Iindidi / ingqondo / isigulana / umntwana-astrocytoma-treament-pdq

Unyango lwe-Astrocytomas yoBuntwana (®) -iPatient Version

Ulwazi ngokubanzi malunga neeAstrocytomas zobuntwana

IINGONGOMA EZIPHAMBILI

• I-astrocytoma yobuntwana sisifo apho iiseli ezinobungozi (ezingezizo ezomhlaza) okanye ezinesifo (somhlaza) ezakha izicwili zobuchopho.

• I-Astrocytomas inokuba yingozi (hayi umhlaza) okanye isifo esibi (umhlaza).

• Inkqubo ye-nervous central ilawula imisebenzi emininzi ebalulekileyo yomzimba.

• Unobangela wezona tumors zobuntwana zingaziwayo.

• Iimpawu kunye neempawu ze-astrocytomas azifani kuwo wonke umntwana.

• Uvavanyo oluvavanya ubuchopho kunye nentambo yomqolo lusetyenziselwa ukukhangela (ukufumana) i-astrocytomas zobuntwana.

• I-astrocytomas zobuntwana zihlala zichongwa kwaye zisuswe kuqhaqho.

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

I-astrocytoma yobuntwana sisifo apho iiseli ezinobungozi (ezingezizo ezomhlaza) okanye ezinesifo (somhlaza) ezakha izicwili zobuchopho.

Ii-Astrocytomas zizidumba eziqala kwiiseli zobuchopho ezinjengeenkwenkwezi ezibizwa ngokuba zii-astrocytes I-astrocyte luhlobo lweseli ye-glial. Iiseli ze-Glial zigcina iiseli zemithambo-luvo endaweni yazo, zizisa ukutya kunye neoksijini, kwaye ziyanceda ukuzikhusela kwizifo, ezinjengosulelo. Iigliomas ngamathumba avela kwiiseli ezomeleleyo. I-astrocytoma luhlobo lwe-glioma.

I-Astrocytoma lolona hlobo luqhelekileyo lwe-glioma olufunyenwe ebantwaneni. Ingenza naphina kwinkqubo yovalo (ubuchopho kunye nentambo yomqolo).

Esi sishwankathelo simalunga nokunyangwa kwamathumba aqala kwii-astrocyte kwingqondo (amathumba aphambili ebuchotsheni). Izidumbu zobuchopho zemetastatic zenziwa ziiseli ezinomhlaza eziqala kwamanye amalungu omzimba zize ziye kufikelela kwingqondo. Unyango lwezifo zengqondo ze-metastatic aluxoxwa apha.

Izidumbu zobuchopho zinokubakho kokubini ebantwaneni nakubantu abadala. Nangona kunjalo, unyango lwabantwana lunokwahluka kunonyango lwabantu abadala. Jonga ezi zishwankathelo zilandelayo ze- ngolwazi oluthe kratya malunga nezinye iintlobo zamathumba engqondo ebantwaneni nakubantu abadala:

• Ubunzima bobuntwana kunye ne-Spinal Cord Tumors Treatment Overview

• Unyango lwaBantu abaDala oluNyango oluNyango

I-Astrocytomas inokuba yingozi (hayi umhlaza) okanye isifo esibi (umhlaza).

Izidumbu zengqondo zeBenign ziyakhula kwaye zicinezele kwiindawo ezikufuphi zobuchopho. Banqabile ukusasazeka kwezinye izicwili. Izilonda ezinobuchopho ezinobungozi kunokwenzeka ukuba zikhule ngokukhawuleza kwaye zinwenwe nakwezinye izicwili zobuchopho. Xa ithumba likhula lingena okanye licinezela kwingingqi yengqondo, linokuyekisa loo ndawo yobuchopho ukuba isebenze ngendlela ebekufanele ukuba isebenza ngayo. Zombini izicubu zobuchopho ezinobungozi nezingalunganga zinokubangela iimpawu kunye neempawu kwaye phantse zonke zifuna unyango.

Inkqubo ye-nervous central ilawula imisebenzi emininzi ebalulekileyo yomzimba.

Ii-Astrocytomas zixhaphake kakhulu kwezi ndawo zenkqubo ye-nervous system (CNS):

• I-Cerebrum: Elona candelo likhulu lobuchopho, phezulu entloko. I-cerebrum ilawula ukucinga, ukufunda, ukusombulula iingxaki, intetho, iimvakalelo, ukufunda, ukubhala, kunye nentshukumo yokuzithandela.

• I-Cerebellum: Inxalenye esezantsi, engasemva yengqondo (kufutshane embindini wentloko). I-cerebellum ilawula ukuhamba, ibhalansi kunye nokuma.

• Isiqu sobuchopho: Inxalenye edibanisa ubuchopho nentambo yomqolo, kwelona candelo lisezantsi lengqondo (ngaphezulu ngentla komqolo wentamo). Ingqondo ilawula ukuphefumla, ukubetha kwentliziyo, kunye neethambo kunye nezihlunu ezisetyenziselwa ukubona, ukuva, ukuhamba, ukuthetha, kunye nokutya.

• Hypothalamus: Indawo embindini wesiseko sobuchopho. Ilawula ubushushu bomzimba, indlala kunye nokunxanwa.

• Indlela ebonakalayo: Iqela leemvakalelo ezidibanisa iliso nengqondo.

• Intambo yomqolo: Ikholamu yeethambo zesisu ezibaleka kwingqondo ziyehla embindini womqolo. Igqunywe ngamalaphu amathathu acekeceke ebizwa ngokuba ziimbrane. Intambo yomqolo kunye neembrane zijikelezwe ngama-vertebrae (amathambo angasemva). Imisipha yomqolo ithwala imiyalezo phakathi kwengqondo kunye nomzimba uphela, njengomyalezo ovela kwingqondo obangela ukuba izihlunu zihambe okanye umyalezo osuka kulusu uye kwingqondo ukuze uve ukubamba.

I-anatomy yengqondo. Indawo ye-supratentorial (inxalenye ephezulu yengqondo) iqulethe i-cerebrum, i-lateral ventricle kunye ne-ventricle yesithathu (ene-cerebrospinal fluid eboniswe ngombala oluhlaza okwesibhakabhaka), i-choroid plexus, ipineal gland, i-hypothalamus, i-pituitary gland, kunye ne-optic nerve. Indawo yangasemva ye-fossa / indawo engafakwanga amandla (icandelo elisezantsi lengqondo) liqukethe i-cerebellum, i-tectum, i-ventricle yesine, kunye nengqondo yengqondo (i-midbrain, iipon, kunye ne-medulla). I-tentorium yahlulahlula i-supratentorium kwi-infratentorium (ipaneli esekunene). Ukhakhayi kunye ne-meninges zikhusela ubuchopho kunye nentambo yomqolo (ipaneli yasekhohlo).

Unobangela wezona tumors zobuntwana zingaziwayo.

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. Izinto ezinokubangela umngcipheko we-astrocytoma zibandakanya:

• Unyango lwe-radiation lwangaphambili kwingqondo.

• Ukuba neziphazamiso ezithile zemfuza, ezinje nge-neurofibromatosis yohlobo 1 (NF1) okanye isifo sephepha esiqatha.

Iimpawu kunye neempawu ze-astrocytomas azifani kuwo wonke umntwana.

Iimpawu kunye neempawu zixhomekeke koku kulandelayo:

• Apho ithumba lenza khona kwingqondo okanye emqolo.

• Ubungakanani bethumba.

• Ukukhawuleza ngokukhawuleza kwethumba.

• Iminyaka yomntwana kunye nokukhula.

Amanye amathumba awabangeli zimpawu okanye zimpawu. Iimpawu kunye neempawu zisenokubangelwa zii-astrocytomas zobuntwana okanye ngezinye iimeko. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Intloko yentsasa okanye intloko ehambayo emva kokugabha.

• Isicaphucaphu nokugabha.

• Umbono, iindlebe, kunye neengxaki zokuthetha.

• Ukuphulukana nokulingana kunye nengxaki yokuhamba.

• Ukwandiswa kokubhala ngesandla okanye intetho ecothayo.

• Ubuthathaka okanye utshintsho kwiimvakalelo kwelinye icala lomzimba.

• Ukulala ngokungaqhelekanga.

• Amandla angaphezulu okanye amancinci kunesiqhelo.

• Guqula kubuntu okanye indlela oziphethe ngayo.

• Ukuxhuzula.

• Ukwehla kobunzima okanye ukuzuza ubunzima ngaphandle kwesizathu esaziwayo.

• Yandisa ubungakanani bentloko (kwiintsana).

Uvavanyo oluvavanya ubuchopho kunye nentambo yomqolo lusetyenziselwa ukukhangela (ukufumana) i-astrocytomas zobuntwana.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

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

• Uvavanyo lwe-Neurological: Uthotho lwemibuzo kunye novavanyo lokujonga ubuchopho, intambo yomqolo kunye nokusebenza kwentliziyo. Uvavanyo lujonga imeko yomntu ngokwengqondo, ulungelelwaniso, kunye namandla okuhamba ngesiqhelo, kunye nendlela esebenza ngayo izihlunu, imizwa kunye nengqondo. Oku kunokubizwa ngokuba luvavanyo lwe-neuro okanye uvavanyo lwe-neurologic.

• Uvavanyo lwentsimi ebonakalayo: Uvavanyo lokujonga indawo yokubona yomntu (indawo iyonke ekubonwa kuyo izinto). Olu vavanyo lilinganisa umbono ophakathi (umntu angabona kangakanani xa ejonge phambili) kunye nombono wendlela (ungakanani umntu anokuzibona kuzo zonke ezinye iindlela ngelixa ejonge phambili). Amehlo avavanywa ngaxeshanye. Iliso elingavavanyiweyo liyogqunywa.

• I-MRI (imaging resonance imaging) enegadolinium: Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zobuchopho kunye nentambo yomqolo. Into ebizwa ngokuba yi-gadolinium itofelwe emthanjeni. I-gadolinium iqokelela malunga neeseli zomhlaza ukuze zibonakale zikhanya emfanekisweni. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI). Ngamanye amaxesha i-magnetic resonance spectroscopy (MRS) yenziwa ngexesha elinye lokuvavanywa kweMRI ukujonga ukwenziwa kweekhemikhali zethishu yobuchopho.

I-astrocytomas zobuntwana zihlala zichongwa kwaye zisuswe kuqhaqho.

Ukuba oogqirha bacinga ukuba kunokubakho i-astrocytoma, kungenziwa i-biopsy ukususa isampulu yethishu. Kwizidumbu ebuchotsheni, inxalenye yokakayi iyasuswa kwaye inaliti isetyenziselwa ukususa izicwili. Ngamanye amaxesha, inaliti ikhokelwa yikhompyuter. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela iiseli zomhlaza. Ukuba iiseli zomhlaza zifunyenwe, ugqirha unokususa i-tumor eninzi ngokukhuselekileyo ngexesha lotyando olufanayo. Ngenxa yokuba kunokuba nzima ukuxela umahluko phakathi kweentlobo zesisu sobuchopho, unokufuna ukuba isampulu yomntwana wakho ihlolwe ngugqirha wezifo onamava okufumanisa izicubu zobuchopho.

I-Craniotomy: Kuvulwa ukakayi kwaye kususwe iqhekeza lekhakhayi ukubonisa indawo yengqondo.

Olu vavanyo lulandelayo lunokwenziwa kwizicubu ezazisuswe:

• I-Immunohistochemistry: Uvavanyo lwaselebhu olusebenzisa ii-antibodies ukukhangela ii-antigen ezithile (iimpawu) kwisampulu yesicwili somguli. Amachiza omzimba ahlala enxulunyaniswa ne-enzyme okanye idayi ye-fluorescent. Emva kokuba ii-antibodies zibophelela kwi-antigen ethile kwisampulu yethishu, i-enzyme okanye idayi iyasebenza, kwaye i-antigen iya kuthi emva koko ibonwe phantsi kwemicroscope. Olu hlobo lovavanyo lusetyenziselwa ukufumanisa isifo somhlaza kunye nokunceda uxelele olunye uhlobo lomhlaza kolunye uhlobo lomhlaza. Uvavanyo lwe-MIB-1 luhlobo lwe-immunohistochemistry ejonga izicwili zesisu kwi-antigen ebizwa ngokuba yi-MIB-1. Oku kunokubonisa ukuba ikhula ngokukhawuleza kangakanani ithumba.

Ngamanye amaxesha amathumba enza kwindawo ebenza nzima ukuba basuse. Ukuba ukususa i-tumor kunokubangela iingxaki ezinzima zomzimba, zengqondo, okanye zokufunda, kwenziwa i-biopsy kwaye unyango oluninzi lunikezelwa emva kwe-biopsy.

Abantwana abane-NF1 banokwenza i-astrocytoma ekumgangatho ophantsi kwindawo yengqondo elawula umbono kwaye abanokufuna i-biopsy. Ukuba ithumba aliqhubeki nokukhula okanye iimpawu azenzeki, kufuneka kwenziwe utyando lokususa ithumba.

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

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Nokuba ithumba linqanaba eliphantsi okanye inqanaba eliphezulu le-astrocytoma.

• Apho ithumba lenze khona kwi-CNS kwaye ukuba ithe yanwenwa nakwizicubu ezikufutshane okanye kwamanye amalungu omzimba.

• Ukukhawuleza ngokukhawuleza kwethumba.

• Iminyaka yomntwana.

• Nokuba iiseli zomhlaza zihlala emva kotyando.

• Nokuba kukho utshintsho kwiijeni ezithile.

• Nokuba umntwana une-NF1 okanye isifo sokuqina kwemithambo.

• Nokuba umntwana unesifo se-diencephalic syndrome (imeko ecothisa ukukhula komzimba).

• Nokuba umntwana une-hypertension yangaphakathi (uxinzelelo lwe-cerebrospinal fluid ngaphakathi kukakayi luphezulu) ngexesha lokuchongwa.

• Nokuba i-astrocytoma isandula ukufumanisa ukuba sele ifunyenwe okanye iphinde yenzeka (buyela).

Kwi-astrocytoma ephindaphindiweyo, ukuxela kwangaphambili kunye nokunyanga kuxhomekeke ekubeni lingakanani ixesha elidlulileyo phakathi kwexesha lokuphela konyango kunye nexesha lokuphindaphinda kwe-astrocytoma.

Amanqanaba ee-Astrocytomas zobuntwana

IINGONGOMA EZIPHAMBILI

• Inqanaba lethumba lisetyenziselwa ukucwangcisa unyango lomhlaza.

• I-astrocytomas ephantsi

• I-astrocytomas ekumgangatho ophezulu

• I-MRI yenziwa emva kotyando.

Inqanaba lethumba lisetyenziselwa ukucwangcisa unyango lomhlaza.

Inqanaba yinkqubo esetyenziselwa ukufumanisa ukuba ungakanani umhlaza okhoyo kwaye ukuba umhlaza usasazekile. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango.

Akukho nkqubo yokubeka kwinqanaba lomgangatho we-astrocytoma yobuntwana. Unyango lusekwe koku kulandelayo:

• Nokuba ithumba likumgangatho ophantsi okanye kwinqanaba eliphezulu.

• Nokuba ithumba lisanda kufunyaniswa ukuba liphindaphindekile okanye liphindaphindekile (libuyile emva konyango).

Inqanaba lethumba lichaza indlela ezingaqhelekanga ngayo iiseli zomhlaza ezibonakala phantsi kwemicroscope kunye nokuba ikhawuleze njani ukuba ikhule ize isasazeke.

Kusetyenziswa la mabakala alandelayo:

I-astrocytomas ephantsi

I-astrocytomas ekumgangatho ophantsi ikhula kancinci kwaye kunqabile ukuba isasazeke kwamanye amalungu engqondo kunye nentambo yomqolo okanye amanye amalungu omzimba. Kukho iintlobo ezininzi ze-astrocytomas eziphantsi. I-astrocytomas ekumgangatho ophantsi inokuba:

• IBakala I tumors-pilocytic astrocytoma, itopusymal giant cell tumor, okanye angiocentric glioma.

• Amathumba eBakala II-asasaza i-astrocytoma, i-pleomorphic xanthoastrocytoma, okanye i-choroid glioma ye-ventricle yesithathu.

Abantwana abane-neurofibromatosis yohlobo 1 banokuba nethumba elingaphezulu kwenqanaba elinye ebuchotsheni. Abantwana abane-tuberous sclerosis banomngcipheko okhulayo we-subependymal giant cell astrocytoma.

I-astrocytomas ekumgangatho ophezulu

I-astrocytomas ekumgangatho ophakamileyo ikhula ngokukhawuleza kwaye ihlala isasazeka ngaphakathi kwengqondo nasemqolo. Kukho iintlobo ezininzi ze-astrocytomas eziphezulu. Amabanga aphezulu e-astrocytomas anokuba:

• Amathumba eBakala III-i-anaplastic astrocytoma okanye i -aplastic pleomorphic xanthoastrocytoma.

• Amathumba ebanga le-IV-glioblastoma okanye i-midline glioma.

I-astrocytomas zobuntwana zihlala zingasasazeki kwamanye amalungu omzimba.

I-MRI yenziwa emva kotyando.

I-MRI (imaging resonance imaging) yenziwa kwiintsuku zokuqala emva kotyando. Oku kukufumanisa ukuba lingakanani ithumba, ukuba likhona, elihlala likhona emva kotyando kunye nokucwangcisela olunye unyango.

Ukuphindaphindeka kweAstrocytomas yoBuntwana

Ukuphindaphindeka kwe-astrocytoma yobuntwana yi-astrocytoma eye yabuya (yabuya) emva kokuba inyangiwe. Umhlaza ungabuya ubuye kwindawo enye nethumba lokuqala okanye kwamanye amalungu omzimba. I-astrocytomas ekumgangatho ophakamileyo ihlala iphinda ibuye kwisithuba seminyaka emi-3 nokuba ikwindawo apho umhlaza waqala khona okanye kwenye indawo kwi-CNS.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-astrocytoma yobuntwana.

• Abantwana abane-astrocytomas kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lwamathumba ebuntwaneni.

• Amathumba obuchopho ebuntwaneni anokubangela iimpawu okanye iimpawu eziqala ngaphambi kokuba umhlaza ubhaqwe kwaye uqhubeke kangangeenyanga okanye iminyaka.

• Unyango lwe-astrocytomas yobuntwana kunokubangela iziphumo ebezingalindelekanga.

• Iindlela ezintandathu zonyango zisetyenzisiwe:

• Ugqirha

• Ukujonga

• Unyango ngemitha

• Unyango ngamayeza

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

• Unyango ekujoliswe kulo

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Olunye unyango lweziyobisi

• Unyango lwe-Immunotherapy

• Ukuba ulwelo luyakhula lujikeleze ingqondo kunye nentambo yomqolo, inkqubo yokuphambukisa ulwelo inokwenziwa.

• 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-astrocytoma yobuntwana.

Iindlela ezahlukeneyo zonyango ziyafumaneka kubantwana abanee-astrocytomas. 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-astrocytomas kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lwamathumba ebuntwaneni.

Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngezempilo abaziingcali kunyango lwabantwana abanezilonda zobuchopho kwaye bagxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wabantwana.

• I-neurosurgeon yabantwana.

• Ingcali yonyango.

• Neuropathologist.

• Neuroradiologist.

• Ingcali yokuvuselela.

• Imitha ye-oncologist.

• Ingcali yezigulana.

• Ingcali yeengqondo.

Amathumba obuchopho ebuntwaneni anokubangela iimpawu okanye iimpawu eziqala ngaphambi kokuba umhlaza ubhaqwe kwaye uqhubeke kangangeenyanga okanye iminyaka.

Iimpawu okanye iimpawu ezibangelwa lithumba zingaqala ngaphambi kokuxilongwa. Ezi mpawu okanye iimpawu zingaqhubeka iinyanga okanye iminyaka. Kubalulekile ukuba uthethe noogqirha bomntwana wakho malunga neempawu okanye iimpawu ezibangelwa lithumba eliya kuqhubeka emva konyango.

Unyango lwe-astrocytomas yobuntwana kunokubangela 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.)

Iindlela ezintandathu zonyango zisetyenzisiwe:

Ugqirha

Utyando lusetyenziselwa ukufumanisa nokunyanga i-astrocytoma yobuntwana, njengoko kuchaziwe kwicandelo loLwazi ngokubanzi kwesi sishwankathelo. Ukuba iiseli zomhlaza zihlala emva kotyando, olunye unyango luxhomekeke:

• Ziphi iiseli zomhlaza eziseleyo.

• Inqanaba lethumba.

• Ubudala bomntwana.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa ichemotherapy okanye unyango lweradiation emva kotyando lokubulala naziphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Ukujonga

Ukujongwa kujongwa ngononophelo kwimeko yesigulana ngaphandle kokunika unyango de kuvele iimpawu okanye utshintsho. Ukujongwa kunokusetyenziswa:

• Ukuba isigulana asinazimpawu, njengezigulana ezine-neurofibromatosis yohlobo1.

• Ukuba ithumba lincinci kwaye lifunyenwe xa kufunyaniswa okanye kunyangwa ingxaki eyahlukileyo yempilo.

• Emva kokuba ithumba lisuswe ngotyando kude kuvele iimpawu okanye iimpawu okanye zitshintshe.

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. Iindlela ezithile zokunika unyango ngemitha kunokunceda ukugcina imitha ingonakalisi izicubu ezisempilweni ezikufutshane. Ezi ntlobo zonyango lwe-radiation zibandakanya oku kulandelayo:

• Unyango lwe-radiation oluguquguqukayo: Unyango lwe-radiation oluguquguqukayo luhlobo lonyango lwangaphandle lwemitha olusebenzisa ikhompyuter ukwenza umfanekiso we-3-dimensional (3-D) yesisu kunye nokuma kwemitha yemitha ukuze ilingane nethumba.

• Unyango lwe-radiation ye-intension-modulated (IMRT): I-IMRT luhlobo lonyango lwe-3-dimensional (3-D) lwangaphandle olusebenzisa ikhompyuter ukwenza imifanekiso yobukhulu kunye nemilo yethumba. Iintsika ezincinci zemitha yokuqina okuhlukeneyo (amandla) zijolise kwithumba kumacala amaninzi.

• Unyango lwe-stereotactic radiation: Unyango lwe-stereotactic radiation luhlobo lonyango lwangaphandle lwemitha. Isakhelo sentloko esiqinileyo siqhotyoshelwe kukhakhayi ukugcina intloko ithe cwaka ngexesha lonyango lwemitha. Umatshini ujolise kwimitha ngqo kwi-tumor. Idosi epheleleyo yemitha yohlulwe yaziidosi ezincinci ezinikezwe kwiintsuku ezininzi. Le nkqubo ikwabizwa ngokuba yinyango ye-stereotactic yangaphandle ye-radiation kunye nonyango lwe-stereotaxic radiation.

• Unyango lwe-Proton beam radiation: Unyango lwe-Proton-beam luhlobo lwamandla amakhulu, unyango lwangaphandle lwemitha. Umatshini wonyango wemitha ujolise kwimilambo yeeproton (ezincinci, ezingabonakaliyo, amasuntswana ahlawuliswe ngokuqinisekileyo) kwiiseli zomhlaza ukuze zibabulale.

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

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo lwethumba kwaye apho ithumba lenzeke kwingqondo okanye kwintambo yomqolo. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga ii-astrocytomas zobuntwana.

Ukunyanga ngemitha kwingqondo kunokuchaphazela ukukhula kunye nokukhula, ngakumbi kubantwana abancinci. Kubantwana abangaphantsi kweminyaka emi-3, i-chemotherapy inokunikwa endaweni yoko, ukulibazisa okanye ukunciphisa isidingo sonyango lwemitha.

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.

Indlela ichemotherapy enikwa ngayo ixhomekeke kuhlobo lwethumba kwaye apho ithumba lenzeke kwingqondo okanye kwintambo yomqolo. Inkqubo yokudibanisa i-chemotherapy isetyenziselwa unyango lwabantwana abane-astrocytoma. Unyango oluphezulu lwe-chemotherapy lunokusetyenziswa kunyango lwabantwana abane-astrocytoma ekumgangatho ophakamileyo.

I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

Amanqanaba aphezulu e-chemotherapy anikezelwa ukubulala iiseli zomhlaza. Iiseli ezisempilweni, kubandakanya iiseli ezenza igazi, nazo ziyatshatyalaliswa lunyango lomhlaza. Ukufakelwa kweseli kwistem kunyango endaweni yeeseli ezenza igazi. Iiseli zeziqu (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana okanye somnikeli kwaye zibandisiwe kwaye zigcinwe. Emva kokuba isiguli sigqibe i-chemotherapy, iiseli ezigciniweyo ezigciniweyo ziyanyibilika kwaye zibuyiselwe kwisigulana ngokufakwa. Ezi seli ze-stem ziphinde zafakwa zikhula ziye (kwaye zibuyisele) iiseli zegazi lomzimba.

Kwi-astrocytoma ekumgangatho ophakamileyo ebuyileyo emva konyango, idosi ephezulu yonyango lwe-chemotherapy kunye nokufakwa kweseli ye-stem kusetyenziswa ukuba kukho inani elincinci le-tumor.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo.

Kukho iintlobo ezahlukeneyo zonyango olujolisiweyo:

• Unyango lwe-monoclonal antibody lusebenzisa ii-antibodies ezenziwe elebhu, ukusuka kuhlobo olunye lweeseli zomzimba, ukumisa iiseli zomhlaza. 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 zinikwa ngokufakwa ngaphakathi emthanjeni. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza.

Unyango lwe-Vascular endothelial growth factor (VEGF) unyango lwe-inhibitor luhlobo lonyango lwe-monoclonal antibody:

• Unyango lwe-VEGF inhibitor: Iiseli zomhlaza zenza into ebizwa ngokuba yi-VEGF, ebangela ukuba imithambo yegazi emitsha ibumbe (angiogenesis) kwaye incede umhlaza ukuba ukhule. I-VEGF inhibitors iyayithintela i-VEGF kwaye iyeke imithambo yegazi emitsha ukuba ingenzeki. Oku kunokubulala iiseli zomhlaza kuba zifuna imithambo yegazi emitsha ukukhula. I-Bevacizumab yi-VEGF inhibitor kunye ne-angiogenesis inhibitor esetyenziselwa ukunyanga i-astrocytoma yobuntwana.

• Iprotein kinase inhibitors isebenza ngeendlela ezahlukeneyo. Kukho iintlobo ezininzi zeprotein kinase inhibitors.

• I-mTOR inhibitors iyeka iiseli ukuba zahlule kwaye inokuthintela ukukhula kwemithambo yegazi emitsha ekufuneka ukuba amathumba akhule. I-Everolimus kunye ne-sirolimus zi-mTOR inhibitors ezisetyenziselwa ukunyanga i-subocymymal cell cell astrocytomas. I-mTOR inhibitors ikwafundwa ukunyanga i-astrocytoma ekumgangatho ophantsi ephindileyo.

• I-BRAF inhibitors zivimba iiproteni ezifunekayo ekukhuleni kweseli kwaye zinokubulala iiseli zomhlaza. Uhlobo lwe-BRAF lufumaneka kwifom eguqulweyo (etshintshiweyo) kwezinye iigliomas kwaye ukuyithintela kunokunceda ukugcina iiseli zomhlaza zingakhuli. I-BRAF inhibitor dabrafenib ifundwa ukunyanga i-astrocytoma ekumgangatho ophantsi ephindileyo. Ezinye ii-inhibitors ze-BRAF, kubandakanya i-vemurafenib kunye ne-trametinib, ziyafundwa ebantwaneni.

• I-MEK inhibitors zivimba iiproteni ezifunekayo ekukhuleni kweseli kwaye zinokubulala iiseli zomhlaza. I-MEK inhibitors ezinje nge-selumetinib ziyafundwa ukunyanga i-astrocytoma ekumgangatho ophantsi ephindileyo.

• I-PARP inhibitors ibhloka i-enzyme ebizwa ngokuba yi-PARP ebandakanyeka kwimisebenzi emininzi yeseli. Ukuthintela i-PARP kunokunceda ukugcina iiseli zomhlaza zingalungisi i-DNA yazo eyonakeleyo, ibangele ukuba bafe. I-Veliparib yi-PARP inhibitor efundwayo ngokudibeneyo nonyango lwe-radiation kunye ne-chemotherapy ukunyanga i-glioma esandula ukufumanisa ukuba ayinalo utshintsho (utshintsho) kuhlobo lwe-BRAF.

Jonga iziyobisi ezivunyiweyo zeBrain Tumors ngolwazi oluthe kratya.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Olunye unyango lweziyobisi

I-Lenalidomide luhlobo lwe-angiogenesis inhibitor. Ithintela ukukhula kwemithambo yegazi emitsha efunekayo ukuba ithumba likhule.

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa nomhlaza. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo lomzimba kumhlaza. Olu hlobo lonyango lomhlaza lukwabizwa ngokuba yi-biotherapy okanye unyango lwe-biologic.

• Unyango lwe-immune checkpoint inhibitor: I-PD-1 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-PD-1 incamathele kwenye iprotein ebizwa ngokuba yi-PDL-1 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. PD-1 inhibitors zinamathele kwi-PDL-1 kwaye zivumele iiseli ze-T ukuba zibulale iiseli zomhlaza. I-PD-1 inhibitors ziyafundwa ukunyanga i-astrocytoma ekumgangatho ophezulu ephindileyo.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-PD-L1 kwiiseli zethumba kunye ne-PD-1 kwiiseli ze-T, zinceda ukugcina iimpendulo ze-immune zitshekishwe. Ukubopha kwe-PD-L1 ukuya kwi-PD-1 kugcina iiseli ze-T ekubulaleni iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-PD-L1 ukuya kwi-PD-1 nge-immune checkpoint inhibitor (anti-PD-L1 okanye anti-PD-1) ivumela iiseli ze-T ukuba zibulale iiseli zesisu (iphaneli esekunene).

Ukuba ulwelo luyakhula lujikeleze ingqondo kunye nentambo yomqolo, inkqubo yokuphambukisa ulwelo inokwenziwa.

Ukuphambukiswa kweCerebrospinal fluid yindlela esetyenziselwa ukukhupha ulwelo olwakhiwe malunga nengqondo kunye nentambo yomqolo. I-shunt (ityhubhu ende, ebhityileyo) ibekwe kwi-ventricle (indawo egcwele ulwelo) yobuchopho kwaye ifakwa phantsi kolusu kwelinye ilungu lomzimba, ngesiqhelo isisu. I-shunt ithwala ulwelo olongezelelekileyo kude nengqondo ukuze ingene kwenye indawo emzimbeni.

Ukuphambuka kweCerebrospinal fluid (CSF). I-CSF eyongezelelweyo iyasuswa kwi-ventricle kwingqondo ngokusebenzisa i-shunt (ityhubhu) kwaye ikhutshelwe esiswini. Ivalve ilawula ukuhamba kwe-CSF.

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. (Jonga icandelo leNgcaciso ngokuBanzi malunga noluhlu lweemvavanyo.) Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza kakuhle kangakanani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ii-MRIs eziqhelekileyo ziya kuqhubeka ukwenziwa emva kokuba unyango luphelile. Iziphumo zeMRI zingabonisa ukuba imeko yomntwana wakho itshintshile okanye ukuba i-astrocytoma iphinde yabuya (buyela). Ukuba iziphumo zeMRI zibonisa ubunzima kwingqondo, kungenziwa i-biopsy ukufumana ukuba yenziwe ngamaseli e-tumor okanye ukuba iiseli zomhlaza ezintsha ziyakhula.

Ukhetho kunyango lweeAstrocytomas zobuntwana

Kweli Candelo

• Ukuchongwa kwaBantwana abaBangaPhantsi kwiBanga le-Astrocytomas

• Ukuphinda-phinda iBanga eliPhantsi leBanga le-Astrocytomas

• Ukuchongwa kwaBantwana abaPhezulu kwiBanga eliPhakamileyo

• Ukuphinda-phinda iBanga eliPhakamileyo le-Astrocytomas

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

Ukuchongwa kwaBantwana abaBangaPhantsi kwiBanga le-Astrocytomas

Xa i-tumor ifunyaniswa okokuqala, unyango lwe-astrocytoma ebuntwaneni obusezantsi luxhomekeke apho ikhoyo ithumba, kwaye ihlala ityandwa. I-MRI yenziwa emva kotyando ukubona ukuba akukho sihlunu sisele na.

Ukuba ithumba lisuswe ngokupheleleyo ngoqhaqho, unyango oluninzi alunakufuneka kwaye umntwana ujongisiswe ukuze abone ukuba ngaba iimpawu okanye iimpawu ziyavela okanye ziyatshintsha. Oku kubizwa ngokuba kukujonga.

Ukuba kukho ithumba elisele emva kotyando, unyango lunokubandakanya oku kulandelayo:

• Ukujonga.

• Utyando lwesibini ukususa ithumba.

• Unyango lwe-radiation, olunokubandakanya unyango lwe-radiation olulinganayo, unyango lwe-radiation olunamandla, unyango lwe-proton beam radiation, okanye unyango lwe-stereotactic radiation, xa ithumba liqala ukukhula kwakhona.

• Ukudibanisa i-chemotherapy kunye okanye ngaphandle kwonyango lwe-radiation.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo ngokudityaniswa kwe-BRAF inhibitors (dabrafenib kunye ne-trametinib) kwizigulana ezinokutshintsha kuguquko lwe-BRAF.

Ngamanye amaxesha, ukubonwa kusetyenziselwa abantwana abanendlela ebonakalayo ye-glioma. Ngamanye amaxesha, unyango lunokubandakanya utyando lokususa ithumba, unyango ngemitha, okanye ichemotherapy. Injongo yonyango kukugcina umbono kangangoko kunokwenzeka. Iziphumo zokukhula kwethumba kumbono womntwana ziya kulandelwa ngokusondeleyo ngexesha lonyango.

Abantwana abane-neurofibromatosis yohlobo 1 (NF1) abanokufuna unyango ngaphandle kokuba ithumba liyakhula okanye iimpawu okanye iimpawu, ezinjengeengxaki zombono, ziyavela. Xa ithumba likhula okanye iimpawu okanye iimpawu zivela, unyango lunokubandakanya utyando lokususa ithumba, unyango ngemitha, kunye / okanye ichemotherapy.

Abantwana abane-tuberous sclerosis banokuphuhlisa i-benign (hayi umhlaza) tumors kwingqondo ebizwa ngokuba yi-subependymal giant cell astrocytomas (SEGAs). Unyango ekujoliswe kulo nge-everolimus okanye i-sirolimus inokusetyenziswa endaweni yoqhaqho, ukunciphisa amathumba.

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.

Ukuphinda-phinda iBanga eliPhantsi leBanga le-Astrocytomas

Xa i-astrocytoma ekumgangatho ophantsi iphinda ibuye emva konyango, ihlala ibuyela apho i-tumor yaqala khona. Phambi kokuba kunikwe unyango lomhlaza, kwenziwa uvavanyo lwe-imaging, i-biopsy, okanye utyando ukufumanisa ukuba ukhona na umhlaza kunye nokuba ungakanani na.

Unyango lwe-astrocytoma yamanqanaba aphantsi ebuntwaneni inokubandakanya oku kulandelayo:

• Utyando lwesibini lokususa ithumba, ukuba ngaba lunyango kuphela konyango olunikiweyo xa kwafunyanwa okokuqala ithumba.

• Unyango lwe-radiation kwi-tumor kuphela, ukuba unyango lwe-radiation aluzange lusetyenziswe xa kwafunyanwa okokuqala ithumba. Unyango lwe-radiation olungaguqukiyo lunokunikwa.

• I-Chemotherapy, ukuba ithumba liphindaphindekile apho lingenakususwa ngoqhaqho okanye isigulana sineyeza lokunyanga ngemitha xa kwafunyaniswa ithumba okokuqala.

• Unyango olujoliswe kwi-anti-monoclonal antibody (bevacizumab) kunye okanye ngaphandle kwe-chemotherapy.

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

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo kunye ne-BRAF inhibitor (dabrafenib), i-mTOR inhibitor (i-everolimus), okanye i-MEK inhibitor (selumetinib).

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.

Ukuchongwa kwaBantwana abaPhezulu kwiBanga eliPhakamileyo

Unyango lwe-astrocytoma yamabanga aphakamileyo ebuntwaneni inokubandakanya oku kulandelayo:

• Ugqirha lokususa ithumba, kulandele ikhemotherapy kunye / okanye unyango ngemitha.

• Uvavanyo lweklinikhi yonyango olutsha.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo kunye ne-PARP inhibitor (i-veliparib) edityaniswe nonyango lwe-radiation kunye ne-chemotherapy ukunyanga i-glioma esandula ukufumanisa ukuba ayinalo utshintsho (utshintsho) kuhlobo lwe-BRAF.

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.

Ukuphinda-phinda iBanga eliPhakamileyo le-Astrocytomas

Xa i-astrocytoma ekumgangatho ophezulu iphinda ibuye emva konyango, ihlala ibuyela apho ithumba laqala khona. Phambi kokuba kunikwe unyango lomhlaza, kwenziwa uvavanyo lwe-imaging, i-biopsy, okanye utyando ukufumanisa ukuba ukhona na umhlaza kunye nokuba ungakanani na.

Unyango lwe-astrocytoma yamabanga aphezulu ebuntwaneni inokubandakanya oku kulandelayo:

• Utyando lokususa ithumba.

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli.

• Unyango olujolise kwi-BRAF inhibitor (vemurafenib okanye dabrafenib).

• Uvavanyo lweklinikhi lwe-immunotherapy ene-immune checkpoint inhibitor.

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

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo ngokudityaniswa kwe-BRAF inhibitors (dabrafenib kunye ne-trametinib) kwizigulana ezinokutshintsha kuguquko lwe-BRAF.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

To Learn More About Childhood Astrocytomas

For more information about childhood astrocytomas, see the following:

• Targeted Cancer Therapies

• Pediatric Brain Tumor Consortium (PBTC)Exit Disclaimer

For more childhood cancer information and other general cancer resources, see the following:

• About Cancer

• Childhood Cancers

• CureSearch for Children's CancerExit Disclaimer

• Late Effects of Treatment for Childhood Cancer

• Adolescents and Young Adults with Cancer

• Children with Cancer: A Guide for Parents

• Cancer in Children and Adolescents

• Staging

• Coping with Cancer

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli