Iindidi / i-extracranial-germ-cell / isigulana / unyango lwe-germ-cell-pdq

Ingxelo yoNyango yoBuntwana yeGrm Cell Tumors Treatment Version

Ulwazi ngokubanzi malunga nokuKhula koBuntwana kwi-Cell Cell Tumors

IINGONGOMA EZIPHAMBILI

• Ithumba leeseli zentsholongwane ezenziwa ebuntwaneni zivela kwiiseli zentsholongwane kwiindawo zomzimba ngaphandle kobuchopho.

• Izidumba zeseli zentsholongwane engaphaya kobuntwana zinokuba nobungozi okanye zibe mbi.

• Izidumba zeseli zentsholongwane engaphaya komntwana ziqokelelwe njenge-gonadal okanye i-extragonadal tumors extracranial tumors.

• IGonadal Germ Cell Tumors

• I-Extragonadal Extracranial Germ Cell Tumors

• Zintathu iintlobo zamathumba eseli yentsholongwane engaphezulu.

• Teratomas

• Ukudumba kweeseli zeGerm ezimbi

• Umxube weGerm Cell Tumors

• Unobangela wesona sizathu sentsholongwane yamadlala eseli sintsholongwane ayaziwa.

• Ukuba neengxaki ezithile ezizuze njengelifa kunokunyusa umngcipheko wokudumba kweeseli zentsholongwane engaphezulu.

• Iimpawu zobuntwana obungekabikho bentsholongwane kwiiseli zentsholongwane zixhomekeke apho ithumba lenzeke khona emzimbeni.

• Izifundo zokulinganisa kunye novavanyo lwegazi zisetyenziselwa ukufumanisa (ukufumana) kunye nokufumanisa isifo samathumbu esentsholongwane.

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

Ithumba leeseli zentsholongwane ezenziwa ebuntwaneni zivela kwiiseli zentsholongwane kwiindawo zomzimba ngaphandle kobuchopho.

Iseli yentsholongwane luhlobo lweseli olwenza njengoko usana olungekazalwa lukhula. Ezi seli kamva ziba ngamadlozi kumasende okanye kumaqanda kwii-ovari.

Esi sishwankathelo simalunga neentsholongwane zeseli zentsholongwane ezenza amalungu omzimba angaphandle (ngaphandle kwengqondo). Izicubu zeseli zentsholongwane ezongezelelekileyo zihlala zenzeka kwezi ndawo zilandelayo zomzimba:

• Amatyhalarha.

• Amaqanda.

• I-Sacrum okanye i-coccyx (umsila).

• I-Retroperitoneum (indawo engasemva kwesisu ngasemva kwethishu ebopha udonga lwesisu kwaye igubungela uninzi lwamalungu esiswini).

• Mediastinum (indawo phakathi kwemiphunga).

• Intloko nentamo.

I-extracranial germ cell tumors form kwiindawo zomzimba ngaphandle kobuchopho. Oku kubandakanya amasende, ii-ovari, i-sacrum (indawo esezantsi yomqolo), i-coccyx (i-tailbone), i-mediastinum (indawo phakathi kwemiphunga), i-retroperitoneum (udonga lwangasemva lwesisu), kunye nentloko nentamo.

Izicubu zeseli zentsholongwane eyongezelelweyo zixhaphake kakhulu kulutsha.

Jonga isishwankathelo se kwinkqubo yoBuntwana yoNyango lweeNkqubo zeNtsholongwane yeeNtsholongwane zoLwazi ngolwazi malunga ne-intracranial (ngaphakathi kwengqondo) ithumba leseli yentsholongwane.

Izidumba zeseli zentsholongwane engaphaya kobuntwana zinokuba nobungozi okanye zibe mbi.

Izicubu zeseli zentsholongwane ezandayo zinokuba nobungozi (ezingezizo ezomhlaza) okanye ezinobungozi (umhlaza).

Izidumba zeseli zentsholongwane engaphaya komntwana ziqokelelwe njenge-gonadal okanye i-extragonadal tumors extracranial tumors.

Izidumba zeseli zentsholongwane eziyingozi ezingaphaya kolusu zizidumba ezenza ngaphandle kwengqondo. Ziyi-gonadal okanye i-extragonadal.

IGonadal Germ Cell Tumors

Gonadal germ cell tumors form in the gonads (testicles and ovaries).

• Iimvumba zentsholongwane yeseli. Amatyhalarha eseli anentsholongwane ahlukaniswe abe ziindidi ezimbini eziphambili, iseminoma kunye nonseminoma. I-Nonseminomas zihlala zikhulu kwaye zibangela iimpawu okanye iimpawu zesifo. Zihlala zikhula kwaye zisasazeka ngokukhawuleza kuneesemina.

Iimvumba zentsholongwane yeseli zihlala zikhona ngaphambi kweminyaka eyi-4 okanye kulutsha nakwishumi elivisayo. Izidudu zeseli zentsholongwane kulutsha (iminyaka eli-11 nangaphezulu) kunye nabantu abadala abancinci bahlukile kwezo zefom ebusaneni.

• Iimvumba zentsholongwane yesibeleko. Iimvumba zentsholongwane ye-Ovarian zixhaphake kakhulu kumantombazana afikisayo nakwabasetyhini abancinci. Uninzi lwezihlunu zentsholongwane yesibeleko zii-teratomas ezivuthiweyo (i-dermoid cysts). Ezinye izilonda zesibeleko se-ovari, ezinje ngeetatomas ezingakhulanga, idysgerminomas, izilonda ze-yolk sac, okanye amathumba eeseli zentsholongwane axubeneyo, ayingozi.

I-Extragonadal Extracranial Germ Cell Tumors

I-Extragonadal extracranial germ cell tumors form kwiindawo zomzimba ngaphandle kwengqondo okanye iigonads (amasende kunye namaqanda).

Uninzi lwamathumba eeseli zentsholongwane ezongezelelekileyo ezenziwa ngaphakathi kwi-midline yomzimba. Oku kubandakanya oku kulandelayo:

• I-Sacrum (ithambo elikhulu elimile unxantathu kumqolo ongezantsi oyinxalenye yesinqe).

• Coccyx (umsila).

• Mediastinum (indawo phakathi kwemiphunga).

• Umva wesisu.

• Intamo.

Kubantwana abangaphantsi kweminyaka eli-11, i-extragonadal extracranial germ cell tumors zihlala zenzeka xa kuzalwa okanye ebuntwaneni. Uninzi lwezi tumors zi-teratomas ezinobungozi kwi-sacrum okanye kwi-coccyx.

Kubantwana abadala, abakwishumi elivisayo, kunye nabantu abadala abancinci (iminyaka eli-11 nangaphezulu), i-extragonadal extracranial germ cell tumors zihlala zikwi-mediastinum.

Zintathu iintlobo zamathumba eseli yentsholongwane engaphezulu.

Izicubu zeseli zentsholongwane ezongezelelekileyo zikwadityaniswa zangama-teratomas, iiseli zentsholongwane ezinobungozi, kunye nezicubu zeseli zentsholongwane.

Teratomas

Zimbini iintlobo eziphambili zeetatomas:

• Iitatomas eziqolileyo. Ezi tumors lolona hlobo luqhelekileyo lwesifo se-germ esibuhlungu esivela ngaphandle. Iitatomas ezikhulileyo zizidumbu ezinobungozi kwaye akunakulindeleka ukuba zibe ngumhlaza. Zihlala zivela kwi-sacrum okanye i-coccyx kwiintsana ezisandul 'ukuzalwa okanye kumasende okanye kwii-ovari ekuqaleni kokufikisa. Iiseli zeetatoma ezivuthiweyo zikhangeleka ngathi ziiseli eziqhelekileyo phantsi kwemicroscope. Ezinye iitatomas ezikhulileyo zikhupha ii-enzymes okanye iihormone ezibangela iimpawu kunye neempawu zezifo.

• Iitatomas ezingafakwanga. Ezi tumors zihlala zenzeka kwiindawo ezingezizo iigonads kubantwana abancinci okanye kwii-ovari ekuqaleni kokufikisa. Zineeseli ezibonakala zahluke kakhulu kwiiseli eziqhelekileyo phantsi kwemicroscope. I-teratomas ezingafakwanga zisenokuba ngumhlaza kwaye zisasazeke kwamanye amalungu omzimba. Bahlala baneendidi ezahlukeneyo zethishu kubo, ezinje ngeenwele, izihlunu, kunye nethambo. Ezinye iitatomas ezingakhulanga zikhupha ii-enzymes okanye iihormone ezibangela iimpawu kunye neempawu zezifo.

Ukudumba kweeseli zeGerm ezimbi

Izilonda ezinobungozi zesifo somhlaza ngumhlaza. Zimbini iintlobo eziphambili zesisu esibi sentsholongwane:

• Izidudu zeseli zentsholongwane. Zintathu iindidi zesisu seminomatous germ tumors:

• Ifom yeseminomas kwityhalarho.

• Ifom yeDysgerminomas kwi-ovary.

• I-Germinomas ifom kwiindawo zomzimba ezingekho i-ovary okanye i-testicle, njenge-mediastinum.

• Izidumba zeseli zentsholongwane ezingezizo ezomzimba. Zintlanu iintlobo zeeseli zentsholongwane ezingezizo ezomzimba.

• Izidumba ze-Yolk sac zenza ihomoni ebizwa ngokuba yi-alpha-fetoprotein (AFP). Banokwenza i-ovary, ityhalarha, okanye ezinye iindawo zomzimba.

• I-Choriocarcinomas yenza ihomoni ebizwa ngokuba yi-beta-human chorionic gonadotropin (β-hCG). Banokwenza i-ovary, ityhalarha, okanye ezinye iindawo zomzimba.

• I-embryonal carcinomas inokwenza ihomoni ebizwa ngokuba yi-β-hCG. Banokwenza ityhalarha okanye ezinye iindawo zomzimba, kodwa hayi kwi-ovary.

• Gonadoblastomas.

• I-Teratoma kunye ne-yolk sac tumors.

Umxube weGerm Cell Tumors

Imixube yeseli yentsholongwane exubileyo yenziwe ubuncinci zimbini iintlobo zesisu esibi. Banokwenza i-ovary, ityhalarha, okanye ezinye iindawo zomzimba.

Unobangela wesona sizathu sentsholongwane yamadlala eseli sintsholongwane ayaziwa.

Ukuba neengxaki ezithile ezizuze njengelifa kunokunyusa umngcipheko wokudumba kweeseli zentsholongwane engaphezulu.

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 ezinokuba semngciphekweni wokuba nezicubu zeseli zentsholongwane zangaphandle zibandakanya oku kulandelayo:

• Ukuba neempawu ezithile zemfuza:

• I-Klinefelter's syndrome inokunyusa umngcipheko we-germ cell tumors kwi-mediastinum.

• I-Swyer syndrome inokunyusa umngcipheko we-gonadoblastoma kunye ne-seminoma.

• I-Turner syndrome inokunyusa umngcipheko we-gonadoblastoma kunye ne-dysgerminoma.

• Ukuba ne-testicle engafunekiyo kunokunyusa umngcipheko womhlaza wamatyhalarha.

• Ukuba ne-gonadal dysgenesis (i-gonad-ovary okanye ityhalarha-ayenzanga ngokwesiqhelo) inokunyusa umngcipheko we-gonadoblastoma.

Iimpawu zobuntwana obungekabikho bentsholongwane kwiiseli zentsholongwane zixhomekeke apho ithumba lenzeke khona emzimbeni.

Amathumba ahlukeneyo anokubangela le miqondiso kunye neempawu zilandelayo. Ezinye iimeko zinokubangela ezi mpawu kunye neempawu ezifanayo. Jonga kugqirha ukuba umntwana wakho unazo ezi zinto zilandelayo:

• Iqhuma entanyeni, esiswini, okanye emqolo ongezantsi.

• Isigaqa esingenantlungu kumatyhalarha.

• Intlungu esiswini.

• Ifiva.

• Ukuqunjelwa.

• Kwabasetyhini, akukho xesha lokuya exesheni okanye ukopha okungaqhelekanga kwilungu lobufazi.

Izifundo zokulinganisa kunye novavanyo lwegazi zisetyenziselwa ukufumanisa (ukufumana) kunye nokufumanisa isifo samathumbu esentsholongwane.

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. Amatyhalarha anokujongwa ukuba anamaqhuma, ukudumba okanye iintlungu. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-serum tumor marker: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu, izicwili, okanye iiseli zethumba emzimbeni. Izinto ezithile zinxulunyaniswa neentlobo ezithile zomhlaza xa zifunyenwe kumanqanaba anyukayo egazini. Oku kubizwa ngokuba kukuphawula amathumba.

Ezinye iiseli zentsholongwane ezinobungozi zikhupha iziphawuli zesisu. Amanqaku alandelayo e-tumor angasetyenziselwa ukufumana i-extracranial germ cell tumors:

• I-Alpha-fetoprotein (AFP).

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

Kwiiseli zentsholongwane yamatyhalarha, amanqanaba egazi ezimakishi zethumba anceda ukubonisa ukuba ithumba siseminoma okanye i-nonseminoma.

• 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) lwento elinokuba ngumqondiso wesifo.

• I-x-ray yesifuba: IX-reyi yamalungu namathambo ngaphakathi kwesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

Ikhompyuter ye-tomography (CT) yesisu. Umntwana ulele phezu kwetafile etyibilika ngesikena se-CT, esithatha imifanekiso ye-x-ray engaphakathi esiswini.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

Imagnetic resonance imaging (MRI) yesisu. Umntwana ulele phezu kwetafile etyibilika kwisikena se-MRI, esithatha imifanekiso engaphakathi komzimba. Iphedi esiswini somntwana inceda ukwenza imifanekiso icace gca.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwizicubu zangaphakathi okanye kwizitho zokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

I-ultrasound yesisu. I-ultrasound transducer edityaniswe kwikhompyuter icinezelwe kulusu lwesisu. I-transducer igxotha amaza esandi kumalungu angaphakathi nakwizicubu ukwenza ii-echoes ezenza i-sonogram (umfanekiso wekhompyuter).

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Ngamanye amaxesha i-biopsy ye-incision okanye i-biopsy yenaliti yenziwa ngaphambi kotyando ukususa isampulu yethishu. Ngamanye amaxesha ithumba liyasuswa ngexesha lotyando kwaye isampulu yethishu iyasuswa kwi-tumor.

Olu vavanyo lulandelayo lunokwenziwa kwisampulu yethishu esusiweyo:

• Uhlalutyo lweCytogenetic: Uvavanyo lwaselebhu apho ii-chromosomes zeeseli kwisampulu yethishu zibalwa kwaye zijongwa kulo naluphi na utshintsho, njengokwaphuka, ukulahleka, ukulungiswa ngokutsha, okanye ii-chromosomes ezongezelelweyo. Utshintsho kwii-chromosomes ezithile kunokuba luphawu lomhlaza. Uhlalutyo lweCytogenetic lusetyenziselwa ukunceda ekuchongeni umhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango.

• 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.

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

• Iminyaka yesigulana kunye nempilo ngokubanzi.

• Inqanaba lomhlaza (nokuba sele usasazekile kwiindawo ezikufuphi, ii-lymph node, okanye kwezinye iindawo emzimbeni).

• Apho ithumba laqala ukukhula khona.

• Ukuphendula kakuhle kwethumba kunyango.

• Uhlobo lwentsholongwane yeseli yentsholongwane.

• Nokuba isigulana sine-gonadal dysgenesis.

• Ingaba i-tumor ingasuswa ngokupheleleyo ngophando.

• Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona (buyela).

Ukuxelwa kwangaphambili kwezidumba zeseli zentsholongwane engaphaya kobuntwana, ngakumbi izilonda zentsholongwane yesibeleko, zilungile.

Amanqanaba okuKhula koBuntwana kwi-Cell Cell Tumors

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo se-germ cell cell esivela ebuntwaneni, kwenziwa iimvavanyo zokufumanisa ukuba iiseli zomhlaza zisasazekile ukusuka apho ithumba laqala khona kwiindawo ezikufutshane okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• Amanqanaba asetyenziselwa ukuchaza iintlobo ezahlukeneyo zamathumba eeseli zentsholongwane engaphezulu.

• Iimvumba zentsholongwane yeseli kwizigulana ezingaphantsi kweminyaka eli-11

• Iimvumba zentsholongwane yeseli kwizigulana ezineminyaka eli-11 nangaphezulu

• Iimvumba zentsholongwane yesibeleko

• Izicubu zeseli zentsholongwane zangaphandle

Emva kokuba kufunyaniswe isifo se-germ cell cell esivela ebuntwaneni, kwenziwa iimvavanyo zokufumanisa ukuba iiseli zomhlaza zisasazekile ukusuka apho ithumba laqala khona kwiindawo ezikufutshane okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ukusuka apho ithumba laqala khona ukuya kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Ngamanye amaxesha, ukulandela inqanaba kunokulandela utyando ukususa ithumba.

Kungasetyenziswa ezi nkqubo zilandelayo:

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngengqondo okanye ii-lymph node. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso.

• I-CT scan (i-CAT scan): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesifuba okanye ii-lymph node, ezithathwe kwii-angles ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yi-computed tomography, ikhompyuter ye-tomography, okanye ikhompyuter ye-axial tomography.

• Ukuskena amathambo: Inkqubo yokujonga ukuba ngaba kukho iiseli ezahlula ngokukhawuleza, ezinje ngeeseli zomhlaza, emathanjeni. Inani elincinci kakhulu lezinto ezisasazeka ngemitha lifakwa emthanjeni kwaye lihamba ngokuhamba kwegazi. Izinto ezinemitha eqhumayo ziqokelela emathanjeni anomhlaza kwaye zifunyenwe siskena.

• I-Thoracentesis: Ukususwa kolwelo kwisithuba esiphakathi kwempahla yesifuba kunye nemiphunga, kusetyenziswa inaliti. Ugqirha wezifo ujonga ulwelo phantsi kwemicroscope ukukhangela iiseli zomhlaza.

• Paracentesis: Ukususwa kolwelo kwisithuba esiphakathi kwempahla yesisu kunye namalungu esiswini, kusetyenziswa inaliti. Ugqirha wezifo ujonga ulwelo phantsi kwemicroscope ukukhangela iiseli zomhlaza.

Iziphumo ezivela kuvavanyo kunye neenkqubo ezisetyenziselwa ukukhangela kunye nokufumanisa isifo samalungu esibeleko esivela ebuntwaneni sinokusetyenziselwa ukuqokelela.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

• Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

• Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba.

I-tumor ye-metastatic yinto efanayo yomhlaza njenge-tumor yokuqala. Umzekelo, ukuba ithumba elingaphaya kwesibindi lisasazeka kwisibindi, iiseli zomhlaza esibindini ziiseli zentsholongwane yomhlaza. Esi sifo sisifo se-cell metastatic extracranial cell tumor, hayi umhlaza wesibindi.

Amanqanaba asetyenziselwa ukuchaza iintlobo ezahlukeneyo zamathumba eeseli zentsholongwane engaphezulu.

Iimvumba zentsholongwane yeseli kwizigulana ezingaphantsi kweminyaka eli-11

Amanqanaba alandelayo avela kwiQela leOncology yaBantwana.

• Inqanaba I

Kwinqanaba I, umhlaza ufumaneka kuphela kumatyhalarha. Ityhalarikhi kunye nentambo yesidoda isuswe ngokupheleleyo ngotyando kwaye zonke ezi zinto ziyinyani:

• i-capsule (isigubungelo sangaphandle se-tumor) ayizange iqhekeke (ivuleke) kwaye i-biopsy ayizange yenziwe ngaphambi kokuba i-tumor isuswe; kwaye

• Zonke ii-lymph node zincinci kune-1 sentimitha kububanzi obufutshane kwi-CT scan okanye kwi-MRI.

• Inqanaba II

Kwinqanaba II, ityhalarha kunye nentambo yesidoda iyasuswa ngotyando kwaye enye yezi zinto ziyinyani:

• i-capsule (isigubungelo sangaphandle se-tumor) yaphuka (yaqhekeka evulekileyo) okanye i-biopsy yenziwa ngaphambi kotyando; okanye

• umhlaza onokuthi ubonwe kuphela ngemicroscope uhlala kwisikram okanye kwintambo yesidoda kufutshane neprototum nasemva kotyando amanqanaba okumakisha awabuyeli esiqhelo okanye awanciphisi.

Umhlaza awusasazekanga kwii-lymph node.

• Inqanaba III

Kwinqanaba le-III, enye yezi zinto zilandelayo iyinyani:

• umhlaza unwenwele kwenye okanye kwiindawo ezininzi ezisesiswini ngasemva kwesisu; okanye

• Zonke ii-lymph node zii-2cm ububanzi okanye zinkulu kune-1 sentimitha kodwa zincinci kuneesentimitha ezi-2 kububanzi obufutshane kwaye mhlawumbi azitshintshanga okanye ziyakhula xa i-CT scan okanye i-MRI iphindaphindwa kwiiveki ezi-4 ukuya kwezi-6.

• Inqanaba IV

Kwinqanaba IV, umhlaza usasazeke kwamanye amalungu omzimba, njengesibindi, imiphunga, ithambo kunye nengqondo.

Iimvumba zentsholongwane yeseli kwizigulana ezineminyaka eli-11 nangaphezulu

Jonga isishwankathelo se- kunyango lomhlaza wamatyhalarha ngolwazi oluthe kratya malunga nokubeka esetyenziselwa iimvavanyo zetyhalarha yeseli kwizigulana ezineminyaka eli-11 nangaphezulu.

Iimvumba zentsholongwane yesibeleko

Iinkqubo ezimbini zokubeka esetyenziselwa ii-ovarian germ cell tumors: Iqela le-Oncology yeQela kunye ne-International Federation ye-Gynecology kunye ne-Obstetrics (FIGO).

Amanqanaba alandelayo avela kwiQela leOncology yaBantwana.

• Inqanaba I

Kwinqanaba I, ithumba elikwi-ovary lisuswe ngokupheleleyo ngotyando kwaye zonke ezi zinto ziyinyani:

• i-capsule (isigubungelo sangaphandle se-tumor) ayizange iqhekeke (ivuleke) kwaye i-biopsy ayizange yenziwe ngaphambi kokuba i-tumor isuswe; kwaye

• akukho mqondiso wokuba umhlaza usasazeke ngephilisi; kwaye

• akukho maseli omhlaza afunyanwa kulwelo oluthathwe esiswini; kwaye

• akukho mhlaza ubonwa kwizicwili ezibeka imigca esiswini okanye zifunyenwe kwiisampulu zeethishu ezithathwe ngexesha lokuvavanywa komzimba; kwaye

• I-lymph nodes zincinci kune-1 cm kwisentimitha esifutshane kwi-CT scan okanye kwi-MRI okanye akukho mhlaza ufumaneka kwiisampuli ze-lymph node ezithathwe ngexesha le-biopsy.

• Inqanaba II

Kwinqanaba lesibini, ithumba elikwi-ovary lisuswe ngokupheleleyo ngotyando kwaye i-biopsy yenziwa ngaphambi kotyando kwaye enye yezi zinto ziyinyani:

• umhlaza usasazeke kuyo yonke okanye kwinxalenye yephilisi (isigubungelo sangaphandle sethumba); okanye

• ithumba likhulu kuneesentimitha ezili-10 kwaye lisuswe ngotyando lwe-laparoscopic; okanye

• ithumba lisuswa ngokwaphuka libe ngamaqhekeza amancinci kwaye alaziwa ukuba umhlaza usasazekile na kwisingxobo.

Iiseli zomhlaza azifumaneki kulwelo oluthathwe esiswini. Umhlaza awubonakali kwii-lymph node okanye izicwili ezibeka isisu kunye nomhlaza akufumaneki kwiisampulu zeethishu ezithathwe ngexesha le-biopsy.

• Inqanaba III

Kwinqanaba lesithathu, ithumba elikwi-ovary lisuswe ngotyando kwaye enye yezi zinto ziyinyani:

• Ii-lymph node zibubuncinane beesentimitha ezi-2 ububanzi okanye zinkulu kuneesentimitha ezi-1 kodwa zincinci kuneesentimitha ezi-2 kububanzi obufutshane kwaye mhlawumbi azitshintshanga okanye ziyakhula xa i-CT scan okanye iMRI iphindaphindwa kwiiveki ezi-4 ukuya kwezi-6 emva kotyando; okanye

• ithumba alisuswanga ngokupheleleyo ngotyando okanye kwenziwa i-biopsy ngaphambi kotyando; okanye

• iiseli zomhlaza (kubandakanya i-teratoma engekakhuli) zifumaneka kulwelo oluthathwe esiswini; okanye

• umhlaza (kubandakanya i-teratoma engekakhuli) ufumaneka kwii-lymph node; okanye

• umhlaza (kubandakanya i-teratoma engekakhuli) ifunyenwe kwizicwili ezibeka isisu.

• Inqanaba III-X

Kwinqanaba le-III-X, ithumba linokuchazwa njengesiqendu I okanye isigaba II, ngaphandle:

• iiseli ezikroba esiswini azizange ziqokelelwe; okanye

• i-biopsy ye-lymph node ezinkulu kune-1 sentimitha kububanzi bayo obufutshane azange zenziwe; okanye

• i-biopsy yeethishu ezivela kwimigca yesisu ayenzekanga; okanye

• Inqanaba aligqitywanga ngexesha lotyando kodwa liya kugqitywa ngexesha lotyando lwesibini.

• Inqanaba IV

Kwinqanaba IV, enye yezi zinto zilandelayo iyinyani:

• umhlaza usasazeke esibindini okanye ngaphandle kwesisu kwezinye iindawo zomzimba, ezinje ngethambo, imiphunga, okanye ingqondo.

• iiseli zomhlaza zifumaneka kulwelo olusemiphungeni.

Amanqanaba alandelayo avela kwi-International Federation ye-Gynecology kunye ne-Obstetrics (FIGO).

• Inqanaba I

Kwinqanaba I, umhlaza ufunyanwa kwelinye okanye kuzo zombini ii-ovari kwaye awusasazekanga. Inqanaba I lahlulwe laba ligaba IA, inqanaba IB, kunye nenqanaba IC.

• Isigaba IA: Umhlaza ufunyanwa kwi-ovary enye.

• Isigaba IB: Umhlaza ufumaneka kuwo omabini amaqanda.

• Isigaba IC: Umhlaza ufunyanwa kwenye okanye zombini ii-ovari kwaye enye yezi zinto ziyinyani:

• umhlaza ufumaneka nakumphezulu ongaphandle wenye okanye zombini ii-ovari; okanye

• i-capsule (isigubungelo sangaphandle) sethumba esigqabhukileyo (savuleka) ngaphambi okanye ngexesha lotyando; okanye

• iiseli zomhlaza zifunyanwa kulwelo oluthathwe esiswini okanye ekuhlanjweni komngxunya we-peritoneal (indawo yomzimba enamalungu amaninzi esiswini).

• Inqanaba II

Kwinqanaba lesi-II, umhlaza ufunyanwa kwenye okanye kuzo zombini ii-ovari kwaye uye wasasazeka kwezinye iindawo zesisu, okanye umhlaza wokuqala we-peritoneal ufunyanwa. Inqanaba II lahlulwe laba linqanaba IIA kunye nenqanaba IIB.

• Isigaba IIA: Umhlaza usasazekile waya esibelekweni kunye / okanye kwimibhobho yesibeleko (imibhobho emide emide edlula kuwo amaqanda ukusuka kumaqanda kuye esibelekweni).

• Isigaba IIB: I-Cancer isasazeke kwezinye izicubu ngaphakathi kwe-pelvis ezifana ne-bladder, rectum, okanye i-vagina.

• Inqanaba III

Kwinqanaba lesithathu, umhlaza ufumaneka kwelinye okanye zombini amaqanda okanye umhlaza wokuqala we-peritoneal. Umhlaza usasazeke ngaphandle kwesinqe kwezinye iindawo zesisu kunye / okanye kwii-lymph node ngasemva kwesisu. Inqanaba III lahlulwe laba linqanaba IIIA, inqanaba IIIB, kunye nenqanaba IIIC.

Ubungakanani beethumba zihlala zilinganiswa ngeesentimitha (cm) okanye ii-intshi. Ukutya okuqhelekileyo okunokusetyenziselwa ukubonisa ubungakanani bethumba nge-cm kubandakanya: ipea (1 cm), ipeanut (2 cm), umdiliya (3 cm), i-walnut (4 cm), ikalika (5 cm okanye 2) I-intshi), iqanda (i-6 cm), ipesika (i-7 cm), kunye ne-grapefruit (i-10 cm okanye ii-intshi ezine).

• Kwinqanaba IIIA, enye yezi zinto ziyinyani:

• umhlaza usasazeke kwii-lymph node ngasemva kwesisu kuphela; okanye

• iiseli zomhlaza ezinokubonakala kuphela ngemicroscope zisasazekile kumphezulu we-peritoneum ngaphandle kwesinqe. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane ngasemva kwesisu.

• Isigaba IIIB: Umhlaza usasazeke kwi-peritoneum ngaphandle kwepelvis kwaye umhlaza kwi-peritoneum ziisentimitha ezi-2 okanye zincinci. Umhlaza unokuthi usasazeke kwii-lymph node ngasemva kwesisu.

• Isigaba IIIC: Umhlaza usasazekile waya kwi-peritoneum ngaphandle kwesinqe kwaye umhlaza kwi-peritoneum mkhulu kune-2 cm. Umhlaza unokuthi usasazeke kwii-lymph node ngasemva kwesisu okanye kumphezulu wesibindi okanye udakada.

• Inqanaba IV

Inqanaba IV lahlulwe laba yinqanaba le-IVA kunye ne-IVB.

• Isigaba se-IVA: Iiseli zomhlaza zifumaneka kulwelo olongezelelekileyo olwakha malunga nemiphunga.

• Isigaba IVB: I-Cancer isasazeke kwizitho kunye nezicubu ngaphandle kwesisu, kubandakanywa i-lymph nodes kwi-groin.

Izicubu zeseli zentsholongwane zangaphandle

Amanqanaba alandelayo avela kwiQela leOncology yaBantwana.

• Inqanaba I

Kwinqanaba I, ithumba lisuswe ngokupheleleyo ngotyando kwaye zonke ezi zinto ziyinyani:

• akukho maseli omhlaza afunyanwa kwindawo apho ithumba lisuswe khona; kwaye

• i-capsule (isigubungelo sangaphandle se-tumor) ayizange iqhekeke (ivuleke) kwaye i-biopsy ayizange yenziwe ngaphambi kokuba i-tumor isuswe; kwaye

• iiseli zomhlaza azifumaneki kulwelo oluthathwe kwisisu, ukuba ithumba lisesiswini; kwaye

• I-lymph nodes zincinci kune-1 centimeter kwi-CT scan okanye kwi-MRI yesisu, i-pelvis kunye nesifuba.

• Inqanaba II

Kwinqanaba II, umhlaza awususwanga ngokupheleleyo ngotyando kwaye enye yezi zinto ziyinyani:

• umhlaza onokubonwa kuphela ngemicroscope uhlala emva kotyando; okanye

• umhlaza onokubonwa ngamehlo ahlala emva kotyando kunye necapsule (isimbozo sangaphandle sethumba) saqhekeka (savuleka) okanye kwenziwa i-biopsy.

Iiseli zomhlaza azifumaneki kulwelo oluthathwe esiswini. Akukho mqondiso womhlaza kwii-lymph nodes esiswini, kwi-pelvis, okanye esifubeni kwi-CT scan okanye kwi-MRI.

• Inqanaba III

Kwinqanaba le-III, enye yezi zinto zilandelayo iyinyani:

• umhlaza awususwanga ngokupheleleyo ngotyando kunye nomhlaza onokubonwa ngamehlo ahlala emva kotyando okanye kwenziwa kuphela i-biopsy; okanye

• Izakhi zofuzo zinee-2cm ububanzi okanye zinkulu kuneesentimitha ezi-1 kodwa zincinci kuneesentimitha ezi-2 kububanzi obufutshane kwaye mhlawumbi azitshintshanga okanye ziyakhula xa i-CT scan okanye iMRI iphindaphindwa kwiiveki ezi-4 ukuya kwezi-6.

• Inqanaba IV

Kwinqanaba IV, umhlaza usasazeke kwamanye amalungu omzimba, anjengesibindi, imiphunga, ithambo, okanye ingqondo.

Ukuphinda-phinda ukuKhula koBuntwana kwi-Cell Cell Tumors

Ukuphinda-phinda ukukhula kobuntwana kwintsholongwane yesifo somhlaza ngumhlaza ophindaphindiweyo (ubuyile) emva kokuba unyangiwe. Umhlaza ungabuya ubuye endaweni enye okanye kwamanye amalungu omzimba.

Inani lezigulana ezinamathumba abuyayo lincinci. Uninzi lwezihlunu zentsholongwane eziphindaphindayo zibuya kwisithuba seminyaka emithathu yoqhaqho. Phantse isiqingatha seetatomas eziphinda zibuyele kwi-sacrum okanye i-coccyx ziyingozi, ke kulandelwa kubalulekile.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango lwabantwana abanezicubu zeseli zentsholongwane ezingaphezulu.

• Abantwana abanezicubu zeseli zentsholongwane ezingaphaya kwemfuneko kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

• Unyango lwezihlunu zentsholongwane engaphezulu kobuntwana ezinokubangela iziphumo ebezingalindelekanga.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Ugqirha

• Ukujonga

• Unyango ngamayeza

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• I-dose ephezulu ye-chemotherapy kunye nokufakelwa kweseli

• Unyango ngemitha

• 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 lwabantwana abanezicubu zeseli zentsholongwane ezingaphezulu.

Iindidi ezahlukeneyo zonyango ziyafumaneka kubantwana abanezicubu zeseli zentsholongwane ezingaphezulu. 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 abanezicubu zeseli zentsholongwane ezingaphaya kwemfuneko kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngezempilo abaziingcali ekunyangeni abantwana abane-extracranial germ cell cell tumors kwaye abagxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wabantwana.

• Ugqirha wabantwana.

• I-hematologist yezilwanyana.

• Imitha ye-oncologist.

• Ingcali yezigulana.

• Ingcali yomongikazi wabantwana.

• Ingcali yokuvuselela.

• Umsebenzi wobomi bomntwana.

• Ingcali yeengqondo.

• Unontlalontle.

• Umfuziselo.

Unyango lwezihlunu zentsholongwane engaphezulu kobuntwana ezinokubangela 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, ezinjengokungachumi, iingxaki zokuva kunye neengxaki zezintso.

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

• Umhlaza wesibini (iintlobo ezintsha zomhlaza), njengeleukemia.

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).

Zintathu iintlobo zonyango olusetyenziswayo:

Ugqirha

Ugqirha lokususa ngokupheleleyo ithumba lwenziwa xa kunokwenzeka. Ukuba ithumba likhulu kakhulu, kunokunikwa ichemotherapy kuqala, ukwenza ithumba libe lincinci kunye nokunciphisa inani lezihlunu ekufuneka zisuswe ngexesha lotyando. Injongo yotyando kukugcina umsebenzi wokuzala. Ezi ndidi zilandelayo zotyando zinokusetyenziswa:

• Ukubuyisela kwakhona: Utyando lokususa izicwili okanye inxenye okanye lonke ilungu.

• I-orchiectomy ye-Radical inguinal: Utyando lokususa elinye okanye omabini amasende ngokuqhekezwa (ukusikwa) kwindawo yokugcuma.

• Unilateral salpingo-oophorectomy: Utyando lokususa i-ovary enye kunye nebhubhu enye ye-fallopian kwicala elinye.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, ezinye izigulana zinokunikwa ichemotherapy emva kotyando ukubulala 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. Kwimeko yamathumba eseli ekhula ebuchotsheni yobuntwana, oku kubandakanya iimviwo zomzimba, iimvavanyo zokucinga, kunye neemvavanyo zokumakisha ithumba.

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 kunye nenqanaba lomhlaza ophathwayo. Inkqubo ye-chemotherapy isetyenziselwa ukunyanga i-extracranial germ cell tumors.

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.

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.

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 kunye nokuba ubuyile na. Unyango lwangaphandle lwemitha lufundelwa unyango kunyango lwesifo samathumba esibelekweni sabantwana esiye sabuya.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuhlasela iiseli ezithile zomhlaza. Unyango ekujoliswe kulo lisafundelwa unyango lwe-extracranial germ cell tumors ezibuyileyo.

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.

Ukufumana amathumba eseli yentsholongwane engaphezulu kobuntwana, ukulandelelwa kunokubandakanya iimviwo zomzimba eziqhelekileyo, iimvavanyo zokumakisha ithumba, kunye neemvavanyo zokucinga njenge-CT scan, iMRI okanye isifuba x-ray.

Ukhetho kunyango lokuKhula koBuntwana kwi-Cell Cell Tumors

Kweli Candelo

• AmaTeratomas aqolileyo kunye namaxesha amancinci

• Iimpawu eziMbi zeGonadal Germ Cell Tumors

• Amatyhalarha amabi amaGerm Cell Tumors

• Izibilini ze-Ovarian Germ Cell Tumors

• Iimpawu eziMbi ze-Extragonadal Extracranial Germ Cell Tumors

• Ukuphinda-phinda ukuKhula koBuntwana okuMbi ngokuDlakadlisayo kweGerm Cell Tumors

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

AmaTeratomas aqolileyo kunye namaxesha amancinci

Unyango lweetatoma ezivuthiweyo lubandakanya oku kulandelayo:

• Utyando lokususa ithumba elandelwa kukuqwalaselwa.

Unyango lweetatomas ezingakhuli kubandakanya oku kulandelayo:

• Utyando lokususa ithumba elandelwa kukuqwalaselwa kwenqanaba lam tumors.

• Ugqirha lokususa ithumba kwinqanaba le-II-IV. Kubantwana abancinci, utyando lulandelwa kukubona; ukusetyenziswa kwechemotherapy emva kotyando kuyimpikiswano. Kubantu abakwishumi elivisayo nakubantu abadala abancinci, ichemotherapy inikwa emva kotyando.

Ngamanye amaxesha i-teratoma ekhulileyo okanye engakhulanga nayo ineeseli ezimbi. I-teratoma eneeseli ezinobungozi inokufuna ukuphathwa ngokwahlukileyo.

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.

Iimpawu eziMbi zeGonadal Germ Cell Tumors

Amatyhalarha amabi amaGerm Cell Tumors

Unyango lwe-testicular malignant germ cell tumors lunokubandakanya oku kulandelayo:

Kumakhwenkwe angaphantsi kweminyaka eli-11:

• Utyando (i-orchiectomy eguqukayo ye-inguinal) elandelwa kukujongwa kwinqanaba le-I tumors.

• Utyando (i-orchiectomy eguqukayo ye-inguinal) elandelwa yichemotherapy yenqanaba II-IV tumors.

• Uvavanyo lweklinikhi yerejimeni entsha yoqhaqho elandelwa kukuqwalaselwa kwenqanaba lam tumors okanye ichemotherapy yenqanaba II-IV tumors.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango ngamayeza enqanaba lesibini le-IV.

Kumakhwenkwe aneminyaka eli-11 nangaphezulu:

Izilonda ezonakalisayo zesisu seentsholongwane zamakhwenkwe aneminyaka eli-11 nangaphezulu ziphathwa ngendlela eyahlukileyo kunaleyo yamakhwenkwe amancinci. (Jonga isishwankathelo se kunyango lomhlaza wamatyhalarha ngolwazi oluthe kratya.)

• Utyando lokususa ithumba. Ngamanye amaxesha i-lymph nodes esiswini nazo ziyasuswa.

• Uvavanyo lweklinikhi yerejimeni entsha yoqhaqho elandelwa kukuqwalaselwa kwenqanaba lam tumors okanye ichemotherapy yenqanaba II-IV tumors.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango ngamayeza.

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.

Izibilini ze-Ovarian Germ Cell Tumors

Dysgerminomas

Unyango lwenqanaba I-dysgerminomas ye-ovary inokubandakanya oku kulandelayo:

• Utyando (unilateral salpingo-oophorectomy) elandelwa kukujonga. I-Chemotherapy inokunikwa ukuba amanqanaba okuphawula amathumba awanciphi emva kotyando okanye ithumba libuye.

• Uvavanyo lweklinikhi yerejimeni entsha yoqhaqho elandelwa kukuqwalaselwa.

Unyango lwamanqanaba e-II-IV dysgerminomas e-ovary anokubandakanya oku kulandelayo:

• Utyando (unilateral salpingo-oophorectomy) elandelwa yichemotherapy.

• I-Chemotherapy ukunciphisa ithumba, kulandele utyando (unilateral salpingo-oophorectomy).

• Uvavanyo lweklinikhi yerejimeni entsha yotyando elandelwa yichemotherapy.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango ngamayeza.

AmaNongerminomas

Unyango lwe-nongerminomas ye-ovary, enjenge-yolk sac tumors, i-germ cell tumors, i-choriocarcinoma, kunye ne-embryonal carcinomas, kumantombazana amancinci anokubandakanya oku kulandelayo:

• Utyando olulandelwa kukuqwalaselwa kwenqanaba lam tumors.

• Utyando olulandelwa yichemotherapy kwinqanaba le-IV-tumors.

• Uvavanyo lweklinikhi yerejimeni entsha yoqhaqho elandelwa kukuqwalaselwa kwenqanaba lam tumors.

• Uvavanyo lweklinikhi yerejimeni entsha yotyando elandelwa yichemotherapy yenqanaba II-IV tumors.

Unyango lwe-nongerminomas ye-ovary kulutsha nakwabasetyhini abancinci banokubandakanya oku kulandelayo:

• Ugqirha kunye nonyango lwechemotherapy kwinqanaba le-IV-tumors.

• Uvavanyo lweklinikhi yerejimeni entsha yoqhaqho elandelwa kukuqwalaselwa okanye unyango lwechemotherapy.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango ngamayeza.

Unyango lwe-nongerminomas ye-ovary engenakususwa ngotyando lokuqala ngaphandle komngcipheko kwizihlunu ezikufuphi kunokubandakanya oku kulandelayo:

• I-Biopsy ilandelwa yi-chemotherapy kunye nokuhlinzwa.

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.

Unyango lwe-Extracranial Germ Cell Tumors ye-Extracranial Unyango lobunzima babantwana abancinci be-extragonadal extracranial germ cell cell tumors kubantwana abancinci banokubandakanya oku kulandelayo:

• Ugqirha kunye nonyango lwechemotherapy kwinqanaba le-IV-tumors.

• I-Biopsy ilandelwa yi-chemotherapy kwaye mhlawumbi nokuhlinzwa kwi-III kunye ne-IV tumors.

Ukongeza kwinqanaba lesi sifo, unyango lwezihlunu ezinobungozi ezingaphezulu kwe-extragonadal extracranial cell zixhomekeka nakwindawo apho ithumba lenzeke emzimbeni:

• Kwiithumba kwi-sacrum okanye kwi-coccyx, i-chemotherapy yokunciphisa i-tumor elandelwa ngophando lokususa i-sacrum kunye / okanye i-coccyx.

• Kwiithumba kwi-mediastinum, chemotherapy ngaphambi okanye emva kotyando ukususa ithumba kwi-mediastinum.

• Kwizilonda esiswini, i-biopsy elandelwa yi-chemotherapy ukunciphisa i-tumor kunye nokuhlinzwa ukususa isisu esiswini.

• Kwiithumba entloko nasentanyeni, utyando lokususa ithumba entloko okanye entanyeni elandelwa yichemotherapy.

Unyango lwezihlunu zentsholongwane engalunganga yobuntwana kwi-extrasadal extracranial cell tumors kulutsha nakubantu abadala abancinci banokubandakanya oku kulandelayo:

• Ugqirha.

• Unyango ngamayeza.

• I-Chemotherapy elandelwa lutyando lokususa ithumba.

• Uvavanyo lweklinikhi yerejimeni entsha yoqhaqho elandelwa kukuqwalaselwa okanye unyango lwechemotherapy.

• Uvavanyo lweklinikhi yerejimeni entsha yonyango ngamayeza.

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 ukuKhula koBuntwana okuMbi ngokuDlakadlisayo kweGerm Cell Tumors

Unyango lwezihlunu zentsholongwane engaphezulu kobuntwana ezinokubandakanya ezi zinto zinokubandakanya oku kulandelayo:

• Ugqirha.

• I-Chemotherapy inikwe ngaphambi okanye emva kotyando, kwizifo ezinobungozi ezingaphezulu kwe-germ cell cell kubandakanya i-teratomas ezingafakwanga, izilonda ezinobungozi zeseli kunye ne-ovarian germ cell tumors.

• I-Chemotherapy yokuphindaphindeka kwamathumba amancinci esibeleko kunye ne-nongerminomas ephindaphindayo ye-ovary eyayikwinqanaba I ekuchongeni.

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

• Unyango ngemitha lulandelwa lutyando lokususa umhlaza osele udlulele kwingqondo.

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

• Uvavanyo lwezonyango lwe-chemotherapy kuphela xa kuthelekiswa nonyango lweedosi ephezulu elandelwa kukufakwa kweseli.

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.

Ukufunda ngakumbi malunga noMhlaza woMntwana

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nezihlunu zentsholongwane engaphaya kobuntwana, jonga oku kulandelayo.

• I-Extracranial Germ Cell Tumor (yoBuntwana) Ikhasi lasekhaya

• Ikhompyuter yeTomography (CT) kunye noMhlaza

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