Kubantu abaningi namuhla, i-chemotherapy ibhekisela kuhlobo lwe-cytotoxic, noma i-cell-killing, imithi esetshenziselwa ukwelapha umdlavuza. Nokho, ekuqaleni, i-chemotherapy yayiyisikhathi esakhiwe yisazi samakhemikhali saseJalimane uPaul Ehrlich, owawusebenzisa ukusho nje ukuthi ukusetshenziswa kwamakhemikhali okwelapha isifo. Ngakho-ke, "i-chemotherapy" ingafaka noma yikuphi okuvela emithini yama-antibiotic noma ngisho nemithi yokwelapha yemvelo, njengoba iqukethe amakhemikhali futhi isetshenziselwa ukwelapha izifo.
Namuhla, abanye bacabangela " imithi yokwelashwa ehloselwe " kulabo abanemiphumela emibi kakhulu. Kodwa-ke, ngokuvamile kuvame ukuthi lezi zindlela zokwelapha ezintsha zisetshenziselwa ngokuhambisana ne-chemotherapy ejwayelekile, hhayi yedwa. Futhi, nakuba izidakamizwa ezithintekayo ezingathinti umzimba aziphazamisi umzimba ngendlela efanayo nama-standard chemotherapy agents, angabangela imiphumela emibi. Amaseli e-Cancer angase abe ne-receptor noma ihlose elithile kunezingqamuzana ezinempilo - okuhloswe ngezindlela zokwelashwa ngokuqinisekile kungasebenzisa - kodwa amangqamuzana aphilile angase ahlaselwe.
I-Magic Bullet
Ukwelashwa komdlavuza omuhle kungaba into enjenge-bullet bullet, futhi ngenxa yezibi eziningi, ukwelashwa okuhle akukatholakali. Ekupheleni kwe-1800 nasekuqaleni kwe-1900, ososayensi baqala ukufunda ngezibhaktheriya kanye nezimbangela ezithathelwanayo zezifo. UPaul Ehrlich wayengudokotela osebenza nama-bacteria, futhi wayekholelwa ukuthi, njengoba angaphazamisa amabhaktheriya futhi abone ngaphansi kwe-microscope, kufanele futhi akwazi ukuhlasela lezi zifo uma engathola ikhemikhali eyozihlanganisa negciwane futhi ukuyibulala, ukushiya konke okungahambi kahle.
Wabiza amakhemikhali anjalo 'ama-magic bullets.'
Namuhla, sinezinguqulo zalezi zinhlamvu zemilingo ezibizwa ngokuthi ama-antibiotics, kodwa ngisho nemithi emibi kakhulu yama-antibiotic ingase ibe nemiphumela emibi - noma embi nakakhulu, ingabangela ukusabela okuyingozi kwabanye abantu okuthiwa i-hypersensitivity. Lokhu akusho ukuyeka ukucabanga komlingo wamagic, noma kunjalo.
Ukuphumelela ngokuhambisana nobuthakathaka
Ngeshwa, eziningi zokwelashwa zomdlavuza eziphumelelayo nazo zihlotshaniswa nobuthi obukhulu. Amaseli e-Cancer avame ukuvela ezivamile, amangqamuzana aphilile aqoqe amaphutha - okuholela ekukhuleni okungalawulwayo. Zihlukile ngokwanele kusuka kumaseli avamile ukuthi odokotela bangasebenzisa imithi ukulimaza ngokweqile amaseli omdlavuza ngokukhulu kunamaseli anempilo, kodwa amanye amangqamuzana anempilo ayathinteka njalo; lezi zidakamizwa zisekelwa iziguli futhi zilawulwa odokotela, ngenhloso yokubulala amangqamuzana omdlavuza nokuzama ukwandisa impilo yomuntu.
Ngezinye izikhathi kukhona ubudlelwane obuqondile phakathi kokwanda okuqhubekayo nokulwa nomdlavuza nokwandisa ubuthi. Ngakolunye uhlangothi, ososayensi abahlaziya imiphumela yezilingo zomtholampilo bahlale bebheke amaphuzu lapho ukwandisa umthamo wesidakamizwa akukhiqizi lutho kodwa kuhlotshaniswa nobuthakathaka obukhulu. Izikhathi eziningi, kuyisenzo sokulinganisela odokotela neziguli abazenza ndawonye - okuhloswe ukuphumelela okukhulu ngezinga lobuhlungu obamukelekayo, ukuze kutholakale inzuzo yesikhathi eside.
Iziguli ezigugile
Nakuba kungase kube okwesabekayo kwabaningi, ezinye izilingo zomdlavuza zisebenzisa iminyaka engama-60-65 njengesiyingi seziguli "asebekhulile".
Ngokusobala, igama elikhulile lingaba yisikhathi esiphezulu njengabantu abathile kulabo abaneminyaka engama-80 no-90 abasenempilo engcono kunabantu abaningi abaneminyaka emashumi eminyaka. Nokho, njengoba sikhula, sivame ukuthuthukisa izimo zempilo ezingapheli, njengengcindezi ephezulu yegazi. Futhi izinso zethu azivame ukuphumelela ekuhlungeni igazi lethu njengoba bekade bekhona. Ngenxa yalezi zizathu nangezinye izici ezihlukahlukene, ikhono lethu lokubekezelela i-chemotherapy eqinile, ngokwesilinganiso, akuyona into eneminyaka engu-85 ubudala njengoba kungenzeka ukuthi yayineminyaka engu-20.
Ukusabalalisa i-B-cell lymphoma enkulu (i-DLBCL) nezinye izinhlobo zomdlavuza kungavamile kubantu abakhulile eminyakeni.
Ngempela, isibalo sabantu abaneminyaka engama-80 noma ngaphezulu abane-B-cell engeyona i-Hodgkin lymphoma (B-NHL) esandisiwe esimweni semitholampilo. Imishanguzo yokwelapha ye-DLBCL kubantu abasha ifanisiwe noma ihlelwe, okungenani okwamanje. Imizamo yokwandisa isenzo sokulinganisela phakathi kokusebenza kahle nobuthi kuyenzeka manje kubantu asebekhulile, futhi.
Ubuthi Obuncane
Iqembu labantu ososayensi abawaziwayo emhlabeni jikelele ucwaningo lwe-lymphoma - i-Groupe d'Etude des Lymphomes de l'Adulte (GELA) - bahlolisisa lo mbuzo kubantu abane-DLBCL abaneminyaka engu-80 kuya ku-95 ubudala. Bahlose ukuphenya ukuphumelela nokuphepha umthamo we- CHOP (i-doxorubicin, i-cyclophosphamide, i-vincristine, ne-prednisone) i-chemotherapy ne-dosejwayelekile ye-rituximab - i-monoclonal anti-cell anti targeting cells ene-CD20 'tag' - kwiziguli ezindala ezine-DLBCL.
Kuze kube manje, eminyakeni emibili edlule, imiphumela ikhuthaze, futhi iqokomisa 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.
Izivivinyo eziqhubekayo zibuye zihlolisise umbuzo wokuthi ngabe ama-inhibitors omusha wokuzivikela omzimba kanye nezinqubo ezithintekayo angahlanganiswa yini ukuze anciphise ubuthi ngenkathi ephathwa ngomdlavuza kuziguli ezigugile.
Imithombo
I-Peyrade F, Jardin F, Thieblemont C, et al. Abaphenyi be-Groupe d'Etude des Lymphomes de l'Adulte (GELA). Ukunciphisa imithi ye-immunochemotherapy (R-miniCHOP) kwiziguli asebekhulile emdala kuneminyaka engama-80 nge-B-cell lymphoma enkulu ehlukanayo: i-multi-centrere, ingalo eyodwa, isigaba sesivivinyo sesi-2. I-Lancet Oncol . 2011; 12 (5): 460-8.
Iioka F, Izumi K, Kamoda Y, et al. Imiphumela yeziguli ezindala kakhulu nge-B-cell engeyona i-Hodgkin lymphoma ephathwa nge-dose chemotherapy. I-Int J Clin Oncol. 2015 Okthoba 13. [I-Epub ngaphambi kokuphrinta]
Imithi esekelwe eSayensi. https://www.sciencebasedmedicine.org/chemotherapy-doesnt-work-not-so-fast-a-lesson-from-history/. Ifinyelele ngoJanuwari 2016.
Ukuhlola Umlando Wezokwelapha. I-Magic Bullet. Ifinyelele ngoJanuwari 2016.