ngokugqugquzela ukukhula nokuvuthwa kwezinhlobo ezimbili zamangqamuzana egazi ezimhlophe, okuthiwa "i-T ne-B lymphocytes." I-IL-2 esetshenziselwa ukwelapha i-melanoma ye-metastatic ayifuni emzimbeni kodwa kunomkhiqizo okhiqizwayo, usebenzisa amasu obuchwepheshe bezakhi zofuzo.
Inezindawo ezifanayo njengenguqulo yemvelo, kodwa inegama elihlukile, i-aldesleukin.
Ubufakazi bokusebenza kwe-Interleukin-2
Ezifundweni eziholela ekuvumelweni, amaphesenti angu-6 weziguli ezikhethiwe (lezo zisesimweni esihle ngokomzimba nangokwengqondo) nge-melanoma ye-metastatic yayiphendule ngokuphelele kwi-dose ephakeme i-IL-2, kanti amaphesenti angu-10 aphendule kancane.
Impendulo ephelele ichazwa njengenkathi ehlala isikhathi eside (iminyaka engu-10+ nokubala) ukuqedwa kwalesi sifo, nakuba kungeyona "imithi". Kungakhathaliseki ukuthi i-terminology, yiyona yodwa imithi etholakalayo ukuthi inakho ngisho nekhono lomphumela omuhle kakhulu futhi omude. Izimpendulo zitholwa ezigulini ezinezinhlobonhlobo zemithi, kufaka phakathi emaphaphu, isibindi, ama-lymph nodes, izicubu ezithambile, izigulane ezinama-adrenal kanye nezinsika ezingaphansi (ezijulile) zesikhumba. I-IL-2, noma kunjalo, ayinconywa iziguli ezine-metastases ezikhona ebuchosheni.
Izilingo eziningi zokwelapha zenziwe (futhi zisenziwa) ngomzamo wokwandisa izinga lokuphendula le-IL-2 ngokuzihlanganisa neminye imithi. Isibonelo, isifundo sabonisa izinga eliphezulu lokuphendula lapho i-IL-2 inikezwa ngokuhambisana nomgomo (amaphesenti angu-22) uma kuqhathaniswa ne-IL-2 kuphela (amaphesenti angu-13). Ngeshwa, imizamo eminingi yokuhlanganisa i-IL-2 nemithi ehlukahlukene ye-chemotherapy (i-cisplatin, i-vinblastine, i-dacarbazine nabanye) - indlela ebizwa ngokuthi "i-biochemotherapy" - kanye nezinye izidakamizwa (i- interferon-alfa2b , njll), kuze kube manje iboniswe akukho ukuthuthukiswa okuphawulekayo ekubaleni okubaluleke kakhulu: isikhathi sokusinda.
Ukusetshenziswa kwe-Interleukin-2
I-IL-2 inikezwa ukumnika kwamaminithi angu-15 njalo ngamahora angu-8 ngezinsuku ezingu-5.
Inkambo ngayinye yokwelashwa iqukethe imijikelezo emibili yokwelashwa kwezinsuku ezingu-5 ehlukaniswe isikhathi sokuphumula sezinsuku ezingu-9, futhi izifundo eziningi zivamile. Ngokujwayelekile uzocatshangwa cishe inyanga ngemuva kokuqeda ukwelashwa kwakho kokuqala. Uma uphendula, cishe uzonikezwa inkambo yesibili yokwelapha amaviki ayisithupha kuya kwangu-12 ngemuva kokuqeda inkambo yokuqala. Ukuze ufanelekele ukwelashwa kwe-IL-2, kumele ube nesimweni esihle ngokomzimba, ngenhliziyo enhle, emaphaphu, kwesibindi, nasezintweni zokusebenza.
Imiphumela emibi engenzeka
I-IL-2 inemiphumela emibi kaningi, evame ukungathí sina futhi ngezinye izikhathi ezibulalayo. Kumele unikezwe esibhedlela ngaphansi kokuqondiswa kwedokotela oqeqeshiwe ohlangene nokusetshenziswa kwama-antiticancer agents.
Isikhungo sokunakekelwa okujulile kanye nochwepheshe abanolwazi lwe-cardiopulmonary noma olunzulu lokunakekelwa kwemithi kumele batholakale. Isilinganiso sokufa kwezidakamizwa ezivivinyweni zokwelashwa kweziguli ze-melanoma zemetrase ezithola i-IL-2 yayingu-2%.
Imiphumela emibi eminingi ingenxa yokuthi "i-capillary leak," eqala ngokushesha ngemva kokuba ukwelashwa kuqalwa. Ukuvuza kwama-capillary kubangelwa ukuvuza kwamaprotheni ngaphandle kwegazi okwenza kube nokuncipha kwengcindezi yegazi. Imiphumela emibi ejwayelekile kakhulu kanje:
- ukunxanxathela, ukuhlanza, isifo sohudo, ukulahlekelwa ukudla
- ubuthakathaka nokukhathala
- izimpawu ezifana nomkhuhlane (umkhuhlane, izikhukhula, izinhlungu zekhanda kanye nama-acule aches)
- umfutho wegazi ophansi
- ubuhlungu obuvamile, ubuhlungu besifuba (angina)
- izinkinga zokuphefumula ngenxa yoketshezi emaphashini
- inzuzo yesisindo, ukugcinwa kwamanzi
- imiphumela yengqondo (i-paranoia, i-hallucinations, ukulala)
- itching, ukuhlunga isikhumba
- i-anemia (inani elibomvu lesisindo segazi)
- isibalo seplatelet esincane (okwandisa ingozi yokuphuma)
- isibalo esincane segazi elimhlophe
- ukulimala kwezinso
- izilonda zomlomo
Le miphumela emibi ihlukumezeka kepha ibikwe kwabanye abantu abathatha i-IL-2:
- inhliziyo engavamile, isifo senhliziyo
- ukwehluleka ukuphefumula
- izifo ezinzima
- ukuphuma kwamathumbu
- izinkinga ze-thyroid
- izinkinga zesibindi
- isiyezi esikhulu, ukuphelelwa amandla
Ukuqapha / Ukuxhumana
I-IL-2 ingenza imiphumela emibi yezinye izidakamizwa nezifo zibi kakhulu, ngakho tshela udokotela wakho uma unayo:
- izinkinga zezinso
- Isifo senhliziyo
- isifo sesibindi
- isifo sengculazi
- ukuphazamiseka kwengxabano
- isifo se-thyroid
- ukutheleleka
- noma yisiphi isifo somzimba
- noma yiziphi izifo zokuzivikela
Futhi vumela udokotela wakho wazi nganoma yimaphi ama-counter-the-counter noma imishanguzo kadokotela oyisebenzisayo, ikakhulukazi i-corticosteroids, i-indomethacin, izidakamizwa zegazi, izidakamizwa zokucindezeleka, izidakamizwa zokulwa nokukhathazeka noma ezinye izidakamizwa ze-anticancer. Ungaqala noma umise noma imuphi umuthi ngaphandle kwemvume kadokotela.
Qaphela: Lolu lwazi lungase lumboze zonke izinyathelo zokuphepha, ukusebenzisana noma imiphumela emibi yalesi sidakamizwa. Uma unemibuzo mayelana nanoma imuphi umuthi oyithathayo, qiniseka ukuthi uhlole nomsebenzi wakho wezokwelapha.
Imithombo:
"I-Melanoma." I-National Comprehensive Cancer Network. V.1.2009. 27 Januwari 2009.
"Ulwazi lwe-Proleukin lokubhala." Novartis Pharmaceuticals Corp. 27 Januwari 2009.
USmith FO, Downey SG, uKlapper JA, et al. Ukwelashwa kwe-melanoma ye-metastatic usebenzisa i-interleukin-2 yedwa noma ngokuhambisana nemigomo. Clin Cancer Res 2008 14: 5610-5618. 27 Januwari 2009.