I-SBRT ye-Cancer Primary Lung ne-Oligometastases
I-SBRT (i-radiotherapy yomzimba ebizwa ngokuthi i-stereotactic radiotherapy) yinqubo entsha kakhulu yokuphatha umdlavuza wamaphaphu osebenzisa ukuphakama okukhulu kwemisebe enikezwe ekuhlosweni okuqondile. Ngokusebenzisa izikhundla ezikhethekile kanye nezimpawu ezifakwe emzimbeni, izazi ze-radiologists ziyakwazi ukuletha umthamo ophakeme kakhulu wemisebe yomdlavuza kunomuthi wendabuko we- radiation , ngenkathi uvikela izicubu ezinempilo.
Ukusebenzisa Abantu abane-Cancer Lung
Ngalesi sikhathi, kunezizathu ezintathu eziyinhloko ukuthi kungani i-SBRT ingasetshenziswa ngomdlavuza wamaphaphu.
- Ngomdlavuza wamaphaphu, i-SBRT isetshenziselwa isigaba sokuqala, amagciwane amancane amaphaphu (okungewona omncane wesifo somdlavuza wamaphaphu) abangakwazi ukuhlinzwa ngenxa yesizathu esithile. Umdlavuza wamaphaphu ungabhekwa njengomdlavuza ongaphazamiseki ngenxa yomzimba , noma ezinye izimo zezempilo ezingenza ingozi yomdlavuza wamaphaphu .
- Iziguli ezikhulile okungenzeka kulindeleke ukuthi zenze kabi ngokuhlinzwa noma zibe nemibandela yezokwelapha ezingabangela ingozi yokuhlinzwa izinkinga.
- Kwindawo eyodwa noma ezimbalwa zokusabalalisa umdlavuza wamaphaphu noma i-metastasis (i-oligometastases.)
Inqubo
I-radiotherapy yomzimba ebizwa ngokuthi i-stereotactic isebenzisa umthamo ophezulu wemisebe ehanjiswa endaweni ecacile kakhulu yezicubu. Lokhu kuqhathaniswa nokwelashwa kwemisebe ejwayelekile yomdlavuza wamaphaphu osebenzisa umthamo omncane kakhulu wemisebe yanikezwa isikhathi esiningi.
Ama-Radiologists abala izixhumanisi ezilinganisweni ezingu-4 ukuchaza ngokunembile indawo okuzophathwa ngayo.
I-SBRT ye-Cancer Primary Lung Cancer
I-SBRT ngezinye izikhathi ingasebenza ngokuphumelelayo njengokuhlinzwa kwabanye abantu abane-cancer encane yamangqamuzana amaphaphu amancane angasebenzi, noma ezigulini ezinezimo zempilo ezingenza ukwelashwa kube yingozi.
I-SBRT ibangele ukulawula lesi sifo kufana nokuhlinzwa, futhi ukusinda isikhathi eside kuye kwenzeka kubantu abakhethwe ngokucophelela ngenqubo. Ama-Tumor kumele abe amancane, ngokuvamile angaphansi kwama-5 cm (2-3 amasentimitha) ububanzi, futhi angabi eduze kakhulu ne-airways noma inhliziyo.
I-SBRT ye-Oligometastases
Esikhathini esedlule, ukutholakala kwezinhlelo zokwelashwa okulinganiselwe ukwelashwa kwamakhemikhali, futhi ukusinda okungaphansi konyaka kwakuwukubusa. Kubantu abanendawo eyodwa kuphela noma ezimbalwa zomdlavuza wamaphaphu (ukusakaza) ukusetshenziswa kwe-SBRT kushintshile lokho. Kutholakale ukuthi kubantu abane-oligometastases (i-oligo isho ukuthi "bambalwa") ukuphatha ama-metastases ne-SBRT uye wakhula amanani okuphila okuphakathi futhi kuye kwaba nabantu abathile abasinda isikhathi eside ngenxa yalolu cwaningo.
Umdlavuza womlenze uvame ukusabalalisa ebuchosheni, amathambo, isibindi, nezigulane ezidalwa yi-adrenal, nge-SBRT esetshenziselwa kakhulu abantu abanesifo se- metastase nesifo sobuchopho ngenxa ye-cancer emaphaphu. Ngenxa yentuthuko ye-oligometastases - njenge-SBRT - kungenzeka ukuthi abanye abantu abanomdlavuza wamaphaphu bakwazi ukuhlala isikhathi eside kakhulu sokusinda okungenalesi sifo nekhwalithi engcono yokuphila kunalokho okungenzeka kube khona.
Izinkinga ezingenzeka
Kunezinkinga eziningi ezingase zibe khona ze-SBRT yomdlavuza wamaphaphu, ofanayo nemiphumela emibi yokwelapha okuvamile emisebentini njengokhathala kanye ne- radiation pneumonitis . Izinkinga ezimbili ezivame kakhulu ze-SBRT ezisetshenziselwa umdlavuza wamaphaphu zibandakanya:
- I-Brachial plexopathy - I-radiation ingalimaza izinzwa endaweni ebizwa nge- plexus ye-brachial . Lokhu kungabangela ubuhlungu engalweni noma ehlombe, ngobuthakathaka bese kuba yingxenye yesandla nesandla.
- Ubuhlungu bezindonga zesifuba noma ukungasebenzi - Uma isisu siseduze nodonga lwesifuba, izicubu ezibomvu zingabangela ubuhlungu nokuvinjelwa.
Ikusasa
Imiphumela yokuqala ibonisa imiphumela nge-SBRT efana nokuhlinzekwa komdlavuza wamaphaphu iphakamisa ithemba lokuthi, kwabanye abantu noma kunjalo, i-SBRT ingahle isetshenziswe njengendlela ehlukile engavumelani nokuhlinzwa komdlavuza wamaphaphu esikhathini esizayo.
Kungenzeka nokuthi, ukwelashwa kangcono komdlavuza wamaphaphu manje kuvunyelwe futhi kuvivinyo lwezokwelapha, futhi ngemiphumela yokuqala etholakala ngamathambo, ukuthi i-SBRT ingasetshenziswa futhi ukususa amasayithi we-tumor metastatic.
Eyaziwa nangokuthi : i- radiotherapy e-stereotactic, i-radiosurgery e-stereotactic, i-stereotactic radiation therapy
Imithombo:
Ashworth, A., Rodriques, G., Boldt, G., noDalma. Ingabe kunombuso we-oligometastatic emdlalweni wesifo samangqamuzana ongasona omncane? Ukubuyekezwa okuhlelekile kwezincwadi. I-Cancer Lung . 2013. 82 (2): 197-203.
I-Ashword, A., iSenan, S., uPalma, R. et al. I-metaanalysis yedatha yesiguli ngabanye yemiphumela nezici zokubikezela ngemuva kokwelashwa komdlavuza we-oligometastatic ongasona omncane-wamaphaphu wamaphaphu. Cancer Cancer Clinic . 2014. 15 (5): 346-55.
Griffoen, G., Toquri, D., Dahele, M. et al. Ukwelashwa okunamandla kwe-oligometastatic engeyona encane yamaphaphu carcinoma (NSCLC): imiphumela yeziguli kanye nezici zokubikezela. I-Cancer Lung . 2013. 82 (1): 95-102.
UGuerrero, E., noMnu Ahmed. Indima ye-radiotherapy ye-stelotactic radiotherapy (i-SBRT) ekulawuleni umdlavuza we-oligometastatic omncane wesifo samaphaphu. I-Cancer Lung . 2015. (Epub 2015 Dec 2).
U-Ricardi, U., uBadellino, S., no-A. Filippi. I-radiotherapy yomzimba wesifo somzimba wesifo somdlavuza wesifo samaphaphu emasenini okuqala: Umlando kanye nendima ebuyekeziwe. I-Cancer Lung . 2015. 90 (3): 388-96.
USalama, J., noS S. Schild. Ukwelashwa kwemithi yesifo somdlavuza we-oligometastatic non-small cell. Ukubukeza kwe-Canast Metastasis . 2015. 34 (2): 183-93.