I-SAVI Idivayisi Yokunciphisa Ukwelashwa Kwesifo Sebele

by Pam Stephan

I-Pros and Cons ye-SAVI Brachytherapy Device ye-APBI

Uma i-oncologist yakho yokushisa imisebe iphakamisa idivayisi ye-SAVI breast brachytherapy yesifo somdlavuza wakho webele , cishe unemibuzo eminingi. I-irradiation yamabele ephuthumayo (APBI) iyindlela eyodwa uma une- lumpectomy yomdlavuza webele. Yini okufanele ukwazi mayelana nale divayisi futhi yini ongayilindela ekwelapheni? Yeka indlela le ndlela ephumelelayo ngayo leyindlela ehlobene nezinhlobo eziningi zendabuko yokwelashwa kwemisebe? Ake sikhulume ngokuthi idivayisi ye-SAVI brachytherapy isebenza kanjani, futhi izinzuzo nezimo ezingalungile okufanele uzicabangele uma wenza isinqumo sakho.

Umgomo we-radiation therapy ngemuva kwe-lumpectomy ukusiza ukuvimbela ukuphindaphinda komdlavuza wakho webele. Empeleni ukuphindaphindiwe komdlavuza webele kunesibopho sokufa kwabantu abaningi kule sifo. Ukwelashwa kokubeletha kwebele, okufana ne-lumpectomy, kuncane kakhulu kune-mastectomy futhi kuhambisana nokusinda uma nje kulandelwa imithi yokwelapha ukubulala noma yikuphi ukutholakala kwamangqamuzana omdlavuza webele webele. Isici esibi salokhu, noma kunjalo, ukuthi leyo mithi yokwelashwa ingaphazamisa izicubu ezivamile. I-Brachytherapy, noma i-radiation ngaphakathi-ngaphakathi, kuyindlela yokwelapha izicubu ezinempilo ngenkathi ukwelapha izicubu ezungeze isisu sakho.

Ukulwa neCanscer Breast Ukusuka Ngaphakathi

Iyini i-SAVI brachytherapy yomdlavuza webele ?. Isikweletu: Istockphoto.com/Stock Photo © Stephanie Zieber

Imithi yokwelashwa yomdlavuza webele inganikezwa ngemisebe yangaphandle noma yangaphakathi.

Imisebe yangaphandle, ebizwa ngokuthi i-whole-breast irradiation (WBI), iphatha lonke isifuba ngaphandle, ngokuhlosisa kakhulu ama-x-rays esithombeni sakho somzimba.

I-brachytherapy yesibindi , ebizwa nangokuthi i-brachytherapy ye-interstitial, ifomu langaphakathi lemisebe esebenzisa ama-catheter akhethekile (amashubhu amancane) ukuletha imisebe evela ngaphakathi kwebele yakho kuya emathunjini akho kanye nesamba esincane sezingcubu ezizungezile.

Ukusheshisa kwe-Bretial Irradiation (APBI) okusheshayo

Sizokhuluma ngedivayisi ye-SAVI ye-irradiation yebele yamahhala esheshayo (APBI), kodwa kubalulekile ukuqaphela ukuthi i-APBI ingenziwa njengamafomu emisebe yangaphandle, noma njengama-radiation yangaphakathi noma i-brachytherapy njengensimbi ye-SAVI.

Ngaphandle kwesinye isikhathi i-irradiation yangaphakathi yebele iyenziwa, kodwa ngokuyinhloko emitholampilo yomdlavuza eyenza i-brachytherapy APBI. Uma kuqhathaniswa nokwelashwa kwemisebe yangaphandle yebele, izifundo zokuqala zathola ukuthi i-APBI yangaphandle ihlotshaniswa nengozi ephakeme yokuphindaphinda kwendawo kanye nomngcipheko omkhulu womdlavuza omusha oqalayo esifubeni esifanayo njengomdlavuza wokuqala.

Ngokuphathelene nokwelashwa kwe-radiation yangaphakathi lonke, i-APBI yangaphandle ibonakala ihlotshaniswa nomphumela onobuhle obumpofu kepha unobuthi obuncane obunesikhumba. Ezicwaningweni, i-APBI yangaphandle yayisetshenziselwa kaningi kulabo besifazane abanezinambuzane ezincane ezazingekho kahle, i-estrogen receptor positive, ne-HER2 negative.

Ngombono omuhle, i-APBI ingaqhutshwa ngesikhathi esifushane kakhulu, ukukhathala ngokweqile kwekhwalithi kanye nekhwalithi yokuphila.

Nakuba ukusetshenziswa kwe-APBI yangaphandle okwamanje kungezungezwe ngxabano, izikhungo ezithile zomdlavuza zifunda izindlela zokuthuthukisa ukulawulwa kwendawo ngalolu hlobo lwemisebe.

Manje ake sibheke ngaphakathi (brachytherapy) APBI ngedivayisi ye-SAVI.

I-SAVI ™ Ephuthumayo I-Bretial Irradiation (APBI)

I-SAVI Radiation Applicator. Isikweletu: I-SAVI Applicator - Isithombe © Cianna Medical

I-SAVI, eyayiyi-FDA evunyelwe ngo-2006, iyisisetshenziswa se-radiation lesifuba esingasikelwa esimweni sakho se-lumpectomy cavity, kungakhathaliseki ukuthi isimo noma ubukhulu bungakanani.

Le divayisi iyisigxobo sezintambo ezithambile, ezincane. I-SAVI ingeniswa ngomshini omncane, futhi isikhwama se-catheter sihamba ngendlela efanayo, kodwa ukuklama kwayo okuyingqayizivele kuvumela ukuba kuvulwe ngendlela ehambelana nobukhulu nesimo se-tumor cavity.

Umthamo we-radiation ungalawulwa ngokwawo ngamakhemikhali ngayinye, okuvumela ukuqondiswa okucacile yi-oncologist yemisebe. Le divayisi ikwazi ukwenza ngokwezifiso ngokwengeziwe kunedivaysi yendabuko ye-balloon catheter ngakho abesifazane abanamabele amancane bangase bafanelekele lolu hlobo lwezokwelapha.

Yini Ongayilindela Kumfakisicelo We-SAVI

Ukufakwa Kwama-Radiation Applicator Placement. Isikweletu: Ukubekwa - Isithombe © Cianna Medical

Udokotela wakho ohlinzayo angabeka umfakisicelo we-SAVI emisebeni yesikhatsi ngesikhathi se-lumpectomy yakho, noma ingafakwa ngesikhathi sokuhlinzwa okuhlukile. Ukunciphisa okuncane kuphela okudingekayo, ukuvumela isisindo samakhemikhali e-compact ukuba sibekwe ngaphakathi kwebele. Indawo yokucwiliswa izokuvikeleka ngokugqoka, futhi ingxenye yomugqa ngamunye we-catheter izokwandisa ngaphandle kwebele lakho kuze kube yilapho ukwelashwa kwakho kuqediwe.

I-catheters iguquguquka kakhulu futhi ilula, ngakho kufanele ikhululeke kuwe phakathi kwezinsuku ezingu-5 kuya kwezingu-7 zemisebe. Ukugqoka kwakho isayithi kuzoguqulwa kabili ngosuku ngesikhathi ukwelashwa, futhi kumele kugcinwe eyomile. Ukuvimbela ukutheleleka, unganikezwa ngama-antibiotics ukuthatha.

Ngaphakathi kwale divayisi kukhona imbewu encane ye- brachytherapy (ama-pellets asebenza ngamagesi ayenziwe ngokulingana kokusanhlamvu kwelayisi).

Ukushiswa Kwemitha Ngesikhathi Sokwelapha

I-SAVI Radiation Applicator Dosing. Isikweletu: Ukuzikhethela - Isithombe © Cianna Medical

Uzobika esiteshini sakho se-radiation oncology kabili ngosuku ngezinsuku eziyisihlanu kuya kwezingu-7, ukuze uthole ukwelashwa. Hlela ukuchitha imali engaba ngu-30 ngomjikelezo ngamunye; cishe imizuzu engu-5-10 yokuqokwa kwakho izosetshenziselwa isikhathi sokwelapha imisebe. Ithimba lakho le-radiation oncology lizokwenza ukhululeke, futhi uxhumane nesicelo sakho se-SAVI emthonjeni wemisebe.

Ngesikhathi ukwelashwa ngalunye, umthombo we-radiation uthunyelwa phansi catheter ngamunye ngesikhathi esisodwa. Inani elihlukile lemisebe liyokwenziwa ngamaphuzu ahlukene eduze nobude bekhotha ngalinye. Lokhu kukunika i-dose engcono kakhulu yezicubu ezithintekile, nokuvikelwa okudlula zonke izicubu ezinempilo ezizungezile.

Ukuqedela ukukhwabanisa nokususa i-SAVI Applicator yakho

Ukususwa Kwamafayili Okusabalalisa i-SAVI. Isikweletu: Ukususwa - Isithombe © Cianna Medical

Ngemuva kokwelashwa kwakho kokugcina kwemisebe, i-oncologist yakho yomuthi ingasusa idivayisi ye-SAVI. Kufanele kuthathe imizuzu emibili ukususa idivayisi, uhlanza isitifiketi sakho sokungcola, futhi uvale isikhumba ngamathebhu okunamathisela. Ukubopha noma ukugqoka kufakwe phezulu, futhi uzobe ukhululekile ukuhamba. Qinisekisa ukuthi uya ekuvakashelweni kwakho okulandelelako, ngakho udokotela wakho angabona ukuthi ukukhokha kwakho kuphulukisa kahle.

Ukuphumelela

Umdlavuza wesibeletho. Isikweletu: I-Chicago Tribune / Umhlanganyeli / i-Getty Izithombe

Njengoba ukuvinjelwa kwesifuba sebele esifushane esisheshayo (i-brachytherapy noma i-APBI) kwavunyelwa okokuqala ngo-2002, odokotela bathole ukuthi le nqubo inikeza izinga eliphakeme lokulawulwa kwezicubu kulabo abanomdlavuza wesifuba sokuqala, futhi ngubani ozokwazi ukuzisebenzisa.

Uma kuqhathaniswa ne-irradiation yonke yebele eholela emaphesenti angu-2 edinga isidingo somzimba, i-APBI ibangele isilinganiso se-mastectomy samaphesenti angu-4 kuphela. Idivayisi ye-SAVI brachytherapy ibonakala isebenza kahle uma iqhathaniswa namanye amadivaysi asebenzayo okwamanje atholakalayo.

I-Brassytherapy yebele yezinzuzo

I-Breast Radiotherapy. Isikweletu: BSIP / Umhlanganyeli / i-Getty Images

Uma ukhetha uhlobo lwe-radiation therapy, kungaba usizo ukuhlunga izinzuzo nezinkinga zokwelashwa ngalunye. Yiqiniso, izinzuzo nezindleko kaningi akuzona ukubaluleka okulinganayo, futhi ungaphetha ukukhetha ukwelapha okunomthelela owedlula izinzuzo. Ezinye izinzuzo ze-brachytherapy yebele zihlanganisa:

Ukulimala kwezicubu ezinempilo. I-irradiation yebele lonke (imisebe yangaphandle) ithinta izicubu ezinempilo kanye namangqamuzana omdlavuza futhi ingabangela imiphumela emibi emathangeni enempilo. I-brachytherapy yesisu iklanyelwe ukudala ukulimala okuncane emathangeni enempilo.
Imvamisa yokwelashwa. Izitho zokwelapha zonke zebele zomzimba zivame ukunikezwa ngoMsombuluko kuze kube uLwesihlanu cishe amasonto ayisithupha. Nge-brachytherapy yebele, ukwelashwa ngokuvamile kungagcwaliswa esikhathini sesishiyagalombili kuya kwezingu-7. I-brachytherapy yebele isithinta inani elincane lamathisamu asebele futhi linikeza umthamo ohlosiwe wemisebezi endaweni yakho ye-lumpectomy.
Isikhathi sokubuyisela. Isikhathi sokubuyisela ngokuvamile sivame kakhulu nge-brachytherapy yebele kunesifo se-irradiation lonke.
Okuqhamuka uma udla imishanguzo. Ngokuvamile, imiphumela emibi njengokhathala ayincane ne-brachytherapy yebele.

Izinkinga ze-Breastytherapy yebele

Njengoba nje kunezinzuzo ze-brachytherapy yebele, kungase kube nokulimala kanye. Lokhu kungafaka:

Ingozi yokuphindaphinda umdlavuza webele. Njengoba kuphawulwe ngokuphumelelayo, ingozi yokuphindaphinda umdlavuza webele ihamba kancane nebele yebele. Lokho kusho, okwamanje akukho bufakazi bokuthi lelizinga eliphakeme lokuphindaphinda linomthelela emiphumeleni.
Ingozi yokutheleleka. Ngenxa yobuningi bezikhumba ezifaka isikhumba sakho, ingozi yokutheleleka iphakeme kunemisebe yangaphandle, nakuba incane.
Induduzo. Abanye abantu bathola ukuthi idivaysi ingakhululekile.
Imiphumela emisiwe. Izindwangu zesikhathi eside kanye nemiphumela yokuphuza zingase zibe ziphakeme kakhulu ne-brachytherapy yebele, nakuba kubonakala sengathi inobuthi obuncane besikhumba (amathuba amancane okubomvu nokuhlukumeza).
Ukutholakala. Ukwelashwa kwemisebe yangaphandle kutholakala kakhulu kune-brachytherapy yebele.

Ingabe i-SAVI iyatholakala kimi?

Owesifazane Ekubonisanweni. Isikweletu: BSIP / Umhlanganyeli / i-Getty Images

I-SAVI ye-breast brachytherapy iyatholakala kulo lonke elaseMelika, kodwa ayitholakali kuzo zonke izikhungo zomdlavuza. Izosebenza amabele amancane noma amancane, kodwa ezinye izici zingenza ukuthi akufaneleki kwabanye abantu. Hlola nodokotela wakho mayelana nenketho ye-irradiation yebele yamahhala esheshayo.

Izwi elivela kwi-Savi Brachytherapy ye-Cancer Breast

Izinketho eziningi ezintsha zitholakale zokwelapha umdlavuza webele eminyakeni yamuva. Nakuba lokhu kumangalisayo, kusho futhi izinqumo eziningi. Kubaluleke kunanini ngaphambili kubantu abanomdlavuza ukufunda ngesifo sabo futhi badlale indima esebenzayo eqenjini labo lokunakekelwa umdlavuza.

Njalo ukwelashwa kunezingozi nezinzuzo, futhi yini okufanele umuntu oyedwa angase abe yinye. Yiba ngummeli wakho siqu ukunakekelwa komdlavuza wakho futhi ukhethe ukwelashwa okuzizwa ukhululekile kakhulu kuwe njengomuntu hhayi omunye umuntu. Ukwenza izinqumo zakho mayelana nokwelapha umdlavuza webele kuyindlela eyodwa yokuzihlonipha ngokwelapha nangaphezulu.

> Imithombo:

> Gabani, P., Cyr, A., Zoberi, J. et al. Iziphumo Zesikhathi Eside ze-APBI nge-Multicatheter Interstitial HDR Brachytherapy: Imiphumela ye-Registry Single-Institutional Registry. I-Brachytherapy . 2017 Oct 28. (Epub ngaphambi kokuphrinta).

> Hepel, J., Arthur, J., Shaitelman, S. et al. I-American Brachytherapy Society Umbiko Wokubambisana Wokusheshisa I-Breast Irradiation Ngokushesha Ngokusebenzisa I-Mutlicatheter Brachytherapy Engaphakathi. I-Brachytherapy . 2017. 16 (5): 919-928.

> Hickey, B., Lehman, M., Francis, D., no A. Bheka. I-Irradiation ehlukile ye-Breast For Cancer Early Breast. I-Cochrane Database yezibuyekezo ezihleliwe . 2016. 7: CD007077.pub3.

> Polgar, C., Ott, O., Hildebrandt, G. et al. Imiphumela Ehlangene Neziphumo Nezicathulo Ze-Breastytherapy Eziphuthumayo Eziphuthumayo Ne-Brachytherapy Ephakathi Nama-Breastythérapie Ephelele-Emva Kwe-Breast-Conserving Surgery ye-Breast-Risk Invasive and In-Situ Carcinoma ye-Breast. I-Lancet Oncology . 2017. 18 (2): 259-268.

> Rana, Z., Nasr, N., Ji, H. et al. Izilinganiso ze-Dosimetric eziqhathaniswayo Ukusebenzisa i-Breast-Breast Irradiation esheshayo Ngama-Catheter Five subtypes. I-Radiation Oncology . 2015. 10: 160.