Mitundu / mutu-ndi-khosi / wodwala / wamkulu / laryngeal-treatment-pdq

Chithandizo cha Khansa ya Laryngeal (Wamkulu)

Zambiri Zokhudza Khansa ya Laryngeal

MFUNDO ZOFUNIKA

• Khansa ya m'mapapo ndi matenda omwe mumapezeka maselo owopsa (khansa) m'matumba am'mphako.

• Kugwiritsa ntchito fodya komanso kumwa mowa mopitirira muyeso kumatha kuyika chiopsezo cha khansa yapakhungu.

• Zizindikiro za khansa ya m'mapapo zimaphatikizapo zilonda zapakhosi komanso khutu.

• Kuyesa komwe kumayang'ana pakhosi ndi khosi kumagwiritsidwa ntchito kuthandizira kupeza khansa ya kholingo.

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

Khansa ya m'mapapo ndi matenda omwe mumapezeka maselo owopsa (khansa) m'matumba am'mphako.

Mphuno ndi gawo la pakhosi, pakati pa lilime ndi trachea. M'kholingo mumakhala timphako timeneti, timene timanjenjemera ndikupanga mawu mpweya ukawatsatira. Phokoso limamvekera kudzera pakhosi, pakamwa, ndi mphuno kuti apange mawu amunthu.

Pali magawo atatu akulu a kholingo:

• Supraglottis: Gawo lapamwamba la kholingo pamwamba pa zingwe zamawu, kuphatikiza epiglottis.

• Glottis: Mbali yapakati ya kholingo pomwe pali zingwe zamawu.

• Subglottis: Gawo lakumunsi kwa kholingo pakati pa zingwe zamawu ndi trachea (mphepo).

Khansa ya m'mapapo imapangika m'matumba a kholingo (m'khosi pakhosi momwe muli zingwe zamawu). M'mphako mwake mumakhala supraglottis, glottis (zingwe zamawu), ndi subglottis. Khansayo imafalikira kumatenda oyandikira kapena ku chithokomiro, trachea, kapena kummero. Ikhozanso kufalikira ku ma lymph node m'khosi, mtsempha wama carotid, kumtunda kwa msana, chifuwa, ndi ziwalo zina za thupi (zosawonetsedwa).

Khansa zambiri zam'mimba zimapangika m'maselo oopsa, maselo ofooka, okhala mkati mwa kholingo.

Khansa ya laryngeal ndi mtundu wa khansa yamutu ndi khosi.

Kugwiritsa ntchito fodya komanso kumwa mowa mopitirira muyeso kumatha kuyika chiopsezo cha khansa yapakhungu.

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 ngati mukuganiza kuti mutha kukhala pachiwopsezo.

Zizindikiro za khansa ya m'mapapo zimaphatikizapo zilonda zapakhosi komanso khutu.

Zizindikiro ndi zizindikilozi zimatha kubwera chifukwa cha khansa yapakhosi kapena zovuta zina. Funsani dokotala ngati muli ndi izi:

• Pakhosi kapena chifuwa chosatha.

• Mavuto kapena ululu mukameza.

• Kumva khutu.

• Bulu m'khosi kapena pakhosi.

• Kusintha kapena kukweza mawu.

Kuyesa komwe kumayang'ana pakhosi ndi khosi kumagwiritsidwa ntchito kuthandizira kupeza khansa ya kholingo.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuyesa mthupi pakhosi ndi m'khosi: Kuyesa poyang'ana pakhosi ndi m'khosi ngati simunali bwino. Dokotala amamva mkamwa ndi chala chovala ndipo amafufuza pakamwa ndi pakhosi ndi galasi yaying'ono yayitali ndi kuwala. Izi ziphatikizapo kuyang'ana zamkati mwa masaya ndi milomo; nkhama; kumbuyo, denga, ndi pansi pakamwa; pamwamba, pansi, ndi mbali za lilime; ndi mmero. Khosi limamvekera chifukwa chamatupa am'mimba. Mbiri ya zizolowezi za wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala chidzachitikanso.

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Zitsanzo za minofu zimatha kuchotsedwa pamachitidwe awa:

• Laryngoscopy: Njira yomwe dokotala amafufuzira kholingo (mawu amawu) ndi galasi kapena laryngoscope kuti aone ngati ali ndi vuto. Laryngoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera mkatikati mwa pakhosi ndi mawu amawu. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa.

• Endoscopy: Ndondomeko yoyang'ana ziwalo ndi zotupa mkati mwa thupi, monga pakhosi, pakhosi, ndi trachea kuti muwone ngati pali zovuta zina. Endoscope (chubu chowonda, chowala ndi kuwala ndi mandala owonera) imalowetsedwa kudzera potsegula m'thupi, monga pakamwa. Chida chapadera pa endoscope chitha kugwiritsidwa ntchito kuchotsa zitsanzo za minofu.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamatupi amthupi, zojambulidwa mosiyanasiyana. 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.

Kujambula kwa tomography (CT) pamutu ndi khosi. Wodwalayo amagona patebulo lomwe limadutsa mu makina a CT, omwe amatenga zithunzi za x-ray zamkati mwa mutu ndi khosi.

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

• 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.

• PET-CT scan: Njira yophatikiza zithunzizo kuchokera pa sikani ya positron emission tomography (PET) ndi scan computed tomography (CT) Makina a PET ndi CT amachitika nthawi yomweyo ndi makina omwewo. Zithunzi zophatikizidwazo zimapereka chithunzi chatsatanetsatane cha malo amkati mwathupi kuposa momwe scan iliyonse imadzipangira yokha. Kujambula kwa PET-CT kungagwiritsidwe ntchito kuthandizira kuzindikira matenda, monga khansa, kukonzekera chithandizo, kapena kudziwa momwe chithandizo chikuyendera.

• 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.

• Kumeza kwa Barium: Ma x-ray angapo am'mero ​​ndi m'mimba. Wodwalayo amamwa madzi omwe amakhala ndi barium (siliva yoyera yachitsulo). Madziwo amaphimba kumimba ndi m'mimba, ndipo ma x-ray amatengedwa. Njirayi imatchedwanso mndandanda wapamwamba wa GI.

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

Kulosera kumatengera izi:

• Gawo la matenda.

• Malo ndi kukula kwa chotupacho.

• Mulingo wa chotupacho.

• Msinkhu wa wodwala, jenda, komanso thanzi labwino, kuphatikiza ngati wodwalayo alibe magazi.

Njira zochiritsira zimadalira izi:

• Gawo la matenda.

• Malo ndi kukula kwa chotupacho.

• Kuthandiza wodwalayo kuti azitha kuyankhula, kudya, komanso kupuma mwachibadwa momwe angathere.

• Kaya khansara yabwerera (yabwereranso).

Kusuta fodya ndi kumwa mowa kumachepetsa mphamvu ya chithandizo cha khansa ya m'mimba. Odwala omwe ali ndi khansa yapakamwa yomwe imapitilizabe kusuta ndi kumwa sakonda kuchiritsidwa ndipo atha kukhala ndi chotupa chachiwiri. Mukalandira chithandizo cha khansa yapakhungu, kutsatira pafupipafupi komanso mosamala ndikofunikira.

Magawo a Khansa ya Laryngeal

MFUNDO ZOFUNIKA

• Khansa ya m'kamwa itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa kholingo kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Magawo otsatirawa amagwiritsidwa ntchito pa khansa yapakhungu:

• Gawo 0 (Carcinoma mu Situ)

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Pambuyo pa opaleshoni, gawo la khansa limatha kusintha ndipo pamafunika chithandizo china.

• Khansa yaposachedwa ya kholingo ndi khansa yomwe yabwerera pambuyo pochiritsidwa.

Khansa ya m'kamwa itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa kholingo kapena mbali zina za thupi.

Njira yomwe amagwiritsidwa ntchito pofufuza ngati khansara yafalikira mkati mwa kholingo kapena mbali zina za thupi amatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunika kudziwa gawo la matendawa kuti mukonzekere chithandizo. Zotsatira za mayeso ena omwe amagwiritsidwa ntchito pozindikira kuti khansa yapakhungu nthawi zambiri imagwiritsidwanso ntchito kuthana ndi matendawa.

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 khansa ya m'mapapo imafalikira m'mapapu, maselo a khansa m'mapapo alidi khansa ya kholingo. Matendawa ndi khansa ya m'mapapo, osati khansa yamapapo.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa yapakhungu:

Gawo 0 (Carcinoma mu Situ)

Mu gawo la 0, maselo osazolowereka amapezeka mchipinda cha kholingo. Maselo achilendowa amatha kukhala khansa ndikufalikira m'minyewa yabwinobwino. Gawo 0 limatchedwanso carcinoma in situ.

Gawo I

Pachigawo choyamba ine, khansa yapangidwa mdera la supraglottis, glottis, kapena subglottis la kholingo:

• Supraglottis: Khansa ili m'dera limodzi la ma supraglottis ndipo zingwe zamawu zimagwira bwino ntchito.

• Glottis: Khansa ili mu chingwe chimodzi kapena zonse ziwiri ndipo zingwe zamawu zimagwira bwino ntchito.

• Subglottis: Khansa ili mu subglottis yokha.

Gawo II

Gawo lachiwiri, khansa yapangidwa mdera la supraglottis, glottis, kapena subglottis la kholingo:

• Supraglottis: Khansa ili m'malo opitilira umodzi wa supraglottis kapena yafalikira kudera lomwe lili pansi pa lilime kapena kumatenda omwe ali pafupi ndi zingwe zamawu. Zingwe za mawu zimagwira ntchito bwino.

• Glottis: Khansa yafalikira ku supraglottis, subglottis, kapena zonse ziwiri, ndipo / kapena zingwe zamawu sizigwira ntchito bwino.

• Subglottis: Khansa yafalikira ku chingwe chimodzi kapena zonse ziwiri ndipo zingwe zamagulu sizigwira ntchito bwino.

Gawo III

Gawo lachitatu, khansa yapangidwa mdera la supraglottis, glottis, kapena subglottis la kholingo:

Kukula kwa zotupa nthawi zambiri kumayeza masentimita (cm) kapena mainchesi. Zakudya zodziwika bwino zomwe zitha kugwiritsidwa ntchito posonyeza kukula kwa chotupa mu cm zimaphatikizapo: nsawawa (1 cm), chiponde (2 cm), mphesa (3 cm), mtedza (4 cm), laimu (5 cm kapena 2) mainchesi), dzira (6 cm), pichesi (7 cm), ndi manyumwa (masentimita 10 kapena mainchesi 4).

Khansa lachitatu la supraglottis:

• Khansara ili mu kholingo lokha ndipo zingwe zamagulu sizigwira ntchito, ndipo / kapena khansara yafalikira pafupi kapena kudzera mkatikati mwa chithokomiro. Khansara itha kufalikira ku lymph lymph node imodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo lymph node ndi 3 masentimita kapena ocheperako; kapena

• Khansara ili m'dera limodzi la ma supraglottis ndipo zingwe zamawu zimagwira bwino ntchito. Khansara yafalikira ku lymph node imodzi mbali yomweyo ya khosi monga chotupa choyambirira ndi chotupa cha 3 ndi masentimita atatu kapena ocheperako; kapena

• khansara ili m'malo opitilira gawo limodzi la supraglottis kapena yafalikira kudera lomwe lili pansi pa lilime kapena kumatumba pafupi ndi zingwe zamawu. Zingwe za mawu zimagwira ntchito bwino. Khansara yafalikiranso kumatope amodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo chotupa chake chimakhala 3 masentimita kapena ocheperako.

Gawo lachitatu khansa ya glottis:

• Khansara ili mu kholingo lokha ndipo zingwe zamagulu sizigwira ntchito, ndipo / kapena khansara yafalikira pafupi kapena kudzera mkatikati mwa chithokomiro. Khansara itha kufalikira ku lymph lymph node imodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo lymph node ndi 3 masentimita kapena ocheperako; kapena

• Khansara ili mu chingwe chimodzi kapena zonse ziwiri ndipo zingwe zamawu zimagwira bwino ntchito. Khansara yafalikira ku lymph node imodzi mbali yomweyo ya khosi monga chotupa choyambirira ndi chotupa cha 3 ndi masentimita atatu kapena ocheperako; kapena

• Khansara yafalikira ku supraglottis, subglottis, kapena zonse ziwiri, ndipo / kapena zingwe zamagulu sizigwira ntchito bwino. Khansara yafalikiranso kumatope amodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo chotupa chake chimakhala 3 masentimita kapena ocheperako.

Gawo lachitatu khansa ya subglottis:

• Khansara ili mu kholingo lokha ndipo zingwe zamagulu sizigwira ntchito, ndipo / kapena khansara yafalikira pafupi kapena kudzera mkatikati mwa chithokomiro. Khansara itha kufalikira ku lymph lymph node imodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo lymph node ndi 3 masentimita kapena ocheperako; kapena

• khansa ili mu subglottis kokha. Khansara yafalikira ku lymph node imodzi mbali yomweyo ya khosi monga chotupa choyambirira ndi chotupa cha 3 ndi masentimita atatu kapena ocheperako; kapena

• Khansara yafalikira ku chimodzi kapena zonse ziwiri ndipo zingwe zamagulu sizigwira ntchito bwino. Khansara yafalikiranso kumatope amodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo chotupa chake chimakhala 3 masentimita kapena ocheperako.

Gawo IV

Gawo IV limagawika gawo la IVA, gawo la IVB, ndi gawo la IVC. Gawo lililonse limafanana ndi khansa mu supraglottis, glottis, kapena subglottis.

• Mu gawo IVA:

• Khansa yafalikira kudzera mumatumbo a chithokomiro ndipo / kapena yafalikira kumatenda opitilira kholingo, monga khosi, trachea, chithokomiro, kapena kholingo. Khansara itha kufalikira ku lymph lymph node imodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo lymph node ndi 3 masentimita kapena ocheperako; kapena

• Khansa ikhoza kufalikira kuchokera ku supraglottis, glottis, kapena subglottis kupita kumatenda opitilira kholingo, monga khosi, trachea, chithokomiro, kapena kholingo. Zingwe za mawu sizigwira ntchito bwino. Khansa yafalikira:

• kumatenda amtundu umodzi mbali imodzi ya khosi monga chotupa choyambirira ndipo mwankhanza ndi 3 masentimita kapena ocheperako. Khansara yafalikira kudzera kunja kwa khungu; kapena

• kumatenda amtundu umodzi mbali imodzi ya khosi monga chotupa choyambirira ndi chotupa chachikulu chimakhala chachikulu kuposa masentimita atatu koma osaposa masentimita 6. Khansara siyinafalikire kudzera pachikuto chakuthupi; kapena

• kumatundu amtundu wopitilira umodzi mbali imodzi ya khosi monga chotupa choyambirira ndi ma lymph node sizoposa masentimita 6. Khansa siyinafalikire kudzera pachikuto cha ma lymph nodes; kapena

• kuti malo am'mbali mbali zonse ziwiri za khosi kapena mbali ya khosi moyang'anizana ndi chotupa choyambirira ndipo ma lymph node sali akulu kuposa masentimita 6. Khansara siyinafalikire kudzera pachikuto cha ma lymph nodes.

• Mu gawo IVB:

• Khansa ikhoza kufalikira kuchokera ku supraglottis, glottis, kapena subglottis kupita kutsogolo kutsogolo kwa msana, dera lozungulira mtsempha wa carotid, kapena dera pakati pa mapapo. Zingwe za mawu sizigwira ntchito bwino. Khansa yafalikira:

• ku lymph node imodzi yomwe imaposa masentimita 6. Khansara siyinafalikire kudzera pachikuto chakuthupi; kapena

• kumatenda amtundu umodzi mbali imodzi ya khosi monga chotupa choyambirira ndi chotupa chachikulu chimaposa masentimita atatu. Khansara yafalikira kudzera kunja kwa khungu; kapena

• kumatupa amtundu umodzi paliponse m'khosi. Khansa yafalikira kudzera kunja kwa chotupa cham'mimba; kapena

• ku lymph node imodzi yamtundu uliwonse kumbali ya khosi moyang'anizana ndi chotupa choyambirira. Khansara yafalikira kudzera kunja kwa khungu;

kapena

• Khansara yafalikira kuchokera ku supraglottis, glottis, kapena subglottis kupita kumalo kutsogolo kwa msana, malo ozungulira mitsempha ya carotid, kapena dera pakati pa mapapo. Khansara itha kufalikira kumatenda amtundu umodzi kapena angapo paliponse m'khosi ndipo ma lymph node amatha kukula.

• Pa gawo la IVC, khansa yafalikira mbali zina za thupi, monga mapapo, chiwindi, kapena fupa.

Pambuyo pa opaleshoni, gawo la khansa limatha kusintha ndipo pamafunika chithandizo china.

Khansayo ikachotsedwa mwa kuchitidwa opareshoni, wodwala matenda amafufuza nyemba za khansa pansi pa microscope. Nthawi zina, kuwunikiridwa kwa a pathologist kumatha kusintha kusintha kwa khansa ndikuthandizidwa pambuyo pa opaleshoni.

Khansa yaposachedwa ya kholingo ndi khansa yomwe yabwerera pambuyo pochiritsidwa.

Khansara ya laryngeal ikamabwerako mutalandira chithandizo, imachedwa khansa yapawokha. Khansara imatha kubwerera m'zaka ziwiri zoyambirira kapena zitatu. Itha kubwereranso m'mphako kapena mbali zina za thupi, monga mapapu, chiwindi, kapena fupa.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi khansa ya m'mapapo.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Thandizo la radiation

• Opaleshoni

• Chemotherapy

• Chitetezo chamatenda

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo chofuna

• Othandizira ma Radiosensitizers

• Chithandizo cha khansa ya m'mapapo chingayambitse mavuto.

• 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 kwa odwala omwe ali ndi khansa ya m'mapapo.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi khansa ya m'mapapo. 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. Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

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. Thandizo la radiation lakunja limagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chakuthupi ndi khansa.

Mankhwala opangira ma radiation kunja kwa mutu ndi khosi. Makina amagwiritsidwa ntchito kupangira ma radiation amphamvu ku khansa. Makinawo amatha kuzungulira mozungulira wodwalayo, ndikupereka cheza kuchokera kumakona osiyanasiyana kuti apereke chithandizo chofananira. Chovala chophimba kumaso chimathandiza kuti mutu ndi khosi la wodwalayo zisasunthike akamalandira chithandizo. Zizindikiro zazing'ono zazing'ono zimayikidwa pachigoba. Zizindikiro za inki zimagwiritsidwa ntchito pokonza makina a radiation pamalo omwewo asanalandire chithandizo chilichonse.

Thandizo la radiation lingagwire ntchito bwino kwa odwala omwe asiya kusuta asanayambe kulandira chithandizo. Mankhwala ochokera kunja kwa ma chithokomiro kapena ma pituitary gland amatha kusintha momwe chithokomiro chimagwirira ntchito. Kuyezetsa magazi kuti muwone kuchuluka kwa mahomoni a chithokomiro mthupi lanu kumatha kuchitika musanachitike komanso mutalandira mankhwala kuti mutsimikizire kuti chithokomiro chikuyenda bwino.

Mankhwala othandizira ma radiation atha kugwiritsidwa ntchito pochiza khansa ya m'mapapo. Mankhwala opatsirana pogwiritsa ntchito ma radiation ndi mankhwala ochizira ma radiation omwe mankhwala ocheperako tsiku lililonse amagawika magawo awiri ndipo mankhwalawa amaperekedwa kawiri patsiku. Mankhwala othandizira ma radiation amaperekedwa munthawi yomweyo (masiku kapena masabata) monga mankhwala wamba. Mitundu yatsopano yamankhwala opangidwa ndi radiation ikuwerengedwa pochiza khansa ya m'mimba.

Opaleshoni

Kuchita opaleshoni (kuchotsa khansara mu opaleshoni) ndi njira yodziwika bwino yothandizira magawo onse a khansa ya m'mapapo. Njira zotsatirazi zingagwiritsidwe ntchito:

• Cordectomy: Kuchita maopaleshoni kuti muchotse zingwe zamawu zokha.

• Supraglottic laryngectomy: Opaleshoni kuti muchotse ma supraglottis okha.

• Hemilaryngectomy: Opaleshoni yochotsa theka la kholingo (mawu amawu). Matenda a hemilaryngectomy amapulumutsa mawu.

• Laryngectomy pang'ono: Opaleshoni yochotsa gawo lina la kholingo (mawu amawu). Laryngectomy pang'ono imathandiza kuti wodwalayo azitha kuyankhula.

• Kuchuluka kwa kholingo: Kuchita opaleshoni kuchotsa kholingo lonse. Pogwira ntchitoyi, dzenje limapangidwa kutsogolo kwa khosi kuti wodwalayo apume. Izi zimatchedwa tracheostomy.

• Thyroidectomy: Kuchotsa zonse kapena gawo la chithokomiro.

• Opaleshoni ya Laser: Njira yochitira opaleshoni yomwe imagwiritsa ntchito mtanda wa laser (kamtengo kakang'ono kowala kwambiri) ngati mpeni wopangira magazi mopanda magazi kapena kuchotsa zotupa zapamtunda monga chotupa m'mphako.

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

Chemotherapy ndi chithandizo cha khansa chomwe chimagwiritsa ntchito mankhwala kuletsa kukula kwa maselo a khansa, mwina popha ma cell kapena poyimitsa ma cell 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).

Onani Mankhwala Ovomerezeka a Khansa ya Mutu ndi Khosi kuti mumve zambiri. (Khansara ya Laryngeal ndi mtundu wa khansa yamutu ndi khosi.)

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. Nivolumab ndi pembrolizumab ndi mitundu yamatenda oyang'anira chitetezo cha mthupi omwe amagwiritsidwa ntchito pochiza khansa yam'mapapo kapena yam'mapapo.

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).

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 mtundu wa chithandizo chomwe chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti ziwononge maselo ena a khansa. Njira zochiritsira zomwe zimayang'aniridwa sizimavulaza maselo wamba kuposa chemotherapy kapena radiation.

• Ma antibodies a monoclonal: Mankhwalawa amagwiritsira ntchito ma antibodies opangidwa mu labotore kuchokera ku mtundu umodzi wamthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino m'magazi kapena minofu yomwe ingathandize 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. Cetuximab ikuwerengedwa pochiza khansa yapakhungu.

Othandizira ma Radiosensitizers

Ma Radiosensitizers ndi mankhwala omwe amachititsa kuti maselo am'mimba azindikire kwambiri mankhwalawa. Kuphatikiza mankhwala a radiation ndi ma radiosensitizers atha kupha ma cell ambiri otupa.

Chithandizo cha khansa ya m'mapapo chingayambitse mavuto.

Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

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 vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Kuchiza kwa Khansa ya Laryngeal

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

Chithandizo cha siteji yomwe yangotipeza kumene khansa ya kholingo imadalira komwe khansa imapezeka m'mphako.

Ngati khansa ili mu supraglottis, chithandizo chitha kuphatikizira izi:

• Thandizo la radiation.

• Supraglottic laryngectomy.

Ngati khansa ili mu glottis, chithandizo chitha kuphatikizira izi:

• Thandizo la radiation.

• Opaleshoni ya Laser.

• Cordectomy.

• Kupumira pang'ono kwa laryngectomy, hemilaryngectomy, kapena laryngectomy yathunthu.

Ngati khansa ili mu subglottis, chithandizo chitha kuphatikizira izi:

• Thandizo la radiation popanda kapena opaleshoni.

• Opaleshoni yokha.

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.

Kuchiza kwa Gawo lachiwiri la khansa ya kholingo

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

Chithandizo cha khansa yaposachedwa yapa khansa laryngeal imadalira komwe khansa imapezeka m'mphako.

Ngati khansa ili mu supraglottis, chithandizo chitha kuphatikizira izi:

• Thandizo la radiation kwa chotupacho ndi ma lymph node apafupi.

• Supraglottic laryngectomy yomwe ingatsatidwe ndi mankhwala a radiation.

Ngati khansa ili mu glottis, chithandizo chitha kuphatikizira izi:

• Thandizo la radiation.

• Opaleshoni ya Laser.

• Kupumira pang'ono kwa laryngectomy, hemilaryngectomy, kapena laryngectomy yathunthu.

Ngati khansa ili mu subglottis, chithandizo chitha kuphatikizira izi:

• Thandizo la radiation popanda kapena opaleshoni.

• Opaleshoni yokha.

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.

Kuchiza kwa Gawo lachitatu la khansa ya kholingo

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

Chithandizo cha khansa yaposachedwa yapa khansa laryngeal imadalira komwe khansa imapezeka m'mphako.

Ngati khansa ili mu supraglottis, chithandizo chitha kuphatikizira izi:

• Chemotherapy ndi mankhwala a radiation operekedwa limodzi

• Chemotherapy yotsatira ndi chemotherapy ndi radiation radiation yoperekedwa limodzi. Laryngectomy itha kuchitika ngati khansara idatsalira.

• Mankhwala a radiation okha kwa odwala omwe sangachiritsidwe ndi chemotherapy ndi opaleshoni.

• Opaleshoni, yomwe ingatsatidwe ndi mankhwala a radiation.

Ngati khansa ili mu glottis, chithandizo chitha kuphatikizira izi:

• Chemotherapy ndi mankhwala a radiation operekedwa limodzi.

• Chemotherapy yotsatira ndi chemotherapy ndi radiation radiation yoperekedwa limodzi. Laryngectomy itha kuchitika ngati khansara idatsalira.

• Mankhwala a radiation okha kwa odwala omwe sangachiritsidwe ndi chemotherapy ndi opaleshoni.

• Opaleshoni, yomwe ingatsatidwe ndi mankhwala a radiation.

• Kuyesedwa kwachipatala kwa mankhwala a radiation okha poyerekeza ndi radiation ndi targeted cetuximab).

• Kuyesedwa kwachipatala kwa immunotherapy, chemotherapy, radiosensitizers, kapena radiation radiation.

Ngati khansa ili mu subglottis, chithandizo chitha kuphatikizira izi:

• Laryngectomy kuphatikiza thyroidectomy yathunthu ndikuchotsa ma lymph node pakhosi, nthawi zambiri amatsatiridwa ndi radiation radiation.

• Mankhwala a radiation amatsatiridwa ndi opaleshoni ngati khansa ibwerera mderalo.

• Mankhwala a radiation okha kwa odwala omwe sangachiritsidwe ndi chemotherapy ndi opaleshoni.

• Chemotherapy yotsatira ndi chemotherapy ndi radiation radiation yoperekedwa limodzi. Laryngectomy itha kuchitika ngati khansara idatsalira.

• Kuyesedwa kwachipatala kwa mankhwala a radiation okha poyerekeza ndi radiation ndi targeted cetuximab).

• Kuyesedwa kwachipatala kwa immunotherapy, chemotherapy, radiosensitizers, kapena radiation 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.

Kuchiza kwa Khansa ya Laryngeal Cancer IV

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

Kuchiza kwa khansa yaposachedwa ya IVA, IVB, ndi IVC laryngeal khansa zimadalira komwe khansa imapezeka m'mphako.

Ngati khansa ili mu supraglottis kapena glottis, chithandizo chitha kuphatikizira izi:

• Chemotherapy ndi mankhwala a radiation operekedwa limodzi.

• Chemotherapy yotsatira ndi chemotherapy ndi radiation radiation yoperekedwa limodzi. Laryngectomy itha kuchitika ngati khansara idatsalira.

• Mankhwala a radiation okha kwa odwala omwe sangachiritsidwe ndi chemotherapy ndi opaleshoni.

• Opaleshoni yotsatiridwa ndi mankhwala a radiation. Chemotherapy itha kuperekedwa ndi mankhwalawa.

• Kuyesedwa kwachipatala kwa mankhwala a radiation okha poyerekeza ndi radiation ndi targeted cetuximab).

• Kuyesedwa kwachipatala kwa immunotherapy, chemotherapy, radiosensitizers, kapena radiation radiation.

Ngati khansa ili mu subglottis, chithandizo chitha kuphatikizira izi:

• Laryngectomy kuphatikiza thyroidectomy yathunthu ndikuchotsa ma lymph node pakhosi, nthawi zambiri amatsatiridwa ndi radiation radiation kapena chemotherapy.

• Chemotherapy ndi mankhwala a radiation operekedwa limodzi.

• Kuyesedwa kwachipatala kwa mankhwala a radiation okha poyerekeza ndi radiation ndi targeted cetuximab).

• Kuyesedwa kwachipatala kwa immunotherapy, chemotherapy, radiosensitizers, kapena radiation 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.

Kuchiza kwa Khansa ya Metastatic and Recurrent Laryngeal Cancer

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

Chithandizo cha khansa yam'mapapo ndi m'mene mungaphatikizire izi ndi izi:

• Kuchita opaleshoni kapena popanda mankhwala a radiation.

• Thandizo la radiation.

• Chemotherapy.

• Immunotherapy ndi pembrolizumab kapena nivolumab.

• Kuyesedwa kwachipatala kwa chithandizo chatsopano.

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 za khansa ya m'mapapo

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza khansa ya m'mapapo, onani izi:

• Tsamba Loyambira Khansa Yam'mutu Ndi Khosi

• Zovuta Zamlomo za Chemotherapy ndi Head / Neck Radiation

• Lasers mu Chithandizo cha Khansa

• Mankhwala Ovomerezeka a Khansa ya Mutu ndi Khosi

• Njira Zochizira Khansa

• Immunotherapy Kuchiza Khansa

• Khansa ya Mutu ndi Khosi

• Fodya (kuphatikizapo chithandizo chosiya)

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa

• Kusinthana

• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa

• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira