Types/brain/patient/child-glioma-treatment-pdq

Unyango lweBrain Stem Glioma yoNyango (®) -iPatient Version

Ulwazi ngokubanzi malunga neBrain Stem Glioma

IINGONGOMA EZIPHAMBILI

• Ingqondo yobuntwana yokuthintela i-glioma sisifo apho iiseli ezinobungozi (ezingezizo ezomhlaza) okanye ezinesifo (somhlaza) ezakha izicwili zobuchopho.

• Zimbini iintlobo zeengqondo ezibangelwa ziigliomas ebantwaneni.

• Unobangela wezona zicubu zininzi zobuntwana awaziwa.

• Iimpawu kunye neempawu zobuchopho be-glioma azifani kuye wonke umntwana.

• Uvavanyo oluvavanya ingqondo lusetyenziselwa ukukhangela (ukufumana) ubuchopho bengqondo yomntwana.

• I-biopsy inokwenziwa ukufumanisa iintlobo ezithile zobuchopho be-glioma.

• Izinto ezithile zichaphazela isifo (ithuba lokuchacha kwakhona).

Ingqondo yobuntwana yokuthintela i-glioma sisifo apho iiseli ezinobungozi (ezingezizo ezomhlaza) okanye ezinesifo (somhlaza) ezakha izicwili zobuchopho.

Iigliomas ngamathumba akhiwa kwiiseli ze-glial. Iiseli ze-Glial kwingqondo zibamba iiseli zemithambo-luvo endaweni yazo, zizise ukutya kunye neoksijini kwiiseli zemithambo-luvo, kunye nokunceda ukukhusela iiseli zemithambo-luvo kwizifo, ezinjengosulelo. Kwi-brain stem glioma, iiseli ze-glial kwingcambu yengqondo ziyachaphazeleka.

Isiqu sobuchopho senziwe nge-midbrain, iipon, kunye ne-medulla. Yeyona nxalenye isezantsi yengqondo kwaye idibanisa intambo yomqolo, ngaphezulu ngentla komqolo wentamo. Ukuma kwengqondo kulawula imisebenzi ebalulekileyo njengokuphefumla, ukubetha kwentliziyo, kunye noxinzelelo lwegazi, kunye nemithambo-luvo kunye nezihlunu ezisetyenziselwa ukubona, ukuva, ukuhamba, ukuthetha, kunye nokutya.

Uninzi lwee-gliomas zobuchopho bobuntwana zisasazeka ngaphakathi kwi-pontine gliomas (DIPG), eyenzeka kwiipon. Ifom gliomas yefocal kwezinye iindawo zobuchopho.

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).

Izidumbu zobuchopho lolona hlobo lwesibini luqhelekileyo lomhlaza ebantwaneni.

Esi sishwankathelo simalunga nokunyangwa kwamathumba engqondo aphambili (amathumba aqala kwingqondo). Unyango lwamathumba obuchopho be-metastatic, amathumba abunjwe ziiseli zomhlaza eziqala kwamanye amalungu omzimba kwaye zisasazeka kwingqondo, akuxoxwa ngazo kwesi sishwankathelo.

Izidumbu zobuchopho zinokubakho kokubini ebantwaneni nakubantu abadala; nangona kunjalo, unyango lwabantwana lunokwahluka kunonyango lwabantu abadala. Ngolwazi malunga nonyango lwezihlunu zobuchopho kubantu abadala, jonga isishwankathelo se- soNyango lwaBantu abaDala oluNyango.

Zimbini iintlobo zeengqondo ezibangelwa ziigliomas ebantwaneni.

Nangona i-DIPG kunye nengqondo egxile kubume be-glioma kuhlobo olufanayo lweseli, benza ngokwahlukileyo:

• IDIPG . I-DIPG lithumba elikhula ngokukhawuleza elenza kwiipon. I-DIPG kunzima ukuyinyanga kwaye inesimo esingalunganga (ithuba lokuchacha) ngenxa yoku kulandelayo:

• Ayisiyo ithumba elichazwe kakuhle kwaye lisasazeka phakathi kweeseli ezisempilweni kwingcambu yengqondo.

• Imisebenzi ebalulekileyo, njengokuphefumla kunye nokubetha kwentliziyo, kunokuchaphazeleka.

• Ingqondo ejolise kwingqondo iglioma. I-glioma egxile kukukhula kancinci okwenzeka ngaphandle kweepon kunye nakwindawo enye yengqondo. Kulula ukunyanga kwaye unokuxelwa okungcono kune-DIPG.

Unobangela wezona zicubu zininzi zobuntwana awaziwa.

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 wobuchopho be-glioma zibandakanya:

• Ukuba neengxaki ezithile zofuzo, ezinje nge-neurofibromatosis yohlobo 1 (NF1).

Iimpawu kunye neempawu zobuchopho be-glioma azifani kuye wonke umntwana.

Iimpawu kunye neempawu zixhomekeke koku kulandelayo:

• Apho ithumba lenza khona kwingqondo.

• Ubungakanani besisu kunye nokuba sele sisasazekile kwingqondo.

• Ukukhawuleza ngokukhawuleza kwethumba.

• Ubudala bomntwana kunye nenqanaba lokukhula.

Iimpawu kunye neempawu zinokubangelwa yingqondo yobuntwana ebangelwa zii-gliomas okanye ngezinye iimeko. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Ingxaki ngokuhamba kwamehlo (iliso lijikile ngaphakathi).

• Iingxaki zombono.

• Intloko yentsasa okanye intloko ehambayo emva kokugabha.

• Isicaphucaphu nokugabha.

• Ukulala ngokungaqhelekanga.

• Ukuphulukana namandla okuhambisa icala elinye lobuso okanye umzimba.

• Ukuphulukana nokulingana kunye nengxaki yokuhamba.

• Amandla angaphezulu okanye amancinci kunesiqhelo.

• Utshintsho kwindlela yokuziphatha.

• Ingxaki yokufunda esikolweni.

Uvavanyo oluvavanya ingqondo lusetyenziselwa ukukhangela (ukufumana) ubuchopho bengqondo yomntwana.

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 yeendawo ezingaphakathi kwengqondo. 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).

I-biopsy inokwenziwa ukufumanisa iintlobo ezithile zobuchopho be-glioma.

Ukuba ukuvavanywa kweMRI kujongeka ngathi ithumba yi-DIPG, i-biopsy ihlala ingenziwa kwaye ithumba alisuswanga. Xa iziphumo zokuvavanywa kweMRI zingaqinisekanga, i-biopsy inokwenziwa.

Ukuba ukuskena kwe-MRI kujongeka ngathi kugxile kwingqondo ye-glioma, i-biopsy inokwenziwa. Inxalenye yokakayi iyasuswa kwaye inaliti isetyenziselwa ukususa isampulu yethishu yobuchopho. Ngamanye amaxesha, inaliti ikhokelwa yikhompyuter. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela 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.

Olu vavanyo lulandelayo lunokwenziwa kwisampulu yethishu esuswe ngexesha le-biopsy okanye uqhaqho:

• 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 isifo (ithuba lokuchacha kwakhona).

Ukuxelwa kwangaphambili komntwana kuxhomekeke koku kulandelayo:

• Uhlobo lwe-brain stem glioma (DIPG okanye i-focal glioma).

• Apho ithumba lifumaneka khona kwingqondo kwaye ukuba lisasazekile ngaphakathi kwesiqu sobuchopho.

• Iminyaka yomntwana ekuchongeni isifo.

• Umntwana uneempawu ezingakanani ngaphambi kokuba afunyaniswe.

• Nokuba umntwana akanayo imeko ebizwa ngokuba yi-neurofibromatosis yohlobo 1.

• Nokuba kukho utshintsho oluthile kuhlobo lwe-H3 K27m.

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

Uninzi lwabantwana abane-DIPG baphila ngaphantsi kweenyanga ezili-18 emva kokuchongwa. Abantwana abane-glioma egxile ekuhlaleni bahlala ixesha elide kuneminyaka emi-5.

Amanqanaba obuBongo boBuntwana beGlioma

IINGONGOMA EZIPHAMBILI

• Isicwangciso sonyango lomhlaza sixhomekeke ekubeni ithumba likwindawo enye yengqondo okanye lisasazeke kuyo yonke ingqondo.

Isicwangciso sonyango lomhlaza sixhomekeke ekubeni ithumba likwindawo enye yengqondo okanye lisasazeke kuyo yonke ingqondo.

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

Akukho nkqubo ikumgangatho oqhelekileyo wobuchopho bengqondo yomntwana. Unyango lusekwe koku kulandelayo:

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

• Uhlobo lwethumba (nokuba kukusasazeka kwangaphakathi kwepontine glioma okanye i-focal glioma).

Ingqondo egxile kwingqondo ye-glioma inokuphinda ibuye emva kweminyaka emininzi inyangiwe. I-tumor inokubuyela kwingqondo okanye kwezinye iindawo zenkqubo ye-nervous system. Phambi kokuba unikwe unyango lomhlaza, kungenziwa uvavanyo lokucinga, i-biopsy, okanye utyando ukuqinisekisa ukuba kukho umhlaza kunye nokufumanisa ukuba umhlaza ungakanani.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango lwabantwana abane-stem yeglioma yengqondo.

• Abantwana abanesifo se-glioma sobuchopho kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango

amathumba engqondo ebuntwaneni.

• Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Ukuphambukiswa kweCerebrospinal fluid

• Ukujonga

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango ekujoliswe kulo

• Unyango lwe-stem yeglioma yobuntwana lunokubangela 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-stem yeglioma yengqondo.

Iindidi ezahlukeneyo zonyango ziyafumaneka kubantwana abane-stem yeglioma yengqondo. 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 abanesifo se-glioma yengqondo kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali ekunyangeni amathumba engqondo 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:

• Ugqirha wabantwana.

• Neurosurgeon.

• Neuropathologist.

• I-oncologist yemitha yabantwana.

• Neuro-oncologist.

• Ingcali yonyango.

• Neuroradiologist.

• Ingcali yezigulana.

• Ingcali yeengqondo.

• Ingcali yokuvuselela.

• Unontlalontle.

• Ingcali kubomi bomntwana.

Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

I-Biopsy okanye utyando lokususa i-DIPG alwenziwa rhoqo ngenxa yoku kulandelayo:

• I-DIPG ayisiyiyo enye ubunzima. Isasazeka phakathi kweeseli zengqondo esempilweni kwingcambu yengqondo.

• Imisebenzi ebalulekileyo, njengokuphefumla kunye nokubetha kwentliziyo kunokuchaphazeleka.

I-biopsy yokufumanisa isifo okanye utyando ukususa ithumba inokusetyenziselwa ubuchopho obujolise ebuntwaneni.

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.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo lomhlaza ophathwayo. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga i-DIPG. Unyango lwangaphandle kunye / okanye lwangaphakathi lwemitha lunokusetyenziselwa ukunyanga i-gliomas yengqondo egxile kwingqondo.

Kwiinyanga ezininzi emva konyango lwemitha kwingqondo, iimvavanyo zokucinga zinokubonisa utshintsho kwizicubu zobuchopho. Olu tshintsho lunokubangelwa lonyango lwemitha okanye kunokuthetha ukuba ithumba liyakhula. Kubalulekile ukuba uqiniseke ukuba ithumba liyakhula ngaphambi kokuba kunikwe olunye unyango.

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 ichemotherapy ibekwe ngqo kulwelo lwe-cerebrospinal, ilungu, okanye indawo yomzimba efana nesisu, amachiza ikakhulu achaphazela iiseli zomhlaza kwezo ndawo (chemotherapy yengingqi). Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo lomhlaza ophathwayo.

Ngenxa yokuba unyango lwe-radiation kwingqondo lunokuchaphazela ukukhula kunye nokukhula kwengqondo kubantwana abancinci, ichemotherapy inokunikwa ukulibazisa okanye ukunciphisa isidingo sonyango lwemitha.

Ukuphambukiswa kweCerebrospinal fluid

Ukuphambukiswa kweCerebrospinal fluid yindlela esetyenziselwa ukukhupha ulwelo olwakhiwe kwingqondo. 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.

Ukujonga

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

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 ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo.

Kukho iintlobo ezahlukeneyo zonyango olujolisiweyo ezifundwayo kunyango lwee-gliomas zobuchopho:

• Unyango lwe-Kinase inhibitor luthintela iiproteni ezithile, ezinje nge-BRAF okanye i-MEK, enokunceda ukugcina iiseli zomhlaza zingakhuli okanye zahlule. I-Dabrafenib (i-BRAF kinase inhibitor) kunye ne-trametinib (i-MEK kinase inhibitor) ziyafundwa ukunyanga i-focal glioma kunye nengqondo ephindaphindiweyo ye-glioma.

• Unyango lwe-histone deacetylase inhibitor (HDI) lunokumisa ukukhula kweeseli zethumba ngokuthintela ezinye ii-enzymes ezifunekayo ekukhuleni kweseli. Ikwaluhlobo lwearhente ye-angiogenesis. IPanobinostat iyafundwa kunyango lwe-DIPG engaphendulanga kunyango okanye ephindayo.

• Unyango lwe-monoclonal antibody lusebenzisa ii-antibodies ezenziwe elebhu ezivela 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.

I-antioclonal antibody, APX005M, ibopha kwi-CD40, iseli engaphezulu yeselfowuni efumaneka kwiiseli ezithile zomzimba kunye neeseli ezithile zomhlaza. Inokulwa umhlaza ngokwandisa amajoni omzimba kunye nokucothisa ukukhula komhlaza weseli. Kufundwa kunyango lwamathumba ebuchopho babantwana akhulayo, asasazekayo, okanye aya esiba mandundu (aqhubela phambili), okanye kwi-DIPG esandula kufunyaniswa.

Unyango lwe-stem yeglioma yobuntwana lunokubangela 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 ezinokubakho emva kwexesha zinokubandakanya 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).

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

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.

Ukuba iziphumo zovavanyo lokucinga olwenziwe emva konyango lwe-DIPG lubonisa ubunzima kwingqondo, i-biopsy inokwenziwa ukufumana ukuba yenziwe ngamaseli e-tumor okanye ukuba iiseli zomhlaza ezintsha ziyakhula. Kubantwana ekulindeleke ukuba baphile ixesha elide, ii-MRIs eziqhelekileyo zinokwenziwa ukubona ukuba umhlaza ubuyile na.

Unyango lwe-DIPG

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

Isifo esisanda kufunyaniswa sokuba ngumntwana esisasaza ubuchopho be-stem yeglioma (DIPG) sisisu esingafumananga nyango. Umntwana usenokuba ufumene iziyobisi okanye unyango ukukhupha iimpawu okanye iimpawu ezibangelwa lithumba.

Unyango oluqhelekileyo lwe-DIPG lunokubandakanya oku kulandelayo:

• Unyango lwangaphandle lwemitha.

• I-Chemotherapy (kwiintsana).

• Uvavanyo lweklinikhi yonyango olutsha.

Unyango lwe-Focal Brain Stem Glioma

Isifo esisandula ukufumanisa ukuba ngumntwana ekugxilwe kuso liglioma sisisu esingafumananga nyango. Umntwana usenokuba ufumene iziyobisi okanye unyango ukukhupha iimpawu okanye iimpawu ezibangelwa lithumba.

Unyango lwe-focal glioma lungabandakanya oku kulandelayo:

• Utyando lokususa ithumba lunokulandelwa yichemotherapy kunye / okanye unyango lwangaphandle lwemitha.

• Ukuqwalaselwa kwamathumba amancinci akhula kancinci. Ukuphambukiswa kweCerebrospinal fluid kunokwenziwa xa kukho ulwelo olongezelelekileyo kwingqondo.

• Unyango lwangaphakathi lwemitha kunye nembewu ye-radioactive, kunye okanye ngaphandle kwe-chemotherapy, xa ithumba lingenakususwa ngotyando.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo kunye ne-BRAF kinase inhibitor (dabrafenib) edityaniswe ne-MEK inhibitor (trametinib), yamathumba athile angenakususwa ngotyando.

Unyango lwe-stem yeglioma yengqondo kubantwana abane-neurofibromatosis yohlobo lwe-1 inokuqwalaselwa. Amathumba akhula kancinci kwaba bantwana kwaye anokungafuneki kunyango oluthile iminyaka.

Unyango lweBrain Stem Glioma eQhubekayo okanye eQhubekayo yaBantwana

Xa umhlaza ungangcono kunyango okanye ubuya, ukhathalelo lokuthomalalisa yinxalenye ebalulekileyo yesicwangciso sonyango somntwana. Kubandakanya ukuxhasa ngokwasemzimbeni, ngokwasengqondweni, ngokwasentlalweni nangokwasemoyeni umntwana kunye nosapho. Injongo yokhathalelo oludlamkileyo kukunceda ukulawula iimpawu kunye nokunika umntwana elona qondo lobomi lifanelekileyo. Abazali banokungaqiniseki malunga nokuba baqhubeke na unyango okanye loluphi uhlobo lonyango olulungele umntwana wabo. Iqela lokhathalelo lwempilo linokunika abazali ulwazi ukubanceda benze ezi zigqibo.

Unyango oluninzi ngemitha lunokunikwa abantwana abane-pontine glioma (DIPG) ye-intrinsic eqhubekayo okanye ephindaphindayo eyaphendula xa yaqala yanyangwa ngonyango lwemitha. Unyango lwe-DIPG eqhubekayo okanye ephindaphindayo inokubandakanya oku kulandelayo:

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

• Uvavanyo lweklinikhi yonyango ekujolise kulo kunye ne-histone deacetylase inhibitor (panobinostat) okanye i-monoclonal antibody (APX005M).

Unyango lwe-glioma yobuchopho obujolise rhoqo kubuntwana inokubandakanya oku kulandelayo:

• Utyando lwesibini ukususa ithumba.

• Unyango lwangaphandle lwemitha.

• 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

• Unxibelelwano kuNonophelo loMhlaza

• Ukucwangcisa ukuTshintshela kuKhathalelo lokuPhela kobomi kwiCancer ePhambili

• Unonophelo lwaBantwana oluXhasayo (Ukuphela koKhathalelo loBomi)

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