Iindidi / intloko-nentamo / isigulana / umntu omdala / unyango laryngeal-pdq

Unyango lweLaryngeal Cancer (yabantu abadala)

Ulwazi ngokubanzi malunga noMhlaza weLaryngeal

IINGONGOMA EZIPHAMBILI

• Umhlaza welaryngeal sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu zelarynx.

• Ukusetyenziswa kweemveliso zecuba kunye nokusela kakhulu utywala kunokuchaphazela umngcipheko wokuhlaselwa ngumhlaza kwilaryngeal.

• Iimpawu kunye neempawu zomhlaza welaryngeal zibandakanya umqala obuhlungu kunye nentlungu yendlebe.

• Uvavanyo oluvavanya umqala nentamo lusetyenziselwa ukunceda ekufumaneni kunye nasezingeni lomhlaza welaryngeal.

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

Umhlaza welaryngeal sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu zelarynx.

Ingqula yinxalenye yomqala, phakathi kwesiseko solwimi nakwitrachea. Ingqula inemiphimbo, engcangcazelayo nokwenza isandi xa umoya ujonge ngakubo. Isandi siyangqinelana ngomqala, umlomo kunye nempumlo ukwenza ilizwi lomntu.

Zintathu iinxalenye eziphambili zelarynx:

• I-Supraglottis: Inxalenye ephezulu ye-larynx ngaphezulu kweentambo zezwi, kubandakanya i-epiglottis.

• IGlottis: Icandelo eliphakathi lengqula apho kukho imicu yezwi.

• I-Subglottis: Inxalenye esezantsi yomqala phakathi kweentambo zamagama kunye netreyi (umbhobho womoya).

Iifom zomhlaza weLaryngeal kwizicubu zomqala (indawo yomqala equlethe iintambo zezwi). Ingqula ibandakanya i-supraglottis, iglottis (iintambo zamagama), kunye ne-subglottis. Umhlaza unokusasazeka kwizicwili ezikufutshane okanye kwi-thyroid, kwi-trachea, okanye kwi-esophagus. Ingasasazeka kwii-lymph nodes entanyeni, i-carotid artery, inxalenye ephezulu yomqolo wesifuba, isifuba, nakwezinye iindawo zomzimba (ezingaboniswanga).

Uninzi lwee-cancary laryngeal form kwiiseli ezi-squamous, iiseli ezinqabileyo, ezisicaba ngaphakathi ngaphakathi kwengqula.

Umhlaza welaryngeal luhlobo lomhlaza wentloko nentamo.

Ukusetyenziswa kweemveliso zecuba kunye nokusela kakhulu utywala kunokuchaphazela umngcipheko wokuhlaselwa ngumhlaza kwilaryngeal.

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 usengozini.

Iimpawu kunye neempawu zomhlaza welaryngeal zibandakanya umqala obuhlungu kunye nentlungu yendlebe.

Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ngumhlaza womhlaza okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• Umqala obuhlungu okanye ukukhwehlela okungapheliyo.

• Ingxaki okanye iintlungu xa uginya.

• Intlungu yendlebe.

• Isigaqa entanyeni okanye emqaleni.

• Utshintsho okanye ukungxola kwilizwi.

Uvavanyo oluvavanya umqala nentamo lusetyenziselwa ukunceda ekufumaneni kunye nasezingeni lomhlaza welaryngeal.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba womqala nentamo: Uvavanyo lokujonga umqala kunye nentamo kwiindawo ezingaqhelekanga. Ugqirha uzakuva umphakathi womlomo ngomnwe osigilavu ​​kwaye ujonge umlomo nomqala ngesipili esincinci esiphatha ixesha elide kunye nokukhanya. Oku kuya kubandakanya ukukhangela ingaphakathi lezidlele nemilebe; iintsini; umva, uphahla, kunye nomgangatho womlomo; umphezulu, ezantsi kunye namacala olwimi; kunye nomqala. Intamo iya kuziva ngokuvuvukala kwee-lymph node. Imbali yemikhwa yempilo yesigulana kunye nezigulo zangaphambili kunye nonyango ziya kuthathwa.

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Isampulu yethishu ingasuswa ngexesha lenkqubo ilandelayo:

• I-Laryngoscopy: Inkqubo apho ugqirha akhangela khona ilarynx (ibhokisi yelizwi) ngesipili okanye i-laryngoscope ukukhangela iindawo ezingaqhelekanga. I-laryngoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga ngaphakathi komqala kunye nebhokisi yelizwi. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

• I-Endoscopy: Inkqubo yokujonga amalungu kunye nezicubu ngaphakathi emzimbeni, ezinje ngomqala, umqala kunye netrachea ukujonga iindawo ezingaqhelekanga. I-endoscope (ityhubhu ebhityileyo, ekhanyisiweyo enokukhanya kunye nelensi yokujonga) ifakwa ngokuvula emzimbeni, njengomlomo. Isixhobo esikhethekileyo kwi-endoscope sinokusetyenziselwa ukususa iisampulu zethishu.

• 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) yentloko nentamo. Isigulana silele kwitafile etyibilika kwiskena se-CT, esithatha imifanekiso ye-x-ray ngaphakathi kwentloko nentamo.

• 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).

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

• Iskena se-PET-CT: Inkqubo edibanisa imifanekiso evela kwiskena se-positron emission tomography (PET) kunye nekhompyuter ye-tomography (CT). Ukuskena i-PET kunye ne-CT kwenziwa ngaxeshanye kumatshini omnye. Izikena ezidityanisiweyo zinika imifanekiso eneenkcukacha ngakumbi yeendawo ezingaphakathi komzimba kunokuba iskena sinikwe sisodwa. Ukuskena i-PET-CT kunokusetyenziselwa ukufumanisa isifo, njengomhlaza, ukucwangcisa unyango, okanye ukufumanisa ukuba lusebenza njani unyango.

• 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.

• Ukuginya kweBarium: Uthotho lwee-x-reyi zomqala nesisu. Isigulana sisela ulwelo oluqukethe i-barium (ikhompawundi yesilivere emhlophe). Ulwelo ludibanisa umqala kunye nesisu, kwaye ii-x-reyi zithathiwe. Le nkqubo ikwabizwa ngokuba luchungechunge oluphezulu lwe-GI.

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

Ukuxela kwangaphambili kuxhomekeke koku kulandelayo:

• Inqanaba lesi sifo.

• Indawo kunye nobungakanani bethumba.

• Inqanaba lethumba.

• Iminyaka yesigulana, isini, kunye nempilo ngokubanzi, kubandakanya ukuba ngaba isigulana sinesifo segazi.

Ukhetho lonyango luxhomekeke koku kulandelayo:

• Inqanaba lesi sifo.

• Indawo kunye nobungakanani bethumba.

• Ukugcina amandla esigulana okuthetha, ukutya kunye nokuphefumla njengesiqhelo ngangokunokwenzeka.

• Nokuba umhlaza ubuyile (uphindile).

Ukutshaya icuba kunye nokusela utywala kunciphisa ukusebenza konyango lomhlaza welaryngeal. Izigulana ezinomhlaza welungu lokuqhubeka nokutshaya nokusela akunakufane kunyangeke kwaye kunokwenzeka ngakumbi ukuba zenze ithumba lesibini. Emva konyango lomhlaza welaryngeal, ukulandelwa rhoqo kunye ngononophelo kubalulekile.

Amanqanaba oMhlaza waseLaryngeal

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyaniswe isifo somhlaza wamazinyo, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zinwenwele ngaphakathi kwingqula okanye kwamanye amalungu omzimba.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa umhlaza welaryngeal:

• Inqanaba 0 (iCarcinoma kwiSitu)

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• Emva kotyando, inqanaba lomhlaza linokutshintsha kwaye unyango oluninzi luyafuneka.

• Umhlaza ophindaphindeneyo womhlaza ngumhlaza obuyileyo emva konyango.

Emva kokuba kufunyaniswe isifo somhlaza wamazinyo, kwenziwa iimvavanyo zokufumanisa ukuba ingaba iiseli zomhlaza zinwenwele ngaphakathi kwingqula okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphakathi kwingqula okanye kwamanye amalungu omzimba ubizwa ngokuba yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba lesi sifo ukuze ucwangcise unyango. Iziphumo zezinye zeemvavanyo ezisetyenziselwa ukuxilonga umhlaza we-laryngeal zihlala zisetyenziselwa ukubeka isifo.

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 umhlaza welaryngeal usasazeka ukuya emiphungeni, iiseli zomhlaza emiphungeni ziiseli zomhlaza womqala. Esi sifo ngumhlaza we-lastngeal somhlaza, hayi umhlaza wemiphunga.

La manqanaba alandelayo asetyenziselwa umhlaza welaryngeal:

Inqanaba 0 (iCarcinoma kwiSitu)

Kwinqanaba le-0, iiseli ezingaqhelekanga zifumaneka kuludwe lweengqula. Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane. Inqanaba 0 likwabizwa ngokuba yi-carcinoma in situ.

Inqanaba I

Kwinqanaba I, umhlaza wenziwe kwindawo ephezulu kakhulu, iglottis, okanye indawo engaphantsi kwengqula:

• I-Supraglottis: Umhlaza ukwindawo enye ye-supraglottis kunye neentambo zezwi zisebenza ngesiqhelo.

• IGlottis: Umhlaza ukwenye okanye zombini iintambo zamagama kunye neentambo zezwi zisebenza ngesiqhelo.

• I-Subglottis: Umhlaza uku-subglottis kuphela.

Inqanaba II

Kwinqanaba lesibini, umhlaza wenziwe kwindawo ephezulu kakhulu, iglottis, okanye indawo engaphantsi kwengqula:

• I-Supraglottis: I-Cancer ingaphezulu kweyodwa kwindawo ye-supraglottis okanye isasazeke kwindawo esezantsi kolwimi okanye kwiimfucu ezikufutshane neentambo zezwi. Iintambo zezwi zisebenza ngesiqhelo.

• IGlottis: Umhlaza usasazeke kwi-supraglottis, subglottis, okanye zombini, kunye / okanye iintambo zezwi azisebenzi ngesiqhelo.

• I-Subglottis: I-Cancer isasazeke kwelinye okanye zombini imicu yezwi kunye neentambo zezwi azinakusebenza ngesiqhelo.

Inqanaba III

Kwinqanaba le-III, umhlaza wenziwe kwindawo ephezulu kakhulu, iglottis, okanye indawo engaphantsi kwengqula:

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 lesithathu lomhlaza we-supraglottis:

• umhlaza ukwingqula kuphela kwaye iintambo zamagama azisebenzi, kwaye / okanye umhlaza usasazeke kufutshane okanye ngaphakathi kwinxalenye ye-thyroid cartilage. Umhlaza usenokusasazeka kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye ezincinci; okanye

• Umhlaza ukwindawo enye ye-supraglottis kwaye iintambo zezwi zisebenza ngesiqhelo. Umhlaza usasazeke kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye zincinci; okanye

• Umhlaza ukwindawo engaphezulu kwenye ye-supraglottis okanye usasazeke kwindawo esezantsi kolwimi okanye kwizihlunu ezikufutshane neentambo zezwi. Iintambo zezwi zisebenza ngesiqhelo. Umhlaza ukwasasazekile kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye zincinci.

Kwinqanaba lesithathu lomhlaza weglottis:

• umhlaza ukwingqula kuphela kwaye iintambo zamagama azisebenzi, kwaye / okanye umhlaza usasazeke kufutshane okanye ngaphakathi kwinxalenye ye-thyroid cartilage. Umhlaza usenokusasazeka kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye ezincinci; okanye

• Umhlaza ukwenye okanye zombini iintambo zamagama kunye neentambo zezwi zisebenza ngesiqhelo. Umhlaza usasazeke kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye zincinci; okanye

• Umhlaza usasazekile kwi-supraglottis, subglottis, okanye zombini, kunye / okanye iintambo zezwi azisebenzi ngesiqhelo. Umhlaza ukwasasazekile kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye zincinci.

Kwinqanaba lesithathu lomhlaza we-subglottis:

• umhlaza ukwingqula kuphela kwaye iintambo zamagama azisebenzi, kwaye / okanye umhlaza usasazeke kufutshane okanye ngaphakathi kwinxalenye ye-thyroid cartilage. Umhlaza usenokusasazeka kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye ezincinci; okanye

• Umhlaza ukwindawo engaphantsi kuphela. Umhlaza usasazeke kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye zincinci; okanye

• umhlaza usasazeke waya komnye okanye kuzo zombini iintambo zamagama kwaye imithambo yezwi ayinakusebenza ngesiqhelo. Umhlaza ukwasasazekile kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye zincinci.

Inqanaba IV

Inqanaba IV lahlulwe laba yinqanaba le-IVA, lesigaba se-IVB, kunye nele-IVC. Indawo nganye efanayo iyafana nomhlaza kwi-supraglottis, glottis, okanye subglottis.

• Kwinqanaba le-IVA:

• I-Cancer isasazeke nge-cartilage ye-thyroid kunye / okanye isasazeka kwizicubu ngaphaya kwe-larynx, njengentamo, i-trachea, i-thyroid, okanye i-esophagus. Umhlaza usenokusasazeka kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node ziisentimitha ezi-3 okanye ezincinci; okanye

• Umhlaza usenokusasazeka ukusuka kwi-supraglottis, i-glottis, okanye i-subglottis ukuya kwizicubu ezingaphaya kwengqula, njengentamo, itrachea, idlala lengqula, okanye isopha. Iintambo zezwi zisenokungasebenzi ngokwesiqhelo. Umhlaza usasazekile:

• kwi-lymph node enye kwicala elifanayo lentamo njenge-tumor yokuqala kunye ne-lymph node yi-3 centimeters okanye encinci. Umhlaza usasazekile ngesigqumathelo sangaphandle se-lymph node; okanye

• kwi-lymph node enye kwicala elifanayo lentamo njengoko ithumba lokuqala kunye ne-lymph node likhulu kuneesentimitha ezi-3 kodwa alikho likhulu kuneesentimitha ezi-6. Umhlaza awusasazekanga ngesigqubuthelo sangaphandle se-lymph node; okanye

• ukuya kwi-lymph node engaphezu kweyodwa kwicala elifanayo lentamo njengoko i-tumor yokuqala kunye ne-lymph nodes ayinkulu kune-6 cm. Umhlaza awusasazekanga ngesigqubuthelo sangaphandle se-lymph node; okanye

• kwii-lymph node kumacala omabini entamo okanye kwicala lentamo ejongene nethumba lokuqala kunye ne-lymph node azikho mkhulu kuneesentimitha ezi-6. Umhlaza awusasazekanga ngogqume lwangaphandle lwee-lymph node.

• Kwinqanaba le-IVB:

• Umhlaza usenokusasazeka ukusuka kwi-supraglottis, i-glottis, okanye i-subglottis ukuya kwindawo ephambi komqolo, indawo ejikeleze umthambo we-carotid, okanye indawo phakathi kwemiphunga. Iintambo zezwi zisenokungasebenzi ngokwesiqhelo. Umhlaza usasazekile:

• kwi-lymph node enye enkulu kuneesentimitha ezi-6. Umhlaza awusasazekanga ngesigqubuthelo sangaphandle se-lymph node; okanye

• kwi-lymph node enye kwicala elifanayo lentamo njenge-tumor yokuqala kunye ne-lymph node inkulu kune-3 centimeters. Umhlaza usasazekile ngesigqumathelo sangaphandle se-lymph node; okanye

• ukuya kwi-lymph node ngaphezu kweyiphi na entanyeni. Umhlaza usasazekile ngesigqumathelo sangaphandle se-lymph node; okanye

• kwi-lymph node enye yobuphi na ubungakanani kwicala lentamo ejongene nethumba lokuqala. Umhlaza usasazekile ngesigqumathelo sangaphandle se-lymph node;

okanye

• Umhlaza usasazekile ukusuka kwi-supraglottis, glottis, okanye subglottis ukuya kwindawo ephambi komqolo, indawo ejikeleze umthambo we-carotid, okanye indawo phakathi kwemiphunga. Umhlaza usenokwasasazeka kwenye okanye kwiindawo ezininzi ezikwindawo apho entanyeni kwaye ii-lymph node zinokuba nabuphi na ubungakanani.

• Kwinqanaba le-IVC, umhlaza usasazeke kwamanye amalungu omzimba, njengemiphunga, isibindi, okanye ithambo.

Emva kotyando, inqanaba lomhlaza linokutshintsha kwaye unyango oluninzi luyafuneka.

Ukuba umhlaza ususwe ngotyando, ugqirha wezonyango uya kuvavanya isampulu yethishu yomhlaza phantsi kwemicroscope. Ngamanye amaxesha, ukuphononongwa kwezifo kuya kukhokelela kutshintsho kwinqanaba lomhlaza kunye nonyango olungaphezulu emva kotyando.

Umhlaza ophindaphindeneyo womhlaza ngumhlaza obuyileyo emva konyango.

Xa umhlaza welaryngeal ubuya emva konyango, ubizwa ngokuba ngumhlaza welaryngeal. Umhlaza kunokwenzeka ukuba ubuye kwiminyaka emi-2 ukuya kwemi-3 yokuqala. Inokubuyela kwingqula okanye kwamanye amalungu omzimba, njengemiphunga, isibindi, okanye ithambo.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza womqala.

• Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

• Unyango ngemitha

• Ugqirha

• Unyango ngamayeza

• Unyango lwe-Immunotherapy

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango ekujoliswe kulo

• Radiosensitizers

• Unyango lomhlaza welaryngeal 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 kwizigulana ezinomhlaza womqala.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza welaryngeal. 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. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Iindidi ezine zonyango olusetyenziswayo zisetyenziswa:

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.

Unyango lwe-radiation lwangaphandle lwentloko nentamo. Umatshini usetyenziselwa ukujolisa kwimitha ephezulu yamandla kumhlaza. Umatshini unokujikeleza ujikeleze isigulana, ahambise imitha evela kwii-engile ezahlukeneyo ukubonelela ngonyango oluhambisanayo. Imaski yemaski inceda ukugcina intloko nentamo yesigulana ekuhambeni kwonyango. Iimpawu ezincinci ze-inki zibekwa kwimaski. Amanqaku e-inki asetyenziselwa ukulinganisa umatshini we-radiation kwindawo efanayo phambi konyango ngalunye.

Unyango ngemitha lungasebenza ngcono kwizigulana eziyekile ukutshaya ngaphambi kokuqala unyango. Unyango lwangaphandle lwemitha kwi-thyroid okanye i-pituitary gland inokutshintsha indlela esebenza ngayo i-thyroid gland. Uvavanyo lwegazi lokujonga inqanaba lehomoni yegazi emzimbeni lunokwenziwa ngaphambi nasemva konyango ukuze uqiniseke ukuba idlala lengqula lisebenza ngokufanelekileyo.

Unyango lwe-radiation olunokususwa olunokusetyenziselwa ukunyanga umhlaza welaryngeal. Unyango lwe-radiation lwe-Hyperfractionated lunyango lwe-radiation apho incinci kunesiqhelo idosi yemihla ngemihla yohlulahlulwe yangamanani amabini kwaye unyango lunikwa kabini ngemini. Unyango lwe-radiation olungenaxengiweyo lunikwa ngaphezulu kwexesha elifanayo (iintsuku okanye iiveki) njengonyango oluqhelekileyo lwe-radiation. Iindidi ezintsha zonyango lweradiya ziyafundwa kunyango lomhlaza welungu lomlomo.

Ugqirha

Utyando (ukususa umhlaza ekusebenzeni) lunyango oluqhelekileyo kuwo onke amabakala omhlaza welaryngeal. Kungasetyenziswa ezi nkqubo zilandelayo:

• I-Cordectomy: Utyando lokususa iintambo zezwi kuphela.

• I-laryngectomy ye-Supraglottic: Utyando lokususa i-supraglottis kuphela.

• I-Hemilaryngectomy: Utyando lokususa isiqingatha se-larynx (ibhokisi yelizwi). I-hemilaryngectomy igcina ilizwi.

• I-laryngectomy ekhethekileyo: Utyando lokususa inxenye yelarynx (ibhokisi yelizwi). I-laryngectomy ekhethekileyo inceda ukugcina amandla esigulana ekuthetheni.

• I-laryngectomy iyonke: Utyando lokususa yonke i-larynx. Ngexesha lalo msebenzi, kwenziwa umngxuma ngaphambili kwentamo ukuvumela umguli ukuba aphefumle. Oku kubizwa ngokuba yi-tracheostomy.

• I-Thyroidectomy: Ukususwa kwayo yonke into okanye inxalenye ye-thyroid gland.

• Utyando lwe-Laser: Inkqubo yotyando esebenzisa umqadi we-laser (umqadi omxinwa wokukhanya okungaphaya) njengemela yokusika ngaphandle kwegazi kwizicwili okanye ukususa isilonda somhlaba esifana nethumba elikwingqula.

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 ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba kungokubulala iiseli okanye kukumisa iiseli zahlule. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy).

Jonga iziyobisi ezivunyiweyo kwiNtloko kunye neCancer Neck ngolwazi oluthe kratya. (Umhlaza weLaryngeal luhlobo lomhlaza wentloko nentamo.)

Unyango lwe-Immunotherapy

I-Immunotherapy lunyango olusebenzisa amajoni omzimba omzimba ukulwa nomhlaza. Izinto ezenziwe ngumzimba okanye ezenziwe elebhu zisetyenziselwa ukonyusa, ukuqondisa, okanye ukubuyisela ukhuseleko lwendalo lomzimba kumhlaza. Olu hlobo lonyango lomhlaza lukwabizwa ngokuba yi-biotherapy okanye unyango lwe-biologic.

• Unyango lwe-immune checkpoint inhibitor: I-PD-1 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-PD-1 incamathele kwenye iprotein ebizwa ngokuba yi-PDL-1 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. PD-1 inhibitors zinamathele kwi-PDL-1 kwaye zivumele iiseli ze-T ukuba zibulale iiseli zomhlaza. I-Nivolumab kunye ne-pembrolizumab ziindidi ze-immune checkpoint inhibitors ezisetyenziselwa ukunyanga umhlaza we-lastngeal.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-PD-L1 kwiiseli zethumba kunye ne-PD-1 kwiiseli ze-T, zinceda ukugcina iimpendulo ze-immune zitshekishwe. Ukubopha kwe-PD-L1 ukuya kwi-PD-1 kugcina iiseli ze-T ekubulaleni iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-PD-L1 ukuya kwi-PD-1 nge-immune checkpoint inhibitor (anti-PD-L1 okanye anti-PD-1) ivumela iiseli ze-T ukuba zibulale iiseli zesisu (iphaneli esekunene).

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

• Iintsholongwane zeMonoclonal: Olu nyango lusebenzisa ii-antibodies ezenziwe elebhu ezivela kuhlobo olunye lweseli yomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo egazini okanye kwizicubu ezinokunceda iiseli zomhlaza zikhule. Amachiza omzimba ancamathele kwizinto kwaye abulale iiseli zomhlaza, athintele ukukhula kwazo, okanye azigcine zisasazeka. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza. I-Cetuximab ifundwa kunyango lomhlaza welaryngeal.

Radiosensitizers

IiRadiosensitizers ngamachiza enza ukuba iiseli zethumba zibuthathaka ngakumbi kunyango lwemitha. Ukudibanisa unyango lwemitha kunye neeradiosensitizers kunokubulala iiseli ezininzi zethumba.

Unyango lomhlaza welaryngeal lunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

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 yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Unyango lweSigaba I Cancer yeLaryngeal

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

Unyango lwesigaba esandula ukufumanisa isifo somhlaza welaryngeal kuxhomekeke apho umhlaza ufumaneka khona kwingqula.

Ukuba umhlaza ukwisupraglottis, unyango lunokubandakanya oku kulandelayo:

• Unyango ngemitha.

• I-laryngectomy yesupraglottic.

Ukuba umhlaza ukwiglottis, unyango lunokubandakanya oku kulandelayo:

• Unyango ngemitha.

• Utyando lweLaser.

• ICordectomy.

• I-laryngectomy ekhethekileyo, i-hemilaryngectomy, okanye i-laryngectomy iyonke.

Ukuba umhlaza uku-subglottis, unyango lunokubandakanya oku kulandelayo:

• Unyango ngemitha okanye ngaphandle kotyando.

• Utyando ndedwa.

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 lweCandelo II loMhlaza weLaryngeal

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

Unyango lwesigaba sesibini somhlaza welaryngeal osandula ukufunyanwa uxhomekeke apho umhlaza ufumaneka khona kwingqula.

Ukuba umhlaza ukwisupraglottis, unyango lunokubandakanya oku kulandelayo:

• Ukunyanga ngemitha kwi-tumor nakwi-lymph node ezikufutshane.

• I-laryngectomy ye-Supraglottic enokuthi ilandelwe ngonyango lwe-radiation.

Ukuba umhlaza ukwiglottis, unyango lunokubandakanya oku kulandelayo:

• Unyango ngemitha.

• Utyando lweLaser.

• I-laryngectomy ekhethekileyo, i-hemilaryngectomy, okanye i-laryngectomy iyonke.

Ukuba umhlaza uku-subglottis, unyango lunokubandakanya oku kulandelayo:

• Unyango ngemitha okanye ngaphandle kotyando.

• Utyando ndedwa.

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 lweCancer III Laryngeal Cancer

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

Unyango lomhlaza wesifo se-laryngeal esanda kufunyaniswa luxhomekeke apho umhlaza ufumaneka khona kwingqula.

Ukuba umhlaza ukwisupraglottis, unyango lunokubandakanya oku kulandelayo:

• I-Chemotherapy kunye nonyango lwemitha olunikezwe kunye

• I-Chemotherapy ilandelwa yichemotherapy kunye nonyango lwemitha olunikezwe kunye. I-Laryngectomy inokwenziwa ukuba umhlaza uhlala.

• Unyango ngemitha lodwa kwizigulana ezinganyangekiyo ngekhemotherapy kunye notyando.

• Ugqirha, olunokuthi lulandelwe ngonyango lwemitha.

Ukuba umhlaza ukwiglottis, unyango lunokubandakanya oku kulandelayo:

• I-Chemotherapy kunye nonyango lwemitha olunikezwe kunye.

• I-Chemotherapy ilandelwa yichemotherapy kunye nonyango lwemitha olunikezwe kunye. I-Laryngectomy inokwenziwa ukuba umhlaza uhlala.

• Unyango ngemitha lodwa kwizigulana ezinganyangekiyo ngekhemotherapy kunye notyando.

• Ugqirha, olunokuthi lulandelwe ngonyango lwemitha.

• Uvavanyo lweklinikhi yonyango lwemitha kuphela xa kuthelekiswa nemitha kunye nonyango ekujoliswe kulo (cetuximab).

• Uvavanyo lweklinikhi lwe-immunotherapy, chemotherapy, radiosensitizers, okanye unyango ngemitha.

Ukuba umhlaza uku-subglottis, unyango lunokubandakanya oku kulandelayo:

• I-Laryngectomy kunye ne-thyroidectomy iyonke kunye nokususwa kwee-lymph node emqaleni, zihlala zilandelwa lonyango lwe-radiation.

• Unyango ngemitha lulandelwa lityando ukuba umhlaza ubuyela kwakule ndawo inye.

• Unyango ngemitha lodwa kwizigulana ezinganyangekiyo ngekhemotherapy kunye notyando.

• I-Chemotherapy ilandelwa yichemotherapy kunye nonyango lwemitha olunikezwe kunye. I-Laryngectomy inokwenziwa ukuba umhlaza uhlala.

• Uvavanyo lweklinikhi yonyango lwemitha kuphela xa kuthelekiswa nemitha kunye nonyango ekujoliswe kulo (cetuximab).

• Uvavanyo lweklinikhi lwe-immunotherapy, chemotherapy, radiosensitizers, okanye unyango ngemitha.

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 lweCancer IV yeLaryngeal Cancer

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

Unyango lwe-IVA, IVB, kunye ne-IVC yomhlaza welaryngeal kuxhomekeke apho umhlaza ufumaneka khona kwingqula.

Ukuba umhlaza ukwisupraglottis okanye iglottis, unyango lunokubandakanya oku kulandelayo:

• I-Chemotherapy kunye nonyango lwemitha olunikezwe kunye.

• I-Chemotherapy ilandelwa yichemotherapy kunye nonyango lwemitha olunikezwe kunye. I-Laryngectomy inokwenziwa ukuba umhlaza uhlala.

• Unyango ngemitha lodwa kwizigulana ezinganyangekiyo ngekhemotherapy kunye notyando.

• Utyando olulandelwa lunyango ngemitha. I-Chemotherapy inokunikezelwa ngonyango lwe-radiation.

• Uvavanyo lweklinikhi yonyango lwemitha kuphela xa kuthelekiswa nemitha kunye nonyango ekujoliswe kulo (cetuximab).

• Uvavanyo lweklinikhi lwe-immunotherapy, chemotherapy, radiosensitizers, okanye unyango ngemitha.

Ukuba umhlaza uku-subglottis, unyango lunokubandakanya oku kulandelayo:

• I-Laryngectomy kunye ne-thyroidectomy iyonke kunye nokususwa kwee-lymph node emqaleni, zihlala zilandelwa ngonyango lwe-radiation kunye okanye ngaphandle kwe-chemotherapy.

• I-Chemotherapy kunye nonyango lwemitha olunikezwe kunye.

• Uvavanyo lweklinikhi yonyango lwemitha kuphela xa kuthelekiswa nemitha kunye nonyango ekujoliswe kulo (cetuximab).

• Uvavanyo lweklinikhi lwe-immunotherapy, chemotherapy, radiosensitizers, okanye unyango ngemitha.

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 lweCancer Metastatic and Recurrent Laryngeal Cancer

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

Unyango lomhlaza wamathumba ophindaphindiweyo unokuphinda ubandakanye oku kulandelayo:

• Ugqirha kunye okanye ngaphandle kwonyango lwemitha.

• Unyango ngemitha.

• Unyango ngamayeza.

• Immunotherapy nge pembrolizumab okanye nivolumab.

• Uvavanyo lweklinikhi yonyango olutsha.

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 weLaryngeal

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza welaryngeal, bona oku kulandelayo:

• Ikhasi lasekhaya leNtloko kunye neCancer Neck

• Iingxaki zomlomo zeChemotherapy kunye neNtloko / iNtsholongwane yeNtsholongwane

• I-Lasers kunyango lomhlaza

• Iziyobisi ezivunyiweyo kwiNtloko kunye noMhlaza weNtamo

• Iithagethi zoMhlaza ezijolise kuko

• Unyango lwe-Immunotherapy ukunyanga uMhlaza

• Umhlaza weNtloko kunye neNtamo

• Icuba (kubandakanya uncedo ngokuyeka)

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli