Mhando / chiropa / murwere / mwana-chiropa-kurapwa-pdq

Hwechidiki Chiropa Cancer Kurapa

General Ruzivo nezveUdiki Chiropa Kenza

PFUNGWA DZINOKOSHA

• Kenza yechiropa gomarara chirwere icho chinotyisa (gomarara) maseru anoumba mumatumbu echiropa.

• Kune akasiyana marudzi ehucheche chiropa kenza.

• Zvimwe zvirwere nemamiriro ezvinhu zvinogona kuwedzera njodzi yekenza yechiropa kenza.

• Zviratidzo uye zviratidzo zvehucheche hwegomarara rechiropa zvinosanganisira bundu kana kurwadziwa mudumbu.

• Kuyedza kunoongorora chiropa neropa kunoshandiswa kuona (kutsvaga) uye kuongorora gomarara rechiropa rehucheche uye kuona kana gomarara rapararira.

• Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Kenza yechiropa gomarara chirwere icho chinotyisa (gomarara) maseru anoumba mumatumbu echiropa.

Chiropa ndiyo imwe yenhengo huru mumuviri. Iine makobvu maviri uye inozadza nechekumusoro kurudyi kwedumbu mukati membabvu. Matatu emabasa akakosha echiropa ndeaya:

• Sefa zvinhu zvinokuvadza kubva muropa kuitira kuti zvigone kupfuudzwa kubva mumuviri muzvituru uye neweti.

• Kugadzira bile yekubatsira kugaya mafuta kubva muchikafu.

• Kuchengeta glycogen (shuga), iyo iyo muviri unoshandisa simba.

Anatomy yechiropa. Chiropa chiri mudumbu repamusoro padyo nedumbu, ura, nduru, uye rwatata. Chiropa chine denderedzwa rerudyi uye reruboshwe. Lobe rimwe nerimwe rakakamurwa kuita zvikamu zviviri (zvisina kuratidzwa).

Gomarara rechiropa harishoma muvana nevechiri kuyaruka.

Kune akasiyana marudzi ehucheche chiropa kenza.

Kune maviri akakosha marudzi ehucheche chiropa kenza.

• Hepatoblastoma: Hepatoblastoma ndiyo inonyanya kufarirwa nekenza yechiropa kenza. Kazhinji zvinokanganisa vana vari pasi pemakore matatu ekuberekwa.

Mune hepatoblastoma, iyo histology (maseru ekenza anotaridzika sei pasi pe microscope) inokanganisa mabatiro anoita kenza. Iyo histology yehepatoblastoma inogona kunge iri yeinotevera:

• Yakanyatsosiyaniswa fetal (pure fetal) histology.

• Sero diki isina kusiyaniswa histology.

• Kwete-yakanyatsosiyaniswa fetal histology, isiri-diki sero isina kusiyaniswa histology.

• Hepatocellular carcinoma: Hepatocellular carcinoma inowanzo bata vana vakura nevachiri kuyaruka. Izvo zvinowanzoitika munzvimbo dzeAsia dzine huwandu hwakanyanya hwehutachiona hwehepatitis B kupfuura muUS

Dzimwe dzisingawanzo kujairika mhando dzehucheche chiropa kenza inosanganisira zvinotevera:

• Undifferentiated embryonal sarcoma yechiropa: Rudzi urwu rwegomarara rechiropa runowanzoitika muvana vari pakati pemakore mashanu kusvika gumi ezera. Iyo inowanzopararira kwese kuburikidza nechiropa uye / kana kumapapu.

• Infantile choriocarcinoma yechiropa: Ichi chibundu chisingawanzoitika chinotanga muplasenta uye chinopararira kumucheche. Bundu rinowanzo kuwanikwa mukati memwedzi mishoma yekutanga yehupenyu. Zvakare, amai vemwana vanogona kuongororwa vane choriocarcinoma. Choriocarcinoma rudzi rwegestational trophoblastic chirwere. Ona pfupiso ye paGestational Trophoblastic Disease Kurapa kuti uwane rumwe ruzivo nezve kurapwa kwechoriocarcinoma kuna amai vemwana.

• Vascular chiropa tumota: Aya mamota anoumba muchiropa kubva kumasero anogadzira tsinga dzeropa kana lymph lymph. Vascular chiropa tumota dzinogona kuva benign (kwete cancer) kana yakaipa (cancer). Ona pfupiso ye paChidiki Vascular Tumors Kurapa kuti uwane rumwe ruzivo nezvevascular chiropa tumota.

Pfupiso iyi ndeyekurapwa kwekenza yechiropa yekutanga (gomarara rinotanga muchiropa). Kurapa kwegomarara repachiropa, rinova gomarara rinotanga mune dzimwe nhengo dzemuviri uye richipararira kuchiropa, harikurukuriwe muchidimbu ichi.

Kenza yechiropa yepuraimari inogona kuitika kune vese vakuru nevana. Zvisinei, kurapwa kwevana kwakasiyana nekurapwa kwevanhu vakuru. Ona pfupiso yePDPQ yeAdult Primary Chiropa Cancer Kurapa kuti uwane rumwe ruzivo nezve kurapwa kwevakuru.

Zvimwe zvirwere nemamiriro ezvinhu zvinogona kuwedzera njodzi yekenza yechiropa kenza.

Chero chipi zvacho chinowedzera mukana wako wekutora chirwere chinonzi njodzi chinhu. Kuva nenjodzi hazvireve kuti uchawana gomarara; kusava nenjodzi hazvireve kuti hauzobatwe negomarara. Taura nachiremba wemwana wako kana iwe uchifunga kuti mwana wako angave ari panjodzi.

Njodzi zvinhu zvehepatoblastoma zvinosanganisira anotevera syndromes kana mamiriro:

• Aicardi chirwere.

• Beckwith-Wiedemann chirwere.

• Hemihyperplasia.

• Inowanzozivikanwa adenomatous polyposis (FAP).

• Chirwere chekuchengetedza Glycogen.

• Kurema kwakaderera kwazvo pakuzvarwa.

• Simpson-Golabi-Behmel chirwere.

• Dzimwe shanduko dzemagetsi, senge Trisomy 18.

Vana vari panjodzi yehepatoblastoma vanogona kunge vaine bvunzo dzinoitwa kuti vatarise kenza zvisati zvaonekwa zviratidzo. Mwedzi mitatu yega yega kusvika mwana ave nemakore mana ekuberekwa, bvunzo dzemudumbu dze ultrasound dzinoitwa uye padanho reAlpha-fetoprotein muropa rinotariswa.

Njodzi zvinhu zvehepatocellular carcinoma zvinosanganisira anotevera syndromes kana mamiriro:

• Alagille chirwere.

• Chirwere chekuchengetedza Glycogen.

• Hepatitis B hutachiona hutachiona hwakapfuudzwa kubva kuna amai kuenda kumwana pakuzvarwa.

• Kufambira mberi kwemhuri intrahepatic chirwere.

• Tyrosinemia.

Vamwe varwere vane tyrosinemia vachange vaine chiropa chekurapa chirwere ichi pasati paine zviratidzo kana zviratidzo zvegomarara.

Zviratidzo uye zviratidzo zvehucheche hwegomarara rechiropa zvinosanganisira bundu kana kurwadziwa mudumbu.

Zviratidzo nezviratidzo zvinowanzoitika mushure mekunge bundu rakura. Mimwe mamiriro ezvinhu anogona kukonzera iwo iwo zviratidzo nezviratidzo. Tarisa nechiremba wemwana wako kana mwana wako ane chero chinotevera:

• Bundu mudumbu rinogona kurwadza.

• Kuzvimba mudumbu.

• Kurera huremu pasina chikonzero chinozivikanwa.

• Kupererwa nechido.

• Kusvotwa uye kurutsa.

Kuyedza kunoongorora chiropa neropa kunoshandiswa kuona (kutsvaga) uye kuongorora gomarara rechiropa rehucheche uye kuona kana gomarara rapararira.

Iyi inotevera bvunzo uye maitiro anogona kushandiswa:

• Kuongorora kwepanyama uye nhoroondo: Kuongororwa kwemuviri kutarisa zviratidzo zvehutano, kusanganisira kuongorora zviratidzo zvehosha, zvakadai semapundu kana chero chinhu chinoratidzika sechisina kujairika. Nhoroondo yemaitiro ehutano hwemurwere uye kurwara kwakapfuura uye kurapwa kuchatorwawo.

• Serum tumor marker bvunzo: Maitiro umo muyedzo weropa unotariswa kuyera huwandu hwezvimwe zvinhu zvakaburitswa muropa nenhengo, nyama, kana maseru emota mumuviri. Zvimwe zvinhu zvinosunganidzwa kune chaiwo marudzi ekenza kana akawanikwa mune akawedzera mwero muropa. Aya anonzi mamarara mamark. Ropa revana vane gomarara rechiropa rinogona kunge rakawedzera huwandu hwehomoni inonzi beta-human chorionic gonadotropin (beta-hCG) kana protein inonzi alpha-fetoprotein (AFP). Mimwe kanzira, bundu rechiropa, uye mamwe mamiriro asina cancer, anosanganisira cirrhosis uye hepatitis, anogona zvakare kuwedzera AFP mazinga.

• Yakazara kuverenga kweropa (CBC): Maitiro umo muyenzaniso weropa unodhonzwa nekuongororwa zvinotevera:

• Huwandu hwemasero matsvuku eropa, machena masero eropa, uye maplatelet.

• Huwandu hwehemoglobin (protein inotakura oxygen) mumasero matsvuku eropa.

• Chikamu chemuenzaniso weropa chakaumbwa nemasero matsvuku eropa.

• Chiropa basa bvunzo: Maitiro umo muyedzo weropa unoongororwa kuyera huwandu hwezvimwe zvinhu zvaburitswa muropa nechiropa. Iyo yakakwira kupfuura yakajairwa huwandu hwechinhu inogona kuve chiratidzo chekukuvara kwechiropa kana gomarara.

• Ropa kemisitiri zvidzidzo: Maitiro umo muyedzo weropa unoongororwa kuyera huwandu hwezvimwe zvinhu, senge bilirubin kana lactate dehydrogenase (LDH), yakaburitswa muropa nenhengo uye zvinyama mumuviri. Chinhu chisina kujairika (chakakwirira kana chakaderera pane zvakajairwa) chiyero chechinhu chinogona kunge chiri chiratidzo chechirwere.

• Epstein-Barr virus (EBV) bvunzo: Kuongororwa kweropa kuti utarise ma antibodies kune EBV uye DNA mamaki eESVV. Izvi zvinowanikwa muropa revarwere vakatapukirwa neEBV.

Hepatitis assay: Maitiro umo muyero weropa unoongororwa zvidimbu zvehutachiona hwehepatitis.

• MRI (magnetic resonance imaging) ine gadolinium: Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira akateedzana emifananidzo yakajeka yenzvimbo dziri mukati mechiropa. Chinhu chinonzi gadolinium chinopinzwa mutsinga. Iyo gadolinium inounganidza yakatenderedza maseru ekenza kuitira kuti varatidze kupenya mumufananidzo. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI).

Magnetic resonance imaging (MRI) yedumbu. Mwana akarara patafura inotsvedza ichipinda muMRI scanner, inotora mifananidzo yemukati memuviri. Iyo padhi padumbu remwana inobatsira kujekesa mifananidzo.

• CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, inotorwa kubva kumakona akasiyana. Mifananidzo yacho inogadzirwa nekombuta yakabatana neiyo x-ray muchina. Dhayi inogona kuiswa jekiseni kana kumedzwa kubatsira nhengo kana zvinyama kuratidza zvakajeka. Iyi nzira inonziwo computed tomography, computerized tomography, kana komputa axial tomography. Muhudiki gomarara rechiropa, CT scan yechipfuva uye mudumbu inowanzoitwa.

Computed tomography (CT) scan yemudumbu. Mwana akarara patafura inotsvedza kuburikidza neCT scanner, iyo inotora mifananidzo ye x-ray yemukati medumbu.

• Ultrasound bvunzo: Maitiro umo ma-high-energy ruzha mafungu (ultrasound) anodonhedzwa kubva mukati memukati nyama kana nhengo uye anoita maungira. Maungira anoumba mufananidzo wemuviri munyama unonzi sonogram. Mufananidzo wacho unogona kudhindwa kuti utariswe gare gare. Muhudiki gomarara rechiropa, kuongororwa kweiyo ultrasound yemudumbu kuongorora iyo hombe midziyo yeropa inowanzoitwa.

Abdominal ultrasound. Ultrasound transducer yakabatana nekombuta inosvinwa yakanangana neganda remudumbu. Iyo transducer inovhuvhuta masaisai ezwi kubva mukati memukati uye matishu kuti aite maungira anoita iyo sonogram (komputa mufananidzo).

• Abdominal x-ray: X-ray yenhengo dziri mudumbu. X-ray imhando yesimba remagetsi rinokwanisa kupfuura nemuviri kupinda mufirimu, richiita mufananidzo wenzvimbo dziri mukati memuviri.

• Biopsy: Kubviswa kwesampula yemaseru kana matukisi saka inogona kutariswa pasi pe microscope kutarisa zviratidzo zvegomarara. Muenzaniso unogona kutorwa panguva yekuvhiyiwa kubvisa kana kuona bundu. Nyanzvi yezvirwere anotarisa muyenzaniso pasi pe microscope kuti awane mhando yekenza yechiropa.

Chiyero chinotevera chingaitwe pane sampuro yetishu inobviswa.

• Immunohistochemistry: Kuongororwa kwerabhoritari inoshandisa masoja ekudzivirira mamwe maantigen (mamaki) mune imwe sampuro yetishu yemurwere. Masoja ekudzivirira chirwere anowanzo sunganidzwa ne enzyme kana dhayi ye fluorescent. Mushure mekunge maantibodies akasunga kune yakasarudzika antigen mune yeiyo sampuli, iyo enzyme kana dhayi inogoneswa, uye iyo antigen inogona kuzoonekwa pasi pe microscope. Rudzi urwu rweyedzo runoshandiswa kutarisa kumwe kuchinja kwemajini, kubatsira kuongorora gomarara, uye kubatsira kutaurira imwe mhando yekenza kubva kune imwe mhando yegomarara.

Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Kufungidzira (mukana wekupora) uye sarudzo dzekurapa hepatoblastoma dzinoenderana nezvinotevera:

• Boka rePRETEXT.

• Kukura kwebundu.

• Kunyangwe iyo mhando yehepatoblastoma yakanyatsosiyaniswa fetal (pure fetal) kana diki sero isina kukamurwa histology.

• Kunyangwe kenza yapararira kune dzimwe nzvimbo mumuviri, senge diaphragm, mapapu, kana mimwe midziyo mikuru yeropa.

• Kunyangwe paine anopfuura rimwe bundu muchiropa.

• Kunyangwe chifukidziro chekunze chakakomberedza bundu chatsemuka.

• Iyo kenza inopindura sei chemotherapy.

• Kunyangwe kenza inogona kubviswa zvachose nekuvhiyiwa.

• Kunyangwe murwere anogona kuve nechiropa chekuisa.

• Kunyangwe iyo AFP mazinga eropa anoenda pasi mushure mekurapwa.

• Zera remwana.

• Kunyangwe kenza ichangobva kuongororwa kana kuti yakadzoka zvakare.

Kufungidzira (mukana wekupora) uye nzira dzekurapa hepatocellular carcinoma zvinoenderana nezvinotevera:

• Boka rePRETEXT.

• Kunyangwe kenza yapararira kune dzimwe nzvimbo mumuviri, senge mapapu.

• Kunyangwe kenza inogona kubviswa zvachose nekuvhiyiwa.

• Iyo kenza inopindura sei chemotherapy.

• Kunyangwe mwana ane hutachiona hwehepatitis B.

• Kunyangwe kenza ichangobva kuongororwa kana kuti yakadzoka zvakare.

Nezve kenza yechiropa kenza inodzokororwa (inodzoka) mushure mekutanga kurapwa, kufungidzira uye sarudzo dzekurapa dzinoenderana ne:

• Iko mumuviri bundu riya rakadzoka zvakare.

• Mhando yekurapa inoshandiswa kurapa kenza yekutanga.

Kenza yechiropa yehudiki inogona kurapwa kana bundu iri diki uye rinogona kubviswa zvachose nekuvhiyiwa. Kubvisa kwakazara kunogoneka kazhinji kune hepatoblastoma kupfuura hepatocellular carcinoma.

Matanho eChidiki Chiropa Kenza

PFUNGWA DZINOKOSHA

• Mushure mehucheche gomarara rechiropa raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru apararira mukati mechiropa kana kune zvimwe zvikamu zvemuviri.

• Iko kune maviri mapoka ehurongwa hwehucheche chiropa kenza.

• Iko kune mana PRETEXT uye POSTTEXT mapoka:

• PRETEXT uye POSTTEXT Boka I

• PRETEXT uye POSTTEXT Boka II

• PRETEXT uye POSTTEXT Boka III

• PRETEXT uye POSTTEXT Boka IV

• Pane nzira nhatu dzinopararira negomarara mumuviri.

• Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

Mushure mehucheche gomarara rechiropa raonekwa, kuongororwa kunoitwa kuti uone kana gomarara maseru apararira mukati mechiropa kana kune zvimwe zvikamu zvemuviri.

Maitiro anoshandiswa kutsvaga kana gomarara rapararira mukati mechiropa, kumatishu kana nhengo dziri pedyo, kana kune zvimwe zvikamu zvemuviri zvinodaidzwa kunzi staging. Muhudiki gomarara rechiropa, mapoka ePRETEXT uye POSTTEXT anoshandiswa panzvimbo pechikamu kuronga kurapwa. Mhedzisiro yemaedzo nemaitiro anoitwa kutsvaga, kuongorora, uye kuona kuti kenza yapararira here inoshandiswa kuona PRETEXT nePOSTTEXT mapoka.

Iko kune maviri mapoka ehurongwa hwehucheche chiropa kenza.

Masisitimu maviri ekumisikidza anoshandiswa kenza yechiropa yehucheche kusarudza kuti bundu rinogona kubviswa nekuvhiya:

• Boka rePRETEXT rinotsanangura bundu murwere asati arapwa.

• POSTTEXT boka rinotsanangura bundu mushure mekunge murwere awana kurapwa senge neoadjuvant chemotherapy.

Iko kune mana PRETEXT uye POSTTEXT mapoka:

Chiropa chakakamurwa kuita zvikamu zvina. Mapoka ePRETEXT nePOSTTEXT anoenderana nezvikamu zvechiropa zvine cancer.

PRETEXT uye POSTTEXT Boka I

Chiropa PRETEXT I. Kenza inowanikwa mune chimwe chikamu chechiropa. Zvikamu zvitatu zvechiropa zviri padhuze nepakati hazvina kenza mavari.

Muboka I, gomarara rinowanikwa mune chimwe chikamu chechiropa. Zvikamu zvitatu zvechiropa zviri padhuze nepakati hazvina kenza mavari.

PRETEXT uye POSTTEXT Boka II

Chiropa PRETEXT II. Gomarara rinowanikwa mune chimwe kana zvikamu zviviri zvechiropa. Zvikamu zviviri zvechiropa zviri padhuze nepakati hazvina kenza mavari.

Muboka II, kenza inowanikwa mune chimwe kana zvikamu zviviri zvechiropa. Zvikamu zviviri zvechiropa zviri padhuze nepakati hazvina kenza mavari.

PRETEXT uye POSTTEXT Boka III

Chiropa PRETEXT III. Gomarara rinowanikwa muzvikamu zvitatu zvechiropa uye chikamu chimwe hachina gomarara, kana gomarara rinowanikwa muzvikamu zviviri zvechiropa uye zvikamu zviviri zvisina kuenderana hazvina gomarara mavari.

Muboka III, chimwe cheanotevera ichokwadi:

• Gomarara rinowanikwa muzvikamu zvitatu zvechiropa uye chikamu chimwe hachina gomarara.

• Gomarara rinowanikwa muzvikamu zviviri zvechiropa uye zvikamu zviviri zvisiri padhuze nepadyo hazvina kenza mavari.

PRETEXT uye POSTTEXT Boka IV

Chiropa PRETEXT IV. Gomarara rinowanikwa muzvikamu zvina zvechiropa.

Muboka IV, gomarara rinowanikwa muzvikamu zvina zvechiropa.

Pane nzira nhatu dzinopararira negomarara mumuviri.

Kenza inogona kupararira kuburikidza nematinji, iyo lymph system, uye neropa:

• Tishu. Kenza inopararira kubva kwayakatanga nekukura ichipinda munzvimbo dziri pedyo.

• Lymph maitiro. Kenza inopararira kubva kwayakatanga nekupinda muiyo lymph system. Kenza inofamba nemumidziyo yema lymph ichienda kune dzimwe nhengo dzemuviri.

• Ropa. Kenza inopararira kubva payakatanga nekupinda muropa. Kenza inofamba nemidzi yeropa ichienda kune dzimwe nhengo dzemuviri.

Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

Kana kenza ikapararira kune chimwe chikamu chemuviri, inonzi metastasis. Cancer maseru anotsemuka kubva kwaakatanga (iro bundu rekutanga) uye achifamba kuburikidza neye lymph system kana ropa.

• Lymph maitiro. Gomarara rinopinda mu "lymph system", rinofamba nemumidziyo ye "lymph", uye rinogadzira bundu (metastatic tumor) mune chimwe chikamu chemuviri.

• Ropa. Kenza inopinda muropa, inofamba nemutsinga dzeropa, yoita bundu (metastatic tumor) mune chimwe chikamu chemuviri.

Iyo metastatic bundu irwo rudzi rwecancer seyakanyanya bundu. Semuenzaniso, kana kenza yechiropa yehucheche ichipararira kuenda kumapapu, maseru emukenza mumapapu ndiwo masero ekenza echiropa. Hosha iyi metastatic cancer cancer, kwete yemapapu cancer.

Dzokororo Yehucheche Chiropa Kenza

Kazhinji kenza yechiropa kenza igomarara rakadzokazve (kudzoka) mushure mekurapwa. Gomarara rinogona kudzoka muchiropa kana mune mamwe mativi emuviri. Kenza iri kukura kana kuwedzera panguva yekurapa chirwere chinopfuurira.

Kurapa Sarudzo Kuongorora

PFUNGWA DZINOKOSHA

• Kune akasiyana marudzi ekurapa kwevarwere vane kenza yechiropa yemwana.

• Vana vane gomarara rechiropa vanofanirwa kurapwa kurapwa nechikwata chevanoona nezvehutano avo vari nyanzvi pakurapa gomarara iri risingawanzo hudiki.

• Kurapa kwekenza yechiropa kenza kunogona kukonzera mhedzisiro.

• Mhando nhanhatu dzekurapwa kwakajairika dzinoshandiswa:

• Kuvhiya

• Kurinda kumirira

• Chemotherapy

• Radiation kurapa

• Kurapa kweablation

• Antiviral kurapwa

• Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

• Targeted kurapwa

• Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

• Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

• Yekutevera-bvunzo inogona kudikanwa.

Kune akasiyana marudzi ekurapa kwevarwere vane kenza yechiropa yemwana.

Mhando dzakasiyana dzekurapa dzinowanikwa kune vana vane gomarara rechiropa. Mamwe marapirwo akajairwa (iko kurapwa kwazvino kwashandiswa), uye kumwe kuedzwa mumakiriniki ekuedzwa A kurapwa kiriniki kuyedzwa chidzidzo chekutsvaga chakaitirwa kubatsira kuvandudza marapirwo azvino kana kuwana ruzivo marapirwo matsva evarwere vane gomarara. Kana kiriniki miedzo ikaratidza kuti kurapwa kutsva kuri nani pane kwese kurapwa, kurapwa kutsva kunogona kuve kwakajairwa kurapwa.

Kutora chikamu mukuedzwa kwekiriniki kunofanirwa kutariswa kune vese vana vane gomarara rechiropa. Mimwe miedzo yekiriniki yakavhurwa chete kune varwere vasina kutanga kurapwa.

Vana vane gomarara rechiropa vanofanirwa kurapwa kurapwa nechikwata chevanoona nezvehutano avo vari nyanzvi pakurapa gomarara iri risingawanzo hudiki.

Kurapa kunozoonekwa nachiremba wevana oncologist, chiremba ane hunyanzvi hwekurapa vana vane gomarara. Vanachiremba oncologist vanoshanda nevamwe vanopa hutano vanove nyanzvi dzekurapa vana vane gomarara rechiropa uye vanoziva mune dzimwe nzvimbo dzemishonga. Izvo zvinonyanya kukosha kuve nachiremba wechiremba wechiremba ane ruzivo mukuvhiya kwechiropa uyo anogona kutumira varwere kuchirongwa chekuchinjisa chiropa kana zvichidikanwa. Dzimwe nyanzvi dzinogona kusanganisira zvinotevera:

• Chiremba wevana.

• Radiation oncologist.

• Mukoti wechiremba nyanzvi.

• Rehabilitation nyanzvi.

• Nyanzvi yezvepfungwa.

• Wezvemagariro.

Kurapa kwekenza yechiropa kenza kunogona kukonzera mhedzisiro.

Kuti uwane ruzivo nezve mhedzisiro inotanga panguva yekurapa kenza, ona yedu Side Mhedzisiro peji.

Zvimwe zvinokonzeresa kubva pakurapwa nekenza zvinotanga mushure mekurapwa uye kuenderera kwemwedzi kana makore zvinonzi kunonoka kuitika Kwapera nguva mhedzisiro yekurapwa nekenza inogona kusanganisira:

• Zvinetso zvepanyama.

• Shanduko mumanzwiro, manzwiro, kufunga, kudzidza, kana ndangariro.

• Gomarara repiri (mhando nyowani dzekenza).

Mimwe mhedzisiro mhedzisiro inogona kurapwa kana kudzorwa. Izvo zvakakosha kuti utaure navanachiremba vemwana wako nezve mhedzisiro yekurapwa nekenza kunogona kuve pamwana wako. (Ona pfupiso ye pamusoro peMagumo Ekurapa kweKenza Yevacheche kuti uwane rumwe ruzivo).

Mhando nhanhatu dzekurapwa kwakajairika dzinoshandiswa:

Kuvhiya

Kana zvichibvira, kenza inobviswa nekuvhiyiwa.

• Chikamu hepatectomy: Kubviswa kwechikamu chechiropa panowanikwa gomarara. Chikamu chakabviswa chingave chidimbu chemashuga, chiuno chakazara, kana chikamu chakakura chechiropa, pamwe nehuremu hwetiki hwakajairika.

• Yakazara hepatectomy uye kuisirwa kwechiropa: Kubvisa chiropa chose kuchiteverwa nekuiswa kwechiropa chine hutano kubva kune anenge apa. Kuiswa kwechiropa kunogona kuitika kana kenza isina kupararira kupfuura chiropa uye chiropa chakapihwa chinogona kuwanikwa. Kana murwere achifanira kumirira chiropa chakapihwa, kumwe kurapwa kunopihwa sekudikanwa.

• Kugadziriswa kwemastastases: Kuvhiya kubvisa gomarara rakapararira kunze kwechiropa, senge kumatokisi ari padyo, mapapu, kana huropi.

Mhando yekuvhiya inogona kuitwa zvinoenderana nezvinotevera:

• Boka rePRETEXT uye POSTTEXT boka.

• Hukuru hwebundu rekutanga.

• Kunyangwe paine anopfuura rimwe bundu muchiropa.

• Kunyangwe kenza yapararira kune makuru makuru eropa.

• Chiyero cheAlpha-fetoprotein (AFP) muropa.

• Kunyangwe bundu racho rinogona kudzipwa nekemotherapy kuitira kuti ribviswe nekuvhiya.

• Kunyangwe kuisirwa chiropa kunodiwa.

Chemotherapy dzimwe nguva inopihwa usati wavhiyiwa kudzikisa bundu uye kuita kuti zvive nyore kubvisa. Izvi zvinonzi neoadjuvant therapy.

Mushure mekunge chiremba abvisa kenza yese inoonekwa panguva yekuvhiyiwa, vamwe varwere vanogona kupihwa chemotherapy kana radiation radiation mushure mekuvhiyiwa kuuraya chero gomarara maseru akasara. Mushonga wakapihwa mushure mekuvhiyiwa, kudzikisa njodzi yekuti gomarara richadzoka, inonzi adjuvant therapy.

Kurinda kumirira

Kurindira kumirira kuri kunyatsoongorora mamiriro emurwere pasina kupa chero kurapwa kusvikira zviratidzo kana zviratidzo zvaonekwa kana kuchinja. Mune hepatoblastoma, kurapwa uku kunongoshandiswa chete kumamota madiki akabviswa zvachose nekuvhiyiwa.

Chemotherapy

Chemotherapy mushonga wekenza unoshandisa mishonga kumisa kukura kwemasero ekenza, kungave nekuuraya maseru kana nekuamisa iwo kubva pakupatsanuka. Kana chemotherapy ikatorwa nemuromo kana kujowa mutsinga kana mhasuru, mishonga inopinda muropa uye inogona kusvika masero emukenza mumuviri wese (systemic chemotherapy). Kana chemotherapy ikaiswa yakanangana necerebrospinal fluid, nhengo, kana dumbu remuviri senge dumbu, iwo madhiragi anonyanya kukanganisa cancer maseru munzvimbo idzodzo (remunharaunda chemotherapy). Kurapa uchishandisa anopfuura imwe anticancer mushonga unonzi mubatanidzwa chemotherapy.

Chemoembolization yeiyo hepatic artery (iyo huru arteri inopa ropa kuchiropa) imhando yematunhu chemotherapy inoshandiswa kurapa hudiki gomarara rechiropa risingakwanise kubviswa nekuvhiya Mushonga weanticancer unopinda mukati meiyo hepatic artery kuburikidza necatheter (yakatetepa chubhu). Mushonga uyu wakasanganiswa nechinhu chinodzivirira tsinga, kucheka kuyerera kweropa kuenda kubundu. Mazhinji emushonga weacancer akabatwa padhuze nebundu uye hushoma chete hwemushonga hunosvika kune dzimwe nhengo dzemuviri. Kuvharika kwacho kungave kwechinguva kana kwechigarire, zvinoenderana nechinhu chinoshandiswa kuvhara tsinga. Bundu rinotadziswa kuwana iyo oxygen uye zvinovaka muviri zvainoda kukura. Chiropa chinoramba chichigamuchira ropa kubva kune hepatic portal vein, inotakura ropa kubva mudumbu uye ura kuenda kuchiropa.

Nzira iyo chemotherapy inopihwa inoenderana nemhando yekenza iri kurapwa uye neboka rePRETEXT kana POSTTEXT.

Radiation kurapa

Radiation kurapa kurapwa kenza iyo inoshandisa yakakwira-simba x-rays kana mamwe marudzi e radiation kuuraya cancer maseru kana kuachengeta iwo kuti asakure. Kune mhando mbiri dze radiation radiation:

• External radiation therapy inoshandisa muchina uri kunze kwemuviri kutumira radiation kune kenza.

• Yemukati radiation kurapwa kunoshandisa radioactive chinhu chakavharirwa mune tsono, mhodzi, waya, kana makateti anoiswa akananga mukati kana padyo nekenza.

Radioembolization yeiyo hepatic artery (iyo huru arteri inopa ropa kuchiropa) imhando yemukati radiation radiation inoshandiswa kurapa hepatocellular carcinoma. Chinhu chidiki-diki che radioactive chinosunganidzwa netumabhuru tudiki twunopfekerwa mutsinga ye hepatic kuburikidza ne catheter (rakatetepa chubhu). Marozari aya anosanganiswa nechinhu chinodzivirira tsinga, kucheka kuyerera kweropa kuenda pabundu. Mazhinji emwaranzi akavharirwa padyo nebundu kuuraya maseru egomarara. Izvi zvinoitirwa kurerutsa zviratidzo nekuvandudza hupenyu hwevana vane hepatocellular carcinoma.

Iyo nzira iyo radiation radiation inopihwa zvinoenderana nerudzi rwegomarara riri kurapwa uye nePRETEXT kana POSTTEXT boka. External radiation therapy inoshandiswa kurapa hepatoblastoma isingakwanise kubviswa nekuvhiya kana kupararira kune dzimwe nhengo dzemuviri.

Kurapa kweablation

Kurapa kweablation kunobvisa kana kuparadza nyama. Mhando dzakasiyana dzeablation kurapa dzinoshandiswa kenza yechiropa:

• Radiofrequency ablation: Iko kushandiswa kwesingano dzakakosha dzinoiswa dzakananga kuburikidza neganda kana kuburikidza nekukwiridzwa mudumbu kusvika kune bundu. Yepamusoro-simba redhiyo mafungu anopisa tsono uye bundu iro rinouraya cancer maseru. Radiofrequency ablation iri kushandiswa kurapa zvinowanzoitika hepatoblastoma.

• Percutaneous ethanol jekiseni. Kurapa kunogona kuda majekiseni akati wandei. Percutaneous ethanol jekiseni iri kushandiswa kurapa zvinowanzoitika hepatoblastoma.

Antiviral kurapwa

Hepatocellular carcinoma iyo inosangana nehutachiona hwehepatitis B inogona kurapwa nemishonga inorwisa hutachiona.

Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

Ichi chidimbu chikamu chinotsanangura kurapwa kuri kuongororwa mumakiriniki ekuedzwa. Zvinogona kusataura nezveese marapirwo matsva ari kuongororwa. Ruzivo nezve kiriniki miedzo inowanikwa kubva kuNCI webhusaiti.

Targeted kurapwa

Targeted therapy rudzi rwekurapa runoshandisa zvinodhaka kana zvimwe zvinhu kurwisa mamwe maseru ekenza. Tyrosine kinase inhibitor (TKI) kurapa mhando yekurapa kwakanangwa. TKIs anovharira zviratidzo zvinodiwa kuti mamota akure. Sorafenib uye pazopanib maTKI ari kuongororwa kurapa hepatocellular carcinoma iyo yadzoka uye ichangobva kuongororwa isina kukamurwa embryonal sarcoma yechiropa.

Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

Kune vamwe varwere, kutora chikamu mumuedzo wekiriniki inogona kunge iri sarudzo yekurapa yakanyanya kunaka. Kliniki miedzo chikamu chekenza tsvagiridzo. Zvemakiriniki miedzo inoitwa kuti uone kana marapirwo matsva egomarara akachengeteka uye achishanda kana zvirinani pane akajairwa kurapwa.

Mazhinji emazuva ano marapirwo akajairwa ekenza akavakirwa pamavambo emakiriniki ekuedzwa. Varwere vanotora chikamu mukuyedzwa kwekiriniki vanogona kuwana kurapwa kwakaringana kana kuve pakati pevekutanga kurapwa kutsva.

Varwere vanotora chikamu mumiedzo yekiriniki zvakare vanobatsira kugadzirisa marapirwo achaitwa kenza mune ramangwana. Kunyangwe kana miedzo yemakiriniki isinga tangire kumarapirwo matsva anoshanda, anowanzo pindura mibvunzo yakakosha uye anobatsira kufambisira mberi kutsvagurudza.

Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

Mimwe miedzo yekiriniki inosanganisira chete varwere vasati vagamuchira kurapwa. Mimwe miedzo yekuedza kurapwa kwevarwere vane kenza haina kuve nani. Kune mamwezve emakiriniki miedzo inoedza nzira nyowani dzekumisa cancer kubva kudzokororazve (kudzoka) kana kudzikisira mhedzisiro yemakenza kurapwa.

Kuedzwa kwemakiriniki kuri kuitika munzvimbo zhinji dzenyika. Ruzivo nezve kiriniki miedzo inotsigirwa neNCI inogona kuwanikwa paNCI yekiriniki miedzo yekutsvaga peji rewebhu. Kliniki miedzo inotsigirwa nemamwe masangano inogona kuwanikwa pane yeClinicalTrials.gov webhusaiti.

Yekutevera-bvunzo inogona kudikanwa.

Kumwe kwekuyedzwa kwakaitwa kuongorora kenza kana kutsvaga boka rekurapa kunogona kudzokororwa. Mimwe bvunzo inodzokororwa kuti uone kuti kurapa kuri kushanda sei. Sarudzo nezvekuti uenderere mberi, shandura, kana kumisa kurapwa kunogona kunge kuchibva pamhedzisiro yeiyi bvunzo.

Mimwe bvunzo ichaenderera ichiitwa nguva nenguva mushure mekunge kurapwa kwapera. Mhedzisiro yeiyi bvunzo inogona kuratidza kana mamiriro ako achinja kana kana gomarara radzoka (dzoka). Iyi bvunzo dzimwe nguva inonzi yekuteedzera-bvunzo kana kuongorora-kumusoro.

Kurapa Sarudzo dzeChidiki Chiropa Kenza

Muchikamu chino

• Hepatoblastoma

• Hepatocellular Carcinoma

• Asina kusarudzika Embryonal Sarcoma yeChiropa

• Infantile Choriocarcinoma yeRopa

• Vascular Chiropa Tumors

• Dzokororo Yehucheche Chiropa Kenza

• Kurapa Sarudzo muClinical Miedzo

Kuti uwane ruzivo nezve marapirwo akanyorwa pazasi, ona iyo Chikamu Sarudzo Yekutarisa Chikamu.

Hepatoblastoma

Kurapa sarudzo yehepatoblastoma iyo inogona kubviswa nekuvhiyiwa panguva yekuongororwa inogona kusanganisira zvinotevera:

• Kuvhiya kubvisa bundu, kuchiteverwa nekubatanidzwa chemotherapy ye hepatoblastoma iyo isina kunyatsosiyaniswa fetal histology. Kune hepatoblastoma ine diki sero isina kukamurwa histology, ine hukasha chemotherapy inopihwa.

• Kuvhiya kubvisa bundu, kuchiteverwa nekumirira kwakamirira kana chemotherapy, kune hepatoblastoma ine musiyano wakasarudzika fetal histology.

Kurapa sarudzo yehepatoblastoma isingakwanise kubviswa nekuvhiya kana kusabviswa panguva yekuongororwa inogona kusanganisira zvinotevera:

• Kusanganiswa chemotherapy kurapa bundu, zvichiteverwa nekuvhiya kubvisa bundu.

• Kusanganiswa chemotherapy, inoteverwa nechiropa chekuisa.

• Chemoembolization yeiyo hepatic artery yekudzora bundu, inoteverwa nekuvhiya kubvisa bundu.

• Kana bundu riri muchiropa risingakwanise kubviswa nekuvhiyiwa asi pasina zviratidzo zvegomarara mune mamwe mativi emuviri, kurapwa kwacho kunogona kuve kuwedzerwa kwechiropa.

Kune hepatoblastoma yakapararira kune zvimwe zvikamu zvemuviri panguva yekuongororwa, chemotherapy inosanganiswa inopihwa kudzikisa mamota ari muchiropa nekenza yakapararira kune zvimwe zvikamu zvemuviri. Mushure memakemikari, kuongororwa kwekufungidzira kunoitwa kuti uone kana mamota anogona kubviswa nekuvhiya.

Sarudzo dzekurapa dzinogona kusanganisira zvinotevera:

• Kana bundu riri muchiropa uye zvimwe zvikamu zvemuviri (kazhinji maburi mapapu) anogona kubviswa, kuvhiya kuchaitwa kubvisa mamota achiteverwa nekemotherapy kuuraya chero maseru ekenza anogona kusara.

• Kana bundu iri mune zvimwe zvikamu zvemuviri risingakwanise kubviswa kana kuisirwa chiropa kusingagone, chemotherapy, chemoembolization ye hepatic arteri, kana radiation radiation inogona kupihwa.

• Kana bundu iri mune mamwe mativi emuviri risingakwanise kubviswa kana murwere asingade kuvhiyiwa, radiofrequency ablation inogona kupihwa.

Kurapa sarudzo mumakiriniki ekuedzwa kweachangobva kuongororwa hepatoblastoma anosanganisira:

• Kuongororwa kwekiriniki kwechemotherapy uye kuvhiyiwa.

Hepatocellular Carcinoma

Kurapa sarudzo yehepatocellular carcinoma iyo inogona kubviswa nekuvhiyiwa panguva yekuongororwa inogona kusanganisira zvinotevera:

• Kuvhiya ndega kubvisa bundu.

• Kuvhiya kubvisa bundu, kuchiteverwa nekemotherapy.

• Kusanganiswa chemotherapy, inoteverwa nekuvhiya kubvisa bundu.

Kurapa sarudzo yehepatocellular carcinoma iyo isingakwanise kubviswa nekuvhiya uye isina kupararira kune zvimwe zvikamu zvemuviri panguva yekuongororwa inogona kusanganisira zvinotevera:

• Chemotherapy yekudzora bundu, zvichiteverwa nekuvhiya kubvisa zvachose bundu.

• Chemotherapy yekudzora bundu. Kana kuvhiyiwa kubvisa zvachose bundu racho kusingaiti, kumwe kurapwa kunogona kusanganisira zvinotevera:

• Chiropa chinotamisa.

• Chemoembolization yeiyo hepatic artery yekudzora bundu, inoteverwa nekuvhiya kubvisa bundu kana chiropa chekuisa.

• Chemoembolization yeiyo hepatic artery yega.

• Chemoembolization inoteverwa nechiropa chekuisa.

• Radioembolization yeiyo hepatic arteri senge palliative kurapwa kubvisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

Kurapa kwehepatocellular carcinoma iyo yakapararira kune zvimwe zvikamu zvemuviri panguva yekuongororwa inogona kusanganisira:

• Kusanganiswa chemotherapy kurapa bundu, zvichiteverwa nekuvhiyiwa kubvisa zvakawanda bundu sezvinobvira kubva pachiropa uye dzimwe nzvimbo uko gomarara rapararira. Zvidzidzo hazvina kuratidza kuti kurapwa uku kunoshanda nemazvo asi vamwe varwere vanogona kunge vaine bhenefiti.

Kurapa sarudzo ye hepatocellular carcinoma ine hukama nehutachiona hwehepatitis B (HBV) hutachiona hunosanganisira:

• Kuvhiya kubvisa bundu.

• Antiviral zvinodhaka zvinorapa hutachiona hunokonzerwa nehutachiona hwehepatitis B.

Kurapa sarudzo mumakiriniki ekuedzwa kweachangobva kuongororwa hepatocellular carcinoma anosanganisira:

• Kuongororwa kwekiriniki kwechemotherapy uye kuvhiyiwa.

Asina kusarudzika Embryonal Sarcoma yeChiropa

Kurapa sarudzo dzekusasarudzika embryonal sarcoma yechiropa inogona kusanganisira zvinotevera:

• Kusanganiswa chemotherapy kurapa bundu, zvichiteverwa nekuvhiyiwa kubvisa zvakanyanya bundu sezvinobvira. Chemotherapy inogona zvakare kupihwa mushure mekuvhiyiwa kubvisa bundu.

• Kuvhiya kubvisa bundu, kuchiteverwa nekemotherapy. Kuvhiya kwechipiri kunogona kuitwa kubvisa bundu rinosara, richiteverwa nemamwe machemotherapy.

• Chiropa chinotamisa kana kuvhiya kubvisa bundu racho hazvigoneke.

• Kuongororwa kwekiriniki kweiyo nyowani yekurapa regimen iyo inogona kusanganisira yakanangwa kurapwa (pazopanib), chemotherapy uye / kana radiation radiation isati yavhiyiwa.

Infantile Choriocarcinoma yeRopa

Kurapa sarudzo dzechoriocarcinoma yechiropa muvacheche dzinogona kusanganisira zvinotevera:

• Kusanganiswa chemotherapy kurapa bundu, zvichiteverwa nekuvhiya kubvisa bundu.

• Kuvhiya kubvisa bundu.

Vascular Chiropa Tumors

Ona pfupiso ye paUdiki Vascular Tumors Kurapa kweruzivo nezve kurapwa kwevascular chiropa tumota.

Dzokororo Yehucheche Chiropa Kenza

Kurapa kwe hepatoblastoma inofambira mberi kana inowanzoitika inogona kusanganisira zvinotevera:

• Kuvhiya kubvisa akasarudzika (asina kuroorwa uye akapatsanurwa) mamastastatic tumors ane kana asina chemotherapy.

• Radiofrequency ablation.

• Kusanganiswa chemotherapy.

• Chiropa chinotamisa.

• Ablation Therapy (radiofrequency ablation kana percutaneous ethanol jekiseni) senge yekurapa kurapa kubvisa zviratidzo uye kugadzirisa hupenyu hwehupenyu.

• Kuongororwa kwekiriniki kunoongorora muyenzaniso wemota yemurwere kune mamwe magene ekuchinja. Rudzi rwekurapa kwakanangwa kuchapihwa kumurwere kunoenderana nerudzi rwechinjo yemajini.

Kurapa kweinofambira mberi kana inowanzoitika hepatocellular carcinoma inogona kusanganisira zvinotevera:

• Chemoembolization yeiyo hepatic artery yekudzora bundu pamberi pechiropa kuchinjisa.

• Chiropa chinotamisa.

• Kuongororwa kwekiriniki kweakanangwa kurapwa (sorafenib).

• Kuongororwa kwekiriniki kunoongorora muyenzaniso wemota yemurwere kune mamwe magene ekuchinja. Rudzi rwekurapa kwakanangwa kuchapihwa kumurwere kunoenderana nerudzi rwechinjo yemajini.

Kurapa kwekudzoka kusinganzwisisike embryonal sarcoma yechiropa kunogona kusanganisira zvinotevera:

• Kuongororwa kwekiriniki kunoongorora muyenzaniso wemota yemurwere kune mamwe magene ekuchinja. Rudzi rwekurapa kwakanangwa kuchapihwa kumurwere kunoenderana nerudzi rwechinjo yemajini.

Kurapa kweanowanzoitika choriocarcinoma yechiropa muvacheche kunogona kusanganisira zvinotevera:

• Kuongororwa kwekiriniki kunoongorora muyenzaniso wemota yemurwere kune mamwe magene ekuchinja. Rudzi rwekurapa kwakanangwa kuchapihwa kumurwere kunoenderana nerudzi rwechinjo yemajini.

Kurapa Sarudzo muClinical Miedzo

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Kuti Udzidze Zvakawanda Pamusoro Pehucheche Chiropa Kenza

Kuti uwane rumwe ruzivo kubva kuNational Cancer Institute nezve kenza yechiropa yehucheche, ona zvinotevera:

• Chiropa uye Bile Duct Kenza Peji Peji

• Computed Tomography (CT) Scans uye Cancer

• MyPART - Yangu Yevacheche uye Yevakuru Rare Tumor Network

Kuti uwane rumwe ruzivo rwegomarara rehucheche uye zvimwe zvecancer zviwanikwa, ona zvinotevera:

• Nezve Kenza

• Cancers Yevacheche

• Kurapa Kutsvaga Kwevana Cancer Buda Disclaimer

• Mahedhi Ekupedzisira Ekurapwa kweKenza Yevacheche

• Vechidiki uye Vechidiki Vakuru vane Cancer

• Vana vane Cancer: Nhungamiro Yevabereki

• Kenza muVana neVachiri kuyaruka

• Stage

• Kurarama neCancer

• Mibvunzo Yekubvunza Wako Chiremba nezveCancer

• Kune Vakapona uye Vanotarisira