Izinzuzo kanye Nezinkinga Zokuhlanganiswa Chemotherapy
Iyini i-chemotherapy ehlangene, lapho isetshenziselwa, futhi yiziphi izinzuzo nokungahambi kwalendlela yokwelashwa?
Sibutsetelo
I-chemotherapy yokuhlanganiswa ibhekisela ekusebenziseni imithi engaphezu kweyodwa yokwelapha i-chemotherapy ngesikhathi sokuphatha umdlavuza. Esikhathini esidlule, umdlavuza wawuvame ukwelashwa ngesidakamizwa esisodwa, kodwa ukwelapha kwamanje izinhlobo eziningi zomdlavuza usebenzisa inhlanganisela yezidakamizwa ezimbili noma ngaphezulu ngesikhathi esisodwa.
Umlando Wokuhlanganiswa Chemotherapy
Ukusetshenziswa kwe-chemotherapy ukuxilonga umdlavuza kwaphefumulelwa ngawo-1960 lapho ososayensi bezibuza ukuthi indlela yokwelapha isifo sofuba - besebenzisa inhlanganisela yama-antibiotic ukunciphisa ingozi yokumelana nayo - izosebenza nokwelashwa komdlavuza. Ukusebenzisa le ndlela, ukwelashwa okwakusanda kubulawa emhlabeni jikelele njengokwelapha i-lymphocytic i-lymphocytic kanye ne- Hodgkin's lymphoma kwaphela kakhulu. Kusukela ngaleso sikhathi, i-chemotherapy ehlanganisiwe iye yamukelwa ekwelapheni kwamanye amagciwane amaningi.
Ngawo-1970, i-chemotherapy ehlangene itholakala ukuthi iyasebenza kangcono kubantu abanomdlavuza wamaphaphu, futhi bephumelela kakhulu kunokuba "imithi yokwelashwa elandelanayo" noma ukusebenzisa imithi yokwelashwa ngamakhemikhali ngesikhathi esisodwa ngokulandelana, kunesikhathi esifanayo.
Izinzuzo
Kukhona izinzuzo eziningana zokufunda ukusebenzisa inhlanganisela yemithi yokwelashwa esikhundleni samakhemikhali angabodwa.
Ezinye zazo zihlanganisa:
- Ukwehlisa amathuba okuba isisu siyomelana nokuphathwa. Njengoba nje inhlanganisela yama-antibiotic ingase isetshenziswe uma kwenzeka amabhaktheriya athile emelana nomunye wemithi, ukusebenzisa izidakamizwa ezimbili noma ngaphezulu kwemithi yokwehlisa imingcipheko yokuthi isisu siyomelana nokuphathwa.
- Ukwenza kube lula ukunikeza yonke imithi ngokushesha ngangokunokwenzeka esi sifo.
- Ukukwazi ukubhekana nezinhloso eziningana ohlelweni lomdlavuza ngesikhathi esifanayo. I-cancer yisifo esiyinkimbinkimbi eshilela izinyathelo eziningi. Ukusetshenziswa kwemithi ye-chemotherapy esebenza ezinhlobonhlobo ezihlukahlukene zamangqamuzana, noma amaphuzu enqubo yomdlavuza kufanele, ngokwanele, iphakamise amathuba okuqeda umdlavuza.
- I-tumor "i-heterogeneity" - Ososayensi basebenzisa leli gama elithi tumor heterogeneity ukuchaza ukuthi amangqamuzana omdlavuza wezinsalela ahluke kanjani komunye nomunye. Ngenkathi amangqamuzana okuqala emdlalweni "ama-clones" - ngamanye amagama afanayo - ukuhlukana okulandelanayo kubangelwa ukuguqulwa kwamaseli. Amanye amangqamuzana aphethwe yi-tumor angase aphendule kwesinye isidakamizwa kanti abanye bangabe besabela kakhulu kwesinye isidakamizwa.
- Ucwaningo lwakamuva lubuye lubheke izindlela zokusebenzisa imithi yokwelapha i-chemotherapy ingasetshenziswa ukuvumela oncologists ukuba basebenzise ezinye izidakamizwa ngamanani aphansi, ngakho-ke ukunciphisa amathuba okuba nemiphumela emibi.
Ngokwenza njalo, ukusebenzisa i-chemotherapy ehlangene ne-kansa eminingi kuye kwafunyanwa ukuthuthukisa ukusinda, noma kubangela impendulo engcono ukwelashwa.
Ukungalungi
Ezinye izinkinga ezingase zihlangane zihlanganisa:
- Ukwanda okwenziwe ngamakhemikhali e- chemotherapy -.Ukuthi ngaphandle kwanoma yisiphi isikhathi imithi eminingi isetshenziswa cishe ukuthi imiphumela emibi izokwenzeka.
- Ukulukhuni ukwazi ukuthi imuphi umuthi obangele umphumela othile - Uma isiguli senza umphumela ohlangothini uma kusetshenzwa imithi eminingana, kungase kube nzima ukwazi ukuthi yimiphi imithi enesibopho.
- Ukusebenzisana kwezidakamizwa - Ngezinye izikhathi imiphumela emibi ingenzeki ngenxa yemithi ethile, kodwa ngenxa yokuphendula phakathi kwemithi.
- Ukuqoqwa kwemiphumela emibi - Isibonelo, uma usebenzisa izidakamizwa ezimbili ezenza ukuba amangqamuzana egazi amhlophe ahlasele, ingozi ye -neutropenia eyenziwa ngamakhemikhali (inani elincishisiwe lohlobo lwamhlophe egazi elibizwa ngokuthi i-neutrophils) landa.
Izibonelo
Kunezinhlanganisela eziningi zemithi ye-chemotherapy esetshenziselwa izinhlobo ezahlukene zomdlavuza. Isibonelo somdlavuza wamaphaphu usebenzisa inhlanganisela yePlatinol (cisplatin) ne-Navelbine (vinorelbine) ukuphatha umdlavuza ongasona omncane wamaphaphu.
Ngezinye izikhathi isichazamazwi sisetshenziselwa ukuchaza i-chemotherapy ehlangene. Isibonelo esisodwa yi- ABVD yesifo sikaHodgkin esimele ukuhlanganiswa kwemithi yokwelapha i-Adriamycin (doxorubicin), i-Blenoxane (i-bleomycin), i-Oncovin (i-vinblastine) ne-DTIC-Dome (dacarbazine).
Ukubhekana
Yazi kahle imiphumela ejwayelekile ye-chemotherapy nemiphumela emibi yesikhathi eside ye-chemotherapy , kodwa khumbula ukuthi izindlela zokulawula lezi zimpawu ziye zathuthuka ngokuphawulekayo eminyakeni yamuva. Isibonelo, abantu abaningi abasabhekene nesicashu nokuhlanza ngisho nezidakamizwa ezingase zidale lezi zimpawu.
Ukwenza izinsuku phakathi kwe-chemo uhambe kancane kancane, hlola uhlu olubalulekile lwalokho okuzopakisha for chemotherapy .
Imithombo:
UDelbaldo, C., Michiels, S., Syz, N. et al. Izinzuzo zokufaka imithi kumuntu oyedwa-Agent noma 2-Agent Chemotherapy Regimen in Advanced Non-Small-Cell-Lung Cancer Ukuhlaziywa. I-JAMA . 2004. 292 (4): 470-484.
DeVita, V. no-E. Chua. Umlando weCanscer Chemotherapy. Ucwaningo lweCans . 2008. 68: 8643.
Hu, M., Huang, P, Wang, Y., Su, Y., Zhou, L., Zhu, X., no D. Yan. Ukuhlanganiswa kwe-Synergistic Chemotherapy ye-Camptothecin ne-Floxuridine nge-Self-Assembly of Amphiphilic Drug-Drug Conjugate. I-Bioconjugate Chemistry . 2015. 26 (12): 2497-506.
Zimmermann, G. et al. Imithi yokwelashwa eminingi: uma konke kunkulu kunani lezingxenye. Ukutholakala kwezidakamizwa Namuhla . 2007. 12 (1-2): 34-42.