Ukuqonda Izinzuzo Nezingozi Ze-Proton Beam Therapy
Uma udokotela wakho ekhuthaze ukwelashwa kweproton ye-proton yomdlavuza wakho, kungenzeka ukuthi uyakhathazeka futhi udidekile. Ngokungafani nemithi yokwelapha, ukwelashwa kwe-proton kwe-borrow kuyinto emisha endaweni futhi ulwazi oluncane luyatholakala. Ake sibuke ukuthi lolu hlobo lwezokwelapha lusebenza kanjani, izinzuzo nezingozi ezihlobene nezinye izifo zomdlavuza, kanye nemiphumela emibi ongayithola.
Ngenkathi ukwelashwa kwe-proton kwe-british kusanda "kuthathwa" ngezimbalwa ezimbalwa zezikhungo ezinikezela le nsizakalo, le ndlela iye yaba khona kwezinye izibhedlela zase-United States kusukela ngo-1990.
Ukwelashwa Kweproton Beam Kusebenza Kanjani?
Incazelo emfishane yokuthi indlela yokwelapha i-proton eyasebenza ngayo yiyo-efana nokwelashwa kwemisebe evamile-isebenzisa amandla ukulimaza noma ukubhubhisa amangqamuzana omdlavuza.
Kulabo abafisa ukuqonda indlela yokwelapha ngokujulile okukhulu, ukwelashwa kwe-proton beamasebenza ngokusheshisa ama-proton (izinhlayiya eziqondile) esimweni esiphakeme samandla nge-speed accelerator. Lesi simo samandla aphezulu sivumela ama-proton ukuba ahambe ngokusebenzisa izicubu ngqo kwesisu; okwenza kube nokuqhunyiswa kwamabhodlela amaningi endaweni yakhona.
AmaProtheon ahlawuliswa kahle futhi ngaleyo ndlela athola amacala angalungile. Uma i-proton isungulwe eduze kwe-molecule efana ne-DNA, izizinda ezikhokhiswa kabi ze-molecule ziyokhangwa ku-proton, ngaleyo ndlela ziphazamise lezo zimoya ezimibalabala kanye nokusebenza okuvamile.
Umphumela wale nqubo ekugcineni ukubulawa kwamangqamuzana omdlavuza.
Umehluko Phakathi "Nejwayelekile" Ukwelashwa Kwemithi Ne-Proton Therapy
Ukwelashwa kweproton kanye nokwelashwa kwemisebe evamile kokubili kunqunywe ama-oncologists emisebeni. Enye yezinto ezahluke kakhulu kunendawo yokwelapha. Ukwelashwa kweproton kuhloswe ngokuqondile izindawo eziqondile, okungabangela ukulimala okuncane kumathiskhi azungezile.
Ukwelapha kwama-radial okuvamile akuhlosiwe kancane, futhi amaseli "avamile" angaphezulu kwesifunda somzimba angalimaza.
Ukwelashwa kwe-proton ye-projekthi akuyona uhlobo olulodwa lwezokwelapha, kodwa kunalokho kunezinhlobo ezahlukene nezindlela. Izinhlobo ezintsha ze-proton zokwelashwa kwe-proton ezifana nokukhipha ipeni yamapensela kucatshangwa ukuthi le ndlela yokwelapha ibekezeleleke nakakhulu.
Iziphi I-Cancers Ezibhekwa Ngokwelashwa Kwe-Proton Beam?
Ukwelashwa kwe-proton yegciwane ngokuvamile kuvame ukusetshenziselwa izicubu zangasese (isigaba I, II, noma III) futhi sisetshenziselwa njalo izifo eziyi-4 zesisu (izifo eziye zasakazeka kwezinye izifunda zomzimba). Ezinye izinhlobo zomdlavuza lapho ukwelashwa kwe-proton yegciwane kungasetshenziswa kuhlanganisa:
- Umdlavuza we-Lung: Ngomdlavuza wamaphaphu, ukwelashwa kweproton kungasetshenziselwa umdlavuza wamapayipi okuqala ongasenakekelwa ngokuhlinzwa, noma ukuphindaphinda lapho ukwelashwa kwama-radiation okuvamile.
- Umdlavuza we-Brain: Indawo eqondile yokulethwa kwezifo zokwelashwa kweproton ingaba nenzuzo ebuchosheni bobuchopho lapho ngisho namancane amonakalo ezakhiweni ezivamile eziseduze angaba nemiphumela emibi kakhulu.
- Amanqamu angama-cancer: I- proton yokwelashwa kwegciwane, njengoba kuxoxwa ngezansi, ingase ingonakalise kakhulu amathissi avamile. Njengoba ukulimala kwe-DNA kumangqamuzana avamile kungaholela ekliniki yesibili, kucatshangwa ukuthi le ndlela yokwelapha ingase ibe ngcono kangcono ngezinye izikhathi ezinganeni.
- Izinwele zekhanda nezintamo
- Umdlavuza wesibindi
- Umdlavuza we-Gallbladder
- Umdlavuza we-Esophageal
- Umdlavuza wesisu
- Umdlavuza we-prostate
Izinzuzo kanye Nezinkinga Ze-Proton Beam Therapy
Kunezinhlobo eziningi zokwelashwa emdlavuza oye wavela emashumini eminyaka edlule, futhi lokhu kuyamangalisa. Ngesikhathi esifanayo, noma kunjalo, uma kunezinketho ezahlukene zokwelashwa, wena kanye ne-oncologist yakho kuzodingeka wenze isinqumo mayelana nokuthi iyiphi imithi engcono kuwe.
Abanye abantu balula izindlela zokwelapha bese behlola izinketho ngokusekela ukuthi izifo zingase ziphumelele kanjani kanye nemiphumela emibi (futhi yimiphi imiphumela emibi abayicabanga ukuthi iyayicasula kakhulu).
Ukubhalisa izinzuzo kanye nokuqeda ukwelashwa kweproton kungasiza ngale nqubo.
Izinzuzo ze-proton zokwelapha zihlanganisa:
Ukwelashwa kwe-proton yegobolondo kunika umonakalo endaweni ecacile kakhulu yezicubu. Lokhu kungaba kuhle ikakhulukazi kwezicubu eziseduze nezinhlaka ezibalulekile, njengezicubu zobuchopho , noma iziphunga zamaphaphu eziseduze nenhliziyo. Amakhondomu ekhanda nentamo, ikakhulukazi lawo ahlobene ne- papillomavirus yabantu (i-HPV), anesilinganiso esikhulu sokusinda kunama-tumor ahlobene ne-HPV, okusho ukuthi abantu bazovame ukubhekana nemiphumela emibi yesikhathi eside iminyaka eminingi. Kulesi simo, ukwelashwa kwe-proton ye-proton kungase kube kuhle kumisebe evamile.
Ngenxa yokulethwa ngokuqondile kwama-proton, umthamo we-radiation ophakeme ungaphathwa kaningi ngesifo esinomuthi weproton.
Indawo ecacile yokulethwa kwezidakamizwa nge-proton yokwelashwa kwegciwane kungabangela ukulimala okuncane kumathisamu azungezile. Akukona lokhu kuphela okunciphisa imiphumela emibi (ngenxa yokulimala okuncane kumathambo ajwayelekile aphilile) kodwa kunganciphisa amathuba okuthuthukisa umdlavuza wesibili (umdlavuza ongabangwa yimithi yokwelapha njengokwelashwa kwemithi kanye ne- chemotherapy ). Kucatshangwa ukuthi ingozi yamagciwane e-secondary azokwehlisa ukwelashwa kweproton kune-radiation ejwayelekile, okwenza kucatshangelwe ikakhulukazi kubantu abasha abanomdlavuza.
Izigxobo zeProteton zilula ukulawula kunemisebe ejwayelekile. Ngaphezu kwalokho, uma igoli lifinyelela ku-tumor, liyeka, kunokuba libangele ukusabalalisa nokungena.
Imithi yokwelapha i-Proton ivame ukubekezelela kahle ngemiphumela emibi kakhulu kunezokwelapha ezivamile.
Ukwelashwa kweproton (kanye ne- radiotherapy yomzimba we-stereotactic noma i-SBRT) ingasetshenziselwa ukwelashwa kokuqala okufanele kusetshenziswe, kodwa kubonakala sengathi ayinakwenzeka ngenxa yendawo eseduze nezinhlaka ezibalulekile noma umuntu akuyona inkomba efanele yokuhlinzwa.
I-cons ye-proton yokwelashwa ingafaka:
Ngenxa yendawo eqondile yokulethwa kwezidakamizwa, ukwelashwa kwe-proton kungaphuthelwa izindawo ezincane zamangqamuzana omdlavuza kanye nezidakamizwa eziseduze kodwa ngaphandle kwensimu yemisebe.
Ngesikhathi samanje, ukwelashwa kwe-proton ye-proam isivimbela kabili njengokwelashwa okuvamile ngenxa yezindleko eziphezulu (ukwelashwa kwe-proton kudinga i-accelerator enkulu). Njengamanje kubiza amadola angaphezu kwezigidi ezingu-200 ukwakha isikhungo.
Izinselele zibandakanya ukuphathwa kokuhamba kanye nezinguquko ezithombeni ezenzeka ngaphambi nangesikhathi sokwelashwa.
Ngenxa yokuthi izikhungo zokwelapha ezincane noma ezinamaprotheni ezikhona ezincane zikhona e-United States, abantu bangase badinge ukuhamba kude ukuze bathole lokwelashwa.
Ezinye izindlela zokuhlinzeka nge-Proton Beam Therapy
Ngenkathi ukwelashwa kwemisebe evamile kuvamile kakhulu futhi kuhilela okungaphezulu "ukusabalalisa" kunendlela yokwelashwa kweproton, amasu omlilo amasha nawo ahlinzeke ngokuhlinzekwa okukhulu kwemisebe.
Isibonelo esisodwa yi-radiotherapy yomzimba wesifo somzimba (SBRT). Nge-SBRT, ukuphakama okukhulu kwemisebe kuhanjiswa endaweni eqondile. I-SBRT ingahle isetshenziswe ngenhloso yokunciphisa izicubu ezingenakudliwa ngenxa yendawo yazo, noma ukuphatha "i-oligometastases" (okukodwa noma okuncane kuphela kwe-metastase ebuchosheni, isibindi, noma amaphaphu avela emathunjini aqinile).
Ngo-2017 ukubuyekezwa kwezifundo ngokuqhathanisa ukwelashwa kwe-proton nge-SBRT, abacwaningi abazange bathole umehluko ozwakalayo ekusebenzeni kwalezi zindlela ezimbili zokwelashwa komdlavuza ongasona omncane wamaphaphu.
Imiphumela engase ibe khona ye-Proton Beam Therapy
Njengemithi yokwelapha eminingi, ukwelashwa kwe-proton ibhola kungabangela nemiphumela emibi kanye. Ngisho noma ukwelashwa kwe-proton ye-boram inikezwa endaweni eqondile, ukulimala kwamangqamuzana avamile eduze kwe-tumor kungase kwenzeke. Imiphumela emibi eminingi ifana nemiphumela emibi yemithi yokwelapha ejwayelekile, kodwa ngenxa yokugxila okuqondile komonakalo, kungase kube nzima kakhulu.
Imiphumela emibi kakhulu ehlanganisa:
- Ukukhathala: Njengokwelashwa okuvamile kwemisebe, ukukhathala kungenye yezimpawu zokulashwa ezivame kakhulu. Lokhu ukukhathala kubonakala kunzima nakakhulu ekuhambeni kokwelapha.
- Ukubomvu kwesibhumba (i-radiation dermatitis): Ngokuvamile, ukuphazamiseka kwesisu nokukhwa kwesikhumba kungahle kwenzeke ngelashwa lweproton.
- Ukulahleka kwezinwele: Ukulahleka kwezinwele kungenzeka esifundeni lapho kuhlinzekwa khona ukwelashwa kweproton, isibonelo ikhanda lapho lisetshenziselwa umdlavuza webuchopho noma esifubeni lapho sisetshenziselwa umdlavuza wamaphaphu. Ngokungafani nokulahleka kwezinwele ezihlobene ne-chemotherapy, ukulahlekelwa izinwele okuhlobene nokuphathwa kokwelashwa kweproton kungase kube unomphela.
- Ukuvuvukala kwamapayipi: Ukuvuvukala kwe- Lung kubizwa ngokuthi i- pneumonitis ye-radiation ingenzeka uma ukwelashwa kwe-proton kwegciwane kusetshenziselwa esifubeni. Ukubaluleka kwe-radiation pneumonitis ukuthi kumele kubonwe futhi kuphathwe ukuze kuncishiswe ingozi yokuthuthukisa i -fibrosis yamapulmeri (ukuphulwa kwemaphaphu).
Ukuphi Ukwelashwa Kwe-Proton Beam Kutholakalaphi?
Kukhona inani elilinganiselwe lezikhungo zomdlavuza e-United States nasemhlabeni jikelele ohlinzeka ngokukhetha ukwelashwa kweproton. Imephu yezikhungo zokwelashwa kweproton zingakubonisa ukuthi le nqubo inikezwa eduze nendawo yakho.
Ukulungiselela Ukwelashwa Kwe-Proton Beam
Ngaphambi kokuba uqale ukwelashwa nge-proton yokwelapha ukwelashwa, uzohlangana ne- oncologist yomshini ozoxoxa ngalokho ongayilindela, nezinzuzo kanye nezingozi zenqubo. Uzoba ne-CT scan eyenziwe ukuze udwebe isifunda somzimba wakho ukuze uphathwe futhi uzobe uhambisana nedivayisi yokukhubazeka (njengokwelapha okuvamile). Lesi sikhunta sizobekwa phezu kwengxenye yomzimba wakho othola imisebe ngesikhathi sokwelashwa ngalunye.
Ngokufana nemisebe ejwayelekile, ukwelashwa kwe-proton bethrafikhi ngokuvamile kuyenziwa nsuku zonke phakathi nesonto isamba semihlangano engu-20 kuya ku-40. Ngenkathi ingxenye yangempela ye-radiation yokuhambela ithatha iminithi noma emibili, ukuqokwa okuningi kuzohlala emaminithini angu-30 kuya kwangu-45.
Ukwelashwa kweproton akusizi ubuhlungu, futhi akudingeki i-anesthesia (ngaphandle kwalabo abangase badinga ukuguqulwa ukuba kube namanje ngenkathi ukwelashwa).
Izwi elivela
Ukwelashwa kwe-proton ye-beam inikeza enye indlela yokwelapha umdlavuza. Ngenxa yokukwazi ukugxila ngokuqondile emisebeni yomdlavuza, izinzuzo zayo eziyinhloko azikona ukuqeda umdlavuza kodwa kunciphisa ingozi yemiphumela emibi ehlobene nokwelapha. Njengalokhu, kungase kube yindlela enhle yezinambuzane eziseduze nezinhlaka ezibalulekile kanye nabantu abasha abangase babe nengozi ephansi yamagciwane angokwesibini ane-proton bethérapie ngokumelene nemisebe evamile.
Kungase futhi isetshenziselwe izicubu eziye zaphathwa nge-radiation ezivamile kepha zaphindaphindiwe. Indawo enembile yokwelapha ingavumela futhi ukushisa kwemisebe kunikwe umthamo ophakeme ngaphezu kwemisebe ejwayelekile.
Kukhona okwamanje ukuphikisana mayelana nokwamukelwa okusheshayo nokuthuthukiswa kwezindawo ezihlinzeka ngalezi zindlela njengamanye ama-radiation ezivamile noma inqubo efana ne-SBRT ingahle iphumelele kodwa ingabizi kakhulu. Ngenxa yokuthi ukwelashwa kwe-proton isisanda kusha, asinayo izifundo okwamanje ukuze zivuselele ngokugcwele izinzuzo zemfundiso ye-proton ukwelashwa kwezinye ezinye izifo. Xoxa ngalolu khetho nomhlinzeki wakho ukuze ubone ukuthi kukulungile yini.
> Imithombo:
> Diwangi, T., Mohindra, P., Vyfhuis, M. et al. Ukuthuthukiswa kwe-Radiotherapy Techniques kanye nokulethwa kwe-Can-Small Cell Lung Cancer: Izinzuzo Zokwelashwa Kwe-Radiation Modeling, I-Proton Therapy, ne-Stereotactic Body Radiation. Ucwaningo lwe-Cancer Research . 2017. 6 (2): 131-147.
> Mohan, R., noD. Grosshans. I-Proton Therapy- Namuhla nekusasa. Ukubuyekezwa okuPhuthukisiwe kweziDakamizwa . 2017. 109: 26-44.