Mitundu / minofu yofewa-sarcoma / wodwala / rhabdomyosarcoma-treatment-pdq

Chithandizo cha Childhood Rhabdomyosarcoma Treatment (®) -Patient Version

Zambiri Zokhudza Ubwana Rhabdomyosarcoma

Rhabdomyosarcoma yaubwana ndi matenda omwe ma cell owopsa (khansa) amapangika minofu ya mnofu.

Rhabdomyosarcoma ndi mtundu wa sarcoma. Sarcoma ndi khansa ya minofu yofewa (monga minofu), minofu yolumikizana (monga tendon kapena cartilage), kapena fupa. Rhabdomyosarcoma nthawi zambiri imayamba mu minofu yolumikizidwa ndi mafupa ndipo imathandizira thupi kusuntha. Rhabdomyosarcoma ndi mtundu wofala kwambiri wa sarcoma wofewa mwa ana. Itha kuyamba m'malo ambiri mthupi.

Pali mitundu itatu yayikulu ya rhabdomyosarcoma:

• Embryonal: Mtundu uwu umapezeka kwambiri kumutu ndi m'khosi kapena kumaliseche kapena kumikodzo, koma kumachitika kulikonse m'thupi. Ndiwo mtundu wodziwika bwino wa rhabdomyosarcoma.

• Alveolar: Mtundu uwu umapezeka kwambiri m'manja kapena m'miyendo, pachifuwa, pamimba, kumaliseche, kapena kumatako.

• Anaplastic: Uwu ndiye mtundu wofala kwambiri wa rhabdomyosarcoma mwa ana.

Onani mafupikitsidwe otsatirawa a kuti mumve zambiri zamitundu ina yofewa ya sarcoma:

• Matenda Aang'ono Aunyamata Sarcoma

• Matenda Aakulu Aakulu Sarcoma

Zina mwa majini zimawonjezera chiopsezo cha rhabdomyosarcoma yaubwana.

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

Zowopsa za rhabdomyosarcoma zimaphatikizapo kukhala ndi matenda otsatirawa:

• Matenda a Li-Fraumeni.

• Bluroma yamagazi.

• Mtundu wa Neurofibromatosis 1 (NF1).

• Matenda a Costello.

• Matenda a Beckwith-Wiedemann.

• Matenda a Noonan.

Ana omwe anali ndi kulemera kwambiri kapena anali okulirapo kuposa momwe amayembekezeredwa pakubadwa atha kukhala ndi chiopsezo chowonjezereka cha rhabdomyosarcoma ya m'mimba.

Nthawi zambiri, chifukwa cha rhabdomyosarcoma sichidziwika.

Chizindikiro cha rhabdomyosarcoma chaubwana ndi chotupa kapena chotupa chomwe chimakulirakulira.

Zizindikiro zimatha chifukwa cha rhabdomyosarcoma yaubwana kapena zina. Zizindikiro zomwe zimachitika zimadalira komwe khansa imapangira. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Chotupa kapena chotupa chomwe chimakulirakulira kapena sichitha. Zingakhale zopweteka.

• Kutupa kwa diso.

• Mutu.

• Kuvuta kukodza kapena kukhala ndi matumbo.

• Magazi mkodzo.

• Kutuluka magazi m'mphuno, mmero, kumaliseche, kapena kumtunda.

Mayeso ozindikira ndi ma biopsy amagwiritsidwa ntchito kuti azindikire (kupeza) ndikuzindikira rhabdomyosarcoma yaubwana.

Kuyesa koyezetsa komwe kumachitika kumadalira gawo lomwe khansa imapangira. Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

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

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

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga chifuwa, pamimba, m'chiuno, kapena ma lymph node, otengedwa mbali zosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

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

• MRI (magnetic resonance imaging): Njira yomwe imagwiritsa ntchito maginito, mawailesi, komanso kompyuta kuti ipange zithunzi zingapo za malo amthupi, monga chigaza, ubongo, ndi ma lymph node. 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.

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

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

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

• Kulakalaka kwa mafuta m'mafupa ndi biopsy: Kuchotsa mafupa, magazi, ndi kachigawo kakang'ono ka fupa poika singano yopanda kanthu m'chiuno. Zitsanzo zimachotsedwa m'chiuno chonse. 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.

• Lumbar puncture: Njira yogwiritsira ntchito cerebrospinal fluid (CSF) kuchokera pamtsempha. Izi zimachitika poika singano pakati pa mafupa awiri mumsana ndi CSF mozungulira msana ndikuchotsa madzi. Chitsanzo cha CSF chimayang'aniridwa ndi microscope ngati pali ma cell a khansa. Njirayi imatchedwanso LP kapena tapu ya msana.

Ngati mayeserowa akuwonetsa kuti pakhoza kukhala rhabdomyosarcoma, biopsy yachitika. Biopsy ndikuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwala kuti aone ngati ali ndi khansa. Chifukwa chithandizo chimadalira mtundu wa rhabdomyosarcoma, zitsanzo za biopsy ziyenera kufufuzidwa ndi wazachipatala yemwe ali ndi chidziwitso pakupeza rhabdomyosarcoma.

Chimodzi mwazinthu zotsatirazi zingagwiritsidwe ntchito:

• Zabwino-singano aspiration (FNA) biopsy: Kuchotsa minofu kapena madzi pogwiritsa ntchito singano yopyapyala.

• Core singano biopsy: Kuchotsa minofu pogwiritsa ntchito singano yayikulu. Njirayi imatha kutsogozedwa pogwiritsa ntchito ultrasound, CT scan, kapena MRI.

• Tsegulani biopsy: Kuchotsa minofu kudzera mu kudula (kudula) komwe kumapangidwa pakhungu.

• Sentinel lymph node biopsy: Kuchotsa kwa sentinel lymph node panthawi yochita opareshoni. Sentinel lymph node ndiye njira yoyamba yam'magulu am'magazi kuti alandire madzi m'mimba kuchokera pachotupa choyambirira. Ndi lymph node yoyamba yomwe khansa imafalikira kuchokera ku chotupa choyambirira. Mankhwala a radioactive ndi / kapena utoto wabuluu amabayidwa pafupi ndi chotupacho. Katunduyu kapena utoto umadutsa m'mitsempha yam'mimba kupita kumalo am'mimba. Nthenda yoyamba yolandila mankhwala kapena utoto imachotsedwa. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa. Ngati maselo a khansa sapezeka, mwina sikofunikira kuchotsa ma lymph node ambiri. Nthawi zina, sentinel lymph node imapezeka m'magulu angapo am'magulu.

Mayesero otsatirawa akhoza kuchitidwa pazitsanzo za minofu yomwe yachotsedwa:

• 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: Chiyeso chomwe chimagwiritsa ntchito ma antibodies kuti awone ma antigen ena mwa mnofu. Katemera wotereyu nthawi zambiri amalumikizidwa ndi mankhwala owononga mphamvu kapena utoto womwe umapangitsa kuti minofu iunikire pansi pa microscope. Mayeso amtunduwu atha kugwiritsidwa ntchito posiyanitsa mitundu ingapo ya khansa.

• FISH (fluorescence in situ hybridization): Kuyesa kwa labotale komwe kumayang'ana majini kapena ma chromosomes m'maselo ndi minyewa. Zidutswa za DNA zomwe zimakhala ndi utoto wa fulorosenti zimapangidwa mu labotale ndikuwonjezeredwa m'maselo kapena minofu pamagalasi. Zidutswa za DNAzi zikagwirizana ndi majini ena kapena madera ena a chromosomes omwe ali pamtunda, zimawala zikawonedwa ndi microscope yokhala ndi kuwala kwapadera. Mayeso amtunduwu amagwiritsidwa ntchito pakusintha kwamitundu ina.

• Reverse transcription – polymerase chain reaction (RT – PCR) kuyesa: Kuyeserera kwa labotale komwe maselo amtundu wa minofu amaphunziridwa pogwiritsa ntchito mankhwala kuti awone kusintha kwakapangidwe kake kapena kagwiritsidwe ka majini.

• Kusanthula kwa cytogenetic: Kuyesa kwa labotale komwe maselo amtundu wa minofu amayang'aniridwa ndi microscope kuti ayang'ane kusintha kwama chromosomes.

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

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Msinkhu wa wodwalayo.

• Komwe mthupi mudayamba chotupacho.

• Kukula kwa chotupa pa nthawi ya matenda.

• Kaya chotupacho chachotsedwa kwathunthu ndi opareshoni.

• Mtundu wa rhabdomyosarcoma (embryonal, alveolar, kapena anaplastic).

• Kaya pali kusintha kwina m'majini.

• Kaya chotupacho chinali chitafalikira mbali zina za thupi panthawi yomwe amachipeza.

• Kaya chotupacho chinali m'matenda am'mimba panthawi yodziwitsa.

• Kaya chotupacho chimayankha chemotherapy komanso / kapena radiation radiation.

Kwa odwala omwe ali ndi khansa yabwinobwino, madandaulo ndi chithandizo chimadaliranso izi:

• Komwe m'thupi chotupacho chidabwereranso (kubwerera).

• Ndi nthawi yochuluka bwanji yomwe idadutsa pakati pa kutha kwa chithandizo cha khansa komanso pomwe khansayo idabwereranso.

• Kaya chotupacho chidathandizidwa ndi mankhwala a radiation.

Magawo a Ubwana Rhabdomyosarcoma

MFUNDO ZOFUNIKA

• Pambuyo poti rhabdomyosarcoma yaubwana yapezeka, chithandizo chimakhazikika pagawo la khansa ndipo nthawi zina chimatengera ngati khansa yonse idachotsedwa ndi opaleshoni.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Magawo a rhabdomyosarcoma aubwana amachitika m'magawo atatu.

• Makina okhazikika amatengera kukula kwa chotupacho, komwe kuli mthupi, komanso ngati chafalikira mbali zina za thupi:

• Gawo 1

• Gawo 2

• Gawo 3

• Gawo 4

• Dongosolo lamagulu limadalira ngati khansara yafalikira komanso ngati khansara yonse idachotsedwa ndi opaleshoni:

• Gulu I

• Gulu II

• Gulu III

• Gulu IV

• Gulu lowopsa limakhazikika pamakina owerengera komanso dongosolo lamagulu.

• Rhabdomyosarcoma yaubwana wocheperako

• Chiwopsezo chapakati paubwana rhabdomyosarcoma

• Kuopsa koopsa kwaubwana rhabdomyosarcoma

Pambuyo poti rhabdomyosarcoma yaubwana yapezeka, chithandizo chimakhazikika pagawo la khansa ndipo nthawi zina chimatengera ngati khansa yonse idachotsedwa ndi opaleshoni.

Njira yomwe amagwiritsidwa ntchito pofufuza ngati khansara yafalikira mkati mwa minyewa kapena mbali zina za thupi amatchedwa staging. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo. Dokotala adzagwiritsa ntchito zotsatira zamayeso owunikira kuti athandizire kudziwa gawo la matendawa.

Chithandizo cha rhabdomyosarcoma chaubwana chimakhazikika pagawo linalake ndipo nthawi zina pamakhala kuchuluka kwa khansa yomwe imatsalira pambuyo pochitidwa opaleshoni kuti ichotse chotupacho. Wodwalayo adzagwiritsa ntchito maikulosikopu kuti ayang'ane minofu yomwe yatulutsidwa panthawi yochita opareshoni, kuphatikiza zitsanzo zamatenda m'mbali mwa madera omwe kansa idachotsedwa ndi ma lymph node. Izi zimachitika kuti muwone ngati ma cell onse a khansa adachotsedwa nthawi yochita opaleshoniyi.

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 rhabdomyosarcoma imafalikira m'mapapu, maselo a khansa m'mapapo alidi maselo a rhabdomyosarcoma. Matendawa ndi metastatic rhabdomyosarcoma, osati khansa yamapapo.

Magawo a rhabdomyosarcoma aubwana amachitika m'magawo atatu.

Rhabdomyosarcoma yaubwana imagwiritsidwa ntchito pogwiritsa ntchito njira zitatu zofotokozera khansa:

• Makina oyeserera.
• Ndondomeko yamagulu.
• Gulu lowopsa.

Makina okhazikika amatengera kukula kwa chotupacho, komwe kuli mthupi, komanso ngati chafalikira mbali zina za thupi:

Gawo 1

Gawo 1, chotupacho ndi kukula kwake, mwina chimafalikira kumatenda am'mimba, ndipo chimapezeka m'modzi mwamasamba "abwino" awa:

• Diso kapena malo ozungulira diso.

• Mutu ndi khosi (koma osati mu mnofu pafupi ndi ubongo ndi msana).

• Gallbladder ndi timadontho ta ndulu.

• Ureters kapena urethra.

• Mayeso, ovary, nyini, kapena chiberekero.

Rhabdomyosarcoma yomwe imapangidwa pamalo "abwino" imakhala ndi chiyembekezo chabwinoko. Ngati tsamba lomwe khansa imapezeka sichimodzi mwamasamba abwino omwe atchulidwa pamwambapa, akuti ndi "osavomerezeka".

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 2

Gawo lachiwiri, khansa imapezeka pamalo "osavomerezeka" (dera lililonse lomwe silinafotokozedwe ngati "labwino" mu gawo 1). Chotupacho sichiposa masentimita 5 ndipo sichinafalikire ku ma lymph node.

Gawo 3

Gawo lachitatu, khansa imapezeka pamalo "osavomerezeka" (malo amodzi omwe sanatchulidwe kuti ndi "abwino" mu gawo 1) ndipo chimodzi mwazotsatira ndi chowonadi:

• Chotupacho sichiposa masentimita 5 ndipo khansa yafalikira ku ma lymph node apafupi.

• Chotupacho chimakhala chachikulu kuposa masentimita 5 ndipo khansa imatha kufalikira ku ma lymph node apafupi.

Gawo 4

Pa gawo lachinayi, chotupacho chingakhale kukula kwake ndipo khansa ikhoza kufalikira ku ma lymph node apafupi. Khansa yafalikira kumadera akutali a thupi, monga mapapo, mafupa, kapena fupa.

Dongosolo lamagulu limadalira ngati khansara yafalikira komanso ngati khansara yonse idachotsedwa ndi opaleshoni:

Gulu I

Khansa idapezeka pamalo pomwe idayambira ndipo idachotsedwa kwathunthu ndi opareshoni. Thupi linatengedwa kuchokera m'mphepete mwa kumene chotupacho chinachotsedwa. Minofuyo inayang'aniridwa ndi microscope ndi wodwala ndipo palibe maselo a khansa omwe anapezeka.

Gulu II

Gulu II lidagawika m'magulu IIA, IIB, ndi IIC.

• IIA: Khansa idachotsedwa ndikuchita opareshoni koma ma cell a khansa adawonedwa pomwe minofu, yochotsedwa m'mphepete mwa komwe chotupacho chidachotsedwa, idawonedwa ndi microscope ndi wodwala.

• IIB: Khansa inali itafalikira ku ma lymph node omwe anali pafupi ndipo khansa ndi ma lymph node zidachotsedwa ndi opaleshoni.

• IIC: Khansa idafalikira ku ma lymph node apafupi, khansa ndi ma lymph node adachotsedwa ndikuchitidwa opaleshoni, ndipo chimodzi mwazomwe zili izi ndi chowonadi:

• Minofu yomwe idatengedwa m'mbali mwake pomwe idachotsedwa chotupacho idayang'aniridwa ndi microscope ndi wodwala ndipo ma cell a khansa adawonedwa.

• Lymph node yotalikirapo kwambiri kuchokera pachotupa chomwe chidachotsedwa idayang'aniridwa ndi microscope ndi wamatenda ndipo maselo a khansa adawonedwa.

Gulu III

Khansa idachotsedwa pang'ono ndi biopsy kapena opaleshoni koma pali chotupa chomwe chatsala chomwe chimawoneka ndi diso.

Gulu IV

• Khansa idafalikira kumadera akutali khansa itapezeka.

• Maselo a khansa amapezeka poyesa kujambula; kapena

Pali maselo a khansa m'madzi ozungulira ubongo, msana, kapena mapapo, kapena mumadzi m'mimba; kapena zotupa zimapezeka m'malo amenewo.

Gulu lowopsa limakhazikika pamakina owerengera komanso dongosolo lamagulu.

Gulu lowopsa limafotokoza mwayi woti rhabdomyosarcoma ibwererenso (kubwerera). Mwana aliyense wothandizidwa ndi rhabdomyosarcoma ayenera kulandira chemotherapy kuti achepetse mwayi womwe khansa idzabwererenso. Mtundu wa mankhwala a khansa, mlingo, ndi kuchuluka kwa mankhwala omwe amaperekedwa zimadalira ngati mwanayo ali pachiwopsezo chochepa, wapakatikati, kapena rhabdomyosarcoma.

Magulu omwe ali pachiwopsezo awa amagwiritsidwa ntchito:

Rhabdomyosarcoma yaubwana wocheperako

• Rhabdomyosarcoma ya ana omwe ali pachiwopsezo chochepa kwambiri ndi awa:

Chotupa chamimba chamtundu uliwonse chomwe chimapezeka pamalo "abwino". Pakhoza kukhala chotupa chotsalira pambuyo pochitidwa opaleshoni chomwe chitha kuwoneka ndi microscope. Khansayo ikhoza kufalikira ku ma lymph node apafupi. Madera otsatirawa ndi malo "abwino":

• Diso kapena malo ozungulira diso.

• Mutu kapena khosi (koma osati mu mnofu pafupi ndi khutu, mphuno, sinus, kapena tsinde la chigaza).

• Gallbladder ndi timadontho ta ndulu.

• Ureter kapena urethra.

• Mayeso, ovary, nyini, kapena chiberekero.

Chotupa chamimba chamtundu uliwonse chomwe sichipezeka pamalo "abwino". Pakhoza kukhala chotupa chotsalira pambuyo pochitidwa opaleshoni chomwe chitha kuwonedwa ndi microscope yokha. Khansayo ikhoza kufalikira ku ma lymph node apafupi.

Chiwopsezo chapakati paubwana rhabdomyosarcoma

Rhabdomyosarcoma ya ana omwe ali pachiwopsezo chapakati ndi awa:

• Chotupa chamimba chamtundu uliwonse chomwe sichipezeka m'malo amodzi "abwino" omwe atchulidwa pamwambapa. Pali chotupa chotsalira pambuyo pochitidwa opaleshoni, chomwe chitha kuwonedwa ndi microscope. Khansayo ikhoza kufalikira ku ma lymph node apafupi.

• Chotupa champhako chamtundu uliwonse pamalo "abwino" kapena "osavomerezeka". Pakhoza kukhala chotupa chotsalira pambuyo pochitidwa opaleshoni chomwe chitha kuwoneka ndi microscope. Khansayo ikhoza kufalikira ku ma lymph node apafupi.

Kuopsa koopsa kwaubwana rhabdomyosarcoma

Chiwopsezo chachikulu chaubwana rhabdomyosarcoma ikhoza kukhala mtundu wa embryonal kapena mtundu wa alveolar. Zitha kufalikira ku ma lymph node apafupi ndipo zafalikira ku chimodzi kapena zingapo zotsatirazi:

• Ziwalo zina za thupi zomwe sizili pafupi ndi pomwe chotupacho chidapangidwira.

• Madzi ozungulira ubongo kapena msana.

• Zamadzimadzi m'mapapu kapena m'mimba.

Zowonongeka Zaubwana Rhabdomyosarcoma

Rhabdomyosarcoma yaubwana yabwinobwino ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara imatha kubwerera kumalo omwewo kapena mbali zina za thupi, monga mapapo, fupa, kapena mafupa. Nthawi zambiri, rhabdomyosarcoma imatha kubwerera mchifuwa mwa akazi achichepere kapena pachiwindi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

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

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

• Kuchiza kwa rhabdomyosarcoma yaubwana kumatha kuyambitsa zovuta.

• Mitundu itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chitetezo chamatenda

• Chithandizo chofuna

• 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 rhabdomyosarcoma yaubwana.

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 rhabdomyosarcoma ayenera kukonzekera kukonzekera ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandiza khansa kwa ana.

Chifukwa rhabdomyosarcoma imatha kupangidwa m'magulu osiyanasiyana amthupi, mitundu yambiri yamankhwala imagwiritsidwa ntchito. Chithandizo chidzayang'aniridwa ndi oncologist wa ana, dokotala yemwe amadziwika bwino pochiza ana omwe ali ndi khansa. Ocologist wa ana amagwira ntchito ndi ena othandizira zaumoyo omwe ndi akatswiri pochiza ana omwe ali ndi rhabdomyosarcoma ndipo amakhazikika m'malo ena azamankhwala. Izi zingaphatikizepo akatswiri awa:

• Dokotala wa ana.

• Dokotala wa ana.

• Wofufuza oncologist.

• Dokotala wa hematologist.

• Radiologist wazachipatala.

• Katswiri wa namwino wa ana.

• Katswiri wopanga ma genetiki kapena khansa pangozi.

• Wogwira ntchito.

• Katswiri wokonzanso.

Kuchiza kwa rhabdomyosarcoma yaubwana kumatha kuyambitsa zovuta.

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

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

• Mavuto athupi.

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

• Khansa yachiwiri (mitundu yatsopano ya khansa).

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

Mitundu itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni (kuchotsa khansa mu opareshoni) imagwiritsidwa ntchito kuchiza rhabdomyosarcoma yaubwana. Mtundu wa opareshoni yotchedwa kudulidwa kwapanyumba nthawi zambiri umachitika. Chododometsa chakomweko ndikuchotsa chotupa ndi zina mwa ziwalozo, kuphatikiza ma lymph node. Kuchita opaleshoni yachiwiri kungafunikire kuchotsa khansa yonse. Kaya opareshoni yachitika ndipo mtundu wa opareshoni yachitidwa zimatengera izi:

• Komwe mthupi mudayamba chotupacho.

• Zotsatira za opaleshoniyi ikukhudza momwe mwanayo adzawonekere.

• Zotsatira za opaleshoniyi ikukhudza momwe thupi limagwirira ntchito.

• Momwe chotupacho chidayankhira chemotherapy kapena radiation radiation yomwe mwina idaperekedwa kaye.

Mwa ana ambiri omwe ali ndi rhabdomyosarcoma, sizotheka kuchotsa chotupa chonsecho pochita opaleshoni.

Rhabdomyosarcoma imatha kupangidwa m'malo osiyanasiyana mthupi ndipo opareshoniyo idzakhala yosiyana patsamba lililonse. Kuchita opaleshoni yothandizira rhabdomyosarcoma ya diso kapena malo opatsirana nthawi zambiri kumakhala kovuta. Chemotherapy, ndipo nthawi zina chithandizo chama radiation, chitha kuperekedwa asanachite opaleshoni kuti muchepetse zotupa zazikulu.

Dokotala atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoniyi, odwala adzapatsidwa chemotherapy atachitidwa opaleshoni kuti aphe maselo aliwonse a khansa omwe atsala. Mankhwalawa amatha kuperekedwanso. Chithandizo chomwe chimaperekedwa pambuyo pa opareshoni, kuti muchepetse chiopsezo kuti khansa ibwererenso, amatchedwa adjuvant therapy.

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 kuwaletsa kukula. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa. Njira zina zoperekera mankhwala a radiation zitha kuthandiza kuti ma radiation asawononge minofu yabwinobwino yapafupi. Mitundu iyi yothandizira ma radiation yakunja imaphatikizapo izi:

• Conformal radiation therapy: Conformal radiation Therapy ndi mtundu wa mankhwala akunja a radiation omwe amagwiritsa ntchito kompyuta kupanga chithunzi cha 3-dimensional (3-D) chotupa ndikupanga ma radiation kuti agwirizane ndi chotupacho. Izi zimalola kuchuluka kwa radiation kuti ifike pachotupacho ndipo imawononga pang'ono minofu yabwinobwino yapafupi.

• 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.

• Volumetrical modulated arc therapy (VMAT): VMAT ndi mtundu wa mankhwala a radiation a 3-D omwe amagwiritsa ntchito kompyuta kupanga zithunzi za kukula ndi mawonekedwe a chotupacho. Makina a radiation amayenda mozungulira mozungulira wodwalayo kamodzi mukamalandira chithandizo ndipo amatumiza mizere yoonda ya cheza champhamvu zosiyanasiyana (mphamvu) pachotupacho. Chithandizo ndi VMAT chimaperekedwa mwachangu kuposa chithandizo ndi IMRT.

• 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.

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

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa. Amagwiritsidwa ntchito pochiza khansa m'malo monga nyini, maliseche, chiberekero, chikhodzodzo, prostate, mutu, kapena khosi. Njira yothandizira ma radiation imatchedwanso brachytherapy, radiation ya mkati, kuyika ma radiation, kapena ma radiation apakati.

Mtundu ndi kuchuluka kwa mankhwala a radiation ndipo akapatsidwa zimadalira msinkhu wa mwanayo, mtundu wa rhabdomyosarcoma, komwe m'thupi chotupacho chidayamba, kuchuluka kwa chotupa chomwe chidatsalira pambuyo pochitidwa opaleshoni, komanso ngati pali chotupa m'matumba oyandikira .

Thandizo la radiation lakunja nthawi zambiri limagwiritsidwa ntchito pochiza rhabdomyosarcoma yaubwana koma nthawi zina imagwiritsidwa ntchito pochizira ma radiation.

Chemotherapy

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

Chemotherapy itha kuperekedwanso kuti ichepetse chotupacho asanachite opareshoni kuti ipulumutse minofu yathanzi momwe ingathere. Izi zimatchedwa neoadjuvant chemotherapy.

Mwana aliyense wothandizidwa ndi rhabdomyosarcoma ayenera kulandira chemotherapy yothandizira kuti khansa ibwererenso. Mtundu wa mankhwala a khansa, mlingo, ndi kuchuluka kwa mankhwala omwe amaperekedwa zimadalira ngati mwanayo ali pachiwopsezo chochepa, wapakatikati, kapena rhabdomyosarcoma.

Onani Mankhwala Ovomerezeka a Rhabdomyosarcoma kuti mumve zambiri.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

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

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 biologic therapy kapena biotherapy.

Pali mitundu yambiri ya immunotherapy:

• Chithandizo cha katemera ndi mankhwala a khansa omwe amagwiritsa ntchito chinthu kapena gulu lazinthu zolimbikitsa chitetezo cha mthupi kuti chipeze chotupacho ndikuchipha. Chithandizo cha katemera chikuwerengedwa kuti chithetse rhabdomyosarcoma yamatenda.

• Mankhwala oteteza chitetezo cha mthupi amagwiritsa ntchito chitetezo cha mthupi kupha ma cell a khansa. Mitundu iwiri ya chitetezo cha chitetezo cha mthupi ikuwerengedwa pochiza rhabdomyosarcoma yaubwana yomwe yabwerera pambuyo pochiritsidwa:

• CTLA-4 ndi mapuloteni pamwamba pa ma T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. CTLA-4 ikamangirira puloteni ina yotchedwa B7 pa khungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. CTLA-4 inhibitors amadziphatika ku CTLA-4 ndikulola ma T maselo kupha ma cell a khansa. Ipilimumab ndi mtundu wa CTLA-4 inhibitor.

Chitetezo cha chitetezo cha mthupi. Mapuloteni a checkpoint, monga B7-1 / B7-2 pama cell antigen-presenting cell (APC) ndi CTLA-4 pama cell a T, amathandizira kuteteza mayankho a chitetezo cha mthupi. T-cell receptor (TCR) ikamangirira ku antigen komanso mapuloteni akuluakulu a histocompatibility complex (MHC) pa APC ndi CD28 amamangiriza ku B7-1 / B7-2 pa APC, T cell imatha kuyatsidwa. Komabe, kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 kumapangitsa kuti ma T maselo akhale osagwira ntchito kotero kuti sangathe kupha ma cell am'mimba mthupi (kumanzere). Kuletsa kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 yokhala ndi chitetezo cha chitetezo cha mthupi (anti-CTLA-4 antibody) kumalola ma T kuti azitha kugwira ntchito ndikupha ma cell a chotupa (gulu lamanja).

• 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. Nivolumab ndi pembrolizumab ndi PD-1 inhibitors.

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 chofuna

Chithandizo choyenera ndi mtundu wa chithandizo chomwe chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti ziwononge maselo a khansa. Njira zochiritsira zomwe zimayang'aniridwa sizimavulaza maselo wamba kuposa chemotherapy kapena radiation. Pali mitundu yosiyanasiyana ya mankhwala omwe akulimbana nawo:

• MTOR inhibitors amasiya mapuloteni omwe amathandiza maselo kugawanika ndikukhala ndi moyo. Sirolimus ndi mtundu wa mankhwala a mTOR inhibitor omwe amaphunziridwa pochiza rhabdomyosarcoma.

• Ma Tyrosine kinase inhibitors ndi mankhwala ang'onoang'ono omwe amapyola mu selo ndipo amagwira ntchito mkati mwa maselo a khansa kuti aletse zikwangwani kuti maselo a khansa ayenera kukula ndikugawana. MK-1775 ndi cabozantinib-s-malate ndi tyrosine kinase inhibitors omwe amaphunziridwa pochiza rhabdomyosarcoma.

Odwala angaganize zopita nawo kukayezetsa.

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

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

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

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

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

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

Mayeso otsatirawa angafunike.

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

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

Njira Zothandizira Kuchiza Kwaubwana Rhabdomyosarcoma

M'chigawo chino

• Poyamba Rhabdomyosarcoma Wopanda Ubwana

• Wotsutsa kapena Wowopsa Wabwana Rhabdomyosarcoma

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

Poyamba Rhabdomyosarcoma Wopanda Ubwana

Chithandizo cha rhabdomyosarcoma chaubwana nthawi zambiri chimaphatikizapo opaleshoni, chithandizo cha radiation, ndi chemotherapy. Lamulo loti mankhwalawa apatsidwe limatengera komwe thupi limayamba, chotupacho, kukula kwa chotupacho, komanso ngati chotupacho chafalikira kumatenda am'mimba kapena mbali zina za thupi. Onani gawo la Chidule cha Chithandizo Chachidule cha chidulechi kuti mumve zambiri zamankhwala, ma radiation, komanso chemotherapy yomwe imagwiritsidwa ntchito pochiza ana omwe ali ndi rhabdomyosarcoma.

Rhabdomyosarcoma yaubongo ndi mutu ndi khosi

• Kwa zotupa zaubongo: Chithandizo chingaphatikizepo kuchitidwa opaleshoni kuti muchotse chotupacho, mankhwala a radiation, ndi chemotherapy.

• Kwa zotupa za mutu ndi khosi zomwe zili mkati kapena pafupi ndi diso: Chithandizo chitha kuphatikizira chemotherapy ndi radiation radiation. Ngati chotupacho chimatsalira kapena chimabweranso atalandira chithandizo ndi chemotherapy ndi radiation radiation, opaleshoni yochotsa diso ndi ziwalo zina mozungulira diso zitha kufunikira.

• Kwa zotupa za mutu ndi khosi zomwe zili pafupi ndi khutu, mphuno, sinus, kapena tsinde la chigaza koma osati mkati kapena pafupi ndi diso: Chithandizo chitha kuphatikizira mankhwala a radiation ndi chemotherapy.

• Kwa zotupa za mutu ndi khosi zomwe sizili pafupi kapena pafupi ndi diso osati pafupi ndi khutu, mphuno, sinus, kapena tsinde la chigaza: Chithandizo chitha kuphatikizira chemotherapy, radiation radiation, ndi opaleshoni kuchotsa chotupacho.

• Zotupa za mutu ndi khosi zomwe sizingachotsedwe ndi opaleshoni: Chithandizo chitha kuphatikizira chemotherapy ndi radiation pochotsa ma radiation.

• Pazotupa za kholingo (mawu amawu): Chithandizo chitha kuphatikizira chemotherapy ndi radiation radiation. Opaleshoni yochotsa kholingo nthawi zambiri siyimachitidwa, kuti mawu asavulaze.

Rhabdomyosarcoma ya mikono kapena miyendo

• Chemotherapy kenako opaleshoni yochotsa chotupacho. Ngati chotupacho sichinachotsedwe kwathunthu, opaleshoni yachiwiri yochotsa chotupacho ikhoza kuchitidwa. Mankhwalawa amatha kuperekedwanso.

• Kwa zotupa za dzanja kapena phazi, mankhwala a radiation ndi chemotherapy atha kuperekedwa. Chotupacho sichingachotsedwe chifukwa chimakhudza kugwira kwa dzanja kapena phazi.

• Lymph node dissection (ma lymph node amodzi kapena angapo amachotsedwa ndipo mtundu wa minofu umayang'aniridwa ndi microscope ngati pali zizindikiro za khansa).

• Kwa zotupa m'manja, ma lymph node pafupi ndi chotupacho komanso m'khwapa amachotsedwa.

• Kwa zotupa m'miyendo, ma lymph node omwe ali pafupi ndi chotupacho komanso m'malo am'mimba amachotsedwa.

Rhabdomyosarcoma pachifuwa, pamimba, kapena m'chiuno

• Kwa zotupa m'chifuwa kapena m'mimba (kuphatikiza khoma lachifuwa kapena khoma m'mimba): Opaleshoni (kutulutsa kwina konseko) itha kuchitidwa. Ngati chotupacho ndi chachikulu, chemotherapy ndi radiation radiation amapatsidwa kuti achepetse chotupacho asanachite opareshoni.

• Kwa zotupa za m'chiuno: Opaleshoni (kutulutsa kwina konseko) itha kuchitidwa. Ngati chotupacho ndi chachikulu, chemotherapy imaperekedwa kuti ichepetse chotupacho asanachite opareshoni. Thandizo la radiation lingaperekedwe pambuyo pa opaleshoni.

• Pazotupa zakumbuyo: Chotupa chimatsatiridwa ndi chemotherapy ndi mankhwala a radiation kuti achepetse chotupacho. Opaleshoni imatha kuchitika pambuyo pake kuti ichotse maselo amtundu uliwonse a khansa.

• Kwa zotupa za ndulu kapena ma ndulu am'mimba: Chotupa cha chotupacho chimatsatiridwa ndi chemotherapy ndi radiation radiation.

• Pazotupa zaminyewa kapena zotumphukira mozungulira anus kapena pakati pa maliseche ndi anus kapena scrotum ndi anus: Opaleshoni imachitika kuti ichotse chotupacho momwe zingathere ndi ma lymph node ena apafupi, kenako ndi chemotherapy ndi radiation radiation.

Rhabdomyosarcoma ya impso

• Kwa zotupa za impso: Opaleshoni kuti achotse chotupa chonse momwe angathere. Chemotherapy ndi radiation radiation itha kuperekedwanso.

Rhabdomyosarcoma chikhodzodzo kapena prostate

• Kwa zotupa zomwe zili pamwamba chabe pa chikhodzodzo: Opaleshoni (kutulutsa kwina konseko) kwachitika.

• Kwa zotupa za prostate kapena chikhodzodzo (kupatula pamwamba pa chikhodzodzo):

• Chemotherapy ndi radiation radiation amapatsidwa koyamba kuti achepetse chotupacho. Ngati maselo a khansa atsalira pambuyo pa chemotherapy ndi radiation radiation, chotupacho chimachotsedwa ndi opaleshoni. Kuchita opaleshoni kungaphatikizepo kuchotsa prostate, gawo la chikhodzodzo, kapena kutentha kwa m'chiuno popanda kuchotsa rectum. (Izi zingaphatikizepo kuchotsedwa kwa kholingo m'munsi ndi chikhodzodzo. Mwa atsikana, khomo lachiberekero, nyini, thumba losunga mazira ndi ma lymph nodes omwe ali pafupi atha kuchotsedwa)

• Chemotherapy imaperekedwa koyamba kuti ichepetse chotupacho. Opaleshoni yochotsa chotupacho, koma osati chikhodzodzo kapena prostate, yachitika. Mankhwala amtundu wamkati kapena akunja amatha kuperekedwa pambuyo pa opaleshoni.

• Kuchita opaleshoni kuchotsa chotupacho, koma osati chikhodzodzo kapena prostate. Thandizo la radiation limaperekedwa pambuyo pa opaleshoni.

Rhabdomyosarcoma ya m'deralo pafupi ndi machende

• Opaleshoni yochotsa machende ndi zingwe za umuna. Ma lymph node kumbuyo kwa mimba amatha kufufuzidwa ngati ali ndi khansa, makamaka ngati ma lymph node ndi akulu kapena mwanayo ali ndi zaka 10 kapena kupitilira apo.

• Thandizo la radiation lingaperekedwe ngati chotupacho sichingachotsedwe kwathunthu ndi opaleshoni.

Rhabdomyosarcoma ya maliseche, nyini, chiberekero, khomo pachibelekeropo, kapena ovary

• Kwa zotupa za kumaliseche ndi kumaliseche: Chithandizo chitha kuphatikizira chemotherapy yotsatira opaleshoni yochotsa chotupacho. Mankhwala amtundu wamkati kapena akunja amatha kuperekedwa pambuyo pa opaleshoni.

• Zotupa za chiberekero: Chithandizo chitha kuphatikizira chemotherapy kapena popanda radiation. Nthawi zina pamafunika opaleshoni kuti muchotse maselo amtundu uliwonse a khansa.

• Kwa zotupa za khomo pachibelekeropo: Chithandizo chitha kuphatikizira chemotherapy yotsatira opaleshoni yochotsa chotupa chilichonse chomwe chatsala.

• Kwa zotupa za ovary: Chithandizo chitha kuphatikizira chemotherapy yotsatiridwa ndi opaleshoni kuti ichotse chotupa chilichonse chomwe chatsala.

Metastatic rhabdomyosarcoma

Chithandizo, monga chemotherapy, radiation radiation, kapena opaleshoni yochotsa chotupacho, chimaperekedwa kumalo komwe chotupacho chidayamba. Ngati khansara yafalikira ku ubongo, msana, kapena mapapo, mankhwala a radiation angaperekedwenso kumalo komwe khansara yafalikira.

Mankhwalawa akuphunziridwa pa rhabdomyosarcoma yamatenda:

• Kuyesedwa kwachipatala kwa immunotherapy (chithandizo cha katemera).

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.

Wotsutsa kapena Wowopsa Wabwana Rhabdomyosarcoma

Njira zochiritsira za rhabdomyosarcoma yaubwana kapena yabwinobwino yaubwana zimakhazikitsidwa pazinthu zambiri, kuphatikiza komwe khansa yabwerera m'thupi, mtundu wanji wamankhwala omwe mwanayo anali nawo kale, komanso zosowa za mwanayo.

Chithandizo cha rhabdomyosarcoma chosokoneza kapena chobwerezabwereza chingaphatikizepo chimodzi kapena zingapo zotsatirazi:

• Opaleshoni.

• Thandizo la radiation.

• Chemotherapy.

• Kuyesedwa kwachipatala kwa chithandizo chamankhwala kapena immunotherapy (sirolimus, ipilimumab, nivolumab, kapena pembrolizumab).

• Kuyesedwa kwachipatala kwa mankhwala omwe ali ndi tyrosine kinase inhibitor (MK-1775 kapena cabozantinib-s-malate) ndi chemotherapy.

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

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

Kuti mudziwe Zambiri Zokhudza Ubwana Rhabdomyosarcoma

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza rhabdomyosarcoma yaubwana, onani izi:

• Tsamba Lofewa la Tissue Sarcoma

• Computed Tomography (CT) Zithunzi ndi Khansa

• Mankhwala Ovomerezeka a Rhabdomyosarcoma

• Njira Zochizira Khansa

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