Mitundu / ubongo / wodwala / mwana-astrocytoma-treament-pdq

Kuchiza kwa Astrocytomas Childhood (®) -Patient Version

Zambiri Pazokhudza Ana Astrocytomas

MFUNDO ZOFUNIKA

• Childhood astrocytoma ndi matenda omwe amakhala osakhazikika (noncancer) kapena owopsa (khansa) m'matumba aubongo.

• Astrocytomas akhoza kukhala owopsa (osati khansa) kapena owopsa (khansa).

• Mitsempha yapakati imayang'anira ntchito zambiri zofunika mthupi.

• Zomwe zimayambitsa zotupa zambiri muubongo sizidziwika.

• Zizindikiro za ma astrocytomas sizofanana mwana aliyense.

• Kuyesa komwe kumayesa ubongo ndi msana kumagwiritsidwa ntchito kuzindikira (kupeza) ma astrocytomas aubwana.

• Ma astrocytomas aubwana nthawi zambiri amapezeka ndikuchotsedwa pakuchita opaleshoni.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Childhood astrocytoma ndi matenda omwe amakhala osakhazikika (noncancer) kapena owopsa (khansa) m'matumba aubongo.

Astrocytomas ndi zotupa zomwe zimayambira m'maselo abongo ooneka ngati nyenyezi otchedwa astrocyte. A astrocyte ndi mtundu wamtundu wamphongo. Maselo amadzimadzi amakhala ndi maselo amitsempha m'malo mwake, amabweretsa chakudya ndi mpweya kwa iwo, komanso amawathandiza kuwateteza ku matenda, monga matenda. Gliomas ndi zotupa zomwe zimapangidwa kuchokera m'maselo am'magazi. A astrocytoma ndi mtundu wa glioma.

Astrocytoma ndi mtundu wofala kwambiri wa glioma wopezeka mwa ana. Itha kupanga paliponse mkati mwa ubongo (ubongo ndi msana).

Chidulechi ndi chokhudza zotupa zomwe zimayamba mu ma astrocyte muubongo (zotupa zoyambirira zamaubongo). Zotupa zamaubongo zama metastatic zimapangidwa ndimaselo a khansa omwe amayambira mbali zina za thupi ndikufalikira kuubongo. Chithandizo cha zotupa zamaubongo zam'mimba sichinafotokozedwe pano.

Zotupa zamaubongo zimatha kupezeka mwa ana ndi akulu omwe. Komabe, chithandizo cha ana chingakhale chosiyana ndi chithandizo cha akulu. Onani zidule zotsatirazi za kuti mumve zambiri zamtundu wina wa zotupa zamaubongo mwa ana ndi akulu:

• Ubongo Waubwana ndi Spinal Cord Tumors Chithandizo Mwachidule

• Chithandizo cha Wamkulu Chapakati Manjenje

Astrocytomas akhoza kukhala owopsa (osati khansa) kapena owopsa (khansa).

Zotupa zaubongo wa Benign zimakula ndikusindikiza madera oyandikira aubongo. Nthawi zambiri zimafalikira m'matumba ena. Zotupa zamaubongo zoyipa zimatha kukula msanga ndikufalikira m'minyewa ina yaubongo. Chotupa chikamakula kapena kukanikiza malo amubongo, chimatha kuletsa gawo limenelo la ubongo kugwira ntchito momwe liyenera kukhalira. Zotupa zonse zaubongo komanso zoyipa zimatha kuyambitsa zizindikilo ndipo pafupifupi onse amafunikira chithandizo.

Mitsempha yapakati imayang'anira ntchito zambiri zofunika mthupi.

Astrocytomas amapezeka kwambiri m'magawo awa a CNS:

• Cerebrum: Mbali yayikulu kwambiri yaubongo, pamwamba pamutu. Cerebrum imayang'anira kulingalira, kuphunzira, kuthana ndi mavuto, kuyankhula, momwe akumvera, kuwerenga, kulemba, komanso kuyenda mwakufuna.

• Cerebellum: Mbali yakumunsi, yakumbuyo kwaubongo (pafupi ndi pakati pamutu). Tizilombo toyambitsa matenda timayendetsa kayendetsedwe kake, kayendedwe kake, ndi momwe timakhalira.

• Tsinde la ubongo: Gawo lomwe limalumikiza ubongo ndi msana, mbali yotsika kwambiri yaubongo (pamwambapa kumbuyo kwa khosi). Ubongo umayang'anira kupuma, kugunda kwa mtima, komanso mitsempha ndi minofu yomwe imagwiritsidwa ntchito pakuwona, kumva, kuyenda, kulankhula, ndi kudya.

• Hypothalamus: Malo omwe ali pakatikati paubongo. Imayang'anira kutentha kwa thupi, njala, ndi ludzu.

• Njira yowonera: Gulu la mitsempha yolumikiza diso ndi ubongo.

• Mphepete mwa msana: Mzere wa minyewa yomwe imachokera kuubongo imatsikira pakatikati pa msana. Imakutidwa ndi zigawo zitatu zoyonda zotchedwa nembanemba. Msana ndi nembanemba zimazunguliridwa ndi mafupa (kumbuyo mafupa). Mitsempha ya msana imanyamula mauthenga pakati pa ubongo ndi thupi lonse, monga uthenga wochokera kuubongo wopangitsa kuti minofu isunthe kapena uthenga wochokera pakhungu kupita kuubongo kuti umve kukhudza.

Anatomy yaubongo. Dera la supratentorial (kumtunda kwaubongo) limakhala ndi cerebrum, lateral ventricle ndi third ventricle (yokhala ndi cerebrospinal fluid yowonetsedwa mu buluu), choroid plexus, pineal gland, hypothalamus, pituitary gland, ndi optic nerve. Malo am'mbuyo a fossa / infratentorial (mbali yakumbuyo kwakubongo) imakhala ndi cerebellum, tectum, ventricle yachinayi, ndi tsinde laubongo (midbrain, pons, and medulla). The tentorium imasiyanitsa supratentorium ndi infratentorium (kumanja). Chigaza ndi meninja zimateteza ubongo ndi msana (kumanzere).

Zomwe zimayambitsa zotupa zambiri muubongo sizidziwika.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala wa mwana wanu ngati mukuganiza kuti mwana wanu akhoza kukhala pachiwopsezo. Zowopsa za astrocytoma ndi izi:

• Mankhwala am'mbuyomu a radiation kuubongo.

• Kukhala ndi zovuta zina zamtundu, monga neurofibromatosis mtundu 1 (NF1) kapena tuberous sclerosis.

Zizindikiro za ma astrocytomas sizofanana mwana aliyense.

Zizindikiro zimadalira izi:

• Kumene chotupacho chimapanga muubongo kapena msana.

• Kukula kwa chotupacho.

• Kutupa kumakula msanga.

• Msinkhu wa mwana ndi kukula.

Zotupa zina sizimayambitsa zizindikiro. Zizindikiro zimatha kuyambitsidwa ndi ma astrocytomas aubwana kapena zina. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Mutu wam'mawa kapena mutu womwe umatha pambuyo posanza.

• Nseru ndi kusanza.

• Masomphenya, kumva, ndi kulankhula.

• Kutayika bwino komanso kuyenda movutikira.

• Kukulitsa zolemba pamanja kapena kuyankhula pang'onopang'ono.

• Kufooka kapena kusintha kwakumverera mbali imodzi ya thupi.

• Kugona kwachilendo.

• Mphamvu yochulukirapo kuposa masiku onse.

• Sinthani umunthu kapena chikhalidwe.

• Kugwidwa.

• Kuchepetsa thupi kapena kunenepa popanda chifukwa chodziwika.

• Wonjezerani kukula kwa mutu (mwa makanda).

Kuyesa komwe kumayesa ubongo ndi msana kumagwiritsidwa ntchito kuzindikira (kupeza) ma astrocytomas aubwana.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuyeza kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone ngati pali thanzi labwino. Izi zimaphatikizapo 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.

• Kuyesa kwamitsempha: Mafunso ndi mayeso angapo owunika ubongo, msana, ndi kugwira ntchito kwa mitsempha. Mayesowa amawunika momwe munthu amaganizira, momwe amagwirira ntchito, komanso momwe angayendere bwino, komanso momwe minofu, mphamvu, ndi malingaliro zimagwirira ntchito. Izi amathanso kutchedwa mayeso a neuro kapena mayeso a neurologic.

• Kuyeza kwamasamba owonera: Kuyesa kuti muwone momwe munthu akuwonera (malo onse omwe zinthu zimawonedwa). Kuyesaku kumayang'ana masomphenya apakati (kuchuluka kwa momwe munthu angawonere poyang'ana kutsogolo) ndi masomphenya ozungulira (momwe munthu amatha kuwona mbali zonse kwinaku akuyang'ana patsogolo). Maso amayesedwa kamodzi. Diso lomwe silikuyesedwa limaphimbidwa.

• MRI (magnetic resonance imaging) yokhala ndi gadolinium: Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti ipange zithunzi zingapo zaubongo ndi msana. Chinthu chotchedwa gadolinium chimalowetsedwa mumtsempha. Gadolinium imasonkhanitsa mozungulira maselo a khansa kuti athe kuwonekera pachithunzichi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI). Nthawi zina maginito oyang'ana maginito (MRS) amachitika panthawi imodzimodziyo ya MRI kuti ayang'ane kapangidwe kake ka minyewa yaubongo.

Ma astrocytomas aubwana nthawi zambiri amapezeka ndikuchotsedwa pakuchita opaleshoni.

Ngati madokotala akuganiza kuti pakhoza kukhala astrocytoma, kafukufuku amatha kuchitapo kanthu kuti achotse minofu. Kwa zotupa muubongo, gawo lina la chigaza limachotsedwa ndipo singano imagwiritsidwa ntchito kuchotsa minofu. Nthawi zina, singanoyo imatsogozedwa ndi kompyuta. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa. Ngati maselo a khansa apezeka, adotolo amatha kuchotsa zotupa zambiri momwe angathere pochita opaleshoni yomweyo. Chifukwa zimakhala zovuta kudziwa kusiyana pakati pa mitundu ya zotupa zamaubongo, mungafune kuti mayeso a minofu ya mwana wanu ayang'anitsidwe ndi katswiri wazachipatala yemwe akudziwa bwino zotupa zaubongo.

Craniotomy: Chotsegula chimapangidwa ndi chigaza ndipo chidutswa cha chigaza chimachotsedwa kuti chiwonetse gawo laubongo.

Mayeso otsatirawa atha kuchitidwa paminyama yomwe idachotsedwa:

• 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. Chiyeso cha MIB-1 ndi mtundu wa immunohistochemistry womwe umayang'ana zotupa minofu ya antigen yotchedwa MIB-1. Izi zitha kuwonetsa momwe chotupa chikukula msanga.

Nthawi zina zotupa zimapanga malo omwe zimawavuta kuchotsa. Ngati kuchotsa chotupacho kungayambitse mavuto amthupi, amisala, kapena kuphunzira, chidziwitso chimachitika ndipo chithandizo chambiri chimaperekedwa pambuyo polemba.

Ana omwe ali ndi NF1 amatha kupanga astrocytoma yotsika kwambiri mdera laubongo lomwe limayang'anira masomphenya ndipo sangafunikire kuyika biopsy. Ngati chotupacho sichikupitilira kukula kapena zizindikilo sizikuchitika, opaleshoni yochotsa chotupacho singafunike.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Kaya chotupacho ndi cholembera chotsika kapena chapamwamba kwambiri cha astrocytoma.

• Komwe chotupacho chapangidwa mu CNS ndipo ngati chafalikira kumatenda apafupi kapena mbali zina za thupi.

• Kuthamanga chotupa kumakula.

• Msinkhu wa mwanayo.

• Kaya maselo a khansa amakhalabe pambuyo pochitidwa opaleshoni.

• Kaya pali kusintha kwa majini ena.

• Kaya mwanayo ali ndi NF1 kapena tuberous sclerosis.

• Kaya mwanayo ali ndi matenda a diencephalic (vuto lomwe limachedwetsa kukula kwakuthupi).

• Kaya mwanayo ali ndi matenda oopsa kwambiri (cerebrospinal fluid pressure mkati mwa chigaza ndiwokwera) panthawi yodziwitsa.

• Kaya astrocytoma yangopezekanso kapena yabwereranso (yabwerera).

Kwa astrocytoma yowonongeka, kuyerekezera ndi chithandizo kumadalira nthawi yochuluka yomwe yatha pakati pa nthawi yomwe chithandizo chinatha ndi nthawi yomwe astrocytoma inabwereranso.

Magawo Amwana Astrocytomas

MFUNDO ZOFUNIKA

• Gawo la chotupacho limagwiritsidwa ntchito pokonzekera chithandizo cha khansa.

• Ma astrocytomas otsika

• Ma astrocytomas apamwamba

• MRI imachitika pambuyo pa opaleshoni.

Gawo la chotupacho limagwiritsidwa ntchito pokonzekera chithandizo cha khansa.

Kuyika masitepe ndi njira yomwe imagwiritsidwa ntchito kuti mudziwe kuchuluka kwa khansa yomwe ilipo komanso ngati khansa yafalikira. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo.

Palibe njira yokhazikika ya astrocytoma yaubwana. Chithandizo chimachokera pa izi:

• Kaya chotupacho ndi chotsika kapena chapamwamba.

• Kaya chotupacho chapezeka kumene kapena chabwerezabwereza (wabweranso atalandira chithandizo).

Mulingo wa chotupacho umafotokozera momwe ma cell a khansa amawonekera modabwitsa ndi microscope komanso momwe chotupacho chimakula ndikufalikira mofulumira.

Magulu otsatirawa amagwiritsidwa ntchito:

Ma astrocytomas otsika

Ma astrocytomas otsika kwambiri amakula pang'onopang'ono ndipo samafalikira kumadera ena aubongo ndi msana wam'mimba kapena ziwalo zina za thupi. Pali mitundu yambiri yama astrocytomas otsika. Ma astrocytomas otsika kwambiri akhoza kukhala:

• Zotupa za Gulu I-pilocytic astrocytoma, chotupa chachikulu cha cell, kapena angiocentric glioma.

• Zotupa za Gulu Lachiwiri-zimafalitsa astrocytoma, pleomorphic xanthoastrocytoma, kapena choroid glioma wachitatu wa ventricle.

Ana omwe ali ndi mtundu woyamba wa neurofibromatosis atha kukhala ndi chotupa chopitilira chimodzi muubongo. Ana omwe ali ndi tuberous sclerosis ali ndi chiopsezo chowonjezeka cha subependymal giant cell astrocytoma.

Ma astrocytomas apamwamba

Ma astrocytomas apamwamba kwambiri amakula mofulumira ndipo nthawi zambiri amafalikira mkati mwa ubongo ndi msana. Pali mitundu ingapo yama astrocytomas apamwamba. Ma astrocytomas apamwamba akhoza kukhala:

• Zotupa za Gulu lachitatu-anaplastic astrocytoma kapena anaplastic pleomorphic xanthoastrocytoma.

• Zotupa za grade IV-glioblastoma kapena diffuse midline glioma.

Ma astrocytomas aunyamata nthawi zambiri samafalikira mbali zina za thupi.

MRI imachitika pambuyo pa opaleshoni.

Kujambula kwa MRI (magnetic resonance imaging) kumachitika m'masiku ochepa pambuyo pa opaleshoni. Izi ndikuti mudziwe kuchuluka kwa chotupa, ngati chilipo, chimatsalira pambuyo pochitidwa opaleshoni ndikukonzekera chithandizo china.

Zowonongeka Za Astrocytomas Zaubwana

Acrocytoma yabwana yobwerezabwereza ndi astrocytoma yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara imatha kubwerera pamalo omwewo ngati chotupa choyamba kapena mbali zina za thupi. Ma astrocytomas apamwamba kwambiri amabwereranso mkati mwa zaka zitatu mwina komwe khansa idapangidwira kapena kwinakwake mu CNS.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi ana astrocytoma.

• Ana omwe ali ndi ma astrocytomas ayenera kukonzekera kukonzekera ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandizira zotupa zaubongo zaubwana.

• Zotupa zamaubongo muubwana zimatha kuyambitsa zizindikilo zomwe zimayamba khansa isanapezeke ndikupitilira miyezi kapena zaka.

• Chithandizo cha ma astrocytomas aubwana chingayambitse zovuta.

• Mitundu isanu ndi umodzi yamankhwala imagwiritsidwa ntchito:

• Opaleshoni

• Kuwona

• Thandizo la radiation

• Chemotherapy

• Chemotherapy yamphamvu kwambiri yokhala ndi tsinde lama cell

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Mankhwala ena

• Chitetezo chamatenda

• Ngati madzimadzi amamera mozungulira ubongo ndi msana, njira yothetsera madzi amadzimadzi imatha kuchitika.

• 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 odwala omwe ali ndi ana astrocytoma.

Pali mitundu yosiyanasiyana ya chithandizo kwa ana omwe ali ndi ma astrocytomas. 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 ndiyosowa, kutenga nawo mbali pakuyesa kwachipatala kuyenera kuganiziridwa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Ana omwe ali ndi ma astrocytomas ayenera kukonzekera kukonzekera ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandizira zotupa zaubongo zaubwana.

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 zotupa zamaubongo komanso omwe amakhazikika m'malo ena azamankhwala. Izi zingaphatikizepo akatswiri awa:

• Dokotala wa ana.

• Matenda a ana.

• Katswiri wa zamagulu.

• Neuropathologist.

• Neuroradiologist.

• Katswiri wokonzanso.

• Wofufuza oncologist.

• Katswiri wazamaphunziro.

• Katswiri wa zamaganizo.

Zotupa zamaubongo muubwana zimatha kuyambitsa zizindikilo zomwe zimayamba khansa isanapezeke ndikupitilira miyezi kapena zaka.

Zizindikiro zomwe zimayambitsa chotupacho zimatha kuyamba asanadziwe. Zizindikirozi zimatha kupitilira kwa miyezi kapena zaka. Ndikofunika kulankhula ndi madokotala a mwana wanu za zizindikilo kapena zizindikilo zomwe zimayamba chifukwa cha chotupacho chomwe chimapitilira mukalandira chithandizo.

Chithandizo cha ma astrocytomas aubwana chingayambitse zovuta.

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).

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 isanu ndi umodzi yamankhwala imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni imagwiritsidwa ntchito pozindikira ndikuchiza ana astrocytoma, monga tafotokozera mgawo la General Information pachidule ichi. Ngati maselo a khansa atsalira atachitidwa opaleshoni, chithandizo china chimadalira:

• Kumene maselo otsala a khansa ali.

• Mulingo wa chotupacho.

• Zaka za mwanayo.

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.

Kuwona

Kuyang'anitsitsa kumayang'anitsitsa matenda a wodwala popanda kupereka chithandizo chilichonse mpaka zizindikilo kapena zizindikiritso zikuwoneka kapena kusintha. Kuwona kungagwiritsidwe ntchito:

• Ngati wodwalayo alibe zisonyezo, monga odwala omwe ali ndi mtundu wa neurofibromatosis.

• Ngati chotupacho ndi chaching'ono ndipo chimapezeka matenda ena akupezeka kapena kuthandizidwa.

• Chotupacho chikachotsedwa ndi opaleshoni mpaka zizindikilo kapena zizindikilo zikuwoneka kapena kusintha.

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 zina zoperekera mankhwala a radiation zitha kuthandiza kuti ma radiation asawononge minofu yabwinobwino yapafupi. Mitundu yamankhwalawa ndi awa:

• Conformal radiation therapy: Conformal radiation Therapy ndi mtundu wa mankhwala akunja a radiation omwe amagwiritsa ntchito kompyuta kupanga chithunzi cha 3-dimensional (3-D) chotupa ndikupanga ma radiation kuti agwirizane ndi chotupacho.

• Mphamvu ya radiation-modulated radiation (IMRT): IMRT ndi mtundu wa 3-dimensional (3-D) mankhwala othandizira ma radiation omwe amagwiritsa ntchito kompyuta kupanga zithunzi za kukula ndi mawonekedwe a chotupacho. Mitsinje yoonda ya mphamvu zosiyanasiyana (mphamvu) imapangidwira chotupacho m'makona ambiri.

• Mankhwala opatsirana pogwiritsa ntchito mphamvu ya stereotactic: Thandizo la radiation la stereotactic ndi mtundu wa mankhwala owonekera kunja. Pamutu pake pamakhala chimango cholimba. Makina amayang'ana ma radiation molunjika pachotupa. Mlingo wonse wa radiation umagawidwa m'mayeso ang'onoang'ono angapo operekedwa masiku angapo. Njirayi imatchedwanso stereotactic kunja kwa dothi radiation mankhwala ndi stereotaxic radiation therapy.

• Thandizo la ma proton beam radiation: Thandizo la Proton-beam ndi mtundu wa mphamvu yayikulu, mankhwala owunikira kunja. Makina othandizira ma radiation amayang'ana mitsinje yama proton (tinthu tating'onoting'ono, tosaoneka, tomwe timayikidwa bwino) m'maselo a khansa kuti tiwaphe.

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

Momwe mankhwalawa amaperekera zimadalira mtundu wa chotupacho komanso komwe chotupacho chimapangidwira muubongo kapena msana. Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza ma astrocytomas aubwana.

Thandizo la radiation kuubongo limatha kukhudza kukula, makamaka kwa ana aang'ono. Kwa ana ochepera zaka zitatu, chemotherapy atha kupatsidwa m'malo mwake, kuti achedwetse kapena kuchepetsa kufunika kwa chithandizo cha radiation.

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). Mgwirizano wa chemotherapy ndi kugwiritsa ntchito mankhwala opatsirana angapo opatsirana khansa.

Momwe chemotherapy imaperekedwa imadalira mtundu wa chotupacho komanso komwe chotupacho chimapangidwa muubongo kapena msana. Njira yothandizirana ndi chemotherapy imagwiritsidwa ntchito pochiza ana omwe ali ndi astrocytoma. Chemotherapy yapamwamba ingagwiritsidwe ntchito pochiza ana omwe ali ndi matenda apamwamba kwambiri a astrocytoma.

Chemotherapy yamphamvu kwambiri yokhala ndi tsinde lama cell

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.

Kwa astrocytoma yapamwamba yomwe yabwereranso pambuyo pa chithandizo, chemotherapy yayikulu yomwe imagwiritsidwa ntchito ngati kuli chotupa chochepa chabe.

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa mankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino.

Pali mitundu yosiyanasiyana ya mankhwala omwe akulimbana nawo:

• Thandizo la monoclonal antibody limagwiritsa ntchito ma antibodies opangidwa mu labotore, kuchokera ku mtundu umodzi wa chitetezo chamthupi, kuyimitsa ma cell a khansa. 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 mumtsempha. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa.

Vascular endothelial growth factor (VEGF) inhibitor Therapy ndi mtundu wa monoclonal antibody therapy:

• Thandizo la VEGF inhibitor: Maselo a khansa amapanga chinthu chotchedwa VEGF, chomwe chimayambitsa mitsempha yatsopano yamagazi (angiogenesis) ndikuthandizira khansa kukula. Ma VEGF inhibitors amaletsa VEGF ndikuletsa mitsempha yatsopano yopanga. Izi zitha kupha ma cell a khansa chifukwa amafunikira mitsempha yatsopano yamagazi kuti ikule. Bevacizumab ndi VEGF inhibitor ndi angiogenesis inhibitor yomwe imagwiritsidwa ntchito pochiza mwana astrocytoma.

• Mapuloteni kinase inhibitors amagwira ntchito m'njira zosiyanasiyana. Pali mitundu ingapo yama protein kinase inhibitors.

• MTOR inhibitors amaletsa maselo kuti asagawikane ndipo amalepheretsa kukula kwa mitsempha yatsopano yomwe zotupa zimayenera kukula. Everolimus ndi sirolimus ndi mTOR inhibitors omwe amagwiritsidwa ntchito pochiza ana osagwirizana ndi ma cell astrocytomas. Ma mTOR inhibitors nawonso akuwerengedwa kuti athetse vuto la astrocytoma lomwe labwereranso.

• BRAF inhibitors amaletsa mapuloteni ofunikira kuti maselo akule ndipo amatha kupha ma cell a khansa. Jini la BRAF limapezeka mu mawonekedwe osinthika (mwa ma gliomas ena) ndipo kutsekereza kungathandize kuti maselo a khansa asakule. BRAF inhibitor dabrafenib ikuwerengedwa kuti ithetse astrocytoma yotsika kwambiri yomwe yabwereranso. Ma BRAF inhibitors ena, kuphatikiza vemurafenib ndi trametinib, akuwerengedwa mwa ana.

• MEK inhibitors amaletsa mapuloteni ofunikira kuti maselo akule ndipo amatha kupha ma cell a khansa. MEK inhibitors monga selumetinib akuwerengedwa kuti athetse vuto la astrocytoma lomwe labwereranso.

• PARP inhibitors amaletsa enzyme yotchedwa PARP yomwe imagwira ntchito yama cell ambiri. Kuletsa PARP kungathandize kuti maselo a khansa asakonze DNA yawo yowonongeka, kuwapangitsa kufa. Veliparib ndi PARP inhibitor yomwe ikuwerengedwa limodzi ndi radiation radiation ndi chemotherapy yothandizira kuchiza matenda oopsa a glioma omwe alibe masinthidwe amtundu wa BRAF.

Onani Mankhwala Ovomerezeka a Zotupa za Ubongo kuti mumve zambiri.

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.

Mankhwala ena

Lenalidomide ndi mtundu wa angiogenesis inhibitor. Zimalepheretsa kukula kwa mitsempha yatsopano yomwe imafunika ndi chotupa kuti chikule.

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.

• Mankhwala oteteza ku chitetezo cha mthupi: PD-1 ndi mapuloteni pamwamba pa ma T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. PD-1 ikamangirira puloteni ina yotchedwa PDL-1 pakhungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. PD-1 inhibitors amadziphatika ku PDL-1 ndikulola ma T maselo kupha ma cell a khansa. PD-1 inhibitors akuwerengedwa kuti athetse ma astrocytoma apamwamba kwambiri omwe abwereranso.

Chitetezo cha chitetezo cha mthupi. Mapuloteni owunika, monga PD-L1 pama cell a chotupa ndi PD-1 pama cell a T, amathandizira kuyang'anira mayankho amthupi. Kumanga kwa PD-L1 mpaka PD-1 kumapangitsa kuti ma T asaphe ma cell am'mimba (gulu lakumanzere). Kuletsa kumangiriza kwa PD-L1 mpaka PD-1 yokhala ndi chitetezo chodzitetezera (anti-PD-L1 kapena anti-PD-1) kumalola ma T maselo kupha ma cell a chotupa (gulu lamanja).

Ngati madzimadzi amamera mozungulira ubongo ndi msana, njira yothetsera madzi amadzimadzi imatha kuchitika.

Cerebrospinal fluid diversion ndi njira yomwe imagwiritsidwa ntchito kutulutsa madzi omwe amamanga mozungulira ubongo ndi msana. Thupi (chubu lalitali, locheperako) limayikidwa mu ventricle (malo odzaza ndi madzi) aubongo ndipo amaluka pansi pa khungu kupita mbali ina ya thupi, nthawi zambiri pamimba. Shunt imatenga madzi owonjezera kuchokera kuubongo kuti itengeke kwina kulikonse mthupi.

Kusokonekera kwa Cerebrospinal fluid (CSF). CSF yowonjezera imachotsedwa mu ventricle muubongo kudzera mu shunt (chubu) ndipo imatsanulidwa m'mimba. Valve imayendetsa kayendedwe ka CSF.

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. (Onani gawo la General Information kuti mupeze mndandanda wa mayeso.) Kuyesaku kumabwerezedwa kuti muwone momwe mankhwala akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Ma MRIs nthawi zonse adzapitiliza kuchitika mankhwala atatha. Zotsatira za MRI zitha kuwonetsa ngati matenda a mwana wanu asintha kapena ngati astrocytoma yabwereranso (kubwerera). Ngati zotsatira za MRI zikuwonetsa unyinji muubongo, kafukufuku amatha kuchitidwa kuti apeze ngati amapangidwa ndi maselo otupa kapena ngati khansa yatsopano ikukula.

Njira Zothandizira Kuchiza Ana Astrocytomas

M'chigawo chino

• Astrocytomas Achinyamata Omwe Akupezeka Posachedwa

• Zochitika Zakale Zakale Zakale Zakale za Astrocytomas

• Astrocytomas Aposachedwa Kwambiri Achinyamata

• Zochitika Zakale Zakale Zakale Zakale za Astrocytomas

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

Astrocytomas Achinyamata Omwe Akupezeka Posachedwa

Chotupacho chikapezeka koyamba, chithandizo cha astrocytoma chaubwana chimadalira komwe chotupacho chili, ndipo nthawi zambiri amachitidwa opaleshoni. MRI imachitika atachitidwa opaleshoni kuti awone ngati pali chotupa chotsalira.

Ngati chotupacho chidachotsedwa kwathunthu ndi opareshoni, chithandizo chambiri sichingafunike ndipo mwanayo amayang'anitsitsa kuti awone ngati zizindikilo zikuwoneka kapena kusintha. Izi zimatchedwa kuwona.

Ngati pali chotupa chotsalira pambuyo pochitidwa opaleshoni, chithandizo chitha kuphatikizira izi:

• Kuwona.

• Kuchita opaleshoni yachiwiri kuchotsa chotupacho.

• Thandizo la radiation, lomwe lingaphatikizepo conformal radiation therapy, mphamvu yolimbitsa mphamvu ya radiation, mankhwala a radiation ya radiation, kapena stereotactic radiation, pomwe chotupacho chimayambiranso.

• Kuphatikiza kwa chemotherapy kapena popanda mankhwala a radiation.

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala ophatikizidwa ndi kuphatikiza kwa BRAF inhibitors (dabrafenib ndi trametinib) kwa odwala omwe asintha kusintha mu jini la BRAF.

Nthawi zina, kuwonera kumagwiritsidwa ntchito kwa ana omwe ali ndi njira yowonera glioma. Nthawi zina, chithandizo chitha kuphatikizira opaleshoni kuchotsa chotupacho, mankhwala a radiation, kapena chemotherapy. Cholinga cha chithandizo ndikupulumutsa masomphenya momwe angathere. Zotsatira zakukula kwa chotupa pamasomphenya a mwanayo zimatsatiridwa bwino nthawi ya chithandizo.

Ana omwe ali ndi neurofibromatosis mtundu 1 (NF1) sangafunikire chithandizo pokhapokha chotupacho chikukula kapena zizindikilo, monga zovuta zamasomphenya, zikuwoneka. Chotupacho chikakula kapena zizindikilo zikuwoneka, chithandizo chitha kuphatikizaponso opaleshoni kuchotsa chotupacho, mankhwala a radiation, ndi / kapena chemotherapy.

Ana omwe ali ndi tuberous sclerosis amatha kukhala ndi zotupa zoyipa (osati khansa) muubongo wotchedwa subependymal giant cell astrocytomas (SEGAs). Chithandizo chomwe mukufuna ndi everolimus kapena sirolimus chitha kugwiritsidwa ntchito m'malo mochita opareshoni, kuti muchepetse zotupa.

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.

Zochitika Zakale Zakale Zakale Zakale za Astrocytomas

Astrocytoma yotsika ikamabwerera pambuyo pa chithandizo, nthawi zambiri imabwerera pomwe chotupacho chidayamba. Asanapatsidwe chithandizo chambiri cha khansa, kuyesa kuyerekezera, kusanthula, kapena opaleshoni kumachitika kuti mudziwe ngati pali khansa komanso kuchuluka kwake.

Chithandizo cha astrocytoma chaubwana wosabadwa chimaphatikizapo izi:

• Opareshoni yachiwiri yochotsa chotupacho, ngati opaleshoni inali chithandizo chokhacho chomwe chimaperekedwa pomwe chotupacho chidapezeka koyamba.

• Chithandizo cha ma radiation pachotupa chokha, ngati mankhwala a radiation sanagwiritsidwe ntchito pomwe chotupacho chimapezeka koyamba. Mankhwala othandizira ma radiation atha kuperekedwa.

• Chemotherapy, ngati chotupacho chidabwereranso komwe sichingachotsedwe ndi opaleshoni kapena wodwalayo adalandira mankhwala a radiation pomwe chotupacho chidapezeka koyamba.

• Chithandizo chotsata ndi antioclonal antibody (bevacizumab) wokhala ndi chemotherapy kapena wopanda chemotherapy.

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Kuyesedwa kwachipatala kwa mankhwala olimbana ndi BRAF inhibitor (dabrafenib), mTOR inhibitor (everolimus), kapena MEK inhibitor (selumetinib).

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.

Astrocytomas Aposachedwa Kwambiri Achinyamata

Chithandizo cha astrocytoma yaubwana ungaphatikizepo izi:

• Opaleshoni kuti achotse chotupacho, kenako chemotherapy ndi / kapena radiation radiation.

• Kuyesedwa kwachipatala kwa chithandizo chatsopano.

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala omwe ali ndi PARP inhibitor (veliparib) kuphatikiza ndi mankhwala a radiation ndi chemotherapy kuti athetse glioma yomwe ilipo kumene yomwe sinasinthe (jini) ya BRAF.

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.

Zochitika Zakale Zakale Zakale Zakale za Astrocytomas

Astrocytoma apamwamba akabwereranso atalandira chithandizo, nthawi zambiri amabwerera pomwe chotupacho chidayamba. Asanapatsidwe chithandizo chambiri cha khansa, kuyesa kuyerekezera, kusanthula, kapena opaleshoni kumachitika kuti mudziwe ngati pali khansa komanso kuchuluka kwake.

Kuchiza kwa astrocytoma yapamwamba ya ubwana kungaphatikizepo izi:

• Opaleshoni kuchotsa chotupacho.

• Chemotherapy yamphamvu kwambiri yokhala ndi tsinde lama cell.

• Chithandizo choyenera ndi BRAF inhibitor (vemurafenib kapena dabrafenib).

• Kuyesedwa kwachipatala kwa immunotherapy wokhala ndi cholepheretsa chitetezo cha mthupi.

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala ophatikizidwa ndi kuphatikiza kwa BRAF inhibitors (dabrafenib ndi trametinib) kwa odwala omwe asintha kusintha mu jini la BRAF.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

To Learn More About Childhood Astrocytomas

For more information about childhood astrocytomas, see the following:

• Targeted Cancer Therapies

• Pediatric Brain Tumor Consortium (PBTC)Exit Disclaimer

For more childhood cancer information and other general cancer resources, see the following:

• About Cancer

• Childhood Cancers

• CureSearch for Children's CancerExit Disclaimer

• Late Effects of Treatment for Childhood Cancer

• Adolescents and Young Adults with Cancer

• Children with Cancer: A Guide for Parents

• Cancer in Children and Adolescents

• Staging

• Coping with Cancer

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira