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

Kuchiza Khansa ya Oropharyngeal (Wamkulu) (®) -Patient Version

Zambiri Za Khansa ya Oropharyngeal

MFUNDO ZOFUNIKA

• Khansa ya Oropharyngeal ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a oropharynx.

• Kusuta kapena kutenga kachilombo ka papillomavirus ya anthu (HPV) kumatha kuwonjezera ngozi ya khansa ya oropharyngeal.

• Zizindikiro za khansa ya oropharyngeal zimaphatikizapo chotupa m'khosi ndi pakhosi.

• Kuyesa komwe kumafufuza pakamwa ndi pakhosi kumagwiritsidwa ntchito kuthandizira kupeza khansa ya oropharyngeal.

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

Khansa ya Oropharyngeal ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a oropharynx.

Oropharynx ndi gawo lapakati la pharynx (mmero), kuseri kwa pakamwa. Pharynx ndi chubu chopanda kanthu pafupifupi mainchesi 5 kutalika komwe kumayambira kuseri kwa mphuno ndikumathera pomwe trachea (windpipe) ndi esophagus (chubu kuchokera pakhosi mpaka mmimba) imayamba. Mpweya ndi chakudya zimadutsa kholingo panjira yopita ku trachea kapena kummero.

Anatomy ya pharynx (mmero). Pharynx ndi chubu chopanda pake chomwe chimayambira kuseri kwa mphuno, kutsika khosi, ndikumaliza pamwamba pa trachea ndi kholingo. Magawo atatu a pharynx ndi nasopharynx, oropharynx, ndi hypopharynx.

Oropharynx imaphatikizapo izi:

• Mlomo wofewa.

• Makoma ammbali ndi kumbuyo kwa mmero.

• Tonsils.

• Kubwerera gawo limodzi mwa magawo atatu a lilime.

Mbali za oropharynx. Oropharynx imaphatikizapo mkamwa wofewa, khoma ndi kumbuyo kwa mmero, matani, ndi gawo lachitatu kumbuyo kwa tong

Khansa ya Oropharyngeal ndi mtundu wa khansa yamutu ndi khosi. Nthawi zina khansa yopitilira imodzi imatha kupezeka mu oropharynx komanso mbali zina za mkamwa, mphuno, pharynx, larynx (mawu bokosi), trachea, kapena khosi nthawi yomweyo.

Khansa yambiri ya oropharyngeal ndi squamous cell carcinomas. Maselo a squamous ndi maselo ofooka, opyapyala omwe amakhala mkati mwa oropharynx.

Onani zowerengera zotsatirazi za kuti mumve zambiri za mitundu ina ya khansa yamutu ndi khosi:

• Chithandizo cha Khansa ya Hypopharyngeal (Wamkulu)

• Kuchiza Khansa Yam'milomo ndi pakamwa (Wamkulu)

• Pakamwa Pakamwa, Pharyngeal, ndi Laryngeal Cancer Prevention

• Mphakamwa pakamwa, Pharyngeal, ndi Kuunika kwa Khansa ya Laryngeal

Kusuta kapena kutenga kachilombo ka papillomavirus ya anthu (HPV) kumatha kuwonjezera ngozi ya khansa ya oropharyngeal.

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.

Zowopsa zomwe zimayambitsa khansa ya oropharyngeal ndi izi:

• Mbiri yakusuta ndudu kwa zaka zoposa 10 paketi ndi kugwiritsa ntchito fodya.

• Kukhala ndi kachilombo ka papillomavirus ya anthu (HPV), makamaka mtundu wa HPV 16. Kuchuluka kwa milandu ya khansa ya oropharyngeal yolumikizidwa ndi matenda a HPV ikukula.

• Mbiri ya khansa ya mutu ndi khosi.

• Kumwa mowa kwambiri.

• Kutafuna betel quid, cholimbikitsa chomwe chimagwiritsidwa ntchito kwambiri m'malo ena ku Asia.

Zizindikiro za khansa ya oropharyngeal zimaphatikizapo chotupa m'khosi ndi pakhosi.

Izi ndi zizindikilo zina zimatha kubwera chifukwa cha khansa ya oropharyngeal kapena zovuta zina. Funsani dokotala ngati muli ndi izi:

• Pakhosi pakhungu lomwe silichoka.

• Vuto kumeza.

• Mavuto kutsegula pakamwa kwathunthu.

• Zovuta kusuntha lilime.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Kumva khutu.

• Chotumphuka kumbuyo kwa mkamwa, pakhosi, kapena m'khosi.

• Chigamba choyera pa lilime kapena pamulu pakamwa chomwe sichichoka.

• Kutsokomola magazi.

Nthawi zina khansa ya oropharyngeal siyimayambitsa zizindikilo zoyambirira.

Kuyesa komwe kumafufuza pakamwa ndi pakhosi kumagwiritsidwa ntchito kuthandizira kupeza khansa ya oropharyngeal.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuyezetsa thupi komanso mbiri yaumoyo: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza kuwunika kwa matenda, monga ma lymph node otupa m'khosi kapena china chilichonse chomwe chimawoneka chachilendo. Dokotala kapena wamankhwala amayesa kwathunthu pakamwa ndi m'khosi ndipo amayang'ana pansi pa lilime ndikutsika pakhosi ndi galasi yaying'ono, yayitali kuti aone ngati ali ndi vuto. 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.

• 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 jambulani limadzipangira lokha. Kujambula kwa PET-CT kungagwiritsidwe ntchito kuthandizira kuzindikira matenda, monga khansa, kukonzekera chithandizo, kapena kudziwa momwe chithandizo chikuyendera.

• CT scan (CAT scan): Njira yomwe imafotokozera mwatsatanetsatane madera amkati mwa thupi, monga mutu, khosi, chifuwa, ndi ma lymph node, otengedwa mbali zosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto umalowetsedwa 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.

• 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 (positron emission tomography) sikani. Wodwala amagona patebulo lomwe limadutsa makina a PET. Kupuma kwamutu ndi zingwe zoyera kumathandiza wodwalayo kugona. Kagawidwe kakang'ono ka shuga (radio) kamene kamabayidwa mu mtsempha wa wodwalayo, ndipo sikani yake imapanga chithunzi cha komwe shugawo amagwiritsidwa ntchito mthupi. Maselo a khansa amawonekera bwino pachithunzichi chifukwa amatenga shuga wambiri kuposa momwe maselo amachitira.

• 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).

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Kawirikawiri katemera wa singano amachitidwa kuti achotse nyemba pogwiritsa ntchito singano yopyapyala.

Njira zotsatirazi zitha kugwiritsidwa ntchito kuchotsa maselo kapena minofu:

• Endoscopy: Ndondomeko yoyang'ana ziwalo ndi zotupa mkati mwa thupi kuti muwone ngati pali zovuta zina. Endoscope imalowetsedwa kudzera pakameta (khungu) pakhungu kapena potsegula mthupi, monga pakamwa kapena mphuno. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chotsitsira minofu yachilendo kapena ma lymph node, omwe amayang'aniridwa ndi microscope ngati ali ndi matenda. Mphuno, mmero, kumbuyo kwa lilime, ezophagus, m'mimba, kholingo, mphepo yamkuntho, ndi mayendedwe akulu awunikira. Mtundu wa endoscopy umatchulidwa gawo la thupi lomwe likufufuzidwa. Mwachitsanzo, pharyngoscopy ndimayeso owunika pharynx.

• 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.

Ngati khansa ipezeka, mayeso otsatirawa atha kuchitidwa kuti muphunzire za maselo a khansa:

• Kuyesa kwa HPV (kuyesa kwa papillomavirus ya anthu): Kuyesa kwa labotale komwe kumayang'ana mtundu wa minofu yamitundu ina ya matenda a HPV, monga HPV mtundu wa 16. Kuyesaku kumachitika chifukwa cha khansa ya oropharyngeal imatha kuyambitsidwa ndi matenda a HPV. Izi ndizofunikira chifukwa khansa ya HPV-oropharyngeal khansa imawonekera bwino ndipo imachiritsidwa mosiyana ndi khansa ya HPV-oropharyngeal khansa.

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

Kulosera kumatengera izi:

• Kaya wodwalayo ali ndi matenda a HPV a oropharynx.

• Kaya wodwalayo ali ndi mbiri yosuta ndudu kwa zaka khumi kapena kupitilira apo.

• Gawo la khansa.

• Chiwerengero ndi kukula kwa ma lymph node omwe ali ndi khansa.

Zotupa za Oropharyngeal zokhudzana ndi matenda a HPV zimakhala ndi vuto labwino ndipo sizimatha kubwereranso kuposa zotupa zosagwirizana ndi matenda a HPV.

Njira zochiritsira zimadalira izi:

• Gawo la khansa.

• Kuthandiza wodwalayo kuti azitha kuyankhula ndi kumeza momwe angathere.

• Thanzi labwino la wodwalayo.

Odwala omwe ali ndi khansa ya oropharyngeal ali ndi chiopsezo chowonjezeka cha khansa ina pamutu kapena m'khosi. Izi zimawonjezera odwala omwe akupitiliza kusuta kapena kumwa mowa atalandira chithandizo.

Onani chidule cha Kusuta Fodya: Zowopsa Zaumoyo ndi Momwe Mungasiyire kuti mumve zambiri.

Magawo a Khansa ya Oropharyngeal

MFUNDO ZOFUNIKA

• Khansa ya oropharyngeal itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa oropharynx 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 ya orvaryngeal khansa ya HPV:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya HPV-oropharyngeal khansa:

• Gawo 0 (Carcinoma mu Situ)

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

Khansa ya oropharyngeal itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa oropharynx kapena mbali zina za thupi.

Njira yomwe amagwiritsidwa ntchito pofufuza ngati khansara yafalikira mkati mwa oropharynx kapena mbali zina za thupi amatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo. Zotsatira za mayeso ena omwe amagwiritsidwa ntchito pozindikira khansa ya oropharyngeal amagwiritsidwa ntchito poyambitsa 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 oropharyngeal imafalikira m'mapapu, maselo a khansa m'mapapu alidi khansa ya oropharyngeal. Matendawa ndi khansa ya m'mimba, osati khansa yamapapo.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya orvaryngeal khansa ya HPV:

Gawo I

Pachigawo choyamba, chimodzi mwa izi ndi zoona:

• Ma lymph node amodzi kapena angapo omwe ali ndi khansa omwe ali ndi HPV p16-positive amapezeka koma komwe khansa idayambira sikudziwika. Ma lymph nodes omwe ali ndi khansa ndi masentimita 6 kapena ocheperako, mbali imodzi ya khosi; kapena

• khansara imapezeka mu oropharynx (pakhosi) ndipo chotupacho chili ndi masentimita 4 kapena ocheperako. Khansa ikhoza kufalikira kumatenda amodzi kapena angapo omwe ali masentimita 6 kapena ocheperako, mbali yomweyo ya khosi ngati chotupa choyambirira.

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).

Gawo II

Mu gawo lachiwiri, chimodzi mwa izi ndi chowonadi:

• Ma lymph node amodzi kapena angapo omwe ali ndi khansa omwe ali ndi HPV p16-positive amapezeka koma komwe khansa idayambira sikudziwika. Ma lymph nodes omwe ali ndi khansa ndi masentimita 6 kapena ocheperako, mbali imodzi kapena mbali zonse ziwiri za khosi; kapena

• chotupacho chili ndi masentimita 4 kapena ocheperako. Khansa yafalikira ku ma lymph node omwe ali masentimita 6 kapena ocheperako, mbali inayo ya khosi ngati chotupa chachikulu kapena mbali zonse ziwiri za khosi; kapena

• chotupacho chimakhala chachikulu kuposa masentimita 4 kapena khansa yafalikira pamwamba pa epiglottis (chiphuphu chomwe chimakwirira trachea mukameza). Khansa imatha kufalikira kumatenda amtundu umodzi kapena angapo omwe ali masentimita 6 kapena ocheperako, kulikonse m'khosi.

Gawo III

Mu gawo lachitatu, chimodzi mwazi ndi zoona:

• khansara yafalikira kummero (mawu am'mabokosi), mbali yakutsogolo kwa denga la m'kamwa, nsagwada zapansi, minofu yoyendetsa lilime, kapena mbali zina za mutu kapena khosi. Khansa ikhoza kufalikira ku ma lymph node m'khosi; kapena

• chotupacho chimakhala chachikulu ndipo khansa itha kufalikira kummero, kutsogolo kwa denga la pakamwa, nsagwada zapansi, minofu yomwe imasuntha lilime, kapena mbali zina za mutu kapena khosi. Khansara yafalikira ku ma lymph node amodzi kapena angapo omwe ndi akulu kuposa masentimita 6, kulikonse m'khosi.

Gawo IV

Mu gawo IV, khansa yafalikira mbali zina za thupi, monga mapapo kapena fupa.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya HPV-oropharyngeal khansa:

Gawo 0 (Carcinoma mu Situ)

Mu gawo la 0, maselo osadziwika amapezeka mumtambo wa oropharynx (mmero). Maselo achilendowa amatha kukhala khansa ndikufalikira m'minyewa yabwinobwino. Gawo 0 limatchedwanso carcinoma in situ.

Gawo I

Pachigawo choyamba, khansa yapanga. Chotupacho chili ndi masentimita awiri kapena ocheperako.

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).

Gawo II

Mu gawo lachiwiri, chotupacho chimakhala chachikulu kuposa masentimita awiri koma osaposa 4 sentimita.

Gawo III

Mu gawo lachitatu, khansa:

• imakhala yayikulu kuposa masentimita 4 kapena yafalikira pamwamba pa epiglottis (chiphuphu chomwe chimakwirira trachea mukameza); kapena

• ndi kukula kulikonse. Khansara yafalikira ku lymph node imodzi yomwe ili masentimita atatu kapena ocheperako, mbali yomweyo ya khosi monga chotupa choyambirira.

Gawo IV

Gawo IV lidagawika magawo IVA, IVB, ndi IVC.

• Pa siteji IVA, khansa:

• wafalikira kumphako (mawu am'mabokosi), mbali yakutsogolo kwa denga la pakamwa, nsagwada zapansi, kapena minofu yomwe imasuntha lilime. Khansa ikhoza kufalikira ku lymph node imodzi yomwe ili masentimita atatu kapena ocheperako, mbali yomweyo ya khosi ngati chotupa choyambirira; kapena

• kukula kulikonse ndipo mwina kufalikira kumtunda kwa epiglottis, kholingo, mbali yakutsogolo kwa denga la pakamwa, nsagwada m'munsi, kapena minofu yomwe imasuntha lilime. Khansa yafalikira ku chimodzi mwa izi:

• mwanabele wina yemwe ndi wamkulu kuposa masentimita atatu koma osakulirapo kuposa masentimita 6, mbali yomweyo ya khosi ngati chotupa choyambirira; kapena

• ma lymph node opitilira 1 omwe ali masentimita 6 kapena ocheperako, paliponse m'khosi.

• Mu gawo la IVB, khansa:

• yafalikira ku minofu yomwe imasuntha nsagwada yakumunsi, fupa lomwe limalumikizidwa ndi minofu yomwe imasuntha nsagwada yakumunsi, m'munsi mwa chigaza, kapena kudera lakumbuyo kwa mphuno kapena kuzungulira mtsempha wa carotid. Khansa ikhoza kufalikira ku ma lymph node m'khosi; kapena

• atha kukula ndipo atha kufalikira mbali zina za mutu kapena khosi. Khansara yafalikira kumalo am'mimba omwe ndi akulu kuposa masentimita 6 kapena afalikira kupyola kunja kwa lymph node m'matumba oyandikana nawo.

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

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya oropharyngeal.

• Odwala omwe ali ndi khansa ya oropharyngeal akuyenera kukonzekera chithandizo chawo ndi gulu la madokotala omwe ali ndi ukatswiri wochiza khansa yamutu ndi khosi.

• Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chitetezo chamatenda

• Chithandizo cha khansa ya oropharyngeal 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 cha odwala khansa ya oropharyngeal.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi khansa ya oropharyngeal. 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.

Odwala omwe ali ndi khansa ya oropharyngeal akuyenera kukonzekera chithandizo chawo ndi gulu la madokotala omwe ali ndi ukatswiri wochiza khansa yamutu ndi khosi.

Chithandizo cha wodwalayo chidzayang'aniridwa ndi a oncologist wazamankhwala, dokotala yemwe amachita bwino ntchito yothandiza anthu omwe ali ndi khansa. Chifukwa oropharynx imathandizira kupuma, kudya, komanso kuyankhula, odwala angafunike thandizo lapadera kuti athe kusintha pazotsatira za khansa ndi chithandizo chake. Odwala oncologist atha kutumiza wodwalayo kwa akatswiri ena azaumoyo omwe ali ndi maphunziro apadera othandizira odwala omwe ali ndi khansa yamutu ndi khosi. Izi zingaphatikizepo akatswiri awa:

• Opanga mutu ndi khosi.

• Wofufuza oncologist.

• Dokotala wa pulasitiki.

• Dokotala wamano.

• Kudya.

• Katswiri wa zamaganizo.

• Katswiri wokonzanso.

• Wothandizira kulankhula.

Mitundu inayi yamankhwala omwe amagwiritsidwa ntchito amagwiritsidwa ntchito:

Opaleshoni

Kuchita opaleshoni (kuchotsa khansara mu opaleshoni) ndi njira yodziwika bwino yothandizira magawo onse a khansa ya oropharyngeal. Dokotalayo amatha kuchotsa khansara ndi minofu ina yathanzi. Dokotalayo atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoni, odwala ena amatha 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.

Mitundu yatsopano ya maopareshoni, kuphatikiza opareshoni ya kanthawi kochepa, ikuwerengedwa pochiza khansa ya oropharyngeal. Opaleshoni ya robotic yotsogola itha kugwiritsidwa ntchito kuchotsa khansa m'malo ovuta kufikako mkamwa ndi kukhosi. Makamera ophatikizidwa ndi loboti amapereka chithunzi cha 3-dimensional (3D) chomwe dotolo amatha kuwona. Pogwiritsa ntchito kompyuta, dokotalayo amatsogolera zida zing'onozing'ono kumapeto kwa mikono ya robot kuti achotse khansayo. Njirayi itha kuchitidwanso pogwiritsa ntchito endoscope.

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.

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

• 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: Mankhwala opatsirana pogwiritsa ntchito mphamvu ya stereotactic ndi mtundu wa mankhwala owonekera kunja. Zipangizo zapadera zimagwiritsidwa ntchito kuyika wodwalayo pamalo omwewo pachithandizo chilichonse cha radiation. Kamodzi patsiku kwa masiku angapo, makina opanga ma radiation amayang'ana kuchuluka kwa radiation poyerekeza ndi chotupacho. Pokhala ndi wodwala pamalo omwewo pachithandizo chilichonse, pamakhala kuchepa pang'ono pamatenda athanzi oyandikira. Njirayi imatchedwanso stereotactic kunja kwa dothi radiation mankhwala ndi stereotaxic radiation therapy.

Mu khansa yapadera ya oropharyngeal, kugawa kuchuluka kwa radiation ya mankhwala ocheperako kumathandizira momwe chotupacho chimayankhira kuchipatala. Izi zimatchedwa hyperfractionated radiation therapy.

Thandizo la radiation lingagwire ntchito bwino kwa odwala omwe asiya kusuta asanayambe kulandira chithandizo.

Ngati chithokomiro kapena pituitary gland ndi gawo lamankhwala ochizira ma radiation, wodwalayo ali ndi chiopsezo chowonjezeka cha hypothyroidism (mahomoni ochepa kwambiri a chithokomiro). Kuyezetsa magazi kuti muwone kuchuluka kwa mahomoni a chithokomiro mthupi kuyenera kuchitidwa musanalandire chithandizo.

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).

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

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 ndi mtundu wa mankhwala omwe amagwiritsidwa ntchito pochiza khansa ya oropharyngeal.

Mankhwala a monoclonal antibody ndi mankhwala a khansa omwe amagwiritsa ntchito ma antibodies opangidwa mu labotale 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 ndi mtundu wa anti-monoclonal antibody yomwe imagwira ntchito pomanga puloteni yomwe ili pamwamba pamaselo a khansa ndikuyimitsa ma cell kuti asakule ndikugawana. Amagwiritsidwa ntchito pochiza khansa yapawiri komanso ya metastatic oropharyngeal.

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

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.

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.

PD-1 inhibitors ndi mtundu wa immunotherapy wotchedwa immune checkpoint inhibitor therapy. PD-1 ndi puloteni pamwamba pamaselo a 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.

Pembrolizumab ndi nivolumab ndi mitundu ya PD-1 inhibitors yomwe imaphunziridwa pochiza khansa ya oropharnygeal.

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).

Chithandizo cha khansa ya oropharyngeal 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.

Kutsatira chithandizo, ndikofunikira kuyesa mosamala mutu ndi khosi kuti muwone ngati zizindikiro za khansa zabweranso. Kuyendera kudzachitika milungu isanu ndi umodzi kapena isanu ndi iwiri mchaka choyamba, miyezi itatu iliyonse mchaka chachiwiri, miyezi itatu mpaka inayi iliyonse mchaka chachitatu, komanso miyezi isanu ndi umodzi pambuyo pake.

Njira Zothandizira ndi Gawo

M'chigawo chino

• Gawo I ndi Gawo II Khansa ya Oropharyngeal

• Gawo lachitatu ndi khansa ya khansa ya Oropharyngeal

• Khansa ya Metastatic and Recurrent Oropharyngeal Cancer

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

Gawo I ndi Gawo II Khansa ya Oropharyngeal

Chithandizo cha gawo loyamba ndi khansa yachiwiri ya khansa imatha kukhala ndi izi:

• Thandizo la radiation.

• Opaleshoni.

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.

Gawo lachitatu ndi khansa ya khansa ya Oropharyngeal

Chithandizo cha khansa yaposachedwa ya khansa ya oropharyngeal ndi khansa ya khansa ya oropharyngeal ingaphatikizepo izi:

• Kwa odwala omwe ali ndi khansa yakomweko, opaleshoni yomwe imatsatiridwa ndi ma radiation. Chemotherapy imaperekedwanso nthawi imodzimodzi ngati mankhwala a radiation.

• Mankhwala a radiation okha kwa odwala omwe sangakhale ndi chemotherapy.

• Chemotherapy yoperekedwa nthawi yomweyo ngati mankhwala a radiation.

• Chemotherapy yotsatira ndi mankhwala a radiation operekedwa nthawi yomweyo monga chemotherapy yambiri.

• Kuyesedwa kwachipatala kwa chemotherapy komwe kumatsatiridwa ndi opaleshoni kapena mankhwala a radiation.

• Kuyesedwa kwachipatala kwa mankhwala omwe amalimbana nawo (nivolumab) okhala ndi chemotherapy yoperekedwa nthawi yomweyo ngati mankhwala a radiation kwa odwala omwe ali ndi khansa ya HPV-oropharyngeal advanced.

• Kuyesedwa kwachipatala kwa mankhwala a radiation kapena chemotherapy.

• Kuyesedwa kwachipatala kwa opareshoni yamtsogolo komwe kumatsatiridwa ndi mankhwala ochepetsa mphamvu ya poizoniyu kapena opanda chemotherapy mwa omwe ali ndi khansa ya HPV-oropharyngeal khansa.

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.

Khansa ya Metastatic and Recurrent Oropharyngeal Cancer

Khansa yaposachedwa ya oropharyngeal yabwereranso mu oropharynx kapena mbali zina za thupi itachiritsidwa. Chithandizo cha khansa ya oropharyngeal yomwe yasintha (kufalikira mbali zina za thupi) kapena kubwereranso mu oropharynx ingaphatikizepo izi:

• Opaleshoni, ngati chotupacho sichiyankha mankhwalawa.

• Thandizo la radiation, ngati chotupacho sichinachotsedwe kwathunthu ndi opareshoni komanso cheza cham'mbuyomu sichinaperekedwe.

• Opaleshoni yachiwiri, ngati chotupacho sichinachotsedwe kwathunthu ndi opaleshoni yoyamba.

• Chemotherapy kwa odwala omwe ali ndi khansa yabwinobwino yomwe singachotsedwe ndi opaleshoni.

• Mankhwala a radiation amaperekedwa nthawi yomweyo monga chemotherapy.

• Mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogonana.

• Kuyesedwa kwamankhwala kwamankhwalawa, ma stereotactic radiation radiation, kapena hyperfractionated radiation mankhwala operekedwa nthawi yomweyo monga chemotherapy.

• Kuyesedwa kwachipatala kwa immunotherapy (nivolumab kapena pembrolizumab).

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 Oropharyngeal

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza khansa ya oropharyngeal, onani izi:

• Tsamba Loyambira Khansa Yam'mutu Ndi Khosi

• Pakamwa Pakamwa, Pharyngeal, ndi Laryngeal Cancer Prevention

• Mphakamwa pakamwa, Pharyngeal, ndi Kuunika kwa Khansa ya Laryngeal

• Zovuta Zamlomo za Chemotherapy ndi Head / Neck Radiation

• HPV ndi Khansa

• Mankhwala Ovomerezeka a Khansa ya Mutu ndi Khosi

• 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