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Unyango lwe-Ependymoma yoBuntwana (®) -Ingxelo yePatient

Ulwazi ngokubanzi malunga ne-Ependymoma yobuntwana

IINGONGOMA EZIPHAMBILI

• I-ependymoma yobuntwana sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu zobuchopho kunye nentambo yomqolo.

• Kukho iintlobo ezahlukeneyo zeependymomas.

• Inxalenye yengqondo echaphazelekayo ixhomekeke ekubeni yenziwa phi i-ependymoma.

• Unobangela wezona zicubu zininzi zobuntwana awaziwa.

• Iimpawu kunye neempawu zobuntwana i-ependymoma azifani kuwo wonke umntwana.

• Uvavanyo oluvavanya ubuchopho kunye nentambo yomqolo zisetyenziselwa ukufumana (ukufumana) i-ependymoma yobuntwana.

• I-ependymoma yobuntwana ifunyaniswa kwaye isuswe kuqhaqho.

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

I-ependymoma yobuntwana sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu zobuchopho kunye nentambo yomqolo.

Ingqondo ilawula imisebenzi ebalulekileyo njengememori kunye nokufunda, imvakalelo kunye nezivamvo (ukuva, ukubona, ukuvumba, ukungcamla, kunye nokuchukumisa). Intambo yomqolo yenziwe ngeemfumba zemithambo-luvo edibanisa ingqondo nemithambo-luvo kwiindawo ezininzi zomzimba.

Iifom ze-Ependymomas ezivela kwiiseli ze-ependymal ezihamba ngee-ventricles kunye neendlela zokuhamba kwingqondo kunye nentambo yomgogodla. Iiseli ze-Ependymal zenza ulwelo lwe-cerebrospinal fluid (CSF).

Esi sishwankathelo simalunga nokunyangwa kwamathumba engqondo aphambili (amathumba aqala kwingqondo). Unyango lwamathumba ebuchwephesha metastatic, amathumba aqala kwamanye amalungu omzimba kwaye asasazeka kwingqondo, akuxoxwa ngako kwesi sishwankathelo.

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

• Ubunzima bobuntwana kunye ne-Spinal Cord Tumors Treatment Overview

• Unyango lwaBantu abaDala oluNyango oluNyango

Kukho iintlobo ezahlukeneyo zeependymomas.

Umbutho wehlabathi wezeMpilo (WHO) amaqela ependymal tumors kwii-subtypes ezintlanu eziphambili:

• I-Subependymoma (ibakala le-WHO I; kunqabile ebantwaneni).

• I-Myxopapillary ependymoma (ibakala le-WHO I).

• I-Ependymoma (ibanga lesibini le-WHO).

• I-RELA fusion-positive ependymoma (ibanga lesibini le-WHO okanye ibanga lesithathu kunye notshintsho kuhlobo lweRELA).

• I-Anaplastic ependymoma (ibanga lesithathu le-WHO).

Inqanaba lethumba lichaza indlela engaqhelekanga ngayo iiseli zomhlaza ezibonakala phantsi kwemicroscope kwaye ukuba ngokukhawuleza ithumba linokuthi likhule kwaye lisasazeke kangakanani. Iiseli zomhlaza ezikumgangatho ophantsi (kwibakala I) zijongeka njengeeseli eziqhelekileyo kuneseli zomhlaza ezikumgangatho ophakamileyo (ibanga II kunye no-III). Iiseli zomhlaza kwiBakala I zihlala zikhula kwaye zisasazeka ngokuthe chu kuneseli yomhlaza yebanga lesi-II kunye nelesi-3.

Inxalenye yengqondo echaphazelekayo ixhomekeke ekubeni yenziwa phi i-ependymoma.

I-Ependymomas inokwenza naphi na kwii-ventricles ezigcwele ulwelo kunye neepaseji kwingqondo nakwintambo yomqolo. Uninzi lweependymomas lwenza kwi-ventricle yesine kwaye luchaphazela i-cerebellum kunye nengqondo. Iifom ze-Ependymomas aziqhelekanga kwi-cerebrum kwaye inqabile kwintambo yomgogodla.

I-anatomy yangaphakathi kwengqondo ebonisa i-ventricle esecaleni, i-ventricle yesithathu, i-ventricle yesine, kunye neepaseji eziphakathi kwee-ventricles (ezine-cerebrospinal fluid eboniswe ngombala oluhlaza okwesibhakabhaka). Ezinye iinxalenye zobuchopho ezibonisiweyo zibandakanya i-cerebrum, i-cerebellum, intambo yomqolo, kunye nesiqu sobuchopho (iipon kunye ne-medulla).

Apho iifom ze-ependymoma zichaphazela ukusebenza kwengqondo kunye nentambo yomqolo:

• 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.

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

• 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.

Unobangela wezona zicubu zininzi zobuntwana awaziwa.

Iimpawu kunye neempawu zobuntwana i-ependymoma azifani kuwo wonke umntwana.

Iimpawu kunye neempawu zixhomekeke koku kulandelayo:

• Iminyaka yomntwana.

• Apho lakha khona eli thumba.

Iimpawu kunye neempawu zinokubangelwa yi-ependymoma yobuntwana okanye ngezinye iimeko. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Iintloko rhoqo.

• Ukuxhuzula.

• Isicaphucaphu nokugabha.

• Intlungu entanyeni okanye emqolo.

• Ukuphulukana nokulingana okanye ukuhamba nzima.

• Ubuthathaka emilenzeni.

• Umbono omfiliba.

• Utshintsho ekusebenzeni kwamathumbu.

• Ingxaki yokuchama.

• Ukudideka okanye ukucaphuka.

Uvavanyo oluvavanya ubuchopho kunye nentambo yomqolo zisetyenziselwa ukufumana (ukufumana) i-ependymoma yobuntwana.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: 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, imizwa kunye nengqondo. Oku kunokubizwa ngokuba luvavanyo lwe-neuro okanye uvavanyo lwe-neurologic.

• 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 kwaye ihamba ngegazi. 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. Isampulu inokujongwa kwakhona kwixabiso leprotein kunye neswekile. 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.

I-ependymoma yobuntwana ifunyaniswa kwaye isuswe kuqhaqho.

Ukuba uvavanyo lovavanyo lubonisa ukuba kunokubakho ithumba ebuchotsheni, i-biopsy yenziwa ngokususa inxenye yokakayi kunye nokusebenzisa inaliti ukususa isampulu yethishu yobuchopho. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela iiseli zomhlaza kunye nokujonga inqanaba lethumba. Ukuba iiseli zomhlaza zifunyenwe, ugqirha uya kususa ithumba elininzi ngokukhuselekileyo ngexesha lotyando olunye.

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.

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

Ukuqikelela kunye nokhetho kunyango luxhomekeke:

• Apho ithumba lenze khona kwinkqubo ye-nervous system (CNS).

• Nokuba kukho utshintsho oluthile kwimfuza okanye kwii-chromosomes.

• Nokuba zikhona iiseli zomhlaza ezihlala emva kotyando lokususa ithumba.

• Uhlobo kunye nenqanaba le-ependymoma.

• Iminyaka yomntwana xa kufunyanwa ithumba.

• Nokuba umhlaza unwenwele nakwezinye iindawo zobuchopho okanye umnqonqo.

• Nokuba ithumba lisandula ukufumanisa ukuba likhe lafunyaniswa okanye laphinda labuya (buyela).

Ukuxela kwangaphambili kuya kuxhomekeka ekubeni ngaba unyango lwe-radiation lunikiwe, uhlobo kunye nonyango lonyango, nokuba ngaba unyango lwe-chemotherapy lwalunikwe lodwa.

Amanqanaba okhula ebuntwaneni

IINGONGOMA EZIPHAMBILI

• Akukho nkqubo yokulinganisa esemgangathweni ye-ependymoma yobuntwana.

• Ukuphindaphindeka kobuntwana i-ependymoma sisisu esibuye sabuya (sabuya) emva kokuba sinyangiwe.

Akukho nkqubo yokulinganisa esemgangathweni ye-ependymoma yobuntwana.

Inqanaba yinkqubo esetyenziselwa ukufumanisa ukuba umhlaza uhleli emva kotyando na ukuba umhlaza sele usasazekile.

Unyango lwe-ependymoma luxhomekeke koku kulandelayo:

• Apho umhlaza ukwingqondo okanye umnqonqo.

• Ubudala bomntwana.

• Uhlobo kunye nenqanaba le-ependymoma.

Ukuphindaphindeka kobuntwana i-ependymoma sisisu esibuye sabuya (sabuya) emva kokuba sinyangiwe.

I-ependymoma yobuntwana ihlala iphinda, ihlala kwindawo yomhlaza. I-tumor ingabuya emva kweminyaka eyi-15 okanye ngaphezulu emva kokunyanga kokuqala.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango lwabantwana abane-ependymoma.

• Abantwana abane-ependymoma kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngononophelo lwempilo abaziingcali kunyango lwamathumba ebuntwaneni.
• Iindlela ezintathu zonyango zisetyenzisiwe:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango ekujoliswe kulo

• Unyango lwe-ependymoma yobuntwana kunokubangela iziphumo ebezingalindelekanga.

• 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 lwabantwana abane-ependymoma.

Iindlela ezahlukeneyo zonyango ziyafumaneka kubantwana abane-ependymoma. 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-ependymoma kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngononophelo lwempilo abaziingcali kunyango lwamathumba ebuntwaneni. Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngononophelo lwempilo yabantwana abaziingcali ekunyangeni abantwana abanezilonda zobuchopho kwaye begxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• I-neurosurgeon yabantwana.

• Ingcali yonyango.

• Ugqirha wabantwana.

• Imitha ye-oncologist.

• Ugqirha wezonyango.

• Ingcali yezigulana.

• Ingcali yokuvuselela.

• Ingcali yeengqondo.

• Ingcali kubomi bomntwana.

Iindlela ezintathu zonyango zisetyenzisiwe:

Ugqirha

Ukuba iziphumo zovavanyo lokuchonga zibonisa ukuba kunokubakho ithumba ebuchotsheni, i-biopsy yenziwa ngokususa inxenye yokakayi kunye nokusebenzisa inaliti ukususa isampulu yethishu yobuchopho. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukujonga iiseli zomhlaza. Ukuba iiseli zomhlaza zifunyenwe, ugqirha uya kususa ithumba elininzi ngokukhuselekileyo ngexesha lotyando olunye.

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

I-MRI ihlala isenziwa emva kokuba isisu sisuswe ukufumanisa ukuba ngaba likhona na ithumba elihlala likhona. Ukuba i-tumor ihlala, utyando lwesibini lokususa uninzi lwethumba eliseleyo kangangoko kunokwenzeka.

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.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Unyango lwangaphandle lwemitha lusebenzisa umatshini ongaphandle komzimba ukuthumela imitha kwindawo yomzimba enomhlaza.

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) olusebenzisa ikhompyuter ukwenza imifanekiso yobukhulu kunye nemilo yethumba. Iintsika ezincinci zemitha yokuqina okuhlukeneyo (amandla) zijolise kwithumba kumacala amaninzi.

• Unyango lwe-Proton-beam yonyango: 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.

• 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.

Abantwana abancinci abafumana unyango ngemitha kwingqondo banomngcipheko ophezulu wokukhula kunye nokukhula kunabantwana abadala. Unyango lwe-3-D engafaniyo nonyango kunye nonyango lwe-proton-beam ziyafundwa kubantwana abancinci ukubona ukuba iimpembelelo zemitha ekukhuleni nasekuphuculweni ziyancipha.

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).

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 ekujoliswe kulo lubangela ukwenzakala okuncinci kwiiseli eziqhelekileyo kunonyango lwechemotherapy okanye unyango ngemitha.

Unyango ekujolise kulo luyafundwa kunyango lwe-ependymoma yobuntwana ebuye yabuya (buyela).

Unyango lwe-ependymoma 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, kubandakanya iingxaki:

• Uphuhliso lwezinyo.

• Umsebenzi wokuva.

• Ukukhula kwamathambo kunye nezihlunu kunye nophuhliso.

• Umsebenzi we-thyroid.

• Ukubetha.

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

• Umhlaza wesibini (iintlobo ezintsha zomhlaza), njengomhlaza wedlala lengqula okanye umhlaza wobuchopho.

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.)

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.

Uvavanyo olulandelayo lwe-ependymoma yobuntwana lubandakanya iMRI (imaging resonance imaging) yengqondo kunye nentambo yomqolo kula maxesha alandelayo:

• Kuqala ukuya kwiminyaka emi-3 emva konyango: Qho kwiinyanga ezi-3 ukuya kwezi-4.

• Iminyaka emine ukuya kwemihlanu emva konyango: Rhoqo kwiinyanga ezi-6.

• Ngaphezulu kweminyaka emi-5 emva konyango: Kanye ngonyaka.

Unyango lwe-Myxopapillary Ependymoma

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

Unyango lwe-myxopapillary ependymoma (ibakala I) yobutsha esanda kufunyaniswa:

• Ugqirha. Ngamanye amaxesha unyango lwemitha lunikezelwa emva kotyando.

Unyango lwe-Ependymoma yoBuntwana, iAnaplastic Ependymoma, kunye neRELA Fusion-positive Ependymoma

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

Unyango lwe-ependymoma yobuntwana (ibakala II), i-anaplastic ependymoma (ibanga lesi-III), kunye ne-RELA fusion-positive ependymoma (ibanga lesibini okanye ibanga lesithathu) yile:

• Ugqirha.

Emva kotyando, isicwangciso sonyango olungaphezulu sixhomekeke koku kulandelayo:

• Nokuba zikhona iiseli zomhlaza ezihlala emva kotyando.

• Nokuba umhlaza unwenwele nakwezinye iindawo zobuchopho okanye umnqonqo.

• Ubudala bomntwana.

Xa ithumba lisuswe ngokupheleleyo kwaye iiseli zomhlaza zingasasazekanga, unyango lunokubandakanya oku kulandelayo:

• Unyango ngemitha.

Xa inxenye yethumba isala emva kotyando, kodwa iiseli zomhlaza zingasasazekanga, unyango lunokubandakanya oku kulandelayo:

• Utyando lwesibini lokususa ithumba eliseleyo kangangoko.

• Unyango ngemitha.

• Unyango ngamayeza.

Xa iiseli zomhlaza zisasazekile ngaphakathi kwengqondo nasemqolo, unyango lunokubandakanya oku kulandelayo:

• Unyango ngemitha kwingqondo kunye nentambo yomqolo.

• Unyango ngamayeza.

Unyango lwabantwana abangaphantsi konyaka omnye unokubandakanya oku kulandelayo:

• Unyango ngamayeza.

• Unyango ngemitha. Unyango ngemitha alunikwa abantwana de babe badala kubudala bonyaka omnye.

• Uvavanyo lweklinikhi yonyango lwe-3-dimensional (3-D) yonyango lwemitha ehambisanayo okanye unyango lwepron-beam radiation.

Unyango lwe-Ependymoma yabantwana

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

Unyango lwe-ependymoma ebuntwaneni engabandakanya oku kulandelayo:

• Ugqirha.

• Unyango lwe-radiation, olunokubandakanya i-stereotactic radiosurgery, unyango lwe-radiation olomeleleyo, okanye unyango lwe-proton-beam radiation.

• Unyango ngamayeza.

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

Ukufunda ngakumbi ngeeNgqumbo zeBongo zaBantwana

Ngolwazi oluthe kratya malunga nethumba lobuchopho ebuntwaneni, bona 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