Iyiphi impela ukwelashwa kwe-proton yegciwane lomdlavuza wamaphaphu ? Ngabe lolu hlobo lwezokwelapha lusetshenziswa nini, yiziphi izinzuzo nezinzuzo ezihlobene nezinye izifo, futhi yimiphi imiphumela emibi?
Uphi Ukwelashwa Kwe-Proton Beam?
Abantu abangaphezu kwesigamu abanomdlavuza wamaphaphu banalo uhlobo oluthile lwe- radiation therapy njengokwelapha kweproton ngesikhathi sokuhamba kwabo. Ukwelashwa kwama-radial okuvamile kusebenza ngokuletha amandla aphezulu x-ray ku-tumor. Ngokuphambene nalokho, ukwelashwa kwe-proton isisindo esinika amandla ngendlela yama-protons (izinhlayiya ezithweswe kahle) endaweni yesikhumba ezizobhujiswa.
I-accelerator ye-particle isetshenziselwa ukukhulisa amandla adingekayo ukukhiqiza la ma-proton. Ngenxa yendleko kanye nendawo okudingekayo ukuze i-accelerator yezinhlayiyana, kuphela izikhungo zemithi yomdlavuza zinikeza lokhu ukwelashwa e-United States nasemhlabeni jikelele.
Ukwelashwa Kweproton Beam Kusebenza Kanjani?
Njengoba kuphawuliwe ngenhla, ukwelashwa kwe-proton ye-british isebenza ngokushaya ibhomu ngesibalo ngokuchofoza izinhlayiya ezithintekayo ezibizwa ngokuthi i-protons. Amaprotoni wona, abangela ukulimala ekuphatheni kwezesisindo zamangqamuzana omdlavuza emzimbeni, okuholela ekufeni kwamangqamuzana omdlavuza.
Indlela yakamuva ye-proton yokwelashwa kwe-proton, eyaziwa ngokuthi ukuskena kwepensela ye-pencil, isebenzisa ukuskena kwendawo ukuze ithumele imifudlana yama-proton emuva nangemva ngokusebenzisa isisu.
Ukwelashwa Kwe-Proton Beamhlukana Kanjani Nezokwelapha Ezivamile?
Kokubili ukwelashwa kwama-radial okuvamile kanye nokwelashwa kwe-proton ukugcoba kunqunywe futhi kulawulwa yi-oncologist yemisebe, isazi somdlavuza ogxila ekwelapheni umdlavuza ngemisebe.
Ngokungafani nokwelashwa kwemisebe evamile, ukwelashwa kwe-proton beamgogodla kugxile endaweni eqondile yezicubu. Lokhu kuhanjiswa okugxile kungavumeli kuphela ukukhululeka kwemisebe okumele kusetshenziswe kodwa kubangele ukulimala okuncane kumathishu aseduze angenawo umdlavuza. Ukulimala kwezicubu ezinempilo eduze kwesikhumba kubangelwa eminye yemiphumela emibi, kufaka phakathi neminye imiphumela emibi yesikhathi eside efana nokuthuthukiswa kwamagciwane wesibili (ukwelashwa okubangelwa ukwelashwa komdlavuza oyinhloko).
Enye yezinzuzo ezinkulu kunazo zonke zokwelashwa kwe-proton yegridi iyakwazi ukuyisebenzisa izicubu eziseduze nezinhlaka ezibucayi, okungenza ukuhlinzwa kunzima noma akunakwenzeka. Ukwelashwa kwe-proton yegridi kungasetshenziswa nalabo abangase bazuze emithini yokwelashwa kwemisebe kodwa sebevele bathola imisebe evamile.
Ngabe Ukwelapha Kwe-Proton Beam Kusetshenziselwa I-Cancer Lung?
Kunezizathu ezimbalwa ezahlukahlukene zokuthi kungani ukwelashwa kwe-proton kwe-proton kunganconywa kulabo abanomdlavuza wamaphaphu. Ngesifo somdlavuza wamaphaphu ekuqaleni , esingenakuphathwa ngokuhlinzwa komdlavuza wamaphaphu , ukwelashwa kwe-proton ibhethri kungaba yindlela yokukhetha.
I-tumor yamaphaphu ingase ingasebenzi ngenxa yendawo yomdlavuza eduze kwezakhiwo ezibalulekile, noma ngenxa yezimo zezokwelapha ezenza ukuhlinzwa kube yingozi kakhulu. Kulesi simo, ukwelashwa okunye okubizwa ngokuthi i- stereotactic body radiotherapy (SBRT) ingasetshenziswa futhi. Zombili lezi zinqubo zinikeza inani eliphakeme lemisebe endaweni encane nendawo yendawo yezicubu. Kokubili ukwelashwa kwe-proton ye-proton kanye ne-SBRT ingahle isetshenziswe ngenhloso yokunciphisa.
Ukwelashwa kwe-proton yegridi kungase kube yindlela yokukhetha abantu abaye baphinde bahlaselwa umdlavuza wamaphaphu kodwa sebevele benemithi yokwelashwa.
Ukwelashwa kwe-proton ye-british ngokuvamile akunconywa kubantu abanomdlavuza wamapapu ophakeme , njengesigaba 3B nesisu se-4. Njengokuhlinzwa, amagciwane amaphaphu ethuthukile ngokuvamile aphathwa kangcono ngezinye izindlela zokwelashwa ezifana ne-chemotherapy, imithi ehlosiwe, noma i- immunotherapy .
Imiphumela Ephakathi Nengcindezi Ekhona
Njengawo wonke ukwelashwa komdlavuza, imiphumela emibi ingenzeka. Imiphumela emibi eminingi ifana nemiphumela emibi yelashwa ejwayelekile yomuthi futhi ihlanganisa:
- Ubomvu kwesikhumba esifubeni (imisebe ye-dermatitis.)
- Ukukhathala.
- I-radiation pneumonitis: I- radiation pneumonitis ibhekisela ukuvuvukala kwemaphaphu ahlobene nokwelashwa. Iyakwelapha kakhulu (ngokuvamile nge-steroids) kodwa kubalulekile ukukhuluma nodokotela wakho nganoma yisiphi ukukhwehlela, ushintsho ekuphefumuleni kwakho, noma ukuphefumula ukuze ukuhlolwa kwenziwe.
- Ukulahlekelwa izinwele okuhlala njalo esifubeni.
Imiphumela emibi yesikhathi eside kanye nezinkinga ze-proton zokwelashwa kwegciwane akuzona ngokucacile njengoba ukwelashwa kuqhathaniswa nokuqhathaniswa nezinye izinhlobo zokwelapha imisebe. Imiphumela emibi yesikhathi eside yokwelashwa kwemisebe esifubeni ingabandakanya i-pulmonary fibrosis (ukuqeda amaphaphu okuqala njengemisebe ye-pneumonitis engashiywa ingelashwa), ukwelashwa okuyisithupha (umdlavuza obangelwa umonakalo wezinto ezifuywayo ezakhiweni zamangqamuzana avamile ukwelashwa), futhi isifo senhliziyo (kuhlanganise nesifo se-valve, isifo somzimba we-coronary, isifo senhliziyo, kanye nesimo senhliziyo esingavamile) lapho kutholakala imisebe ngakwesokunxele kwesifuba. Ngokwemfundiso, le miphumela emibi kufanele ingajwayelekile kangako kunezokwelapha zokwelashwa ezivamile ngenxa yomonakalo owenziwe ukunciphisa izicubu ezivamile, kodwa maduzane ukwazi ngokuqinisekile.
Ngokwelapha okujwayelekile kwemishanguzo yomdlavuza wamaphaphu, ukubhema kungenza ukwelashwa kungasebenzi kahle futhi kwandise imiphumela emibi. Ukwelashwa kwe-proton yegciwane kungathinteka nokubhema. Uma ubhema, qiniseka ukuthi ufunda ngezizathu zokuthi kungani ukuyeka ukubhema kubalulekile ngemuva kokuthola ukuthi unomdlavuza .
Ukuba ne-Proton Beam Therapy-Ukulungiselela, Isikhathi, Nokulandelela
Ukwelashwa kwe-proton kwe-borrow kunikelwa nsuku zonke ngezinsuku zamasonto ukuvakashelwa okungu-30 okuzungezile. Inombolo yokuvakashelwa ingaba yinde noma ifushane kuncike kumdlavuza wakho.
Ngaphambi kokuba ukwelashwa kweproton ukuqaliswa, uzoba nokuqokwa kokulungiselela kanye ne-oncologists yakho. Izindlela zenziwe ngezingqinamba ezifana ne-CT scan ukuze kuchaze ngokunembile indawo okufanele ihanjiswe.
Kufanele uhlele kuze kube ihora ukuvakashelwa ngalunye, nakuba ukwelashwa kwemisebe ngokwayo kuthatha isikhathi esifushane. Uzocelwa ukuba ucindezeleke futhi uzofakwa efayilini lakho ekufakeni ukuvakasha. Idivayisi izokwenziwa ngesikhathi sokuqokwa kwakho kokuqala kokuhlela.
Ngemuva kokuthi usuqedile konke ukwelashwa kwakho, uzolandela nge-oncologist yakho yezokwelapha. Ukulandwa kokulandelela ngaleso sikhathi kuzokwenziwa ukuze ubone ukuthi ukwelashwa kweproton kwasebenza kanjani. Izikrini zingenziwa futhi ngenkathi uthola ukwelashwa kwakho uma unezimpawu ezimbi kakhulu.
Imibuzo Yokubuza I-Radiation Oncologist Yakho
Ukuze uqonde kangcono ukwelashwa kwe-proton yegciwane futhi unqume ukuthi kukulungile yini, kuyasiza ukuba nohlu lwemibuzo njengoba uxhumana nama-oncologists akho emisebeni. Lokhu kufaka:
- Kungani ukhuthaza lokhu ukwelashwa?
- Zikhona yini ezinye izindlela zokwelapha ezingase ziphumelele?
- Iyini izindleko zokwelashwa? Ingabe umshuwalense uzofihla ukwelashwa kwami noma ngizobe ngizikhokhela ngezindleko?
- Zingaki zokwelashwa engizodinga ukuba nazo zonke? Kungani?
- Uma kufanele uhambe ngezinyango zakho, cela umhlengikazi wakho oncology noma omunye ochwepheshe kumdlavuza wakho ukuthi yiziphi izinketho zokulala ezikhona. Ezinye izikhungo zomdlavuza, njengeMayo Clinic eRochester, Minnesota, zinezindleko ezincishisiwe noma ngisho mahhala.
- Yimiphi imiphumela emibi engingayilindela?
- Iziphi ezinye iziguli zakho ezikushoyo ngezokwelapha?
- Bangaki abantu oye waphatha nge-proton yokwelashwa kwesibhamu?
- Ungase ufise ukubuza i-oncologist yakho yezokwelapha ukuthi yimuphi ukwelashwa okungase kunconywe ngokulandelayo uma ukwelashwa kwe-proton kube yinto engasebenzi.
Izwi elivela
Ukwelashwa kwe-proton ye-prostramu kuyindlela entsha yokwelashwa engase isetshenziswe kwabanye abantu abanomdlavuza wamaphaphu. Ijwayele ukusetshenziselwa umdlavuza wesifo samangqamuzana omncane ongasencane, okungenzeka uphulukiswe, kodwa endaweni enzima ukufinyelela ngokuphepha ngokuhlinzeka noma uma umuntu onesimo sezokwelapha esibeka ingozi yokuhlinzwa.
Umphumela ovame ukwedlula wonke ukukhathala, kodwa kunomuzwa wokuthi imiphumela emibi ingase ibekezeleleke kakhulu kunezokwelapha zokwelashwa ezivamile, ikakhulukazi ngezinhlobo ezintsha zelashwa leproton njenge-pencil bridge scanning.
Njengoba kunenani elilinganiselwe lezindawo lapho le nqubo ingenziwa khona, kungase kube nzima kwabanye abantu abahlala kude nalezi zikhungo, ikakhulukazi uma ukwelashwa kuyadingeka nsuku zonke amasonto ambalwa.
Ngesikhathi samanje, kukhona ukuphikisana okuthile ngenzuzo yangempela ye-proton yokwelashwa kwegciwane okwenziwe izindleko. Ukwelashwa kwe-proton yegoli kungabiza okungenani kabili njengokuthelela kwe-radiation, futhi izindleko zezindlu, ukuhamba, kanye nokusebenza isikhathi kulabo okufanele bahambe bangaba phezulu. Cabangela zonke izici zokwelapha ngaphambi kokukhetha okulungile kuwe.
> 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.