Mitundu / neuroblastoma / wodwala / neuroblastoma-treatment-pdq

Chithandizo cha Neuroblastoma (®) -Patient Version

Zambiri Zokhudza Neuroblastoma

MFUNDO ZOFUNIKA

• Neuroblastoma ndi matenda omwe ma cell owopsa (khansa) amapangidwa mu ma neuroblast (minofu yaying'ono yamankhwala) m'matenda a adrenal, khosi, chifuwa, kapena msana.

• Neuroblastoma nthawi zina imayamba chifukwa cha kusintha kwa majini (kusintha) kuchokera kwa kholo kupita kwa mwana.

• Zizindikiro za neuroblastoma zimaphatikizapo chotupa m'mimba, khosi, chifuwa kapena kupweteka kwa mafupa.

• Kuyesa komwe kumayang'ana minyewa yambiri yamadzi ndi madzi kumagwiritsidwa ntchito pozindikira neuroblastoma.

• Biopsy yachitika kuti apeze neuroblastoma.

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

Neuroblastoma ndi matenda omwe ma cell owopsa (khansa) amapangidwa mu ma neuroblast (minofu yaying'ono yamankhwala) m'matenda a adrenal, khosi, chifuwa, kapena msana.

Neuroblastoma nthawi zambiri imayamba m'mitsempha ya adrenal gland. Pali zopangitsa ziwiri za adrenal, imodzi pamwamba pa impso iliyonse kumbuyo kwa pamimba. Zotupitsa za adrenal zimapanga mahomoni ofunikira omwe amathandiza kuchepetsa kugunda kwa mtima, kuthamanga kwa magazi, shuga wamagazi, komanso momwe thupi limachitira ndikapanikizika. Neuroblastoma amathanso kuyamba minofu yaminyezi m'khosi, pachifuwa, pamimba, kapena m'chiuno.

Neuroblastoma imatha kupezeka m'matumbo a adrenal ndi minofu ya m'mimba kuchokera m'khosi mpaka m'chiuno.

Neuroblastoma nthawi zambiri imayamba ali wakhanda. Kawirikawiri amapezeka pakati pa mwezi woyamba wa moyo ndi zaka zisanu. Amapezeka pomwe chotupacho chimayamba kukula ndikupangitsa zizindikilo kapena zizindikilo. Nthawi zina amapangidwa asanabadwe ndipo amapezeka panthawi yopanga mwanayo.

Pofika nthawi yomwe khansa imapezeka, imakhala itafalikira (kufalikira). Neuroblastoma imafalikira pafupipafupi ku ma lymph node, mafupa, mafupa, chiwindi, ndi khungu mwa makanda ndi ana. Achinyamata amathanso kukhala ndi metastasis m'mapapu ndi ubongo.

Neuroblastoma nthawi zina imayamba chifukwa cha kusintha kwa majini (kusintha) kuchokera kwa kholo kupita kwa mwana.

Kusintha kwa majini komwe kumawonjezera chiopsezo cha neuroblastoma nthawi zina kumatengera (kuchokera kwa kholo kupita kwa mwana). Kwa ana omwe ali ndi kusintha kwa majini, neuroblastoma nthawi zambiri imachitika akadali aang'ono ndipo chotupa chimodzi chimatha kupangika m'matenda a adrenal kapena muminyewa yapakhosi, pachifuwa, pamimba, kapena m'chiuno.

Ana omwe ali ndi kusintha kwa majini kapena majini obadwa nawo (obadwa nawo) ayenera kufufuzidwa ngati ali ndi matenda a neuroblastoma mpaka atakwanitsa zaka 10. Mayeso otsatirawa atha kugwiritsidwa ntchito:

• Mimba yam'mimba ya ultrasound: Kuyesedwa komwe mafunde amawu amphamvu (ultrasound) amachokera pamimba ndikupanga ma echoes. Zolembawo amapanga chithunzi cha mimba yotchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake.

• Maphunziro a mkodzo wa catecholamine: Kuyesedwa komwe kuyesa kwamkodzo kuti kuyeze kuchuluka kwa zinthu zina, vanillylmandelic acid (VMA) ndi homovanillic acid (HVA), omwe amapangidwa catecholamines zikawonongeka ndikutuluka mkodzo. Kuchulukirapo kuposa VMA kapena HVA kumatha kukhala chizindikiro cha neuroblastoma.

• X-ray pachifuwa : X-ray ya ziwalo ndi mafupa mkati mwa chifuwa. X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi ndikupita mufilimu, ndikupanga chithunzi cha madera omwe ali mthupi.

Lankhulani ndi dokotala wa mwana wanu za momwe mayeserowa akuyenera kuchitidwira kangapo.

Zizindikiro za neuroblastoma zimaphatikizapo chotupa m'mimba, khosi, chifuwa kapena kupweteka kwa mafupa.

Zizindikiro zofala kwambiri za neuroblastoma zimayambitsidwa ndi chotupa chomwe chimakakamira minofu yapafupi ikamakula kapena khansa ikufalikira kufupa. Zizindikiro izi ndi zina zimatha kuyambitsidwa ndi neuroblastoma kapena matenda ena.

Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Chotupa m'mimba, khosi, kapena chifuwa.

• Kupweteka kwa mafupa.

• Kutupa m'mimba ndi kupuma movutikira (mwa makanda).

• Kutulutsa maso.

• Mdima wozungulira mozungulira maso ("maso akuda").

• Zopanda pake, zotumphukira zabuluu pansi pa khungu (mwa makanda).

• Kufooka kapena kufooka (kutaya mphamvu yosuntha gawo la thupi).

Zizindikiro zochepa za neuroblastoma ndi izi:

• Malungo.

• Kupuma pang'ono.

• Kumva kutopa.

• Kuvulaza kosavuta kapena kutuluka magazi.

• Petechiae (malo athyathyathya, osinkhasinkha pansi pa khungu chifukwa cha magazi)

• Kuthamanga kwa magazi.

• Kutsekula m'madzi koopsa.

• Matenda a Horner (chikope chodontha, mwana wocheperako, komanso thukuta pang'ono mbali imodzi ya nkhope).

• Kusuntha kwaminyewa kwa Jerky.

• Kusuntha kosalamulirika kwa diso.

Kuyesa komwe kumayang'ana minyewa yambiri yamadzi ndi madzi kumagwiritsidwa ntchito pozindikira neuroblastoma.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito pozindikira neuroblastoma:

• Kuyezetsa thupi komanso mbiri yaumoyo: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikizapo 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, momwe angathere kuyenda moyenera, komanso momwe minofu, mphamvu, ndi malingaliro zimagwirira ntchito. Izi amathanso kutchedwa mayeso a neuro kapena mayeso a neurologic.

• Maphunziro a mkodzo wa catecholamine: Kuyesedwa komwe kuyesa kwamkodzo kuti kuyeze kuchuluka kwa zinthu zina, vanillylmandelic acid (VMA) ndi homovanillic acid (HVA), omwe amapangidwa catecholamines zikawonongeka ndikutuluka mkodzo. Kuchulukirapo kuposa VMA kapena HVA kumatha kukhala chizindikiro cha neuroblastoma.

• Kafukufuku wama chemistry a magazi: Kuyesedwa komwe kumayesedwa magazi kuti athe kuyeza kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi ziwalo zathupi. Kuchuluka kapena kutsika kuposa chinthu chachilendo kungakhale chizindikiro cha matenda.

• Kusanthula kwa MIBG: Njira yomwe imagwiritsidwa ntchito kupeza zotupa za neuroendocrine, monga neuroblastoma. Kanthu kakang'ono kwambiri kamene kamatchedwa radioactive MIBG kamalowetsedwa mumtsempha ndikuyenda m'magazi. Maselo otupa a Neuroendocrine amatenga MIBG yamagetsi ndipo amadziwika ndi sikani. Zithunzi zitha kutengedwa masiku 1-3. Yankho la ayodini lingaperekedwe musanayesedwe kapena panthawi yoyesera kuti chithokomiro chisatenge MIBG yambiri. Kuyesaku kumagwiritsidwanso ntchito kuti mudziwe momwe chotupacho chikuyendera bwino kuchipatala. MIBG imagwiritsidwa ntchito kwambiri pochiza neuroblastoma.

• 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.

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

• MRI (magnetic resonance imaging) yokhala ndi gadolinium: Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti ipange zithunzi zingapo zazomwe zili mkati mwa thupi. Chinthu chotchedwa gadolinium chimalowetsedwa mumtsempha. Gadolinium imasonkhanitsa mozungulira maselo a khansa kuti athe kuwonekera pachithunzichi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

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

• 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.

• X-ray ya chifuwa kapena fupa: X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi ndikulowa mufilimu, ndikupanga chithunzi cha madera amkati mwa thupi.

• Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake. Kuyezetsa magazi sikuchitika ngati CT / MRI yachitika.

M'mimba ultrasound. Transducer ya ultrasound yolumikizidwa ndi kompyuta imakanikizidwa pakhungu la pamimba. Transducer imaponya mafunde am'mimba ndi ziwalo zamkati kuti apange ma echo omwe amapanga sonogram (chithunzi cha pakompyuta).

Biopsy yachitika kuti apeze neuroblastoma.

Maselo ndi ziphuphu zimachotsedwa panthawi yomwe zimachitika kuti ziwoneke ndi microscope ndi wodwala kuti aone ngati ali ndi khansa. Momwe biopsy imachitikira zimadalira komwe chotupacho chili mthupi. Nthawi zina chotupacho chimachotsedwa nthawi yomweyo kufufuzidwa kumachitika.

Mayesero otsatirawa akhoza kuchitika pa minofu yomwe yachotsedwa:

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

• Ma microscopy owala: Kuyesa kwa labotale komwe ma cell amtundu wa minofu amawonedwa ndi microscopic yanthawi zonse komanso yamphamvu kwambiri kuti ayang'ane zosintha m'maselo.

• 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.

• Kafukufuku wokulitsa wa MYCN: Kafukufuku wa labotale momwe ma cell am'matumbo kapena m'mafupa amayang'aniridwa pamlingo wa MYCN. MYCN ndiyofunikira pakukula kwama cell. Mulingo wapamwamba wa MYCN (mitundu yopitilira 10 ya jini) umatchedwa kukulitsa kwa MYCN. Neuroblastoma yokhala ndi kukweza kwa MYCN imatha kufalikira mthupi ndipo siyimayankha chithandizo.

Ana osakwanitsa miyezi isanu ndi umodzi sangatenge biopsy kapena opareshoni kuti achotse chotupacho chifukwa chotupacho chitha kutha popanda chithandizo.

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

Njira zakulosera zamankhwala ndi chithandizo zimadalira izi:

• Zaka pa nthawi yodziwitsa.

• Mbiri ya chotupa (mawonekedwe, magwiridwe antchito, kapangidwe ka maselo am'mimba).

• Gulu lowopsa la mwana.

• Kaya pali kusintha kwina m'majini.

• Komwe mthupi mudayamba chotupacho.

• Gawo la khansa.

• Momwe chotupacho chimayankhira chithandizo.

• Ndi nthawi yochuluka bwanji yomwe idadutsa pakati pa kuzindikira ndi pomwe khansara idabwereranso (ya khansa yabwereza).

Njira zodziwitsira ndi chithandizo cha neuroblastoma zimakhudzidwanso ndi chotupa cha biology, chomwe chimaphatikizapo izi:

• Mitundu ya zotupa.

• Maselo otupa ndiosiyana bwanji ndi maselo abwinobwino.

• Kuthamanga kwa chotupa kumakula.

• Kaya chotupacho chikuwonetsa kukweza kwa MYCN.

• Kaya chotupacho chasintha mu jini la ALK.

Biology ya chotupayo akuti ndiyabwino kapena yosasangalatsa, kutengera izi. Mwana yemwe ali ndi chotupa cha biology ali ndi mwayi wabwino wochira.

Kwa ana ena mpaka miyezi isanu ndi umodzi, neuroblastoma imatha kutha popanda chithandizo. Izi zimatchedwa kusintha kwadzidzidzi. Mwanayo amayang'anitsitsa kwambiri zizindikiro za neuroblastoma. Ngati zizindikiro zikuchitika, mungafunike chithandizo.

Magawo a Neuroblastoma

MFUNDO ZOFUNIKA

• Pambuyo poti neuroblastoma yapezeka, amayesedwa kuti apeze ngati khansa yafalikira kuchokera pomwe idayambira kupita 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 neuroblastoma:

• Gawo 1

• Gawo 2

• Gawo 3

• Gawo 4

• Chithandizo cha neuroblastoma chimakhazikitsidwa ndi magulu omwe ali pachiwopsezo.

• Nthawi zina neuroblastoma siyiyankha chithandizo kapena imabweranso mutalandira chithandizo.

Pambuyo poti neuroblastoma yapezeka, amayesedwa kuti apeze ngati khansa yafalikira kuchokera pomwe idayambira kupita mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza kukula kapena kufalikira kwa khansa imatchedwa staging. Zomwe amapeza kuchokera pamagawo amathandizira kudziwa momwe matendawa aliri. Kwa neuroblastoma, gawo la matenda limakhudza ngati khansa ili pachiwopsezo chochepa, chiwopsezo chapakatikati, kapena chiopsezo chachikulu. Zimakhudzanso dongosolo la chithandizo. Zotsatira za mayeso ndi njira zina zomwe zimagwiritsidwa ntchito pozindikira kuti ndi neuroblastoma zitha kugwiritsidwa ntchito popanga magawo. Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwanso ntchito kudziwa gawo:

• Kulakalaka kwa mafuta m'mafupa ndi biopsy: Kuchotsa mafupa, magazi, ndi kachigawo kakang'ono ka fupa poika singano yopanda kanthu m'chiuno kapena m'chifuwa. Dokotala akuwona mafupa, magazi, ndi mafupa pansi pa microscope kuti ayang'ane zizindikiro za khansa.

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

• Lymph node biopsy: Kuchotsa zonse kapena gawo la mwanabele. Katswiri wazachipatala amawona minofu yamagulu pansi pa microscope kuti aone ngati ali ndi khansa. Chimodzi mwazinthu zotsatirazi za biopsies zitha kuchitidwa:

• Chisokonezo chodabwitsa: Kuchotsa khungu lonse.

• Incopal biopsy: Kuchotsa gawo la mwanabele.

• Core biopsy: Kuchotsa minofu kuchokera mu lymph node pogwiritsa ntchito singano yayikulu.

• Zabwino za singano (FNA) biopsy: Kuchotsa minofu kapena madzimadzi kuchokera mu lymph node pogwiritsa ntchito singano yopyapyala.

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 neuroblastoma imafalikira pachiwindi, maselo a khansa pachiwindi ndi ma cell a neuroblastoma. Matendawa ndi metastatic neuroblastoma, osati khansa ya chiwindi.

Magawo otsatirawa amagwiritsidwa ntchito pa neuroblastoma:

Gawo 1

Pa gawo 1, khansara ili m'dera limodzi lokha ndipo khansa yonse yomwe imawonekera imachotsedwa kwathunthu pakuchita opaleshoni.

Gawo 2

Gawo 2 lagawidwa magawo 2A ndi 2B.

• Gawo 2A: Khansara ili m'dera limodzi lokha ndipo khansa yonse yomwe imawoneka siyichotsedwa kwathunthu pakuchita opaleshoni.

• Gawo 2B: Khansara ili m'dera limodzi lokha ndipo khansa yonse yomwe imawoneka imatha kuchotsedwa kapena kuchitidwa nthawi yonse ya opareshoni. Maselo a khansa amapezeka m'magulu am'mimba pafupi ndi chotupacho.

Gawo 3

Mu gawo lachitatu, chimodzi mwa izi ndi chowonadi:

• khansara sichitha kuchotsedwa kwathunthu pakuchita opareshoni ndipo yafalikira kuchokera mbali imodzi ya thupi kupita mbali ina ndipo itha kufalikira kuma lymph lymph node; kapena

• khansara ili mbali imodzi ya thupi ndipo yafalikira kumatenda ena mbali ina ya thupi; kapena

• khansara ili mkati mwathupi ndipo yafalikira kumatenda kapena ma lymph node mbali zonse ziwiri za thupi, ndipo khansara sichitha kuchotsedwa mwa opaleshoni.

Gawo 4

Gawo 4 lagawidwa magawo 4 ndi 4S.

• Gawo 4, khansara yafalikira kumatenda akutali kapena mbali zina za thupi.

• Mu gawo la 4S, mwanayo ndi wochepera miyezi 12, ndipo:

• khansara yafalikira pakhungu, chiwindi, ndi / kapena mafupa; kapena

• khansara ili m'dera limodzi lokha ndipo khansa yonse yomwe imawoneka imatha kuchotsedwa kapena kuchitidwa kwathunthu pakuchitidwa opaleshoni; kapena

• Maselo a khansa amapezeka m'matenda am'mimba pafupi ndi chotupacho.

Chithandizo cha neuroblastoma chimakhazikitsidwa ndi magulu omwe ali pachiwopsezo.

Kwa mitundu yambiri ya khansa, magawo amagwiritsidwa ntchito pokonzekera chithandizo. Kwa neuroblastoma, chithandizo chimadalira gulu la omwe ali pachiwopsezo. Gawo la neuroblastoma ndichinthu chimodzi chomwe chimagwiritsidwa ntchito kudziwa gulu lomwe lili pachiwopsezo. Zina ndi zaka, chotupa histology, ndi chotupa biology.

Pali magulu atatu omwe ali pachiwopsezo: chiopsezo chochepa, chiopsezo chapakatikati, ndi chiopsezo chachikulu.

• Ma neuroblastoma omwe ali pachiwopsezo chochepa komanso chapakati amakhala ndi mwayi wochiritsidwa.

• Kuopsa kwa neuroblastoma kungakhale kovuta kuchiza.

Nthawi zina neuroblastoma siyiyankha chithandizo kapena imabweranso mutalandira chithandizo.

Refractory neuroblastoma ndi chotupa chomwe sichimayankha chithandizo.

Recurrent neuroblastoma ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Chotupacho chimatha kubwereranso komwe adayambirapo kapena mkati mwa dongosolo lamanjenje.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

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

• Ana omwe ali ndi neuroblastoma ayenera kukonzekera kukonzekera ndi gulu la madokotala omwe ndi akatswiri othandiza khansa yaubwana, makamaka neuroblastoma.

• Mitundu isanu ndi iwiri yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

• Kuwona

• Opaleshoni

• Thandizo la radiation

• Mankhwala a Iodine 131-MIBG

• Chemotherapy

• Mankhwala apamwamba a chemotherapy ndi ma radiation omwe amapulumutsa khungu

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chitetezo chamatenda

• Chithandizo cha neuroblastoma chimayambitsa zotsatirapo komanso zotsatira zake mochedwa.

• 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 neuroblastoma.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi neuroblastoma. 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 neuroblastoma ayenera kukonzekera kukonzekera ndi gulu la madokotala omwe ndi akatswiri othandiza khansa yaubwana, makamaka neuroblastoma.

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 wa ana omwe ndi akatswiri pochiza ana omwe ali ndi neuroblastoma komanso omwe amakhazikika m'malo ena azamankhwala. Izi zingaphatikizepo akatswiri awa:

• Dokotala wa ana.

• Dokotala oncologist wa radiation.

• Katswiri wazamaphunziro.

• Katswiri wa zamagulu.

• Matenda a ana.

• Neuroradiologist.

• Dokotala wa ana.

• Katswiri wa namwino wa ana.

• Wogwira ntchito.

• Katswiri wamoyo wa ana.

• Katswiri wa zamaganizo.

Mitundu isanu ndi iwiri yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

Kuwona

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

Opaleshoni

Opaleshoni imagwiritsidwa ntchito pochiza matenda a neuroblastoma omwe sanafalikire mbali zina za thupi. Zambiri mwa chotupacho chimachotsedwa. Ma lymph node amachotsedwanso ndikuwunika ngati ali ndi khansa.

Ngati chotupacho sichingachotsedwe, kafukufuku amatha kuchitidwa m'malo mwake.

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 a Iodine 131-MIBG

Mankhwala a ayodini 131-MIBG ndi mankhwala okhala ndi ayodini wa radioactive. Iodini ya radioactive imaperekedwa kudzera mumitsempha yamitsempha (IV) ndikulowa m'magazi omwe amanyamula ma radiation molunjika kumaselo a chotupa. Iodini yama radioactive imasonkhanitsa m'maselo a neuroblastoma ndikuwapha ndi radiation yomwe imaperekedwa. Mankhwala a ayodini 131-MIBG nthawi zina amagwiritsidwa ntchito pochiza matenda a neuroblastoma omwe amabweranso atalandira chithandizo choyambirira.

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).

Kugwiritsa ntchito mankhwala awiri kapena kuposa anticancer amatchedwa kuphatikiza chemotherapy.

Onani Mankhwala Ovomerezeka a Neuroblastoma kuti mumve zambiri.

Mankhwala apamwamba a chemotherapy ndi ma radiation omwe amapulumutsa khungu

Mankhwala apamwamba a chemotherapy ndi ma radiation amaperekedwa kuti aphe maselo aliwonse a khansa omwe angabwererenso ndikupangitsa kuti khansa ibwererenso. Maselo athanzi, kuphatikiza maselo opanga magazi, nawonso amawonongedwa ndi chithandizo cha khansa. Kupulumutsa ma cell ndi chithandizo m'malo mwa maselo omwe amapanga magazi. Maselo opangira magazi (maselo osakhwima amwazi) amachotsedwa m'magazi kapena m'mafupa a wodwalayo ndipo amawundana ndikusungidwa. Wodwalayo akamaliza chemotherapy ndi radiation, ma cell omwe amasungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

Thandizo lokonzanso limaperekedwa pambuyo poti chemotherapy yayikulu ndi mankhwala a radiation opulumutsa ndi cell cell kwa miyezi isanu ndi umodzi ndipo akuphatikizapo mankhwala awa:

• Isotretinoin: Mankhwala ofanana ndi vitamini omwe amachepetsa khansa kuthekera kopanga maselo ambiri a khansa ndikusintha momwe ma cellwa amawonekera komanso momwe amathandizira. Mankhwalawa amatengedwa pakamwa.

• Dinutuximab: Mtundu wa mankhwala a monoclonal antibody omwe amagwiritsa ntchito antibody wopangidwa ku labotale kuchokera ku mtundu umodzi wamatenda amthupi. Dinutuximab imazindikira ndikumamatira pachinthu, chotchedwa GD2, pamwamba pamaselo a neuroblastoma. Dinutuximab ikadziphatika ku GD2, chikwangwani chimatumizidwa ku chitetezo cha mthupi kuti chinthu chakunja chapezeka ndipo chikuyenera kuphedwa. Kenako chitetezo cha mthupi chimapha khungu la neuroblastoma. Dinutuximab imaperekedwa ndi kulowetsedwa. Ndi mtundu wa chithandizo chofunikira.

• Granulocyte-macrophage colony-stimulating factor (GM-CSF): cytokine yomwe imathandizira kupanga ma chitetezo amthupi ambiri, makamaka ma granulocytes ndi macrophages (maselo oyera amwazi), omwe amatha kuwononga ndikupha ma cell a khansa.

• Interleukin-2 (IL-2): Mtundu wa immunotherapy womwe umalimbikitsa kukula ndi magwiridwe antchito am'magazi ambiri amthupi, makamaka ma lymphocyte (mtundu wa maselo oyera amwazi). Ma lymphocyte amatha kuwononga ndikupha ma cell a khansa.

Onani Mankhwala Ovomerezeka a Neuroblastoma kuti mumve zambiri.

Chithandizo chofuna

Chithandizo chomwe mukufuna ndi mtundu wamankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuwukira maselo ena a khansa. Njira zochiritsira zomwe zimayang'aniridwa sizimavulaza maselo wamba kuposa chemotherapy kapena radiation. Pali mitundu yosiyanasiyana ya mankhwala omwe akuwatsata:

• Thandizo la monoclonal antibody: Ma monoclonal antibodies ndi mapuloteni amthupi omwe amapangidwa mu labotale kuti athetse matenda ambiri, kuphatikiza khansa. Monga chithandizo cha khansa, ma antibodies awa amatha kulumikizana ndi chandamale pamaselo a khansa kapena ma cell ena omwe angathandize ma cell a khansa kukula. Ma antibodies amatha kupha ma cell a khansa, kulepheretsa kukula kwawo, kapena kuwaletsa kuti asafalikire. 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.

Pembrolizumab ndi dinutuximab ndi ma anti-monoclonal antibodies omwe amaphunziridwa kuti athetse neuroblastoma yomwe idabweranso atalandira chithandizo kapena sanayankhe kuchipatala.

• Mankhwala a Tyrosine kinase inhibitor: Mankhwalawa amalimbana ndi zizindikilo zofunika kuti zotupa zikule.

Crizotinib ndi tyrosine kinase inhibitor yomwe imagwiritsidwa ntchito pochiza neuroblastoma yomwe idabweranso pambuyo pochiritsidwa. AZD1775 ndi lorlatinib ndi tyrosine kinase inhibitors omwe amaphunziridwa kuti athetse neuroblastoma yomwe idabweranso atalandira chithandizo kapena sanayankhe kuchipatala.

• Histone deacetylase inhibitor therapy: Chithandizochi chimayambitsa kusintha kwamankhwala komwe kumaletsa ma cell a khansa kukula ndikugawana.

Vorinostat ndi mtundu wa histone deacetylase inhibitor yomwe imaphunziridwa kuti ichiritse neuroblastoma yomwe idabweranso atalandira chithandizo kapena sanayankhe kuchipatala.

• Ornithine decarboxylase inhibitor therapy: Mankhwalawa amachepetsa kukula ndi kugawikana kwa maselo a khansa.

Eflornithine ndi mtundu wa ornithine decarboxylase inhibitor yomwe imaphunziridwa kuti ichiritse neuroblastoma yomwe yabwerera pambuyo pochiritsidwa kapena sinayankhe kuchipatala.

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. Chithandizo cha khansa ichi ndi mtundu wa mankhwala a biologic.

• Mankhwala a C-T T-cell: T cell ya wodwalayo (mtundu wa chitetezo chamthupi) imasinthidwa kuti iwononge mapuloteni ena omwe ali pamwamba pa maselo a khansa. Maselo a T amachotsedwa kwa wodwalayo ndipo ma receptors ena apadera amawonjezedwa pamwamba pa labotore. Maselo osinthidwa amatchedwa chimeric antigen receptor (CAR) T maselo. Maselo a CAR T amakula mu labotore ndipo amapatsidwa kwa wodwalayo pomulowetsa. Maselo a CAR T amachulukana m'magazi a wodwalayo ndikuukira ma cell a khansa.

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

Chithandizo cha CAR T-cell chikuwerengedwa kuti chithetse neuroblastoma yomwe idabwerako atalandira chithandizo kapena sanayankhe kuchipatala.

Chithandizo cha neuroblastoma chimayambitsa zotsatirapo komanso zotsatira zake mochedwa.

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 kuphatikiza:

• Mavuto athupi.

• Kukula kwa dzino.

• Kutsekeka kwa m'mimba (kutsekeka).

• Kukula kwa mafupa ndi khungu.

• Ntchito yakumva.

• Matenda a kagayidwe kachakudya (kuthamanga kwamagazi, ma triglycerides okwera, mafuta okwera, kuchuluka kwamafuta amthupi).

• 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.

Odwala angaganize zopita nawo kukayezetsa.

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

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

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

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

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

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

Mayeso otsatirawa angafunike.

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

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

Mayeso otsatira a odwala omwe ali ndi neuroblastoma ndi awa:

• Mkodzo maphunziro a catecholamine.

• Kujambula kwa MIBG.

Chithandizo cha Neuroblastoma Wowopsa

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

Chithandizo cha neuroblastoma yemwe ali ndi chiopsezo chatsopano chingaphatikizepo izi:

• Opaleshoni yotsatiridwa ndikuwona.

• Chemotherapy ndi opareshoni, kwa ana omwe ali ndi zizindikilo kapena ana omwe chotupa chapitilira kukula ndipo sichingachotsedwe ndi opaleshoni.

• Chemotherapy, kwa odwala ena.

• Kuyang'anitsitsa kokha kwa ana ochepera miyezi isanu ndi umodzi omwe ali ndi zotupa zazing'ono za adrenal kapena makanda omwe alibe zizindikilo za neuroblastoma.

• Thandizo la radiation pochizira zotupa zomwe zimayambitsa mavuto akulu ndipo sizimayankha mwachangu ku chemotherapy kapena opaleshoni.

• Kuyesedwa kwachipatala pozindikira momwe chotupacho chikuyankhira pochiza ndi biology ya chotupa.

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 Neuroblastoma Wapakati-Pangozi

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

Chithandizo cha neuroblastoma yomwe ingapezeke pakatikati ingaphatikizepo izi:

• Chemotherapy kwa ana omwe ali ndi zizindikiro kapena kuchepetsa chotupa chomwe sichingachotsedwe ndi opaleshoni. Opaleshoni imatha kuchitika pambuyo pa chemotherapy.

• Kuchita opaleshoni yokha kwa makanda.

• Kuyang'anitsitsa kokha kwa makanda.

• Thandizo la radiation pochiza zotupa zomwe zapitilira kukula panthawi yamankhwala a chemotherapy kapena zotupa zomwe sizingachotsedwe ndi opaleshoni ndipo zapitilizabe kukula atalandira chithandizo ndi chemotherapy.

• Kuyesedwa kwachipatala pozindikira momwe chotupacho chikuyankhira pochiza ndi biology ya chotupa.

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.

Chithandizo cha Neuroblastoma Wowopsa

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

Chithandizo cha matenda omwe amapezeka kuti ali pachiwopsezo chachikulu cha neuroblastoma chingaphatikizepo izi:

• Mtundu wa mankhwalawa:

• Kuphatikiza chemotherapy.

• Opaleshoni.

• Maphunziro awiri a chemotherapy osakanikirana kwambiri omwe amatsatiridwa ndi kupulumutsa kwa cell.

• Thandizo la radiation.

• Mankhwala a monoclonal antibody (dinutuximab) okhala ndi interleukin-2 (IL-2), granulocyte-macrophage colony-stimulating factor (GM-CSF), ndi isotretinoin.

• Kuyesedwa kwachipatala kwa ayodini 131-MIBG Therapy kapena chithandizo chamankhwala (crizotinib) ndi mankhwala ena.

• Kuyesedwa kwachipatala kwa monoclonal antibody therapy (dinutuximab), GM-CSF, ndi kuphatikiza chemotherapy.

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.

Chithandizo cha Gawo 4S Neuroblastoma

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

Palibe chithandizo chamankhwala amtundu wa 4S neuroblastoma wopezeka kumene koma njira zamankhwala ndi izi:

• Kuyang'anira ndi kusamalira ana omwe ali ndi zotupa zabwino zomwe alibe zisonyezo.

• Chemotherapy, ya ana omwe ali ndi zizindikilo, ana aang'ono kwambiri, kapena ana omwe ali ndi chotupa chosavomerezeka.

• Thandizo la radiation kwa ana omwe ali ndi neuroblastoma yomwe yafalikira pachiwindi.

• Kuyesedwa kwachipatala pozindikira momwe chotupacho chikuyankhira pochiza ndi biology ya chotupa.

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 Neuroblastoma Wowopsa

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

Odwala Amathandizidwa Koyamba pa Neuroblastoma Wowopsa

Kuchiza kwa neuroblastoma kobwerezabwereza komwe kumabwereranso kudera lomwe khansa idayamba kuphatikizira izi:

• Opaleshoni yotsatiridwa ndikuwona kapena chemotherapy.

• Chemotherapy yomwe ingatsatidwe ndi opaleshoni.

Kuchiza kwa neuroblastoma kobwerezabwereza komwe kumabwereranso kumadera ena a thupi kapena komwe sikunayankhe mankhwala kungaphatikizepo izi:

• Kuwona.

• Chemotherapy.

• Opaleshoni yotsatiridwa ndi chemotherapy.

• Chithandizo cha omwe ali ndi chiopsezo chotchedwa neuroblastoma, omwe ali ndi ana opitilira chaka chimodzi.

Odwala Amathandizidwa Koyamba pa Neuroblastoma Yapakatikati

Kuchiza kwa neuroblastoma kobwerezabwereza komwe kumabwereranso kudera lomwe khansa idayamba kuphatikizira izi:

• Opaleshoni yomwe ingatsatidwe ndi chemotherapy.

• Thandizo la radiation kwa ana omwe matenda awo afika poipa pambuyo pa chemotherapy komanso opaleshoni yachiwiri.

Kuchiza kwa neuroblastoma kobwerezabwereza komwe kumabwereranso kumadera ena atha kuphatikizira izi:

• Chithandizo cha omwe ali ndi chiopsezo chotchedwa neuroblastoma, omwe ali ndi ana opitilira chaka chimodzi.

Odwala Amathandizidwa Koyamba Pangozi Yaikulu ya Neuroblastoma

Palibe chithandizo chamankhwala chokhazikika cha neuroblastoma mwa odwala omwe amathandizidwa koyamba ndi chiopsezo cha neuroblastoma. Chithandizo chingaphatikizepo izi:

• Chemotherapy.

• Kuphatikiza kwa chemotherapy ndi monoclonal antibody therapy (dinutuximab).

• Mankhwala a Iodine 131-MIBG ochepetsa zizindikiro komanso kusintha moyo wabwino. Itha kuperekedwa yokha kapena kuphatikiza ndi chemotherapy.

• Chithandizo chotsata ndi crizotinib kapena ma ALK inhibitors ena, kwa odwala omwe asintha mtundu wa ALK.

Chifukwa palibe mankhwala wamba, odwala omwe amalandira chithandizo choyambirira cha neuroblastoma omwe ali pachiwopsezo chachikulu angafune kulingalira zoyeserera zamankhwala. Kuti mumve zambiri zamayesero azachipatala, chonde onani tsamba la NCI.

Odwala omwe ali ndi CNS Neuroblastoma

Chithandizo cha neuroblastoma chomwe chimabwereranso (kubwerera) mkati mwa dongosolo lamanjenje (CNS; ubongo ndi msana) chingaphatikizepo izi:

• Opaleshoni yochotsa chotupacho mu CNS ndikutsatiridwa ndi radiation radiation.

• Kuyesedwa kwachipatala kwa mankhwala atsopano.

Chithandizo Chophunziridwa ndi Progressive / Recurrent Neuroblastoma

Zina mwazithandizo zomwe zikuwerengedwa m'mayesero azachipatala a neuroblastoma omwe amabwereranso (kubwerera) kapena kupitilira (kukula, kufalikira, kapena kusayankha chithandizo) ndi awa:

• Chemotherapy and targeted therapy (dinutuximab yokhala ndi eflornithine kapena yopanda).

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

• Therapy Target (AZD1775) ndi chemotherapy.

• Chithandizo choyenera (pembrolizumab kapena lorlatinib).

• Immunotherapy (chithandizo cha CAR T-cell).

• Mankhwala a Iodine 131-MIBG amaperekedwa okha kapena ndi mankhwala ena a khansa.

• Mankhwala a Iodine 131-MIBG ndi othandizira (dinutuximab).

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 Neuroblastoma

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudzana ndi neuroblastoma, onani izi:

• Tsamba Loyambira la Neuroblastoma

• Kuwunika kwa Neuroblastoma

• Computed Tomography (CT) Zithunzi ndi Khansa

• Mankhwala Ovomerezeka ku Neuroblastoma

• Njira Zochizira Khansa

• Immunotherapy Kuchiza Khansa

• Njira Zatsopano za Neuroblastoma Therapy (NANT) Chotsani Chodzikanira

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

• Za Khansa

• Khansa Za Ana

• Cure Search for Cancer ya Ana Tulukani Chodzikanira

• Zotsatira Zochedwetsa Khansa Yaana

• Achinyamata ndi Achinyamata Achikulire ndi Khansa

• Ana omwe ali ndi khansa: Upangiri wa Makolo

• Khansa mwa Ana ndi Achinyamata

• Kusinthana

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira

Sanjani malinga ndi tsiku Sanjani ndi zigoli

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