I-Therapy Yokulondoloza I-Cancer Lung

by ULynne Eldridge, MD; Kubuyekeziwe ngo-Grant Hughes, MD

Yiziphi izinhloso zokwelashwa kwesondlo nge-Cancer Lung?

Kungenzeka ukuthi uke wazizwa ngabangane nabathandekayo abaye belapha ukwelashwa kwesondlo. Kodwa ukwelashwa kokunakekelwa komdlavuza wamaphaphu kuye kwabukwa kuphela nje. Kuphi ukwelashwa kwesondlo okusetshenziselwa umdlavuza wamaphaphu futhi yiziphi izinhloso zalolukwelapha?

Kuyini Ukwelashwa Kwezokugcina?

Ngaphambi kokuba uqale ukukhuluma ngemithi esetshenzisiwe, kusiza ukuchaza kahle ukuthi imithi yokwelapha iyini.

Ukwelashwa kwesondlo uhlobo lokwelapha olusetshenziselwa umdlavuza wamaphaphu ophakeme - ngokuqondile, umdlavuza omncane ongasemncane wesifo samaphaphu ukuzama ukuthuthukisa ukusinda, kodwa hhayi "ukwelapha" umdlavuza. Lokhu kuqhathaniswa nezinye izindlela zokwelapha izigaba zangaphambili zomdlavuza wamaphaphu ezingase zinikezwe ngomuthi engqondweni.

Kungase futhi isetshenziswe ngezikhathi ezithile kubantu abanomdlavuza omncane we-cell lung (bheka ngezansi.)

Incazelo elula yokwelashwa kwesondlo yindlela yokwelapha eqhubekayo esebenzayo engazange ithuthuke (ebi kakhulu) ngemva kokukhipha imithi yokwelashwa kokuqala - kuze kube khona izibonakaliso ukuthi umdlavuza uye waqhubeka (wabuhlungu.) Ngamanye amazwi, kuyindlela yokwelashwa enikezwe umgomo wokugcina isisu esingaqhubeki ngokushesha, hhayi ukwelashwa okwenzelwe ukunciphisa noma ukwelapha isisu.

Imigomo Yokwelashwa Kwamasondlo

Ngayiphi imithi yokwelashwa owubhekayo, kubalulekile ukucabanga ngemigomo yokwelapha.

Ngalokhu engqondweni, kulula kakhulu ukukala izingozi zokwelashwa ngokumelene nezinzuzo. Lezi zinhloso ezine eziyinhloko yizi:

Ukuvimbela
Ukunciphisa
Ukuphathwa kwezifo
I-Palliative

Ukwelashwa kwesondlo kusetshenziselwa ukuphathwa kwezifo. Akukona ukwelapha, kodwa "kwenza okungaphezu" kunokuphathwa ngendlela yokwelapha ngendlela eyenzelwe ukuthi kwenziwe okungaphezu kokusiza izimpawu kuphela - umgomo wayo ukukhulisa ukusinda kanye nekhwalithi yokuphila ngesikhathi sokuphila.

Kuyasetshenziswa nini?

Ukuchaza imithi yesondlo yomdlavuza wamaphaphu, kusetshenziselwa imithi ngemuva kokuba othile aphathwe ngemikhakha emine ye -chemotherapy "ye-first-line" yephambili (isigaba IIIA nesigaba IV) umdlavuza wamaphaphu uma umdlavuza ungaqhubeki phakathi nalokhu kuqala -lapha ukwelashwa. Njengoba esikhathini esedlule, abantu abazange baphathwe ngokuqhubekayo kuleli phuzu (futhi esikhundleni salokhu kwalandelwa isikhathi " sokulinda okuqaphile " - okuwukuthi, ukuqapha izimpawu kanye nokuhlola i-radiology ukuze ubone ukuthi umdlavuza uzokhula), ukwelashwa kwesondlo kwenzelwe ukusiza ngezimpawu zomdlavuza, futhi, ngethemba lokuthi ngcono isikhathi sokusinda ngaphezu kwalokho okuhlinzekwa yi-chemotherapy yokuqala.

Kunezimpikiswano eziningi ezungeze ukusetshenziswa kokwelashwa kwesondlo. Njenganoma yikuphi ukwelashwa, imiphumela emibi yokwelashwa idinga ukulingwa nganoma iyiphi inzuzo. Futhi - emnothweni wethu wamanje - izindleko nazo zicatshangelwa. Imithi eyenzelwe "isondlo" ingabiza kakhulu. Ucwaningo oluthile lubonisa ukuthuthukiswa okuncane kakhulu ekusindeni (indaba yezinsuku kuya kwamasonto amaningi), futhi imindeni ivame ukushiywa enesisindo esincane kakhulu ekusindeni nemithwalo yemali yokwelashwa.

Imiphi Imithi Eyasetshenziswa?

Njengamanje, kunemithi emibili evunyiwe yi-FDA yokwelashwa kwesondlo yomdlavuza wamapapu ophuthumayo.

Imithi eminingi eminingana (kanye nokuhlanganiswa kwemithi) iyacwaningwa ekuhlolweni kwemitholampilo . Izidakamizwa ezivunyiwe zifaka:

U-Alimta (pemetrexed) - Ngo-2009, i-FDA ivume ukusetshenziswa kuka-Alimta ukuze uthole ukwelashwa kwesondlo ngomdlavuza wamaphaphu.
I-Tarceva (erlotinib) - I-FDA ivumile iTarceva ukuba isetshenziswe njengokwelashwa kwesondlo ngomdlavuza wamaphaphu ngo-2010.

Ubani Ozuza Ngokunengi?

Njengazo zonke izindlela zokwelapha umdlavuza wamaphaphu, kunabantu abathile abaphendula kangcono kakhulu kunabanye ukulashwa.

Izifundo no-Alimta zibonise ukuthi kubonakala sengathi zisebenza kangcono kubantu abane-lung adenocarcinoma nomdlavuza omkhulu wamaphaphu weseli. Kubonakala sengathi iphumelela kakhulu kubantu abanokuguqulwa kwe-EGFR .

Ukufunda ngeTarceva kubonisa nokuthi ukusinda okuthuthukile kubantu abanamanqamu angamancane amaphaphu amaphaphu angewona umdlavuza wesifo samaphaphu. Kubuye kubonakale ukuzuzisa abantu abanokuguqulwa kwe-EGFR ngokwezinga elikhulu kunalabo abangenalo ukuguqulwa komzimba. Inzuzo enkulu kunazo zonke yokulondoloza ukwelashwa ngeTarceva yatholwa ngabesifazane abangeke bebhema abaphila impilo enhle ngenye indlela ngesikhathi sokwelashwa kwabo.

Imiphumela emibi nezinkinga

Ukwelashwa Kwamaintenance for Stage Cancer Lung Extensive Stage

Nakuba ukwelashwa kwesondlo kusetshenziselwa umdlavuza omncane ongasona omncane, ukuhlolwa kwemitholampilo yamuva kuphakamisa ukuthi kungase kube nendima enkulu emdlalweni wesifo somdlavuza omncane wamangqamuzana phansi komugqa, ngesimo esibheke ekusindeni okubonakalayo phakathi kwabantu abaphathwa nge-sunitinib yesondlo kanye ne-prophylactic cranial i-irradiation.

Ukusekela nokuphikisana

Kuthiwa omunye "wemiphumela emibi" yokwelashwa kwesondlo ukuthi abantu abawutholi umuzwa wokuthola ukwelashwa okuqediwe. Ngamanye amazwi, abazizwa bengathi "abasindile." Kungasiza ukukhumbula ukuthi ukwelashwa kwama-hormonal for therapy yomdlavuza wesifuba kubhekwa njengokwelashwa kwesondlo, futhi iningi labantu ababenomdlavuza webele lithatha ukuthatha ukwelashwa kwe-hormonal, noma i-tamoxifen noma i-ahibatase inhibitor uma seliqedile ukwelashwa komdlavuza . Kungasisiza futhi ukusikhumbuza sonke sencazelo yomdlavuza osindile: omunye umuntu unomdlavuza osesikhathini lapho bethola ukuthi unesifo, kanye nakho konke ukuphila kwabo.

Kungenzeka ukuthi ukwelapha ukwelashwa kwemdlavuza wamaphaphu kuzokwandisa kokubili inani labantu abasebenzisa lelashwa kanye nokubaluleka kwalo. Umqondo wukuthi sesiqala ukwelapha umdlavuza wamaphaphu ngokuphindaphindiwe njengesifo esingelapheki . Asikwazi ngempela ukuphulukisa iningi labantu, kodwa lesi sifo singathelwa ukuthi silawulwa isikhathi eside.

_Imithombo:

_{Ahn, M. et al.} _{Ukusebenza Kokugcinwa Kwama Pharmacotherapies ye-Can-Small Cell Lung Cancer.} _{I-Clinical Medical Insights.} _{I-oncology .} _{2012. 6: 253-262.}

_{I-American Society of Clinical Oncology.} _{I-Cancer.Net.} _{Ukuqonda Ukwelashwa Kwamaintenance.} _{Kubuyekezwe 08/15.} _{http://www.cancer.net/navigating-cancer-care/how-cancer-treated/understanding-maintenance-therapy}

_{I-Banz, K. et al.} _{Ukuqhathaniswa kwezindleko zokwelashwa zegreyidi 3/4 izenzakalo ezimbi ezihlobene ne-erlotinib noma i-pemetrexed yokwelapha yokwelapha iziguli ezine-advanced non-small-cell cell lung cancer (NSCLC) eJalimane, eFrance, e-Italy naseSpain.} _{I-Cancer Lung .} _{2011 Meyi 16. (Epub ngaphambi kokuphrinta).}

_{UBrugger, W. et al.} _{Ukuhlola Okumangalisayo Kwama-Molecular Marker Ukuhlaziywa kwe-EGFR ne-KRAS Kusuka Esifundweni Esingahleliwe, EsiPhezulu Esilawulwa Ngama-Erlotinib Maintenance Therapy ku-Advanced Non-Small-Cell-Lung Cancer Lung.} _{I-Journal ye-Clinical Oncology .} _{2011 Oct 3. (Epub ngaphambi kokuphrinta).}

_{I-Cappuzzo, F. et al.} _{U-Erlotinib njengokwelashwa kwesondlo emdlashweni wamapulangwe wamaphaphu ongeyena omncane: isifundo se-3 esilawulwa ngokungahleliwe, esihleliwe, esihleliwe.} _{I-Lancet Oncology .} _{2010. 11 (6): 521-9.}

_{Chen, X., Liu, Y., Roe, O. et al.} _{I-Gefitinib noma i-erlotinib njengokwelashwa kwesondlo kulabo abaneziguli ezingenaso emincane umdlavuza wamaphaphu wamapulangwe: ukuhlolwa okuhlelekile.} _{PLoS One .} _{2013. 8 (3): e5934.}

_{U-Ciuleanu, T. et al.} _{Ukulondolozwa kwempendulo kanye nokunakekelwa okungcono kakhulu okusekela ngokumelene ne-placebo nokunakekelwa okungcono kakhulu okusekela umdlavuza we-non-encane-wamaphaphu wamaphaphu: isifundo sesigaba sesi-3 esingahleliwe, esinezimpumputhe.} _{I-Lancet .} _{2009. 374 (9699): 1432-40.}

_{Cohen, M. et al.} _{Isifinyezo sokuvuma: i-erlotinib ukwelashwa kokugcinwa komdlavuza we-advanced / metastatic non-small cell cell lung cancer (NSCLC).} _{I-Oncologist .} _{2010. 15 (12): 1344-51.}

_{Cohen, M. et al.} _{Isifinyezo sokuvunywa: ukwelashwa kwemetrexed kwesondlo yemikhakha esithuthukisiwe / yemetrafti engenawo amancane, okungewona amancane omdlavuza wamaphaphu (NSCLC).} _{I-Oncologist .} _{2010. 15 (12): 1352-8.}

_{Coudert, B. et al.} _{Inzuzo yokusinda nge-erlotinib yokwelapha ukwelashwa ezigulini ezine-advanced non-small-cell cell lung cancer (NSCLC) ngokusho kwempendulo ye-chemotherapy yokuqala.} _{Amanothi we-Oncology .} _{2011 Meyi 24. (Epub ngaphambi kokuphrinta).}

_{UDickson, R. et al.} _{I-Erlotinib Monotherapy yokwelashwa kwesondlo ye-Can-Small Cell Lung Cancer ngemuva kwePlatinum yangaphambili-Equkethe i-Chemotherapy: I-NICE Ukuhlolwa Kwamanye Ubuchwepheshe.} _{I-Pharmacoeconomics .} _{2011 Oct 3. (Epub ngaphambi kokuphrinta).}

_{Greenhalgh, J. et al.} _{I-Pemetrexed yokwelashwa kwesondlo komdlavuza wesimo samapayipi angaphambilini noma omncane ongasemncane.} _{Ukuhlolwa kobuchwepheshe bezeMpilo .} _{2010. 14 (Isihlomelo 2): 33-9.}

_{Jiang, Y., Liu, L., Shen, L. et al.} _{Ukwelashwa kweMithi yamaShayina yendabuko njengendlela yokwelapha yesondlo kumdlavuza ongapheli omncane-wamangqamuzana wamaphaphu: Isivivinyo esilawulwa ngokungahleliwe.} _{Ukwelashwa Okuhambisanayo Kwezokwelapha .} _{2016. 24: 55-6.}

_{Han, Y., Wang, H., Xu, W. et al.} _{Imithi yemithi yamaShayina njengendlela yokwelapha yokondla ukuthuthukisa ikhwalithi yokuphila yeziguli zomdlavuza ezingapheli ezincane ze-celllung.} _{Ukwelashwa Okuhambisanayo Kwezokwelapha .} _{2016. 24: 81-9.}

_{Hu, X., Pu, K., Feng, X. et al.} _{Indima ye-Gemcitabine kanye ne-Pemetrexed njengeTherapy The Maintenance Therapy ku-Advanced NSCLC: Ukubuyekezwa Okuhlelekile Nokuhlaziywa Kwezinguquko Zemizamo Elawulwe Ngokungahleliwe.} _{PLoS One .} _{2016. 8:11 (3): e0149247.}

_{Karayama, M., Inui, N., Fujisawa, T. et al.} _{Ukwelashwa kwesondlo nge pemetrexed ne-bevacizumab ngokumelene ne-pemetrexed monotherapy ngemuva kokungeniswa kwe-carboplatin, pemetrexed, ne-bevacizumab ezigulini ezine-advanced squamous non-small cell cell cancer.} _{I-European Journal of Cancer .} _{2016 Feb 25. (Epub ngaphambi kokuphrinta).}

_{UKlein, R. et al.} _{Izindleko-ukusebenza kwe-pemetrexed njengendlela yokwelashwa kwe-line yokuqala yesifo somdlavuza ongasemncane ongasemncane wesifo samaphaphu.} _{I-Journal ye-Thoracic Oncology .} _{2010. 5 (8): 1263-72.}

_{Kulkarni, S., Vella, E., Coakley, N. et al.} _{Ukusetshenziswa kweSystemic Treatment ekugcinweni kweziguli ezine-Non-Small Cell Lung Cancer: Ukubuyekeza Okuhlelekile.} _{I-Journal ye-Thoracic Oncology .} _{2016 Mashi 21. (Epub ngaphambi kokuphrinta).}

_{Lu, S., Yu, Y., Chen, Z. et al.} _{I-Treatment Therapy ikwenza ngcono imiphumela yokusinda ezigulini ezine-Advanced Lase-Anti-Small Cell Lung Cancer: Ukuhlaziywa kwe-Meta-Studies 14.} _{Lung .} _{193 (5): 805-14.}

_{U-Muir, u-V., no-S. Chillon.} _{U-Erlotinib: njengesondlo sokunakekela i-monotherapy emdlalweni we-non-small-cell wamaphaphu.} _{BioDrugs .} _{2011. 25 (3): 139-46.}

_{Petrelli, F. et al.} _{U-Erlotinib njengomuthi wokwelashwa ezigulini ezinomdlavuza ophuthumayo wamangqamuzana wesifo samaphaphu: ukuhlaziywa okuhlanganisiwe kwezinhlolo ezintathu ezintathu.} _{Izidakamizwa zeAnticancer .} _{2011. 22 (10): 1010-9.}

_{Pinquie, F., de Chabot, G., Urban, T., noJ. Hureaux.} _{Ukwelashwa kwe-Maintanance nge-Eroltinib i-Cardiomyopathy enobuthi: Umbiko wezehlakalo.} _{I-oncology .} _{2016. 90 (3): 176-7.}

_{Qi, W. et al.} _{I-Erlotinib iphinde icele pemetrexed njengendlela yokwelapha yesondlo yomdlavuza ophuthumayo ongasemncane wesifo samaphaphu: ukubuyekezwa okuhlelekile nokufaniswa okungaqondile.} _{Ucwaningo Lwezokwelapha Namanje .} _{2012 Mhlaka 14. (Epub ngaphambi kokuphrinta).}

_{Rodriguez, P., Popa, X., Martinez, O. et al.} _. _{Ucwaningo lweCancer Clinic .} _{2016 Feb 29. (Epub ngaphambi kokuphrinta).}

_{Salama, J., Gu, L., Wang, X. et al.} _{Ukuxhumana okuhle phakathi kwe-Prophylactic Cranial Irradiation kanye ne-Maintenance Sunitinib ye-Untreated Extensive-Stage Cell Small I-Cancer Patients Iziguli emva kwe-Standard Chemotherapy: Ukuhlaziywa Kwesibili kwe-CALGB 30504 (ALLIANCE).} _{I-Journal ye-Thoracic Oncology .} _{2016. 11 (3): 361 = 9.}

_{Schneider, B. I-sunitinib yokulondolozwa komdlavuza omncane wamaphaphu omncane: isilinganiso esisha, inketho noma isinyathelo ngendlela efanele?} _. _{Ucwaningo lwe-Cancer Research .} _{2015. 4 (5): 6358.}

_{Umalusi, F. Ukwelashwa Kwamaintenance Kufika Ngesikhathi Sengane-Encane-I-Cancer Lung Cancer, kodwa Ngayiphi Imali?} _. _{I-Journal ye-Clinical Oncology .} _{2011 Oct 3. (Epub ngaphambi kokuphrinta).}

Kuyini Ukwelashwa Kwezokugcina?

Imigomo Yokwelashwa Kwamasondlo

Kuyasetshenziswa nini?

Imiphi Imithi Eyasetshenziswa?

Ubani Ozuza Ngokunengi?

Imiphumela emibi nezinkinga

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