Iindidi / ingqondo / isigulana / umntwana-i-cns-germ-cell-treatment-pdq

Unyango lwaBantwana oluPhakathi lweeNzwa zeeNtsholongwane zoNyango lweeSeli (®) -Patient Version

Ulwazi oluBanzi malunga neNkqubo yaBantwana ePhakamileyo yeNervous System (CNS) yeGerm Cell Tumors

IINGONGOMA EZIPHAMBILI

• Inkqubo yobuntwana engaphakathi ebuntwaneni (CNS) intsholongwane yeeseli zentsholongwane ezivela kwiiseli zentsholongwane.

• Kukho iintlobo ezahlukeneyo zobuntwana besifo se-CNS.

• Iijerminomas

• AmaNongerminomas

• Teratomas

• Unobangela wobuninzi besisu se-CNS yamathumba eseli awaziwa.

• Iimpawu kunye neempawu zobuntwana be-CNS yamathumba eseli kubandakanya ukoma okungaqhelekanga, ukuchama rhoqo, okanye utshintsho lombono.

• Izifundo zokulinganisa kunye nezinye iimvavanyo zisetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga amathumba egciwane leseli ye-CNS.

• I-biopsy inokwenziwa ukuze kuqinisekiswe ngoxilongo lwe-CNS yentsholongwane yeseli.

• Izinto ezithile zichaphazela isifo (ithuba lokuchacha kwakhona).

Inkqubo yobuntwana engaphakathi ebuntwaneni (CNS) intsholongwane yeeseli zentsholongwane ezivela kwiiseli zentsholongwane.

Iiseli zentsholongwane ziintlobo ezikhethekileyo zeeseli ezikhoyo xa usana olungekazalwa lukhula. Ezi seli zihlala ziba sisidoda kumatyhalarha okanye amaqanda angenazintsholongwane kwii-ovari njengoko umntwana ekhula. Uninzi lwentsholongwane yeseli yentsholongwane yakha iimvavanyo okanye ii-ovari. Ngamanye amaxesha iiseli zentsholongwane zihambela okanye zisuka kwezinye iinxalenye zomntwana njengoko zikhula kwaye kamva zibe ziintsholongwane zeseli zentsholongwane. Izidumba zeseli zeGerm ezenzeka kwingqondo okanye kumqolo womqolo zibizwa ngokuba yi-CNS (inkqubo ye-nervous system) amathumba egciwane.

Izidumbu zeseli zentsholongwane ze-CNS zihlala zixhaphakile kwizigulana ezineminyaka eli-10 ukuya kweli-19 kwaye ngokufuthi kumadoda kunabafazi. Ezona ndawo zixhaphakileyo zesifo esinye okanye ezingaphezulu zesifo se-CNS zesisu esisebuchosheni kufutshane nengcongolo yepineal nakwindawo yengqondo ebandakanya idlala lengqula kunye nezicubu ezingasentla nje kwayo. Ngamanye amaxesha iintsholongwane zeseli zentsholongwane zenzeka kwezinye iindawo zobuchopho.

I-Anatomy yangaphakathi kwengqondo, ebonisa iipineal kunye ne-pituitary gland, i-optic nerve, i-ventricles (ene-cerebrospinal fluid eboniswe ngombala oluhlaza okwesibhakabhaka), kunye nezinye iindawo zobuchopho.

Esi sishwankathelo simalunga neentsholongwane zeseli zentsholongwane eziqala kwinkqubo ye-nervous system (ingqondo kunye nomqolo womqolo). Izidumba zeseli zentsholongwane zingenza namanye amalungu omzimba. Jonga isishwankathelo se soNyango lweeNtlalontle zeeNtsholongwane zoLutsha kwi-Extracranial yoLwazi ngolwazi malunga neentsholongwane zeseli zentsholongwane ezenziwa ngaphandle (ngaphandle kwengqondo).

Izidumbu zeseli ze-CNS zihlala zenzeka ebantwaneni kodwa zinokwenzeka kubantu abadala. Unyango lwabantwana lunokwahluka kunonyango lwabantu abadala. Jonga ezi zishwankathelo zilandelayo ze- ngolwazi malunga nonyango lwabantu abadala:

• Unyango lwaBantu abaDala oluNyango oluNyango

• Unyango lwe-Extragonadal Germ Cell Tumors

Ngolwazi malunga nezinye iintlobo zobuchopho bobuntwana kunye neethambo zomqolo womqolo, jonga isishwankathelo se- kuBongo boBuntwana kunye ne-Spinal Cord Tumors Treatment Overview.

Kukho iintlobo ezahlukeneyo zobuntwana besifo se-CNS.

Iindidi ezahlukeneyo zamathumba eseli yentsholongwane ye-CNS zinokuvela kwiiseli ezizodwa eziba sisidoda okanye amaqanda angenazintsholongwane. Uhlobo lwe-CNS yentsholongwane yeseli efunyanisiweyo efunyaniswe ixhomekeka ekubeni iiseli zijongeka njani phantsi kwemicroscope kunye neziphumo zovavanyo lwelabhoratri ezijonga amanqanaba okuphawula ithumba.

Esi sishwankathelo simalunga nonyango lweentlobo ezininzi zamathumba egciwane leseli ye-CNS:

Iijerminomas

Iijerminomas lolona hlobo luxhaphakileyo lwe-CNS yentsholongwane yeseli kwaye inesimo sengqondo esifanelekileyo. Amanqanaba okuphawula i-tumor awasetyenziselwa ukufumanisa i-germinomas.

AmaNongerminomas

Ezinye ii-nongerminomas zenza iihormoni, ezinje nge-alpha-fetoprotein (AFP) kunye ne-beta-chorionic gonadotropin (beta-hCG). Iindidi ze-nongerminomas zibandakanya oku kulandelayo:

• I-embryonal carcinomas yenza iihomoni i-AFP kunye ne-beta-hCG.

• Izidumba ze-Yolk sac zenza i-hormone AFP.

• I-Choriocarcinomas yenza i-hormone beta-hCG.

• Imixube yeseli yentsholongwane exubileyo yenziwa ngaphezu kohlobo olunye lweeseli zentsholongwane. Banokwenza i-AFP kunye ne-beta-hCG.

Teratomas

Ii-teratomas ze-CNS zichazwa njengokuvuthwa okanye ukungakhuli, ngokusekwe kwindlela eziqhelekileyo iiseli ezibonakala ngayo kwimicroscope. Iitatomas eziqolileyo zikhangeleka ngathi ziiseli eziqhelekileyo phantsi kwemicroscope kwaye zenziwe ngeentlobo ezahlukeneyo zethishu, ezinjengeenwele, umsipha kunye nethambo. Iitatomas ezingafakwanga zibonakala zahluke kakhulu kwiiseli eziqhelekileyo phantsi kwemicroscope kwaye zenziwe ngeeseli ezibonakala ngathi ziiseli zomntwana. Ezinye iitatomas ezingakhulanga ngumxube weeseli ezivuthiweyo nezingakhulanga. Amanqanaba okuphawula i-tumor awasetyenziselwa ukufumanisa i-teratomas.

Unobangela wobuninzi besisu se-CNS yamathumba eseli awaziwa.

Iimpawu kunye neempawu zobuntwana be-CNS yamathumba eseli kubandakanya ukoma okungaqhelekanga, ukuchama rhoqo, okanye utshintsho lombono.

Iimpawu kunye neempawu zixhomekeke koku kulandelayo:

• Apho lakha khona eli thumba.

• Ubungakanani bethumba.

• Nokuba ithumba okanye umzimba wenza iihomoni ezininzi kakhulu.

Iimpawu kunye neempawu zinokubangelwa kukukhula kwengqondo kwi-CNS yesisu okanye ezinye iimeko. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Ukunxanwa kakhulu.

• Ukwenza isixa esikhulu somchamo ocacileyo okanye ophantse ucace.

• Ukuchama rhoqo.

• Ukumanzisa ibhedi okanye ukuvuka ebusuku ukuyokuchama.

• Ingxaki yokuhambisa amehlo, ukungaboni kakuhle, okanye ukubona kabini.

• Ukuphelelwa ngumdla wokutya.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukufikisa kwasekuqaleni okanye emva kwexesha.

• Isiqu esifutshane (ukuba mfutshane kunesiqhelo)

• Intloko ebuhlungu.

• Isicaphucaphu nokugabha.

• Ndiziva ndidiniwe.

• Ukuba neengxaki ngomsebenzi wesikolo.

Izifundo zokulinganisa kunye nezinye iimvavanyo zisetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga amathumba egciwane leseli ye-CNS.

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.

• 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, ikrelekrele kunye nezivamvo. 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 zeendawo ezingaphakathi kwengqondo kunye nomqolo. 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).

• Ukugqobhoza iLumbar: Inkqubo esetyenziselwa ukuqokelela i-cerebrospinal fluid (CSF) ukusuka kumqolo womqolo. Oku kwenziwa ngokubeka inaliti phakathi kwamathambo amabini emqolo kunye nakwi-CSF ejikeleze intambo yomqolo kunye nokususa isampulu yolwelo. Isampulu ye-CSF ihlolwe phantsi kwemicroscope ngeempawu zeeseli zethumba kwaye kuvavanywa ukumakishwa kwethumba. Isixa seprotein kunye neswekile kwisampulu inokuvavanywa kwakhona. Inani elingaphezulu kweprotheyini eliqhelekileyo okanye elisezantsi kunesiqhelo iswekile inokuba luphawu lwethumba. Le nkqubo ikwabizwa ngokuba yi-LP okanye impompo yomqolo.

Ukugqobhoza iLumbar. Isigulana silele endaweni egobileyo phezu kwetafile. Emva kokuba indawo encinci kumqolo ongezantsi ifakwe inaliti, inaliti yomgogodla (inaliti ende, ebhityileyo) ifakwe kwinxalenye esezantsi yomqolo womqolo ukususa ulwelo lwe-cerebrospinal fluid (CSF, eboniswe ngombala oluhlaza okwesibhakabhaka). Ulwelo lunokuthunyelwa kwilabhoratri kuvavanyo.

• Uvavanyo lokumakisha: Inkqubo apho isampulu yegazi okanye i-cerebrospinal fluid (CSF) ihlolwe ukulinganisa inani lezinto ezithile ezikhutshelwe egazini nakwi-CSF ngamalungu, izicwili, okanye iiseli zethumba emzimbeni. Izinto ezithile zinxulunyaniswa neentlobo ezithile zomhlaza xa zifunyenwe kumanqanaba anyukayo egazini. Oku kubizwa ngokuba kukuphawula amathumba.

Amanqaku alandelayo ethumba asetyenziselwa ukufumanisa ezinye i-CNS zentsholongwane yeseli:

• I-Alpha-fetoprotein (AFP).

• I-beta-chorionic gonadotropin yabantu (beta-hCG).

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu- okanye elisezantsi kunesiqhelo) linokuba luphawu lwesifo.

• Izifundo zehomoni yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zehomoni ezithile ezikhutshelwe egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu- okanye elisezantsi kunesiqhelo) lexabiso linokuba luphawu lwesifo kwilungu okanye kwithishu eyenzayo. Igazi liza kujongwa kumanqanaba eehomoni ezenziwe yidlala yebhinqa kunye namanye amabele.

I-biopsy inokwenziwa ukuze kuqinisekiswe ngoxilongo lwe-CNS yentsholongwane yeseli.

Ukuba oogqirha bacinga ukuba umntwana wakho unokuba nesifo se-CNS yentsholongwane yeseli, kungenziwa i-biopsy. Kwiimpawu zengqondo, i-biopsy yenziwa ngokususa inxalenye yekhayi kunye nokusebenzisa inaliti ukususa isampuli yezicubu. Ngamanye amaxesha, inaliti ekhokelwa yikhompyuter isetyenziselwa ukususa isampulu yethishu. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela iiseli zomhlaza. Ukuba iiseli zomhlaza zifunyenwe, ugqirha unokususa i-tumor eninzi ngokukhuselekileyo ngexesha lotyando olufanayo. Ingcezu yekhakhayi ihlala ibekwa endaweni yayo emva kwenkqubo.

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

Olu vavanyo lulandelayo lunokwenziwa kwisampulu yethishu esusiweyo:

• 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.

Ngamanye amaxesha ukuxilongwa kunokwenziwa ngokusekwe kwiziphumo zovavanyo lokumakisha kunye nokuvavanywa kwethumba kwaye i-biopsy ayifuneki.

Izinto ezithile zichaphazela isifo (ithuba lokuchacha kwakhona).

Ukuxela kwangaphambili (ithuba lokuchacha) kuxhomekeke koku kulandelayo:

• Uhlobo lwentsholongwane yeseli yentsholongwane.

• Uhlobo kunye nenqanaba lalo naliphi na uphawu lwethumba.

• Apho ithumba lisengqondweni okanye kwintambo yomqolo.

• Nokuba umhlaza usasazekile ngaphakathi kobuchopho kunye nentambo yomqolo okanye kwamanye amalungu omzimba.

• Nokuba ithumba lisanda kufunyaniswa okanye likhe laphinda (labuya) emva konyango.

Amanqanaba oBuntwana be-CNS Germ Cell Tumors

IINGONGOMA EZIPHAMBILI

• Inkqubo yobuntwana eyintloko ye-nervous (CNS) intsholongwane yeseli akufane isasazeke ngaphandle kwengqondo kunye nomqolo.

Inkqubo yobuntwana eyintloko ye-nervous (CNS) intsholongwane yeseli akufane isasazeke ngaphandle kwengqondo kunye nomqolo.

Inqanaba yinkqubo esetyenziselwa ukufumanisa ukuba ungakanani umhlaza okhoyo kwaye nokuba umhlaza usasazekile na. Akukho nkqubo yokubeka emgangathweni kwinqanaba lenkqubo ye-nervous system (CNS).

Isicwangciso sonyango sixhomekeke koku kulandelayo:

• Uhlobo lwentsholongwane yeseli yentsholongwane.

• Nokuba eli thumba lisasazekile ngaphakathi kwengqondo nasemqolo okanye kwamanye amalungu omzimba, njengomphunga okanye ithambo.

• Iziphumo zovavanyo kunye neenkqubo ezenziweyo zokufumanisa isifo se-CNS ebuntwaneni.

• Nokuba ithumba lisanda kufunyaniswa okanye likhe laphinda (labuya) emva konyango.

Ukuphindaphindeka kobuntwana kwi-CNS yeeseli zeThumba

Inkqubo yesifo sokukhula kwenkqubo yobuntwana yentsholongwane inokuphinda ibuye (ibuye) emva kokuba inyangwe. Amathumba ahlala ebuyela apho kuqala khona ithumba. I-tumor nayo inokubuyela kwezinye iindawo kunye / okanye kwii-meninges (umaleko omncinci wethishu egubungela nokukhusela ingqondo kunye nomqolo womqolo).

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinesistim se-nervous system se-Childhood (CNS).

• Abantwana abanobuntwana be-CNS yamathumba eseli kufuneka babe nonyango lwabo olucwangcisiweyo liqela lababoneleli ngononophelo lwempilo abaziingcali kunyango lomhlaza ebantwaneni.

• Unyango lobuntwana kwi-CNS yamathumba eseli inokubangela iziphumo ebezingalindelekanga.

• Iindlela ezine zonyango zisetyenzisiwe:

• Unyango ngemitha

• Unyango ngamayeza

• Ugqirha

• I-dose ephezulu ye-chemotherapy kunye nokuhlangulwa kweseli

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango ekujoliswe kulo

• 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 ezinesistim se-nervous system se-Childhood (CNS).

Iindidi ezahlukeneyo zonyango ziyafumaneka kubantwana abanesistim sentsholongwane ebuntwaneni (CNS). 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 abanobuntwana be-CNS yamathumba eseli kufuneka babe nonyango lwabo olucwangcisiweyo liqela lababoneleli ngononophelo lwempilo abaziingcali kunyango lomhlaza ebantwaneni.

Unyango luya kujongwa yi-oncologist yabantwana kunye / okanye i-oncologist yemitha. I-oncologist yabantwana ngugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist ye-radiation igxile ekunyangeni umhlaza ngonyango lwe-radiation. Aba gqirha basebenza nabanye ababoneleli ngezempilo babantwana abaziingcali ekunyangeni abantwana abanesifo se-CNS ebuntwaneni kwaye banobuchule kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wabantwana.

• I-neurosurgeon yabantwana.

• Ingcali yonyango.

• Ingcali yezigulana.

• Ophthalmologist.

• Ingcali yomongikazi wabantwana.

• Ingcali yokuvuselela.

• Ingcali yeengqondo.

• Unontlalontle.

Unyango lobuntwana kwi-CNS yamathumba eseli 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 neziphumo ezinokubakho emva kwexesha ezibangelwa lunyango oluthile. (Jonga isishwankathelo se- malunga neZiphumo eziMva zaNyango zoMhlaza woMntwana ngolwazi oluthe kratya).

Iindlela ezine zonyango zisetyenzisiwe:

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. Olu hlobo lonyango lwemitha lunokubandakanya oku kulandelayo:

• I-radiosurgery ye-stereotactic: I-radiosurgery yestereotactic luhlobo lonyango lwangaphandle lwemitha. Isakhelo sentloko esiqinileyo siqhotyoshelwe kukhakhayi ukugcina intloko ithe cwaka ngexesha lonyango lwemitha. Umatshini ujolise kwidosi enye enkulu yemitha ngokuthe ngqo kwi-tumor. Le nkqubo ayibandakanyi utyando. Ikwabizwa ngokuba yi-stereotaxic radiosurgery, radiosurgery, kunye notyando lwemitha.

• 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 lomhlaza ophathwayo.

Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga amathumba kwiintsholongwane zeseli ze-CNS. Ukunyanga ngemitha kwingqondo kunokuchaphazela ukukhula kunye nokukhula kwabantwana abancinci. Iindlela ezithile zokunika unyango ngemitha kunokunciphisa umonakalo kwizihlunu zobuchopho ezisempilweni. Kubantwana abangaphantsi kweminyaka emithathu, i-chemotherapy inokunikwa endaweni yoko. Oku kunokulibazisa 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).

Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo lomhlaza ophathwayo. Inkqubo yekhemotherapy isetyenziselwa ukunyanga iiseli zentsholongwane ye-CNS.

Ugqirha

Nokuba utyando lokususa ithumba lunokwenziwa kuxhomekeka ekubeni likhona phi ithumba ebuchotsheni. Utyando lokususa ithumba kunokubangela iziphumo ebezingalindelekanga ezibi.

Utyando lunokwenziwa ukususa iitatomas kwaye lunokusetyenziselwa iiseli zentsholongwane ezibuyayo. 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.

I-dose ephezulu ye-chemotherapy kunye nokuhlangulwa 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.

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.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuhlasela iiseli zomhlaza.

Unyango ekujolise kulo lisafundelwa unyango lwe-CNS yesisu seentsholongwane zeseli eziphinde zabuya (zabuya).

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.

Abantwana abanomhlaza ochaphazele isifo sabo somhlaza xa kwafunyaniswa ukuba umhlaza uya kudinga ukuba kuhlolwe amanqanaba egazi labo. Ukuba inqanaba lehomoni yegazi liphantsi, amayeza okubuyisela i-hormone ayanikwa.

Abantwana abanenqanaba eliphezulu lokumakisha (i-alpha-fetoprotein okanye i-beta-human chorionic gonadotropin) xa umhlaza wafunyaniswa ukuba uhlala efuna ukuba kujongwe inqanaba lokumakishwa kwegazi. Ukuba inqanaba lokumakisha lonyuka emva konyango lokuqala, ithumba lisenokuphinda libuye.

Iinketho zonyango kunyango olutsha lwe-CNS yeeseli zesisu

Kweli Candelo

• Ukuchongwa ngokutsha kwe-CNS Germinomas

• Ukuchongwa kwe-CNS eNongerminomas

• Ukuchongwa kwe-CNS Teratomas

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

Ukuchongwa ngokutsha kwe-CNS Germinomas

Unyango lwenkqubo ye-nervous system (CNS) esandula ukufumanisa isifo inokubandakanya oku kulandelayo:

• Unyango ngemitha kwingqondo iphela kubandakanya ii-ventricles (izithuba ezigcwele ulwelo ngengqondo) kunye nentambo yomqolo. Idosi ephezulu yemitha inikwa ithumba kunendawo ejikeleze ithumba.

• I-Chemotherapy ilandelwa ngonyango lwe-radiation.

• Uvavanyo lwezonyango lwe-chemotherapy olulandelwa lonyango lwe-radiation olunikezwe ngeedosi ezisezantsi kuxhomekeka kwindlela ithumba eliphendula ngayo kunyango.

• Uvavanyo lweklinikhi yerejimeni yonyango entsha esekwe ekubeni kungenzeka njani ukuba isimila sibuyele emva konyango.

Ukuchongwa kwe-CNS eNongerminomas

Akucaci ukuba loluphi olona nyango lulungileyo kwinkqubo ye-nervous system esandula ukufunyanwa.

Unyango lwe-choriocarcinoma, i-embryonal carcinoma, i-yolk sac tumor, okanye i-tumor yesifo esinegciwane inokubandakanya oku kulandelayo:

• I-Chemotherapy ilandelwa ngonyango lwe-radiation.

• Ugqirha. Ukuba ubunzima buhlala emva kwe-chemotherapy eqhubeka ikhula kunye namanqanaba okuphawula amathumba aqhelekileyo (abizwa ngokuba yi-teratoma syndrome ekhulayo), kunokufuneka kwenziwe utyando ukujonga ukuba ubunzima buyinxalenye ye-teratoma, i-fibrosis, okanye ithumba elikhulayo.

• Ukuba ubunzima be-teratoma okanye i-fibrosis evuthiweyo, unyango lwe-radiation lunikezelwa.

• Ukuba ubunzima sisisu esikhulayo, olunye unyango lunokunikwa.

Ukuchongwa kwe-CNS Teratomas

Unyango lweetatomas ezisandula ukufumanisa ukuba sele zikhulile kwaye zingakhuli (CNS) zingabandakanya oku kulandelayo:

Ugqirha lokususa ithumba kangangoko kunokwenzeka. Ukuba kukho naliphi na ithumba elihlala likhona emva kotyando, unyango oluninzi lunokunikwa:

• Ukunyanga ngemitha kwi-tumor okanye kwi-stereotactic radiosurgery; kunye / okanye

• Unyango ngamayeza.

Iinketho zonyango kunyango oluqhelekileyo lwabantwana kwi-CNS

Unyango lwenkqubo ephindaphindayo yobuntwana (CNS) yesifo segciwane sinokubandakanya oku kulandelayo:

• I-Chemotherapy elandelwa lonyango lwe-radiation, yegermomas.

• Unyango oluphezulu lwe-chemotherapy kunye nokuhlangulwa kweseli ye-stem usebenzisa iiseli zesigulana somguli, kunye okanye ngaphandle kwonyango lwemitha, yegermomas kunye ne-nongerminomas.

• Uvavanyo lweklinikhi yonyango olutsha.

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

Uvavanyo lweklinikhi lwangoku

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.

Ukuze ufunde okungakumbi malunga ne-CNS yeeseli zeThumba zeSeli

Ngolwazi oluthe kratya malunga nenkqubo yovalo lwesifo sentsholongwane ebuntwaneni, jonga oku kulandelayo:

• Iintsholongwane zeBongo leTumor Consortium (PBTC) Phuma kwisichaso

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