I-R-CHOP yigama elifingqiwe lokuhlanganiswa kwezidakamizwa ezivame ukusetshenziswa njenge-chemotherapy yezinye izinhlobo zomdlavuza, njenge- non-Hodgkin lymphomas, noma i-NHLs . Incwadi ngayinye e-R-CHOP imelela izidakamizwa ezihlukile, kodwa lesi sihloko singase sidideke ngokuthi isidakamizwa esisodwa sinamagama angaphezu kwelilodwa:
R = Rituximab
C = i-Cyclophosphamide
H = Doxorubicin Hydrochloride (Hydroxydaunomycin)
O = Vincristine Sulfate (Oncovin)
P = i-Prednisone
I-Rituximab i-antibody eqondiswa ngokumelene ne-CD20 antigen, iphrotheni etholakala kuma-bymymycyte B angaphambi kweB-B nevuthiwe. I-Rituximab ibangela ukuphendula kwamagciwane omzimba wesiguli ngokumelene nama-CD20-positive cells.
I-Cyclophosphamide ibizwa ngokuthi i-alkylating agent futhi inezo zombili zokulwa nomdlavuza nomsebenzi wokuvikela omzimba. Esibindi, i-cyclophosphamide iguqulwa ibe yi-metabolites ebopha i-DNA, ihlukumeza amangqamuzana ekwenzeni amakhophi e-DNA, futhi iqala ukufa kweseli.
I-Hydroxydaunomycin ifomu lokuguqula i-doxorubicin, eyaziwa ngokuthi i-anthracycline type antibiotic, futhi linomsebenzi wokulwa nomdlavuza.
I-Oncovin noma i-vincristine ibopha ezincane ezingxenyeni ezibizwa ngokuthi ama-microtubules futhi ziphazamise amandla okuhlukanisa amaseli.
I-Prednisone iyi-agent ye-steroid enezindawo zokulwa nokuvuvukala, futhi inezindlela eziningi ezihlukene zokwelapha. Ezinhlobonhlobo ezithile zesifo somdlavuza we-cancer, i-prednisone ingashukumisa ukufa kwe-cell program.
I-R-CHOP isetshenziselwa kabanzi kwi-non-Hodgkin lymphoma. Kungasetshenziswa yedwa, noma ingasetshenziswa kanye nezinye izidakamizwa noma ukwelashwa, noma ukuphatha ezinye izinhlobo zomdlavuza ngaphandle kwe-lymphoma. Ngokufanayo, izingxenye zomuntu ngamunye we-R-CHOP, njenge-rituximab, zingase zisetshenziswe yedwa kwezinye izidakamizwa nakwezinye iziguli, ukusiza ukuphatha izifo.
Okuningi ku-R-CHOP
Njengoba ulwazi lwezinhlobo ezahlukene ze-lymphomas landa, ososayensi bafunda ukuthi ama-subtypes ahlukene e-lymphoma efanayo angaphendula ngokuhlukile emgomweni owanikwa. Izivivinyo zemitholampilo zibheke ekusetshenzisweni kwamanye ama-agent, ngokubambisana no-R-CHOP, ngezinhlobonhlobo zezibi.
I-R-CHOP ibhekwa njengokwelashwa okujwayelekile kweyodwa yezinhlobo ezivame kakhulu ze-NHL, isakaza i-B-cell lymphoma enkulu , noma i- DLBCL . Uma ubheka i-NHL yonke, ama-akhawunti we-DLBCL amaphesenti angama-25 kuya kwangu-35 azo zonke izifo zokuhlola ezintsha emhlabeni wonke ngonyaka. I-R-CHOP ingasetshenziswa futhi kwezinye izimo ze-follicular lymphoma, ngokusho kwemihlahlandlela ka-2016 evela ku-National Comprehensive Cancer Network.
Kanjani I-Agent ngayinye Enikeziwe?
Imininingwane ye-regimen yonke, kubandakanya nokuthi kaningi kangakanani imithi ngayinye inikelwa, ngaphezu kwesikhathi sini, futhi lapho kulandelana khona, ingahluka ngokuya kwesifo esibulalayo, impendulo yesiguli, nodokotela noma izikhungo ezihilelekile.
- Ukulandelana kokunye kwemithi kubizwa njengomjikelezo, ngakho-ke ungase uzwe odokotela bekhuluma ngokuthi "kungakanani imijikelezo ka-R-CHOP" ehlelwe, isibonelo.
- Enye i-protocol ihilela ukuphathwa kwe-rituximab njenge-infusion ngaphezu kwamahora ambalwa ngosuku lokuqala lwezokwelapha, kuyilapho izidakamizwa ze-CHOP zizoqala ngosuku olulandelayo. Yonke inkambo ingahle iphindwe njalo ngemva kwamasonto amathathu ngezinyanga ezingu-6-8. Kodwa-ke, odokotela bezokwelapha namuhla bakhuluma "ngemigomo efana ne-CHOP," futhi, futhi kunezinhlobo ezihlukahlukene zezinhlelo ezidokotela ezingase zilandele ukuthi zisebenzisa le mithi.
Njengesibonelo sezinye zezimo ezivela ku-R-CHOP, into ebizwa ngokuthi i- "R - mini-CHOP" iyahlolwa. I-Groupe d'Etude des Lymphomes de l'Adulte (GELA) - iqembu lokucwaninga elinamagama amaningi aseFrance - lihlolisisa umbuzo wokunciphisa utshwala kubantu abane-DLBCL abaneminyaka engu-80 kuya ku-95 ubudala. Bahlose ukuphenya ukuphumelela nokuphepha kwehla umthamo we-CHOP (doxorubicin, cyclophosphamide, vincristine, kanye ne-prednisone) chemotherapy nge-dose ejwayelekile ye-rituximab - amangqamuzana e-monoclonal targeting antibody aphethe i-CD20 'tag' - kuziguli ezindala ezine-DLBCL.
Kuze kube manje, eminyakeni emibili ephuma, imiphumela ikhuthaze; futhi kugcizelela ukubaluleka kwezici zesiguli ngasinye kule nkathi yobudala.
Lapho isisindo semithi ephansi e-chemotherapy, noma i-"miniCHOP", isetshenziselwa ukusebenza kahle, kubonakala sengathi i-effectiveness ibonakala ingafaniswa neminyaka emibili kuya kwizinga elijwayelekile, kodwa ngezinga eliphansi elithinta izifo ezibhekiswe esibhedlela.
Imiphumela Ejwayelekile Ejwayelekile
Bobabili i-rituximab ne-CHOP banemiphumela emibi, futhi uhlu olugcwele lwemiphumela emibi engaphezu kwesikhala salesi sihloko samanje. Nazi ezimbalwa, ukhethe imiphumela emibi engaba khona, noma kunjalo:
- Ngokuvamile ulahlekelwa zonke izinwele ekhanda lakho. Izinwele emanzini nakwezinye izindawo zingase zibe mncane noma ziphume. Ukulahlekelwa izinwele kuvame ukuqala ngemva komjikelezo wokuqala noma wesibili we-chemotherapy, futhi cishe njalo okwesikhashana lapho izinwele zizokhula emva kokuba i-chemotherapy iphela.
- Ukucabangela nokuhlanza noma ukuzwa ugula kuvamile futhi kungenzeka ngokushesha ngemuva kokulashwa ezinsukwini ezintathu emva kokwelashwa.
- Ukuqokwa kungase kuphakame ngenxa ye-vincristine kanye neminye imithi enganikezwa nge-nausea nobuhlungu.
- Izilonda zomlomo zingase zivele ngemuva kwesikhashana ukwelashwa, futhi lokhu kungakwenza ube nokutheleleka emlonyeni wakho, ngakho-ke ukunakekelwa komlomo kubalulekile.
- I-R-CHOP ingathinta ikhono lakho lokukhulelwa noma ubaba ingane.
- Ungase ulungele ukutheleleka ngesikhathi ukwelashwa kwe-CHOP, ngakho-ke zama ukugwema ukuxhumana nabantu abanomkhuhlane noma umkhuhlane kanye nokugeza izandla njalo ukusiza ukusika ingozi yokuthola igciwane noma ukutheleleka.
- I-R-CHOP inganciphisa inani lamaplatelethi asiza igazi ukuba ligqoke, ngakho-ke qiniseka ukuthi utshele udokotela wakho uma unokulimaza noma ukuphaphaza awukwazi ukuchaza.
- I-Prednisone iyi-steroid futhi inemiphumela emibi eminingi engaba khona, kufaka phakathi ukushintsha kwemizwa, ukuzuza kwesisindo, nokuvuvukala.
> Imithombo:
> Offer F, Samoilova O, Osmanov E, et al. I-Frontline rituximab, i-cyclophosphamide, i-doxorubicin, ne-prednisone ne-bortezomib (i-VR-CAP) noma i-vincristine (R-CHOP) ye-non-GCB DLBCL. Igazi . 2015; 126 (16): 1893-1901.
> Eyre TA, uClafford R, uRoberts C, et al. Isandla esisodwa se-NCRI isigaba II se-CHOP ngokuhlanganiswa ne-Ofatumumab ekufakweni nasekugcineni iziguli ezine-syndrome esanda kutholakala. I-BMC Cancer. 2015; 15: 52.
> Bibas M, Castillo JJ. Ulwazi lwamanje nge-Plasmablastic Lymphoma ehlobene ne-HIV. I-Mediterr J Hematol I-Dis Infect. 2014; 6 (1): e2014064.