Iindidi / umhlaza-womhlaza / i-hp / i-cancer engaqhelekanga-yobuntwana-pdq
Umhlaza oQhelekileyo woNyango lwaBantwana
Ulwazi ngokubanzi malunga noMhlaza oQhelekileyo wobuntwana
Kweli Candelo
- Intshayelelo
Intshayelelo
Umhlaza ebantwaneni nakwishumi elivisayo unqabile, nangona imeko iyonke yomhlaza wobuntwana inyuka kancinci ukusukela ngo-1975. [1] Ukuthunyelwa kumaziko onyango kunye neqela elinamacandelo ahlukeneyo eengcali zomhlaza ezinamava kunyango lomhlaza olwenzeka ebuntwaneni nakwiminyaka yokufikisa kufuneka liqwalaselwe abantwana kunye nolutsha olunomhlaza. Le ndlela yeqela elinamacandelo ahlukeneyo ibandakanya izakhono zonyango, ugqirha wabantwana, i-oncologists ye-radiation, i-oncologists / i-hematologists yezonyango, iingcali zokubuyisela imeko esiqhelweni, iingcali zabongikazi babantwana, oonontlalontle nabanye ukuqinisekisa ukuba abantwana bafumana unyango, ukhathalelo lokuxhasa kunye nokubuyisela kwimeko yesiqhelo ukuba Uya kuphumelela ngokugqibeleleyo kunye nomgangatho wobomi.
Izikhokelo zamaziko anomhlaza wabantwana nendima yabo kunyango lwezigulana ezinomhlaza zichazwe yiAmerican Academy of Pediatrics. [2] Kula maziko omhlaza wabantwana, uvavanyo lwezonyango luyafumaneka kwiintlobo ezininzi zomhlaza ezenzeka kubantwana nakwishumi elivisayo, kwaye ithuba lokuthatha inxaxheba kwezi zilingo linikwa uninzi lwezigulana kunye neentsapho zazo. Uvavanyo lwezonyango lwabantwana nakwishumi elivisayo abafunyaniswe benomhlaza ngokubanzi luyilelwe ukuthelekisa unyango olunokubakho olungcono kunye nonyango olwamkelweyo ngoku njengomgangatho. Uninzi lwenkqubela phambili eyenziweyo ekuchongeni unyango kunyango lomhlaza wabantwana lufezekisiwe kuvavanyo lweklinikhi. Ulwazi malunga novavanyo lweklinikhi oluqhubekayo luyafumaneka kwiwebhusayithi yeNCI.
Ukuphuculwa okumandla ekusindeni kufezekisiwe kubantwana nakwishumi elivisayo abanomhlaza. Phakathi kowe-1975 nowama-2010, ukufa komhlaza wabantwana kwehle ngaphezulu kwama-50%. [3] Amaxhoba omhlaza wobuntwana kunye nokufikisa afuna ukubekwa esweni ngokusondeleyo kuba iziphumo ebezingalindelekanga zonyango zinokuqhubeka okanye ukukhula iinyanga okanye iminyaka emva konyango. .
Umhlaza kubantwana sisifo esinqabileyo, malunga ne-15,000 yamatyala afunyanwa minyaka le e-United States kubantu abangaphantsi kweminyaka engama-20. [4] UMthetho weZifo eziNqabileyo wase-US ka-2002 uchaza isifo esinqabileyo njengesichaphazela abantu abangaphantsi kwama-200,000. Ke ngoko, zonke iintlobo zomhlaza wabantwana zithathwa njengezinqabileyo.
Ukutyunjwa kwesisu esinqabileyo akufani phakathi kwamaqela abantwana kunye nabantu abadala. Umhlaza wabantu abadala onqabileyo uchazwa njengaleyo inezehlo zonyaka ezingaphantsi kwamatyala amathandathu kubantu abayi-100,000, kwaye kuqikelelwa ukuba kuya kuthi ga kwiipesenti ezingama-24 zazo zonke iintlobo zomhlaza ezifunyenwe kwi-European Union kwaye malunga neepesenti ezingama-20 yazo zonke iicancer ezifunyenwe eUnited States. . [5,6] Kwakhona, ukutyunjwa kwethumba elinqabileyo labantwana akufani phakathi kwamaqela amazwe, ngolu hlobo lulandelayo:
- Iprojekthi yentsebenziswano yase-Italiya kwizidumbu ezinqabileyo zabantwana (i-Tumori Rari e-Eta Pediatrica [TREP]) ichaza ithumba elinqabileyo labantwana njengelinye elinamatyala angaphantsi kwamabini kwisigidi esinye sabemi ngonyaka kwaye alibandakanywanga kolunye uvavanyo lwezonyango. [7 ]
- Iqela laBantwana le-Oncology (i-COG) likhethe ukuchaza umhlaza wabantwana onqabileyo njengaleyo idweliswe kuLwahlulo lwaMazwe ngaMazwe lweqela lomhlaza wabantwana i-XI, ebandakanya umhlaza we-thyroid, i-melanoma kunye ne-nonmelanoma ulusu lomhlaza, kunye neentlobo ezininzi ze-carcinomas (umzekelo, i-adrenocortical carcinoma, i-nasopharyngeal i-carcinoma, kunye ne-carcinomas eninzi yabantu abadala efana nomhlaza webele, umhlaza wecolorectal cancer, njl.). [8] Ezi zichonga iakhawunti malunga neepesenti ezi-4 zomhlaza ezifunyenwe kubantwana abaneminyaka eyi-0 ukuya kweli-14, xa kuthelekiswa nama-20% omhlaza ofunyenwe kulutsha oluneminyaka eli-15 ukuya kweli-19 (jonga kwiFigure 1 and 2). [9]
Uninzi lomhlaza ngaphakathi kweqela elincinci le-XI zii-melanomas okanye umhlaza wedlala lengqula, kunye neqela elisele lomhlaza we-XI iintlobo zomhlaza ezibalelwa kwi-1.3% kuphela yomhlaza kubantwana abaneminyaka eyi-0 ukuya kwi-14 iminyaka kunye ne-5.3% yomhlaza kulutsha oluneminyaka eli-15 ukuya kweli-19.
Ezi zomhlaza zinqabile zinzima kakhulu ukuba zifundwe ngenxa yeziganeko ezisezantsi zezigulana ezinesifo esichaphazelekayo, ubukhulu becala bomhlaza obunqabileyo kubemi abakwishumi elivisayo, kunye nokusilela kovavanyo lweklinikhi kulutsha olunomhlaza onqabileyo onje nge-melanoma.
Abanye abaphandi basebenzise iziseko zedatha ezinkulu, ezinje ngoPhononongo, i-Epidemiology, kunye neziphumo zokugqibela (i-SEER) kunye neZiko ledatha likaMhlaza weSizwe, ukufumana ukuqonda ngakumbi kwezi mhlaza zinqabileyo zabantwana. Nangona kunjalo, ezi zifundo zedatha zilinganiselwe. Amanyathelo aliqela okufunda umhlaza wabantwana onqabileyo aphuhliswe yi-COG kunye namanye amaqela amazwe, kubandakanya ne-International Society of Pediatric Oncology (Société Internationale D'Oncologie Pédiatrique [SIOP]). I-Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) projekthi enqabileyo yethumba yasekwa eJamani ngo-2006. [10] I-TREP yaphehlelelwa ngo-2000, [7] kunye nePolish Pediatric Rare Tumor Study Group yasungulwa ngo-2002. [11] EYurophu, amaqela anqabileyo afundisisa amaqela asuka eFrance, eJamani, e-Itali, ePoland, kwaye i-United Kingdom ijoyine i-European Cooperative Group Group kwi-Pediatric Rare Tumors (EXPeRT), egxile kwintsebenziswano yamazwe kunye nohlalutyo lwezinto ezithile ezinqabileyo zethumba. [12] Ngaphakathi kwi-COG, iinzame zigxile ekwandiseni ukongezeleka kubhaliso lwe-COG (iProjekthi yaBanye abantwana) kunye neenkqubo zebhanki zethumba, ukuphuhlisa uvavanyo lweklinikhi yengalo enye, kunye nokwandisa ukusebenzisana kunye novavanyo lwabantu abadala lwentsebenziswano. [13] Ukufezekiswa kunye nemiceli mngeni yeli nyathelo zichazwe ngokweenkcukacha. [8,14] kunye nokonyuka kwentsebenziswano kunye nokulingwa kweqela labantu abadala. [13] Ukufezekiswa kunye nemiceli mngeni yeli nyathelo zichazwe ngokweenkcukacha. [8,14] kunye nokonyuka kwentsebenziswano kunye nokulingwa kweqela labantu abadala. [13] Ukufezekiswa kunye nemiceli mngeni yeli nyathelo zichazwe ngokweenkcukacha. [8,14]
Amathumba adweliswe kolu shwankathelo ahluke kakhulu; zicwangcisiwe ngokuhla kwe-anatomic order, ukusuka kwizidumbu ezingapheliyo zentloko nentamo ukuya kwizidumbu ezinqabileyo zomchamo wesibeleko kunye nolusu. Zonke ezi zomhlaza zinqabile ngokwaneleyo ukuba uninzi lwezibhedlele zabantwana zinokubona ngaphantsi kwesandla seembali ezithile kwiminyaka eliqela. Uninzi lweembali ezidweliswe apha zenzeka rhoqo kubantu abadala. Ulwazi malunga nala mathumba lunokufumaneka kwimithombo efanelekileyo kubantu abadala abanomhlaza.
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