Izinhlobo zokwelashwa kwezidakamizwa kanye nokusetshenziswa komdlavuza wegciwane
Ukwelashwa kwezidakamizwa kuyinkqubo yezokwelapha esebenzisa ukulethwa kwemisebe enamandla kakhulu ukubulala amangqamuzana omdlavuza nokuphuza izicubu.
Isebenza kanjani?
I-High-energy imilayezo ye-DNA yonakalisa amangqamuzana, okwenza ukuba bafe noma bayeke ukuhlukanisa. Njengoba amangqamuzana omdlavuza ahlukanisa kaningi ngaphezu kwamaseli avamile, angakwazi ukulimala. Amaseli aphilile angathinteka futhi kodwa angakwazi ukulungisa umonakalo.
Kuyasetshenziswa nini?
Kokubili ukwelashwa kwamangqamuzana amancane namangqamuzana amaphaphu amaphaphu avame ukwelashwa nge-radiation therapy, okuvame ukuhlanganiswa ne- chemotherapy , ukuhlinzwa noma kokubili. Ngaphezu kwengxenye yalabo abathintekayo abanomdlavuza wamangqamuzana ongewona omncane uzothola ukwelashwa kwemisebe ngesikhathi esithile lapho belashwa. Ngokuya ngohlobo nomkhakha wesifo somdlavuza wakho wamaphaphu , ukwelashwa kwama-radiation kungasetshenziswa:
- Ngemuva kokuhlinzwa - Ukwelapha noma yimaphi amangqamuzana omdlavuza angase ahlale endaweni emva kokuhlinzwa.
- Ngaphambi kokuhlinzwa - Ukuze unciphise ubukhulu besisu futhi wenze ukuhlinzwa kuphumelele nakakhulu.
- Ukwelapha umdlavuza - Ngezicubu ezincane, futhi ezigulini ezingakwazi ukuhlinzwa ngenxa yobudala, indawo yesikhumba noma ezinye izimo zezokwelapha, ukwelapha imisebe ngezinye izikhathi kunganikeza ithuba lokuthola ukwelashwa.
- Ukwelapha umdlavuza wamaphaphu - Kokubili endaweni yangakini, njengezitho zamakhemikhali eziseduze, nakwezinye izingxenye zomzimba, ezifana nobuchopho.
- Ukwelapha izimpawu (ukwelashwa kwama-radiant palliative) - Uma isisu sibangela izimpawu ezifana nokuphefumula nokubuhlungu, ngezinye izikhathi ukwelashwa kwe-radiation kusetshenziselwa ukunciphisa usayizi we-tumor ukunciphisa izimpawu.
- Ukwelapha umdlavuza wamaphaphu we-metastases - i-SBRT (bheka ngezansi) ingase isetshenziswe ngezikhathi ezithile ukuphatha amaminerase ayisithupha noma ambalwa kuphela ebuchosheni noma amastastases wesibindi kusuka kumdlavuza wamaphaphu.
- Ukuvimbela - Emdlalweni wamangqamuzana wamaphaphu amancane, ukwelapha imisebe ebuchosheni ngezinye izikhathi kunikezwa ukubulala noma yiliphi amangqamuzana asakaze ebuchosheni kodwa angatholakali ngesikrini. Lokhu kubizwa nge- Prophylactic Cranial Irradiation (PCI) .
Uyinikezwa?
Ukwelapha imithi yomdlavuza wamaphaphu kuvame ukunikezwa nsuku zonke, ngoMsombuluko kuya ngoLwesihlanu, isikhathi esingamaviki ayisithupha. Ngaphambi kokuba kuqalwe ukwelashwa, uzonikezwa eyodwa noma ngaphezulu "ama-tattoos," ama-inkinki angunaphakade ngobukhulu be-freckle ehambisana ne-tumor emaphaphu. Ukufaniswa kwenziwa ngaleso sikhathi. Phakathi nale nqubo, kuzodingeka uqambe amanga kakhulu etafuleni ngenkathi i-oncologist yemisebe iveza ukuthi kufanele ihlose kuphi imisebe. I-oncologist ye-radiation izobe ibalwe umthamo wemisebe yelanga (elinganiselwe ku-Gy, ebizwa ngokuthi i- grays ) ezokwenziwa ngesikhathi sokuguqulwa kwakho.
Izinhlobo
Ukwelashwa kwezidakamizwa kungenziwa ngaphandle noma ngaphakathi ukuze uphathe umdlavuza wamaphaphu. Izinqubo ezivamile ezisetshenziswa zihlanganisa:
Ukwelashwa kwemisebe yangaphandle ye-beam - Lokhu kusetshenziselwa kakhulu futhi kuhilela ukusetshenziswa komshini wangaphandle oletha imisebe ephezulu kakhulu. Izinhlobo ezivame kakhulu zokwelapha kwangaphandle ziyi:
- Ukwelapha kwama-radial (amabili-ntathu).
- Ukwelapha kwemisebe ye-3D conformational - Le thérapie ikhula ekwelashweni okuvamile ngokusebenzisa i-computed tomography (CT) -therapy ehlinzekwayo ukubuka isisu ngesilinganiso ezintathu. Umgomo ukuqondisa imisebe ngokuqondile ngqo kwi-tumor futhi uvikele izicubu ezizungezile.
- I-Intensity Modulated Therapy Treatment (IMTR) - Le thérapie inikeza isilinganiso esiphezulu semisebe yezimoto ezihlukahlukene. Ucwaningo luye lwabona ukuthi ukwelashwa kokushisa kwama-radiation kwangaphambili nangaphezulu kunakho konke okungaholela ekuthuthukiseni izinga lokusinda kodwa futhi kuhlotshaniswa nokunyuka utshwala, ikakhulukazi ukuvuvukala kwesifo (isifo se-radiophyitis).
Imisebe yangaphakathi - Ngezinye izikhathi imisebe inikezwa ngaphakathi emdlavuza wamaphaphu. Imisebe yangaphakathi nayo yaziwa nangokuthi i- brachytherapy . Phakathi nale nqubo, ithuluzi elincane lepulasitiki le-plastiki lifakwe ngesikhathi se- bronchoscopy . Inani elincane lezinto ezinomsakazo bese lidluliselwa ngaphakathi kwiphubhu, okuvumela ukuthi ukwelashwa kuhanjiswe endaweni eqondile.
Ithebhu isuswa ngemuva kokwelashwa.
I-radiotherapy yomzimba ebizwa ngokuthi i-stereotactic radiotherapy (i-SBRT) - i- radiotherapy yomzimba wesifo somswakama noma i-SBRT yomdlavuza wamaphaphu yindlela yokwenza umthamo ophezulu wemisebe uhlinzekwe endaweni encane yamathambo ngomzamo wokukhipha umdlavuza. Ngokungafani nezinye izinhlobo zokwelapha imishanguzo, ngezinye izikhathi i-SBRT isetshenziselwa ukuhlosisa okunomdlavuza womaphaphu. Kubantu abathile abanomdlavuza wamaphaphu okuqala okubhekwa njengengasebenzi, i-SBRT ingahlinzeka ngemiphumela efanayo nokuhlinzwa. I-SBRT ingase isetshenziswe futhi, ngezinye izikhathi, ngomdlavuza wamaphaphu osakazekile . Uma kuphela imithi emincane yomdlavuza wamaphaphu ikhona ebuchosheni noma esibindi, i-SBRT ngezinye izikhathi ibangele ukulawula isikhathi eside lesi sifo.
Uzokuthinta Kanjani?
Abantu abaningi bayakwazi ukwenza imisebenzi yansuku zonke ngesikhathi sokulashwa, nakuba ukukhathala kuvame kakhulu futhi kuvame ukwanda kakhulu ngesikhathi sokwelashwa. Ngokwelashwa kwemisebe yangaphandle, akudingeki ukuba ukhathazeke ngokuthi imishanguzo izothinta labo abakuzungezile, njengezinye izindlela zokwelashwa ezisetshenziselwa ezinye ukwelapha.
Okuqhamuka uma udla imishanguzo
Ukucasula isikhumba, kufaka phakathi ukubomvu nokupenda, kuvame ukuqala ngeviki lokuqala noma kokubili ukwelashwa. I-oncologist yakho ingase ibeke ukhilimu kuwe futhi ukunakekelwa okukhethekile ekunakekeleni isikhumba kubalulekile. Ukukhathala kuvame kakhulu futhi kungaphikelela amasonto ambalwa kungakapheli ukwelashwa. Ubuhlungu noma ubunzima ngokugwinya (isophagitis) kungenzeka futhi kukhona izizathu zokuxhumana ne-oncologist yakho. Izimpawu ezinjengezimpumputhe ezibangelwa ukushisa imisebe zingenziwa, kodwa ezimweni eziningi, izinzuzo zokwelapha zidlula kakhulu izingozi zalezi zinkinga.
Kubalulekile ukujwayela imiphumela emibi yezokwelapha ngaphambi kokuthola lezi zindlela zokwelapha. Imiphumela emibi efana ne- radiation pneumonitis - ukuvuvukala kwamapayipi ngenxa yokwelashwa kwemisebe - iyaphathwa, kodwa ingabangela ukubola kwe-fibrosis - okungahlali njalo - uma kungatholakali futhi kutholakala ngokushesha.
Njengoba izinga lokusinda lomdlavuza wamaphaphu lithuthuka, kubalulekile futhi ukuqaphela eminye yemiphumela emibi yesikhathi eside ye-radiation therapy engase iqale futhi iqhubeke inyanga noma ngonyaka ngemuva kokwelashwa kwemisebe.
Ukulandelela Ngemva Kokuphulukiswa Kwemithi
Ukwelashwa kwezidakamizwa kungathatha isikhathi esithile ukuqala ukusebenza kodwa uqhubeke ukusebenza isikhathi esithile ngemuva kokuba ukwelashwa kuqediwe. I- oncologist yakho ye-radiation izokwazisa uma ukuhlolwa okulandelwayo kufanele kwenziwe ukuhlola inqubekelaphambili yakho.
Imithombo:
De Ruysscher, D., Lueza, B., Le Pechoux, C. et al. Impact ye-Thoracic Radiotherapy Isikhathi Esikhathini Esilinganiselwe I-Can-Stage Small-Cell Cancer Lung: Ukusetshenziswa Kwemininingwane Yeziguli Ezigulayo Ukuhlaziywa kwe-Meta-analysis. Amanothi we-Oncology . 2016 Jul 19. (Epub ngaphambi kokuphrinta).
UGiaj-Levra, uN., uRicchetti, F., noF. Alongi. Kuyini Ukuguqulwa Kwe-Radiotherapy ye-Treatment of Patient Lon Advanced Nonsmall Cell Lung Cancer Patients? Ukubuyekezwa. Ucwaningo lweCans . 2016. 34 (2): 80-93.
Maquilan, G., no R. Timmerman. I-Stereotactic Body Radiation Therapy for Cancer Stage Cancer. I-Cancer Journal . 2016. 22 (4): 274-9.
Stevens, R., Macbeth, F., Toy, E., Coles, B., noJester. I-Palliative Radiotherapy Imithi yeziguli ezinezifo ezinamahloni ezivela ku-Non-Small Cell Lung Cancer. I-Cochrane Database yezibuyekezo ezihleliwe . 2015. 1: CD002143.
Zheng, M., Sun, H., Xu, J. et al. Ukuhlanganisa i-Whole-Brain Radiotherapy ne-Gefitinib / Erlotinib ye-Brain Metastase evela ku-Non-Small-Cell Cell Lung Cancer: A Meta-Analysis. I-BioMed Research International . 2016. 2016: 5807346.