Ukukhuliswa kwemisipha yomdlavuza wesifuba kubonakala sengathi kuyini -a "umthamo owengeziwe" wama-radiation owenziwe ngemuva kokuthi imihlangano evamile yemisebe igcwaliswe. Ake sihlole le nqubo ekwelapheni umdlavuza webele, kufaka phakathi ucwaningo ngemuva kokusebenza kwayo, kanye nemiphumela emibi engaba khona.
Incazelo ye-Radiation Boost
Umdlavuza wesibeletho uvame ukwelashwa ngokuhlinzwa, kungaba i- lumpectomy noma i- mastectomy .
Ngaphandle kokuhlinzwa, ezinye izindlela zokwelapha zinganikezwa, njengokwelashwa kwemishanguzo , okuyinto yokwelapha ngemisebe enamandla kakhulu noma izinhlayiyana ezibulala amangqamuzana omdlavuza. Uhlobo oluvame kakhulu lwe-radiation therapy olunikezwa ngemva kwe-lumpectomy (ebizwa ngokuthi ukuhlinzwa kwesifuba) yi-radiation yangaphandle yesibhamu se-whole breast (ebizwa ngokuthi i-irradiation yonke ye-breast).
Ngemuva kokuthi zonke izikhathi zakho zokwelashwa ze-irradiation zebele ziphelile, ukukhuliswa kwemisebe kuyasetshenziswa, njengendlela yokuvimbela ukuphindaphindiwe (umdlavuza webele usabuya).
Ngokuqondile, ukukhuliswa kwemisebe kuhlanganisa eyodwa noma ngaphezulu yokwelashwa okubhekiswe embhedeni we-tumor, okuyingxenye encane yezincuba zesifuba lapho umdlavuza wokuqala wasuswa khona. Umbhede wezinambuzane uhloswe ngoba yiyona ndawo cishe lapho umdlavuza webele uzobuyela khona.
Le nsizakalo yokukhushulwa ehlosiwe inikezwa, isebenzisa umshini ofanayo njengalowo osetshenziselwa ukukhipha lonke isifuba, kodwa usebenzisa inani eliphansi lemisebe.
Kubalulekile ukuphawula ukuthi umbhede we-tumor uhlonishwa kakhulu ngesikhathi se-lumpectomy yowesifazane. Yingakho iziqeshana zokuhlinzwa zingabekwe ngesikhathi sokuhlinzwa, njengoba lezi ziqeshana zisiza ithimba lakho le-oncology libheke ukugxilongwa kwe-radiation.
Umphumela we-Radiation Boostation on Breast Cancer Recurrence and Survival
Ucwaningo luye lwabonisa ukuthi abesifazane abathinteka ukushisa imisebe banomdlavuza omncane wendawo wendawo, uma kuqhathaniswa nabesifazane abangenayo amandla.
Ukwengeza, ukunciphisa ukuphindaphinda kubaluleke kunabesifazane abaneminyaka engama-50 noma encane abatholwa ukuthi bane- ductal carcinoma in situ (DCIS).
Lokhu kusho ukuthi, nakuba ukukhuliswa kwemisebe kunciphisa kakhulu ingozi yokuphindaphinda umdlavuza webele (okuthiwa inzuzo ekulawuleni kwendawo), akubonakali ukuthi inomphumela ekusindeni jikelele (eminyakeni engama-20 emva kokulashwa).
Imiphumela emibi yeSikhathi Esifishane Sesikhathi Esikhunjulwa Nesikhashana
Ukuvuthwa kwemisebe ngokuvamile kuvame ukubekezelela kahle, kuthwala imiphumela efanayo njengoba yonke imisebe yesifuba, njengokukhathala, ukuvuvukala kwesifuba, nokuguquka kwesikhumba, njengokubomvu, ukugcoba, nokwehliswa kwesikhumba.
Lokho kusho, ngokwemiphumela yesikhathi eside, i- radiation fibrosis yebele ingase ivele. Eqinisweni, ucwaningo oluthile lwathola ukuthi uma kuqhathaniswa nabesifazane abangazange bathuthukise imishanguzo, labo abenzayo babe engozini enkulu yokwenza ngcono i-fibrosis yebele.
Okubalulekile lapha ukuthi ukubonakala kwesifuba kungase kube kubi nakwabesifazane ababhekana nokuthuthukiswa kwemisebe ngokungafani nalabo abangazange-nakuba, ucwaningo olusekela lokhu okutholayo alunamandla.
Izwi elivela
Ngokufingqa, kulabo besifazane abahlinzwa ngokubeletha okulandelwa yizinyolo ezilandelwa yi-irradiation yonke yebele, ukuthuthukiswa kwemisebe kuhloswe ukuvimbela ukuphindaphinda umdlavuza webele emasimini.
Leli dose elikhushulayo lisho ukuthi umthamo owengeziwe wemisebe unikezwa phezu kwesayithi lokuqala lezinsalela, lapho ubuncane obungabonakali khona) kungase kufihlwe.
Nakuba ukuthuthukiswa kwemisebe kungatholakali ekuthuthukiseni ukusinda okujwayelekile kwabesifazane abanomdlavuza wesifuba, kunciphisa ingozi yokuphindaphinda, ngenzuzo enkulu kunayo yonke ebonwayo kwabesifazane abasebasha.
> Imithombo:
> Bartelink H et al. I-irradiation ephelele yebele noma ngaphandle kokuqiniswa kweziguli ezithinteka ngokuhlinzwa kokubelethwe kwesisu ngenxa yomdlavuza webele webele: ukulandelwa kweminyaka engu-20 kwesilingo sesigaba esilandelayo. I-Lancet Oncol . 2015 Jan; 16 (1): 47-56.
> Franco, P., Cante, D., Sciacero, P. et al. Ukulala kwe-Tumor Ukukhuthaza Ukuhlanganiswa ngesikhathi sonke se-Breast Radiotherapy: Ukubukezwa kobufakazi bamanje. Ukunakekelwa kwebele . 2015. 10 (1): 44-9.
> Amaphethini I, Laenen A, Depuydt T, Weltens C, Ukukhulelwa kombhede we-bedroost radiotherapy kwabesifazane emva kokuhlinzwa kokubeletha kwebele. Cochrane Databse Syst Rev. 2017 Nov 6; 11: CD011987.
> Moran, M., Schnitt, S., Giuliano, A. et al. Umhlangano Wokuhlinzeka Nge-Oncology-American Society for Radiation Oncology isiqondiso sokubambisana emaphethini ekuhlinzekwa kwebele ngokulondolozwa kwe-breast-breast irradiation ngezigaba I no-II zihlasela umdlavuza webele, Amanals of Oncology Yokuhlinzwa . 2014. 21 (3): 704-16.
> Vrieling C et al. Izici zokubikezela zokulawulwa kwendawo emdlalweni wesibeletho sebele ngemva kokulandela isikhathi eside ku-EORTC Boost no-No Boost Trial: Isivivinyo Sengqondo Esingahleliwe. I-JAMA i-Oncol . 2017 Jan 1; 3 (1): 42-48.