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I-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma yonyango lwe-Bone (®) -Patient Version

Ulwazi ngokubanzi malunga ne-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

IINGONGOMA EZIPHAMBILI

• I-Osteosarcoma kunye ne-malignant fibrous histiocytoma (MFH) yethambo zizifo apho iiseli ezimbi (zomhlaza) zenza ithambo.

• Ukuba unyango lwangaphambili kunye nemitha kunokunyusa umngcipheko we-osteosarcoma.

• Iimpawu kunye neempawu ze-osteosarcoma kunye ne-MFH zibandakanya ukudumba ngaphezulu kwethambo okanye indawo yebhony yomzimba kunye nentlungu edibeneyo.

• Uvavanyo lokulinganisa lusetyenziselwa ukufumana (ukufumana) i-osteosarcoma kunye neMFH.

• I-biopsy yenziwa ukufumanisa i-osteosarcoma.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

I-Osteosarcoma kunye ne-malignant fibrous histiocytoma (MFH) yethambo zizifo apho iiseli ezimbi (zomhlaza) zenza ithambo.

I-Osteosarcoma ihlala iqala kwii-osteoblasts, eziluhlobo lweseli leethambo eliba ngamathambo amatsha. I-Osteosarcoma ixhaphake kakhulu kulutsha. Ngokwesiqhelo zenzeka kwiiphelo zamathambo amade omzimba, kubandakanya amathambo ezandla kunye nemilenze. Kubantwana nakwishumi elivisayo, ihlala ifomathambo amade, kufutshane nedolo. Ngokuqhelekileyo, i-osteosarcoma inokufumaneka kwizicubu ezithambileyo okanye kwizitho esifubeni okanye esiswini.

I-Osteosarcoma lolona hlobo luqhelekileyo lomhlaza wamathambo. Imbali ye-fibrous histiocytoma (MFH) yethambo sisifo esinqabileyo sethambo. Iphathwa njenge-osteosarcoma.

I-Earc sarcoma lolunye uhlobo lomhlaza wamathambo, kodwa awugutyungelwanga kwesi sishwankathelo. Jonga isishwankathelo se- malunga ne-Ewing Sarcoma Treatment ngolwazi oluthe kratya.

Ukuba unyango lwangaphambili kunye nemitha kunokunyusa umngcipheko we-osteosarcoma.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba umntwana wakho usengozini. Imiba yomngcipheko we-osteosarcoma ibandakanya oku kulandelayo:

• Unyango lwangaphambili ngonyango lwemitha.

• Unyango oludlulileyo ngamachiza antancer

• Ukuba notshintsho oluthile kuhlobo lwe-RB1.

• Ukuba neemeko ezithile, ezinje ngezi zilandelayo:

• Isifo seBloom.

• Idayimani-Blackfan anemia.

• Isifo seLi-Fraumeni.

• Isifo sePaget.

• I-retinoblastoma yelifa.

• Isifo sikaRothmund-Thomson.

• Isifo seWerner.

Iimpawu kunye neempawu ze-osteosarcoma kunye ne-MFH zibandakanya ukudumba ngaphezulu kwethambo okanye indawo yebhony yomzimba kunye nentlungu edibeneyo.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa yi-osteosarcoma okanye i-MFH okanye ezinye iimeko. Jonga kugqirha ukuba umntwana wakho unazo ezi zinto zilandelayo:

• Ukudumba ngaphezulu kwethambo okanye ithambo lomzimba.

• Intlungu kwithambo okanye ngokudibeneyo.

• Ithambo elophuka ngaphandle kwesizathu esaziwayo.

Uvavanyo lokulinganisa lusetyenziselwa ukufumana (ukufumana) i-osteosarcoma kunye neMFH.

Ukujonga iimvavanyo kwenziwa ngaphambi kokuba kwenziwe i-biopsy. Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• IX-reyi: X-reyi yamalungu namathambo ngaphakathi komzimba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

I-biopsy yenziwa ukufumanisa i-osteosarcoma.

Iiseli kunye nezicubu ziyasuswa ngexesha le-biopsy ukuze zibonwe phantsi kwemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Kubalulekile ukuba i-biopsy yenziwe ngugqirha oyingcali kunyango lomhlaza wethambo. Kungcono ukuba loo gqirha ikwangulo ususa eli thumba. I-biopsy kunye notyando lokususa ithumba zicwangciswe kunye. Indlela eyenziwe ngayo i-biopsy ichaphazela ukuba loluphi uhlobo lotyando olunokwenziwa kamva.

Uhlobo lwe-biopsy olwenziweyo luya kusekelwa kubungakanani be-tumor nalapho ikhoyo emzimbeni. Zimbini iintlobo zebhayopsy enokusetyenziswa:

• I-biopsy engundoqo: Ukususwa kwezicubu kusetyenziswa inaliti ebanzi.

• I-biopsy ye-incisional: Ukususwa kwenxalenye yesigaxa okanye isampulu yethishu engabonakali njengeqhelekileyo.

Olu vavanyo lulandelayo lunokwenziwa kwizicubu ezisusiweyo:

• I-electron microscopy: Uvavanyo lwaselebhu apho iiseli kwisampulu yethishu zijongwa phantsi kwemicroscopes eqhelekileyo kunye nephakamileyo ukujonga utshintsho oluthile kwiiseli.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxela kwangaphambili (ithuba lokuchacha) kuchaphazeleka zizinto ezithile ngaphambi nasemva konyango.

Ukuxelwa kwangaphambili kwe-osteosarcoma enganyangekiyo kunye ne-MFH kuxhomekeke koku kulandelayo:

• Apho ithumba likhona emzimbeni nokuba ingaba amathumba akhiwe ngaphezulu kwethambo elinye.

• Ubungakanani bethumba.

• Nokuba umhlaza unwenwele kwamanye amalungu omzimba nalapho sele usasazeke khona.

• Uhlobo lwethumba (ngokusekwe kwindlela iiseli zomhlaza ezibonakala ngayo phantsi kwemicroscope).

• Iminyaka yesigulana kunye nobunzima ngexesha lokuchongwa.

• Nokuba isigulana sinonyango lomhlaza owahlukileyo.

• Nokuba eli thumba libange ikhefu kwithambo.

• Nokuba isigulana sinezifo ezithile zofuzo.

Emva kokunyangwa kwe-osteosarcoma okanye i-MFH, ukuxela kwangaphambili kuxhomekeke koku kulandelayo:

• Ungakanani umhlaza obulewe yi-chemotherapy.

• Lingakanani ithumba elikhutshwe ngotyando.

• Nokuba umhlaza ubuyile (ubuyile) kwisithuba seminyaka emi-2 yokufunyaniswa kwesifo.

Ukhetho lonyango lwe-osteosarcoma kunye ne-MFH luxhomekeke koku kulandelayo:

• Apho ithumba likhona emzimbeni.

• Ubungakanani bethumba.

• Inqanaba kunye nenqanaba lomhlaza.

• Nokuba amathambo asakhula na.

• Iminyaka yesigulana kunye nempilo ngokubanzi.

• Umnqweno wesigulana kunye nosapho ukuba isiguli sikwazi ukuthatha inxaxheba kwimidlalo enjengemidlalo okanye ukujonga indlela ethile.

• Nokuba umhlaza usanda kufunyaniswa okanye ubuyile emva konyango.

Amanqanaba e-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

IINGONGOMA EZIPHAMBILI

• Emva kokuba i-osteosarcoma okanye i-fibrous histiocytoma (i-MFH) ifunyenwe, iimvavanyo zenziwa ukufumanisa ukuba ngaba iiseli zomhlaza zisasazekile kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• I-Osteosarcoma kunye ne-MFH zichazwa njengabendawo okanye imastastatic.

Emva kokuba i-osteosarcoma okanye i-fibrous histiocytoma (i-MFH) ifunyenwe, iimvavanyo zenziwa ukufumanisa ukuba ngaba iiseli zomhlaza zisasazekile kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza sele usasazekile na kwamanye amalungu omzimba kuthiwa yi-staging. Kwi-osteosarcoma kunye ne-fibrous histiocytoma enobungozi (MFH), uninzi lwezigulana lubekwa ngokwamaqela ukuba ngaba umhlaza ufumaneka kwicandelo elinye lomzimba (elalapha ekhaya) okanye usasazekile (metastatic).

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• IX-reyi: X-reyi yamalungu, afana nesifuba, kunye namathambo ngaphakathi komzimba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba. IX-reyi iyakuthathwa esifubeni nakwindawo apho lenze khona ithumba.

• I-CT scan (i-CAT scan): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezifana nesifuba, esithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography. Imifanekiso iyakuthathwa kwisifuba nakwindawo apho lenze khona ithumba.

• Iskena se-PET-CT: Inkqubo edibanisa imifanekiso evela kwiskena se-positron emission tomography (PET) kunye nekhompyuter ye-tomography (CT). Ukuskena i-PET kunye ne-CT kwenziwa ngexesha elinye kumatshini omnye. Imifanekiso evela kuzo zombini ezi skena zidityanisiwe ukwenza umfanekiso ogcwele ngakumbi kunaluphi na uvavanyo olunokuzenzela lona. Ukuskena i-PET yinkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• Ukuskena amathambo: Inkqubo yokujonga ukuba ngaba kukho iiseli ezahlula ngokukhawuleza, ezinje ngeeseli zomhlaza, emathanjeni. Inani elincinci kakhulu lezinto ezisasazeka ngemitha lifakwa emthanjeni kwaye lihamba ngokuhamba kwegazi. Izinto ezinemitha eqhumayo ziqokelela emathanjeni anomhlaza kwaye zifunyenwe siskena.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

• Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

• Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba.

I-tumor ye-metastatic yinto efanayo yomhlaza njenge-tumor yokuqala. Umzekelo, ukuba i-osteosarcoma isasazeka emiphungeni, iiseli zomhlaza emiphungeni ziyiseli ze-osteosarcoma. Esi sifo yi-metastatic osteosarcoma, hayi umhlaza wemiphunga.

I-Osteosarcoma kunye ne-MFH zichazwa njengabendawo okanye imastastatic.

• Indawo ye-osteosarcoma okanye i-MFH ayisasazekanga kwithambo apho umhlaza waqala khona. Kukho indawo enye okanye ezingaphezulu zomhlaza kwithambo elinokususwa ngexesha lotyando.

• I-metastatic osteosarcoma okanye i-MFH iye yasasazeka kwithambo apho umhlaza waqala kwamanye amalungu omzimba. Umhlaza uhlala usasazeka ukuya emiphungeni. Inokusasazeka nakwamanye amathambo.

Ukuphindaphindeka kwe-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

I-osteosarcoma ephindaphindayo kunye ne-fibrous histiocytoma (MFH) yethambo ngamanqatha aphindaphindiweyo (abuye) emva kokunyangwa. Umhlaza ungabuyela emathanjeni okanye kwamanye amalungu omzimba. I-Osteosarcoma kunye neMFH zihlala ziphinda zibuye emiphungeni, ithambo, okanye zombini. Xa i-osteosarcoma iphinda ibuye, ihlala ngaphakathi kweenyanga ezili-18 emva kokuba unyango lugqityiwe.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-osteosarcoma okanye i-histrococoma (MFH) yethambo.

• Abantwana abane-osteosarcoma okanye i-MFH kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

• Unyango lwe-osteosarcoma okanye i-histiocytoma enobungozi inokubangela iziphumo ebezingalindelekanga.

• Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

• Ugqirha

• Unyango ngamayeza

• Unyango ngemitha

• Samarium

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-osteosarcoma okanye i-histrococoma (MFH) yethambo.

Iindlela ezahlukeneyo zonyango ziyafumaneka kubantwana abane-osteosarcoma okanye i-histrococoma (MFH) yethambo. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni.

Kuba umhlaza ebantwaneni unqabile, ukuthatha inxaxheba kuvavanyo lweklinikhi kufuneka kuthathelwe ingqalelo. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Abantwana abane-osteosarcoma okanye i-MFH kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngononophelo lwempilo yabantwana abaziingcali kunyango lwe-osteosarcoma kunye ne-MFH kwaye abagxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wabantwana.

• Ugqirha wamathambo onamava okunyanga amathumba.

• Imitha ye-oncologist.

• Ingcali yokuvuselela.

• Ingcali yomongikazi wabantwana.

• Unontlalontle.

• Ingcali kubomi bomntwana.

• Ingcali yeengqondo.

Unyango lwe-osteosarcoma okanye i-histiocytoma enobungozi inokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga eziqala ngexesha lonyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Iziphumo ebezingalindelekanga ezivela kunyango lomhlaza eziqala emva konyango kwaye ziqhubeke iinyanga okanye iminyaka zibizwa ngokuba ziziphumo ezifike kade. Iziphumo zokunyanga komhlaza zingabandakanya oku kulandelayo:

• Iingxaki zomzimba.

• Utshintsho kwiimvakalelo, iimvakalelo, ukucinga, ukufunda, okanye inkumbulo.

• Umhlaza wesibini (iintlobo ezintsha zomhlaza).

Ezinye iziphumo ezinokufika emva kwexesha zinokunyangwa okanye zilawulwe. Kubalulekile ukuba uthethe noogqirha bomntwana wakho malunga nefuthe unyango lomhlaza olunokuba nalo emntwaneni wakho. (Jonga isishwankathelo se- malunga neZiphumo eziMva zaNyango zoMhlaza woMntwana ngolwazi oluthe kratya).

Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

Utyando lokususa lonke eli thumba luya kwenziwa xa kunokwenzeka. I-Chemotherapy inokunikwa ngaphambi kotyando ukwenza ithumba lincinci. Oku kubizwa ngokuba yi-neoadjuvant chemotherapy. I-Chemotherapy inikwa izicubu ezincinci zethambo ekufuneka zisuswe kwaye kukho iingxaki ezimbalwa emva kotyando.

Ezi ndlela zilandelayo zinokwenziwa:

• Ukucandwa kwendawo yonke: Utyando lokususa umhlaza kunye nezicubu ezisempilweni ezijikelezileyo.

• Utyando lwamalungu omzimba: Ukususa ithumba kwilungu (ingalo okanye umlenze) ngaphandle kokunqunyulwa, ngoko ke ukusetyenziswa kunye nokubonakala kwelungu kuyagcinwa. Uninzi lwezigulana ezine-osteosarcoma kwilungu zinokunyangwa ngoqhaqho lokugcina amalungu. I-tumor isuswe ngokukhutshwa ngokubanzi kwendawo. Amathambo kunye nethambo elisusiweyo linokufakwa endaweni yegraft kusetyenziswa izicwili kunye nethambo elithathwe kwelinye ilungu lomzimba wesigulana, okanye ngokumiliselwa okufana nethambo lokuzenzela. Ukuba uqhekeko lufunyenwe ngexesha lokuxilongwa okanye ngexesha le-chemotherapy ngaphambi kotyando, utyando lokulondolozwa kwamalungu kusenokwenzeka kwezinye iimeko. Ukuba ugqirha akakwazi ukususa lonke ithumba kunye nezicubu ezoneleyo ezijikelezileyo, kunokwenziwa utyando.

• Unyino: Utyando lokususa inxenye okanye yonke ingalo okanye umlenze. Oku kunokwenziwa xa kungenakwenzeka ukuba kususwe lonke ithumba kuqhaqho lokulondolozwa kwamalungu. Isigulana sinokufakwa kwilungu lokufakelwa (ilungu lokufakelwa) emva kokunqunyulwa.

• Rotationplasty: Utyando lokususa ithumba kunye nedolo. Inxalenye yomlenze ehleli ngezantsi kwedolo emva koko iqhotyoshelwe kwinxalenye yomlenze ehleli ngaphezulu kwedolo, unyawo lujonge ngasemva kunye neqatha lisebenza njengedolo. Iprosthesis isenokuqhotyoshelwa elunyaweni.

Izifundo zibonise ukuba ukusinda kuyafana nokuba uqhaqho lokuqala olwenziwe ngotyando lokugcina amalungu okanye ukunqunyulwa.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, izigulana zinikwa ichemotherapy ukubulala naziphi na iiseli zomhlaza ezishiyekileyo kwindawo ebisuswe ithumba okanye ethe yanwenwela kwamanye amalungu omzimba. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy). Xa i-chemotherapy ibekwa ngqo kwi-cerebrospinal fluid, ilungu, okanye indawo yomzimba efana nesisu, iziyobisi zichaphazela kakhulu iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi).

Ukudibanisa i-chemotherapy kukusetyenziswa kweziyobisi ezingaphezu kwesinye.

Inkqubo ye-chemotherapy isetyenziselwa ukunyanga i-osteosarcoma kunye ne-MFH yethambo. I-Chemotherapy ihlala inikwa ngaphambi nasemva kotyando ukususa ithumba lokuqala.

Jonga iziyobisi ezivunyiweyo zomhlaza wethambo ngolwazi oluthe kratya.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza.

Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga i-osteosarcoma kunye neMFH yethambo.

Iiseli ze-Osteosarcoma kunye neMFH azibulawa ngokulula ngonyango lwangaphandle lwemitha. Ingasetyenziselwa xa inani elincinci lomhlaza lishiyekile emva kotyando okanye lisetyenziswe kunye nolunye unyango.

Samarium

I-Samarium sisiyobisi esine-radioactive esijolise kwiindawo apho iiseli zethambo zikhula khona, ezinjengeeseli zethambo kwithambo. Inceda ukunciphisa iintlungu ezibangelwa ngumhlaza emathanjeni kwaye ibulala neeseli zegazi kumongo wethambo. Isetyenziselwa ukunyanga i-osteosarcoma ebuyileyo emva konyango kwelinye ithambo.

Unyango nge-samarium inokulandelwa ukufakelwa kweseli ye-stem. Phambi konyango nge-samarium, iiseli ezinesiqu (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo lesigulana kwaye ziyabanda zigcinwe. Emva kokuba unyango lwe-samarium lugqityiwe, iiseli ze-stem ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo lunyango olusebenzisa iziyobisi okanye ezinye izinto ukufumana nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Kukho iintlobo ezahlukeneyo zonyango olujolisiweyo olusetyenziselwa ukunyanga i-osteosarcoma okanye ukufundwa kuvavanyo lweklinikhi:

• Unyango lwe-Kinase inhibitor luthintela iprotein efunekayo kwiiseli zomhlaza zokwahlulahlula. I-Sorafenib luhlobo lwe-kinase inhibitor yonyango esetyenziselwa ukunyanga i-osteosarcoma ephindaphindayo.

• Ukujoliswa kweMammalia kwe-rapamycin (mTOR) inhibitors kuthintela iprotein ebizwa ngokuba yi-mTOR, enokugcina iiseli zomhlaza zingakhuli kwaye kuthintele ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule. I-Everolimus yi-mTOR inhibitor esetyenziselwa ukunyanga i-osteosarcoma ephindaphindayo.

• Unyango lwe-monoclonal antibody yonyango lomhlaza olusebenzisa ii-antibodies ezenziwe elebhu, ukusuka kuhlobo olunye lweeseli zomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo ezinokunceda iiseli zomhlaza zikhule. Amachiza omzimba ancamathele kwizinto kwaye abulale iiseli zomhlaza, athintele ukukhula kwazo, okanye azigcine zisasazeka. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza. I-Denosumab kunye ne-dinutuximab zii-antibodies ze-monoclonal ezifundwayo kunyango lwe-osteosarcoma ephindaphindayo.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo oluqhubekayo lwezonyango luyafumaneka kwiwebhusayithi ye-NCI.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yomntwana wakho itshintshile okanye ukuba umhlaza ubuye wabuya (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Ukhetho kunyango lwe-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

Kweli Candelo

• Indawo ye-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

• I-Metastatic Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

• Ukuphindaphindeka kwe-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Indawo ye-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

Unyango lunokubandakanya oku kulandelayo:

• Utyando lokususa ithumba lokuqala.

• I-Chemotherapy inokunikwa ngaphambi okanye emva kotyando ukususa ithumba lokuqala.

• Unyango ngemitha ukuba ngaba alunakwenziwa utyando okanye ukuba eli thumba alisuswanga ngokupheleleyo ngotyando.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

I-Metastatic Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

Imiphunga yeMastastasis

Xa i-osteosarcoma okanye isifo se-histiocytoma (MFH) sisasazeka, sihlala sisasazeka emiphungeni. Unyango lwe-osteosarcoma kunye ne-MFH nge-metastasis yemiphunga inokubandakanya oku kulandelayo:

• I-Chemotherapy ilandelwa luqhaqho ukususa umhlaza oyintloko kunye nomhlaza osasazeke waya emiphungeni.

I-Bone Metastasis okanye i-Bone ene-Lung Metastasis

I-Osteosarcoma kunye ne-histiocytoma enobungozi enokuthi isasaze ithambo elikude kunye / okanye umphunga. Unyango lunokubandakanya oku kulandelayo:

• I-Chemotherapy elandelwa lutyando lokususa ithumba lokuqala kunye nomhlaza osele udlulele kwamanye amalungu omzimba. Unyango oluninzi lwe-chemotherapy lunikezelwa emva kotyando.

• Utyando lokususa ithumba lokuqala, kulandele ikhemotherapy kunye notyando lokususa umhlaza osele usasazekile kwamanye amalungu omzimba.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukuphindaphindeka kwe-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

Unyango lwe-osteosarcoma ephindaphindayo kunye ne-fibrous histiocytoma yethambo enokubakho inokubandakanya oku kulandelayo:

• Utyando lokususa umhlaza osele usasazekile kwamanye amalungu omzimba.

• Unyango ngamayeza.

• Kwizidudla eziphinde zabuya emathanjeni kuphela, i-samarium kunye okanye ngaphandle kokufakwa kweseli ye-stem usebenzisa iiseli zesigulana, njengonyango lokuthomalalisa iintlungu kunye nokuphucula umgangatho wobomi.

• Unyango ekujoliswe kulo (i-sorafenib okanye i-everolimus).

• Unyango ngemitha njengonyango oludambisayo lokunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

• Uvavanyo lweklinikhi olujonga isampulu yethumba lesigulana kutshintsho oluthile kwimfuza. Uhlobo lonyango ekujoliswe kulo oluya kunikwa isigulana luxhomekeke kuhlobo lotshintsho lwemfuza.

• Uvavanyo lweklinikhi lweentlobo ezintsha zonyango kwizigulana ezinomhlaza ongenakususwa ngotyando. Oku kunokubandakanya unyango ekujoliswe kulo njengonyango lwe-monoclonal antibody.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi nge-Osteosarcoma kunye ne-Malignant Fibrous Histiocytoma ye-Bone

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga ne-osteosarcoma kunye ne-histiocytoma yamathambo amabi, bona oku kulandelayo:

• Ikhasi lasekhaya lomhlaza wamathambo

• Ikhompyuter yeTomography (CT) kunye noMhlaza

• Iziyobisi ezivunyiweyo zomhlaza wamathambo

• Iithagethi zoMhlaza ezijolise kuko

• Umhlaza wamathambo

Ngolwazi oluthe kratya lomhlaza wabantwana kunye nezinye izixhobo zomhlaza ngokubanzi, jonga oku kulandelayo:

• Malunga noMhlaza

• Umhlaza wabantwana

• Unyango lokuKhangela uMhlaza waBantwanaPhuma kwiNgcazelo yokuzihlangula

• Iziphumo zokugqibela zonyango lweCancer yoMntwana

• Abafikisayo kunye naBantu abaDala abaDala abanomhlaza

• Abantwana abanomhlaza: Isikhokelo sabazali

• Umhlaza kuBantwana nakwishumi elivisayo

• Ukuqokelela

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli