Cishe amaphesenti angu-1 azo zonke izidakamizwa zibandakanya i-thyroid, futhi umdlavuza we-thyroid uphindwe kathathu kubantu besifazane. Emazweni aseNtshonalanga anezinga elanele le-iodine emithonjeni yokudla, iningi eliphawulekayo lala khansela luhlobo lomdlavuza we-thyroid obizwa ngokuthi i- papillary thyroid carcinoma . Ngenhlanhla, kubantu abadala abane-papillary thyroid carcinoma, izidakamizwa ezikude azivamile.
Kodwa-ke, ama-metastases asekude-okuyinto ehambela uhlelo lokujikeleza (ukusakazeka kwegazi) nokuzingela kumasayithi a-anatomic afana ne-lung ne-bone-ajwayelekile kakhulu nomunye uhlobo lomdlavuza we -roid obizwa ngokuthi i- follicular thyroid carcinoma . Ngesabeka, ukuqubuzana okunjalo kungase kube uphawu lokubonisa! Ngeshwa, abanye balaba bantu abane-carlicoma ye-follicular ye-thyroid abahluleki ukuphendula i-radiotherapy (i-radioiodine) ngemva kokususwa kwe-thyroid. Kulezi ziguli ezineziguli ezinomqondo ophikisayo, umdlavuza we-thyth differentiation, i-lenvatinib yezidakamizwa (Lenvima) ingasiza. Inothi, i-lenvatinib ifika efomini ye-capsule.
Okungaphezulu Kokwehluka Kwegciwane Le-Thyroid
Kokubili i-carillaoma ye-papillary ne-follicular ye-thyroid ivela kumangqamuzana e-follicular epithelial ku-thyroid. Zitholwa yizinto ezihlukene zokwakha nezakhi zenuzi. Amaphesenti angamashumi ayisishiyagalolunye nesishiyagalolunye wegciwane lesifo se-thyroid ayingqayizivele engenalo ifa lomndeni elitholakalayo.
Imisebe yangaphandle iyona kuphela engcupheni yomdlavuza we -roid futhi ihlukanisa umdlavuza we-thyroid-ikakhulukazi umdlavuza wegciwane lesiguli-kodwa-ke, i-iodine ngokweqile noma ukungabi nalutho nakho kungadlala indima.
Ngomdlavuza we-thyroid, ama-nodules we-thyroid noma "izimpumputhe" ziyisifo esivela kakhulu sokwethulwa . Ngenxa yokuthi ama-nodules ezinjalo ngokuvamile "abanda" ku-scan ye-thyroid, ama-asple ama-aspiration amahle (uhlobo lwe-biopsy) yindlela enhle yokuxilonga lezi zicubu.
Ukuhlukana komdlavuza we-thyroid kuqala ukuphathwa ngokuhlinzwa, ubukhulu obuningi noma obuthakathaka-buphikisana futhi buxhomeke kokubandakanyeka kokubili i-thyroid ne-lymph nodes. Ezimweni zomdlavuza we-follicular we-thyroid (invastve distant), yonke i-thyroid kumele isuswe ukuze i-radioiodine ithathe.
Inothi, umdlavuza we -roid follicular uvame kakhulu kubantu abaneminyaka engama-50 no-60 ubudala, futhi uma usuqedile, izinga lokusinda iminyaka engu-10 yizingxenye ezingu-10. (Ngokuphelele, ngo-2014, abantu abangu-1 890 e-United States babulawa ngumdlavuza we-thyroid njengamanye.) Ngaphezu kwalokho, i-chemotherapy ayifaka ukusebenza kahle kulabo abane-carcinoma ye-thyroid.
Okuningi mayelana ne-Lenvatinib
Ngaphandle kokwenza okuqondile, i-lenvatinib yi-multitargeting tyrosine kinase inhibitor evimbela izindlela zamakhemikhali ezihilelekile ekukhuleni nasekugcineni kwesisu. Ngamanye amazwi, i-lenvatinib ivimbela ukukhula kwamangqamuzana omzimba okude kude ne-thyroid okuye yalahla ukwelashwa nge-iodine yama-radioactive.
NgoFebruwari 2015 emva kokubukeza imiphumela evela kuleso sivivinyo sesigaba sesi-3 somtholampilo, i-lenvatinib ye-FDA evunyelwe. Abacwaningi bahlolisisa abantu abangu-392 abanomdlavuza we-thyroid ohlukile owawuphikisana no-radioiodine. Ngokuqondile, i-lenvatinib yayiqondiswa kwabahlanganyeli abangu-261 kanti abangu-131 abahlanganyeli bathola indawo ye-placebo.
Okubalulekile, lolu cwaningo lwakhiwe nge-crossover eyenza abantu abanezinkinga zokuguqula ukushintsha kusuka endawenibo kuya lenvatinib. Ngenxa ye-crossover enjalo, abacwaningi abakwazi ukukhipha ukuthi i-lenvatinib yanda isikhathi esiningi sokusinda.
Kodwa-ke abacwaningi bakwazi ukufakazela ukuthi ukusinda okungahambisani nokuqhubeka kwamahora kwaba yizinyanga eziyi-18.3 eqenjini lokuhlola noma labo abathola i-lenvatinib ngokumelene nezinyanga ezingu-3.6 kulabo abaseqembu elilawulayo abathola i-placebo.
Amaphesenti angu-40 abathintekayo abathatha i-lenvatinib babhekana nemiphumela emibi, okuyizikhathi eziningi ezilawulwa ngokulungisa izilinganiso zomuthi.
Noma kunjalo, amaphesenti angu-14.2 abathintekayo athatha i-lenvatinib aphumile ekutadisheni, kanti ukufa kwabangu-6 kwabangu-20 okwenzeka ngesikhathi sokufunda kwenyanga engu-14 babhekwa njengobangela umuthi.
Ngokuqondile, nansi eminye yemiphumela emibi ye-lenvatinib:
- umfutho wegazi ophezulu (amaphesenti angu-67.8 wabathintekayo)
- isifo sohudo (59.4 amaphesenti abahlanganyeli)
- ukukhathala (abangamaphesenti angu-59 abahlanganyeli)
- ukunciphisa ukudla (amaphesenti angu-50.2 wabathintekayo)
- isisindo esinciphile (amaphesenti angu-46.4 abahlanganyeli)
- isicanucanu (amaphesenti angu-41.0 wabathintekayo)
Ngokuvamile, imiphumela evela kulolu cwaningo ikhombisa ukuthi kulabo abanomdlavuza we-thyroid ohluke kakhulu owenzela i-radiotherapy, i-lenvatinib ingamisa ukukhula komdlavuza. Uma wena noma othandekayo ephathwa nezifo ezinjalo ezibulalayo, okutholakele kwalolu cwaningo kuyakhuthaza. Kodwa-ke, ucwaningo olwengeziwe luzodingeka lwenziwe ukuze uthole ukuthi ubani odinga isidakamizwa, yiziphi izilinganiso eziphumelela kakhulu, nokuthi ngabe ukuyeka ukuqhubeka kuholela emgangathweni wokuphila okungcono. Phela, ngisho nemithi yokwelashwa ephumelela kakhulu ingasho lutho uma izinga lakho lokuphila libi kakhulu.
Imithombo:
Isihloko sencwadi ethi "Ukuhlukaniswa kwe-carcinoma ye-thyroid" e-O. Gimm noHr. Dralle kusukela ekuhlinzekeni okuhlinzekwayo: Ukufakazelwa kobufakazi nobunzima - okushicilelwe ngo-2001.
Isihloko esithi "Lenvatinib sithuthukisa ukusinda komdlavuza we-teatrogen" (Sicker) we- The Lancet eshicilelwe ngo-2015.
Isihloko esibizwa ngokuthi "Isibalo Sokuhlinza Ngokwehlukana Kwemdlavuza Wegciwane: Ikhombandlela Ephakanyisiwe" nguGa Rahman wase- Oman Medical Journal eshicilelwe ngo-2011.
Isihloko esithi "Lenvatinib ngokumelene ne-Placebo ku-Radioiodine Refractory Cancer Cancer" yi-M Shlumberger nabalobi ababambisene nabo abavela ku- NEJM enyatheliswa ngo-2015.