Mitundu / fupa / wodwala / ewing-treatment-pdq

Kuchiza Chithandizo cha Sarcoma

Zambiri Zokhudza Ewing Sarcoma

MFUNDO ZOFUNIKA

• Ewing sarcoma ndi mtundu wa chotupa chomwe chimakhala m'mafupa kapena minofu yofewa.

• Sarcoma yozungulira yosasiyananso imathanso kupezeka m'mafupa kapena minofu yofewa.

• Zizindikiro za Ewing sarcoma zimaphatikizapo kutupa ndi kupweteka pafupi ndi chotupacho.

• Kuyesa komwe kumafufuza fupa ndi minofu yofewa kumagwiritsidwa ntchito pozindikira komanso kuyambitsa Ewing sarcoma.

• Chidziwitso chimachitika kuti mupeze Ewing sarcoma.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira).

Ewing sarcoma ndi mtundu wa chotupa chomwe chimakhala m'mafupa kapena minofu yofewa.

Ewing sarcoma ndi mtundu wa chotupa chomwe chimapangidwa kuchokera ku mtundu wina wa khungu m'mafupa kapena minofu yofewa. Ewing sarcoma imapezeka m'mafupa a miyendo, mikono, mapazi, manja, chifuwa, mafupa a msana, msana, kapena chigaza. Ewing sarcoma imapezekanso munthupi zofewa za thunthu, mikono, miyendo, mutu, khosi, retroperitoneum (kumbuyo kwa mimba kumbuyo kwa minofu yomwe imayala khoma la m'mimba ndikuphimba ziwalo zonse m'mimba), kapena madera ena.

Ewing sarcoma imakonda kwambiri achinyamata komanso achinyamata (achinyamata mpaka pakati pa 20s).

Ewing sarcoma yatchedwanso zotumphukira zoyambira neuroectodermal chotupa, Askin chotupa (Ewing sarcoma ya chifuwa khoma), extraosseous Ewing sarcoma (Ewing sarcoma mu minofu kupatula fupa), ndi Ewing sarcoma banja la zotupa.

Sarcoma yozungulira yosasiyananso imathanso kupezeka m'mafupa kapena minofu yofewa.

Sarcoma yozungulira yopanda tanthauzo nthawi zambiri imapezeka m'mafupa kapena minofu yomwe imalumikizidwa ndi mafupa ndipo imathandizira thupi kusuntha. Pali mitundu iwiri yosasiyanitsidwa yozungulira cell sarcoma yomwe imathandizidwa ngati Ewing sarcoma:

• Sarcoma yozungulira yosasiyanitsidwa ndi BCOR-CCNB3 yokonzanso. Mtundu uwu wa chotupa nthawi zambiri umapangidwa m'chiuno, mikono, kapena miyendo. Itha kufalikira mbali zina za thupi. Mumtundu wa cell sarcoma wozungulira, mtundu wa BCOR umalumikizidwa ndi jini la CCNB3. Kuti mupeze cell cell sarcoma, zotupa zimayang'anitsitsa kusintha kwa jini.

• Sarcoma yozungulira yosasiyanitsidwa ndi ma CIC-DUX4 obwezeretsanso. Mtundu wa chotupacho chimakhala mu thunthu, mikono, kapena miyendo. Amakonda kwambiri amuna ndi achinyamata azaka zapakati pa 21 ndi 40. Mumtundu wa cell sarcoma wozungulira, mtundu wa CIC umalumikizidwa ndi jini la DUX4. Kuti mupeze cell cell sarcoma, zotupa zimayang'anitsitsa kusintha kwa jini.

Zizindikiro za Ewing sarcoma zimaphatikizapo kutupa ndi kupweteka pafupi ndi chotupacho.

Izi ndi zizindikilo zina zimatha kuyambitsidwa ndi Ewing sarcoma kapena zovuta zina. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Ululu ndi / kapena kutupa, nthawi zambiri mmanja, miyendo, chifuwa, kumbuyo, kapena m'chiuno.

• Bulu (lomwe limamverera lofewa komanso lotentha) m'manja, miyendo, chifuwa, kapena m'chiuno.

• Kutentha thupi popanda chifukwa chodziwika.

• Fupa lomwe limathyoka popanda chifukwa chodziwika.

Kuyesa komwe kumafufuza fupa ndi minofu yofewa kumagwiritsidwa ntchito pozindikira komanso kuyambitsa Ewing sarcoma.

Ndondomeko zomwe zimapanga zithunzi za mafupa ndi minofu yofewa ndi madera oyandikira zimathandizira kudziwa Ewing sarcoma ndikuwonetsa momwe khansara yafalikira. Njira yomwe amagwiritsidwa ntchito pofufuza ngati maselo a khansa afalikira mkati ndi mozungulira mafupa ndi minofu yofewa kapena mbali zina za thupi amatchedwa staging.

Kukonzekera chithandizo, ndikofunikira kudziwa ngati khansara yafalikira mbali zina za thupi. Kuyesa ndi njira zodziwira, kuzindikira, ndi gawo la Ewing sarcoma nthawi zambiri zimachitika nthawi yomweyo.

Mayesero ndi njira zotsatirazi zitha kugwiritsidwa ntchito pofufuza kapena poyambitsa Ewing sarcoma:

• Kuwunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza kuyang'ana ngati pali matenda, monga zotupa kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• MRI (magnetic resonance imaging): Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, komanso kompyuta kuti ipange zithunzi zingapo za malo amkati mwa thupi, monga dera lomwe chotupacho chidapangika. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

Kujambula kwamaginito (MRI) pamimba. Mwanayo wagona patebulo lomwe limalowa mu sikani ya MRI, yomwe imatenga zithunzi zamkati mwa thupi. Pedi pamimba pamwana limathandizira kuti zithunzizo zizimveka bwino.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga dera lomwe chotupacho chidapangidwa kapena chifuwa, chotengedwa mbali zosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

Kusanthula kwam'mimba kwa kompyuta. Mwanayo wagona patebulo lomwe limadutsa pa scanner ya CT, yomwe imatenga zithunzi za x-ray zamkati mwamimba.

• PET scan (positron emission tomography scan): Njira yopezera maselo oyipa mthupi. Gulu laling'ono la shuga (radio) limabayidwa mumtsempha. Chojambulira cha PET chimazungulira thupi ndikupanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo otupa owopsa amawonekera pachithunzichi chifukwa amakhala otanganidwa ndipo amatenga shuga wambiri kuposa momwe maselo amachitira. Kujambula kwa PET ndi CT scan nthawi zambiri kumachitika nthawi yomweyo. Ngati pali khansa, izi zimawonjezera mwayi woti zipezeke.

Kusanthula kwa Positron emission tomography (PET). Mwanayo wagona patebulo lomwe limadutsa pa makina a PET. Kupuma kwamutu ndi kansalu koyera kumathandiza mwanayo kugona. Kagawidwe kakang'ono ka shuga (radio) kamene kamabayidwa mu mtsempha wa mwanayo, ndipo sikaniyo imapanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo a khansa amawonekera bwino pachithunzichi chifukwa amatenga shuga wambiri kuposa momwe maselo amachitira.

• Kujambula mafupa: Njira yowunika ngati pali magawo omwe amagawa mwachangu, monga maselo a khansa, m'mafupa. Katundu wocheperako kwambiri wa jakisoni amalowetsedwa mumtsempha ndikuyenda m'magazi. Zinthu zowononga nyukiliya zimasonkhanitsa m'mafupa omwe ali ndi khansa ndipo imadziwika ndi sikani.

Kujambula mafupa. Katundu wambiri wama radio amabayidwa mumitsempha ya mwana ndikuyenda m'magazi. Zinthu zakuthupi zimasonkhanitsa m'mafupa. Mwanayo akugona patebulo lomwe limayenda pansi pa sikani, zida zowulutsa ma radio zimapezeka ndipo zithunzi zimapangidwa pakompyuta.

• Kulakalaka kwa mafupa ndi biopsy: Kuchotsa mafupa ndi kachigawo kakang'ono ka fupa poika singano yopanda kanthu m'chiuno. Zitsanzo zimachotsedwa m'chiuno chonse. Dokotala akuwona mafupa ndi mafupa pansi pa microscope kuti awone ngati khansayo yafalikira.

Kukhumba kwamfupa ndi mafupa. Gawo laling'ono la khungu litachita dzanzi, singano ya m'mafupa imalowetsedwa m'fupa la mwana m'chiuno. Zitsanzo zamagazi, mafupa, ndi mafupa amachotsedwa kuti zikaunikidwe ndi microscope.

• X-ray: X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi ndikulowa mufilimu, ndikupanga chithunzi cha madera omwe ali mthupi, monga chifuwa kapena malo omwe chotupacho chidapangidwira.

• Kuwerengera kwathunthu kwa magazi (CBC): Njira yomwe magazi amatengedwa ndikuwunika zotsatirazi:

• Chiwerengero cha maselo ofiira, maselo oyera amwazi, ndi ma platelet.

• Kuchuluka kwa hemoglobin (puloteni yomwe imanyamula mpweya) m'maselo ofiira amwazi.

• Gawo la magazi lomwe limapangidwa ndi maselo ofiira.

• Maphunziro a chemistry yamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina, monga lactate dehydrogenase (LDH), yotulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda.

Chidziwitso chimachitika kuti mupeze Ewing sarcoma.

Zitsanzo zamatenda zimachotsedwa panthawi yolemba kuti ziwonedwe pansi pa microscope ndi wodwala kuti aone ngati ali ndi khansa. Ndizothandiza ngati biopsy ikuchitikira pamalo omwewo komwe akaperekedwe chithandizo.

• Zosakaniza za singano: Pogwiritsa ntchito singano, minofu imachotsedwa pogwiritsa ntchito singano. Zolemba zamtunduwu zitha kuchitika ngati kuli kotheka kuchotsa zitsanzo zamatenda zazikulu zokwanira kuti zingayesedwe.

• Zowonongeka: Pogwiritsa ntchito khungu, khungu la minofu limachotsedwa kudzera mu khungu.

• Chidwi chodabwitsa: Kuchotsa chotupa chonse kapena gawo la mnofu lomwe silikuwoneka bwino.

Akatswiri (pathologist, radiation oncologist, ndi dotolo) omwe amathandizira wodwalayo nthawi zambiri amagwira ntchito limodzi kuti asankhe malo abwino oti ayike singano kapena biopsy incision. Kusankhidwa kwa tsambalo ndikofunikira. Tsamba la biopsy lomwe silinasankhidwe moyenera limatha kuchititsa opaleshoni yayikulu kuchotsa chotupacho kapena malo akulu omwe amathandizidwa ndi mankhwala a radiation.

Ngati pali mwayi kuti khansara yafalikira ku ma lymph node apafupi, ma lymph node amodzi kapena angapo amatha kuchotsedwa ndikuwunika ngati ali ndi khansa.

Mayesero otsatirawa akhoza kuchitika pa minofu yomwe yachotsedwa:

• Kusanthula kwa cytogenetic: Kuyesa kwa labotale komwe ma chromosomes am'maselo amtundu wa minofu amawerengedwa ndikuwunika ngati pali kusintha kulikonse, monga kusweka, kusowa, kukonzedwanso, kapena ma chromosomes owonjezera. Kusintha kwa ma chromosomes ena kungakhale chizindikiro cha khansa. Kusanthula kwa cytogenetic kumagwiritsidwa ntchito kuthandizira kuzindikira khansa, kukonzekera chithandizo, kapena kudziwa momwe chithandizo chikuyendera.

• Immunohistochemistry: Kuyesa kwa labotale komwe kumagwiritsa ntchito ma antibodies kuti aone ngati ali ndi ma antigen (zolembera) muzitsanzo za minofu ya wodwala. Ma antibodies nthawi zambiri amalumikizidwa ndi enzyme kapena utoto wa fulorosenti. Ma antibodies atagwirizana ndi antigen inayake munthawi ya minofu, enzyme kapena utoto umayambitsidwa, ndipo antigen imatha kuwonedwa ndi microscope. Mayeso amtunduwu amagwiritsidwa ntchito pothandiza kuzindikira khansa ndikuthandizira kudziwa khansa yamtundu wina wa khansa.

• Flow cytometry: Kuyesa kwa labotale komwe kumayeza kuchuluka kwa maselo munzitsanzo, kuchuluka kwa maselo amoyo pachitsanzo, ndi mawonekedwe ena amamaselo, monga kukula, mawonekedwe, ndi kupezeka kwa zotupa (kapena zina) pamwamba pa khungu. Maselo ochokera pagazi la wodwalayo, m'mafupa, kapena minofu ina amadetsedwa ndi utoto wa fulorosenti, amaikidwa mumadzimadzi, kenako nkuwudutsa kamodzi mwa kuwala. Zotsatira zakuyesa zimadalira momwe maselo omwe adadetsedwa ndi utoto wa fluorescent amatengera kuwala kwa kuwala.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira).

Zinthu zomwe zimakhudza matenda opatsirana (mwayi wochira) ndizosiyana asanalandire chithandizo komanso pambuyo pake.

Asanapatsidwe chithandizo chilichonse, kudandaula kumadalira:

• Kaya chotupacho chafalikira kumatenda am'mimba kapena mbali zakutali za thupi.

• Komwe mthupi mudayamba chotupacho.

• Kaya chotupacho chimapangidwa mufupa kapena minofu yofewa.

• Chotupacho chimakhala chachikulu chotani chotupacho chikapezeka.

• Kaya chotupacho chinayambitsa mafupa osweka.

• Kaya kuchuluka kwa LDH m'magazi ndikokwera kuposa kwachibadwa.

• Kaya chotupacho chili ndi majini ena amasintha.

• Kaya wodwalayo ndi wochepera zaka 15.

• Kugonana kwa wodwalayo.

• Kaya wodwalayo adalandira khansa ina.

• Kaya chotupacho chapezeka kumene kapena chachitika (kubwerera).

Pambuyo pa chithandizo, chithandizo chamankhwala chimakhudzidwa ndi:

• Kaya chotupacho chinachotsedwa kwathunthu ndi opaleshoni.

• Kaya chotupacho chimayankha chemotherapy kapena radiation radiation.

Ngati khansara ibweranso mutalandira chithandizo choyambirira, kudandaula kumadalira:

• Kaya khansayo idabweranso kupitilira zaka ziwiri atalandira chithandizo choyambirira.

• Kaya khansayo idabwerera pomwe idayamba kapena mbali zina za thupi.

Magawo a Ewing Sarcoma

MFUNDO ZOFUNIKA

• Zotsatira zakuyesa ndikuwonetsa magawo amagwiritsidwa ntchito kuti apeze ngati maselo a khansa afalikira.

• Ewing sarcoma imafotokozedwa kuti ndiyomwe imakhalapo, metastatic, kapena yokhazikika.

• Malo otchedwa Ewing sarcoma

• Metastatic Ewing sarcoma

• Sarcoma Yomwe Ikubwera

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Zotsatira zakuyesa ndikuwonetsa magawo amagwiritsidwa ntchito kuti apeze ngati maselo a khansa afalikira.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yafalikira kuchokera pomwe idayambira kupita mbali zina za thupi imatchedwa staging. Palibe njira zofananira za Ewing sarcoma. Zotsatira za mayeso ndi njira zomwe zachitika kuti azindikire komanso kuyambitsa Ewing sarcoma amagwiritsidwa ntchito pofotokoza zotupazo ngati zam'deralo kapena zam'thupi.

Ewing sarcoma imafotokozedwa kuti ndiyomwe imakhalapo, metastatic, kapena yokhazikika.

Ewing sarcoma imafotokozedwa kuti ndiyomwe imakhalapo, metastatic, kapena yokhazikika.

Malo otchedwa Ewing sarcoma

Khansara imapezeka m'mafupa kapena minofu yofewa pomwe idayambira ndipo mwina idafalikira kumatenda oyandikira, kuphatikiza ma lymph node apafupi.

Metastatic Ewing sarcoma

Khansara yafalikira kuchokera ku fupa kapena minofu yofewa pomwe idayamba kupita mbali zina za thupi. Mu Ewing chotupa cha mafupa, khansa nthawi zambiri imafalikira m'mapapu, mafupa ena, ndi mafupa.

Sarcoma Yomwe Ikubwera

Khansara yabwereranso (kubwerera) itatha. Khansara imatha kubwereranso m'mafupa kapena minofu yofewa pomwe idayambira kapena gawo lina la thupi.

Pali njira zitatu zomwe khansa imafalikira mthupi.

Khansa imatha kufalikira kudzera mu minofu, ma lymph system, ndi magazi:

• Minofu. Khansara imafalikira kuchokera pomwe idayamba ndikukula kupita kumadera oyandikana nawo.

• Lymph dongosolo. Khansara imafalikira kuchokera pomwe idayamba polowa m'mitsempha. Khansara imadutsa m'mitsempha yamafuta kupita mbali zina za thupi.

• Magazi. Khansara imafalikira kuchokera pomwe idayamba ndikulowa m'magazi. Khansara imadutsa m'mitsempha yamagazi kupita mbali zina za thupi.

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa ikafalikira mbali ina ya thupi, imatchedwa metastasis. Maselo a khansa amachoka pomwe adayamba (chotupa choyambirira) ndikuyenda mumitsempha kapena magazi.

• Lymph dongosolo. Khansara imalowa mumitsempha, imadutsa m'mitsempha yamafuta, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

• Magazi. Khansara imalowa m'magazi, imadutsa m'mitsempha yamagazi, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

Chotupa cha metastatic ndi khansa yofanana ndi chotupa chachikulu. Mwachitsanzo, ngati Ewing sarcoma imafalikira m'mapapu, maselo a khansa m'mapapu alidi Masamba a sarcoma. Matendawa ndi metastatic Ewing sarcoma, osati khansa yamapapo.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha ana omwe ali ndi Ewing sarcoma.

• Ana omwe ali ndi swingoma ya Ewing ayenera kukonzekera kukonzekera ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandiza khansa kwa ana.

• Chithandizo cha Ewing sarcoma chingayambitse mavuto.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Chemotherapy

• Thandizo la radiation

• Opaleshoni

• Chemotherapy yamphamvu kwambiri yopulumutsa maselo am'madzi

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo chofuna

• Chitetezo chamatenda

• Odwala angaganize zopita nawo kukayezetsa.

• Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha ana omwe ali ndi Ewing sarcoma.

Pali mitundu ingapo yamankhwala othandizira ana omwe ali ndi Ewing sarcoma. Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba.

Chifukwa khansa mwa ana ndi achinyamata ndiyosowa, kutenga nawo mbali pakuyesa kwachipatala kuyenera kuganiziridwa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Ana omwe ali ndi swingoma ya Ewing ayenera kukonzekera kukonzekera ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandiza khansa kwa ana.

Chithandizo chidzayang'aniridwa ndi oncologist wa ana, dokotala yemwe amadziwika bwino pochiza ana omwe ali ndi khansa. Ocologist wa ana amagwira ntchito ndi ena othandizira zaumoyo omwe ndi akatswiri pochiza ana omwe ali ndi Ewing sarcoma komanso omwe amakhazikika m'malo ena azamankhwala. Izi zingaphatikizepo akatswiri awa:

• Dokotala wa ana.

• Opaleshoni ya oncologist kapena mafupa oncologist.

• Wofufuza oncologist.

• Katswiri wa namwino wa ana.

• Wogwira ntchito.

• Katswiri wokonzanso.

• Katswiri wa zamaganizo.

Chithandizo cha Ewing sarcoma chingayambitse mavuto.

Kuti mumve zambiri zamankhwala oyambilira omwe amayamba mukalandira chithandizo cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Zotsatira zoyipa za mankhwala a khansa omwe amayamba atalandira chithandizo ndikupitilira kwa miyezi kapena zaka amatchedwa zotsatira zakuchedwa. Zotsatira zakumapeto kwa chithandizo cha khansa zitha kuphatikizira izi:

• Mavuto athupi.

• Kusintha kwa malingaliro, malingaliro, kuganiza, kuphunzira, kapena kukumbukira.

• Khansa yachiwiri (mitundu yatsopano ya khansa). Odwala omwe amathandizidwa ndi Ewing sarcoma ali ndi chiopsezo chowonjezeka cha matenda a khansa ya myeloid ndi myelodysplastic syndrome. Palinso chiopsezo chowonjezeka cha sarcoma m'dera lomwe limathandizidwa ndi mankhwala a radiation.

Zotsatira zina mochedwa zimatha kuthandizidwa kapena kuwongoleredwa. Ndikofunika kulankhula ndi madotolo a mwana wanu zamankhwala omwe khansa imatha kukhala nawo pamwana wanu. (Onani chidule cha pa Zotsatira Zotsiriza za Chithandizo cha Khansa ya Ana kuti mumve zambiri.)

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika m'matumbo a cerebrospinal, chiwalo, kapena thupi monga pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera). Kuphatikiza kwa chemotherapy ndi chithandizo chogwiritsa ntchito mankhwala opatsirana ambiri opatsirana khansa.

Njira yothandizirana ndi chemotherapy ndi njira yothandizira odwala onse omwe ali ndi zotupa za Ewing. Nthawi zambiri amalandira chithandizo choyamba ndipo amakhala pafupifupi miyezi 6 mpaka 12. Chemotherapy nthawi zambiri imaperekedwa kuti muchepetse chotupacho musanachite opareshoni kapena mankhwala a radiation ndikupha ma cell am'mimba omwe atha kufalikira mbali zina za thupi.

Onani Mankhwala Ovomerezeka a Soft Tissue Sarcoma kuti mumve zambiri.

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Thandizo la radiation lakunja limagwiritsidwa ntchito kuchiza Ewing sarcoma.

Thandizo la radiation limagwiritsidwa ntchito ngati chotupacho sichingachotsedwe ndi opaleshoni kapena pamene opareshoni yochotsa chotupacho ingakhudze magwiridwe antchito amthupi kapena momwe mwanayo adzawonekere. Itha kugwiritsidwa ntchito kupangitsa chotupacho kukhala chocheperako ndikuchepetsa kuchuluka kwa minofu yomwe imayenera kuchotsedwa pakuchita opaleshoni. Itha kugwiritsidwanso ntchito kuthana ndi chotupa chilichonse chomwe chimatsalira pambuyo pochitidwa opaleshoni ndi zotupa zomwe zafalikira mbali zina za thupi.

Opaleshoni

Opaleshoni nthawi zambiri imachitika kuti muchotse khansa yomwe yatsala pambuyo pa chemotherapy kapena radiation radiation. Ngati n'kotheka, chotupa chonsecho chimachotsedwa ndi opaleshoni. Minofu ndi mafupa omwe amachotsedwa amatha kulowetsedwa ndi zomatira, zomwe zimagwiritsa ntchito minofu ndi mafupa otengedwa kuchokera ku gawo lina la thupi la wodwalayo kapena woperekayo. Nthawi zina amagwiritsa ntchito chomera, monga fupa lopangira.

Dokotala atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoniyi, odwala ena atha kupatsidwa chemotherapy kapena radiation pochita opaleshoni kuti aphe maselo aliwonse a khansa omwe atsala. Chithandizo chomwe chimaperekedwa pambuyo pa opareshoni, kuti muchepetse chiopsezo kuti khansa ibwererenso, amatchedwa adjuvant therapy.

Chemotherapy yamphamvu kwambiri yopulumutsa maselo am'madzi

Mlingo waukulu wa chemotherapy umaperekedwa kuti uphe ma cell a khansa. Maselo athanzi, kuphatikiza maselo opanga magazi, nawonso amawonongedwa ndi chithandizo cha khansa. Kuika timitengo tating'onoting'ono ndi chithandizo m'malo mwa maselo omwe amapanga magazi. Maselo otchedwa stem cells (maselo a magazi osakhwima) amachotsedwa m'magazi kapena m'mafupa a wodwalayo kapena woperekayo ndipo amaundana ndi kusungidwa. Wodwalayo akamaliza chemotherapy, maselo osungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi. Chemotherapy yokhala ndi tsinde lopulumutsa imagwiritsidwa ntchito pochizira Ewing sarcoma yakomweko.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Gawo lachiduleli likufotokoza zamankhwala omwe akuwerengedwa m'mayesero azachipatala. Sizingatchule chithandizo chilichonse chatsopano chomwe akuphunzira. Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo chofuna

Chithandizo choyenera ndi chithandizo chomwe chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti zisokoneze njira zomwe ma cell a khansa amafunika kukula ndikukula. Mitundu yamankhwala omwe amalimbana ndi khansa yachilendo yaubwana ndi awa:

• Thandizo la monoclonal antibody: Ma antibodies a monoclonal amapangidwa mu labotale kuchokera ku mtundu umodzi wamatenda amthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino zomwe zingathandize ma cell a khansa kukula. Ma antibodies amalumikizana ndi zinthuzo ndikupha ma cell a khansa, amalepheretsa kukula kwawo, kapena amalepheretsa kufalikira. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Ganitumab ikuwerengedwa pochiza metastatic Ewing sarcoma.

• Kinase inhibitor therapy: Kinase inhibitors ndi mankhwala omwe amaletsa puloteni yofunikira kuti maselo a khansa agawanike. Akuwerengedwa kuti azichiza Ewing sarcoma.

• NEDD8-activating enzyme (NAE) inhibitor therapy: NAE inhibitors ndi mankhwala omwe amalumikizana ndi NAE ndikuletsa maselo a khansa kuti asagawike. Pevonedistat akuwerengedwa pochiza Ewing sarcoma.

Chitetezo chamatenda

Immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo cha mthupi cha wodwalayo kuthana ndi khansa. Zinthu zomwe thupi limapanga kapena zopangidwa mu labotale zimagwiritsidwa ntchito kukulitsa, kuwongolera, kapena kubwezeretsa chitetezo chamthupi cha khansa. Chithandizo cha khansa choterechi chimatchedwanso biotherapy kapena biologic therapy.

• Thandizo lothanirana ndi chitetezo cha mthupi : Ma anti-checkpoint inhibitors amaletsa mapuloteni ena opangidwa ndi maselo amthupi, monga T cell, ndi ma cell ena a khansa. Mapuloteniwa amathandiza kuteteza mayankho a chitetezo cha mthupi ndipo amatha kuteteza ma T maselo kuti asaphe maselo a khansa. Mapuloteniwa atatsekedwa, "mabuleki" omwe amateteza chitetezo amamasulidwa ndipo ma T cell amatha kupha ma cell a khansa bwino. Nivolumab ndi ipilimumab ndi mitundu ya ma immune blockpoint inhibitors omwe amaphunziridwa kuti athetse Ewing sarcoma.

• Mankhwala a Chimeric antigen receptor (CAR) T-cell Therapy: CAR T-cell therapy ndi mtundu wa immunotherapy womwe umasintha ma cell a wodwalayo (mtundu wama chitetezo amthupi) kuti athe kuwononga mapuloteni ena omwe ali pamwamba pa maselo a khansa. Maselo a T amachotsedwa kwa wodwalayo ndipo ma receptors ena apadera amawonjezedwa pamwamba pa labotore. Maselo osinthidwa amatchedwa chimeric antigen receptor (CAR) T maselo. Maselo a CAR T amakula mu labotore ndipo amapatsidwa kwa wodwalayo pomulowetsa. Maselo a CAR T amachulukana m'magazi a wodwalayo ndikuukira ma cell a khansa. Chithandizo cha CAR T-cell chikuwerengedwa pochiza Ewing sarcoma.

Chithandizo cha CAR T-cell. Mtundu wa chithandizo momwe ma T cell a wodwala (mtundu wa chitetezo chamthupi) amasinthidwa mu labotore kotero amamangiriridwa ndi ma cell a khansa ndikuwapha. Magazi ochokera mumthambo wadzanja la wodwalayo amayenda kudzera mu chubu kupita kumakina a apheresis (osawonetsedwa), omwe amachotsa maselo oyera, kuphatikiza ma T, ndikutumiza magazi otsalawo kwa wodwalayo. Kenako, jini la cholandirira chapadera lotchedwa chimeric antigen receptor (CAR) imalowetsedwa m'maselo a T mu labotale. Maselo a CAR T mamiliyoni amakula mu labotore ndipo amapatsidwa kwa wodwalayo pomulowetsa. Maselo a CAR T amatha kumangiriza antigen pamaselo a khansa ndikuwapha.

Odwala angaganize zopita nawo kukayezetsa.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.

Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.

Mayeso otsatirawa angafunike.

Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati matenda a mwana wanu asintha kapena ngati khansa yabwereranso (kubwerera). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Njira Zothandizira Kuchiza Ewing Sarcoma

M'chigawo chino

• Ewing Sarcoma Yopezeka Kwapafupi

• Metastatic Ewing Sarcoma

• Ewing Sarcoma Yobwereza

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Ewing Sarcoma Yopezeka Kwapafupi

Mankhwala ochiritsira a Ewing sarcoma am'derali ndi awa:

• Chemotherapy.

• Opaleshoni ndi / kapena radiation radiation.

• Chemotherapy yamphamvu kwambiri yopulumutsa maselo am'madzi.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Metastatic Ewing Sarcoma

Mankhwala ochiritsira a metwing a Ewing sarcoma ndi awa:

• Chemotherapy.

• Opaleshoni.

• Thandizo la radiation.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Ewing Sarcoma Yobwereza

Palibe mankhwala ochiritsira a Ewing sarcoma omwe amapezeka koma zosankha zake zitha kukhala izi:

• Kuphatikiza chemotherapy.

• Thandizo la radiation kwa zotupa za mafupa, monga mankhwala ochepetsa nkhawa kuti athetseretu kusintha komanso kukhala ndi moyo wabwino.

• Thandizo la radiation lomwe lingatsatidwe ndikuchitidwa opaleshoni kuchotsa zotupa zomwe zafalikira m'mapapu.

• Chemotherapy yamphamvu kwambiri yopulumutsa maselo am'madzi.

Njira zochiritsira zomwe zikuwerengedwera ku Ewing sarcoma zimaphatikizapo izi:

• Kuyang'ana chotupa cha wodwalayo kuti majini ena asinthe. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Chithandizo choyenera ndi tyrosine kinase inhibitor (cabozantinib).

• Immunotherapy yokhala ndi chitetezo cha chitetezo cha mthupi (nivolumab kapena ipilimumab).

• Chithandizo cha T-cell cha Chimeric antigen receptor (CAR).

• Chithandizo chojambulidwa ndi NEDD8-activating enzyme inhibitor (pevonedistat) ndi chemotherapy.

• Kuyesedwa kwachipatala kwamtundu watsopano wamankhwala omwe akhudzidwa.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe Zambiri Zokhudza Ewing Sarcoma

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza Ewing sarcoma, onani izi:

• Tsamba Loyambira Khansa Yam'mafupa

• Computed Tomography (CT) Zithunzi ndi Khansa

• Njira Zochizira Khansa

• Khansa Yam'mafupa

Kuti mumve zambiri za khansa yaubwana ndi zina zothandiza za khansa, onani izi:

• Za Khansa

• Khansa Za Ana

• Cure Search for Cancer ya Ana Tulukani Chodzikanira

• Zotsatira Zochedwetsa Khansa Yaana

• Achinyamata ndi Achinyamata Achikulire ndi Khansa

• Ana omwe ali ndi khansa: Upangiri wa Makolo

• Khansa mwa Ana ndi Achinyamata

• Kusinthana

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira