Types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq

Unyango lweNasopharyngeal Cancer (yabantu abadala)

Ulwazi ngokubanzi malunga noMhlaza weNasopharyngeal

IINGONGOMA EZIPHAMBILI

• Umhlaza we-Nasopharyngeal sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu ze-nasopharynx.

• Imvelaphi yobuhlanga kunye nokuvezwa kwintsholongwane ka-Epstein-Barr inokuchaphazela umngcipheko wesifo somhlaza.

• Iimpawu zomhlaza womhlaza ziquka ukuphefumla, ukuthetha, okanye ukuva.

• Uvavanyo oluvavanya impumlo, umqala, kunye namalungu akufuphi asetyenziselwa ukukhangela (fumana), ukuxilonga, kunye nenqanaba lomhlaza wamanopharyngeal.

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

Umhlaza we-Nasopharyngeal sisifo apho umhlaza (umhlaza) weeseli zenzeka kwizicubu ze-nasopharynx.

I-nasopharynx yinxalenye ephezulu yepharynx (umqala) emva kwempumlo. Ipharynx yityhubhu engenasiphelo emalunga ne-intshi ezintlanu ubude eqala emva kwempumlo kwaye iphele phezulu kwitrachea (umbhobho womoya) kunye nomqala (ityhubhu ephuma emqaleni iye esiswini). Umoya kunye nokutya kudlula kwi-pharynx kwindlela eya kwi-trachea okanye kwi-esophagus. Iimpumlo zikhokelela kwi-nasopharynx. Ukuvulwa kwicala ngalinye le-nasopharynx kukhokelela kwindlebe. Umhlaza weNasopharyngeal udla ngokuqala kwiiseli ezinobunzima obulungelelanisa i-nasopharynx.

I-anatomy ye-pharynx (umqala). Ipharynx yityhubhu engenamphambili eqala ngasemva kwempumlo, yehle intamo, kwaye iphele ngaphezulu kwitrachea kunye nomqala. Amacandelo amathathu e-pharynx yi-nasopharynx, oropharynx, kunye ne-hypopharynx.

Umhlaza weNasopharyngeal luhlobo lomhlaza wentloko nentamo.

Imvelaphi yobuhlanga kunye nokuvezwa kwintsholongwane ka-Epstein-Barr inokuchaphazela umngcipheko wesifo somhlaza.

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. Izinto ezinobungozi kumhlaza wesifo se-nasopharyngeal zibandakanya oku kulandelayo:

• Ukuba nookhokho baseTshayina okanye baseAsia.

• Ukuvezwa kwintsholongwane ka-Epstein-Barr: Intsholongwane ka-Epstein-Barr inxulunyaniswa nomhlaza othile, kubandakanya umhlaza wamazinyo kunye nezinye ii-lymphomas.

• Ukusela izixa ezikhulu zotywala.

• Iimpawu zomhlaza womhlaza ziquka ukuphefumla, ukuthetha, okanye ukuva.

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

• Isigaxa empumlweni okanye entanyeni.

• Umqala obuhlungu.

• Ukuphefumla nzima okanye ukuthetha.

• Iimpumlo.

• Ingxaki yokuva.

• Intlungu okanye ukukhala endlebeni.

• Intloko ebuhlungu.

Uvavanyo oluvavanya impumlo, umqala, kunye namalungu akufuphi asetyenziselwa ukukhangela (fumana), ukuxilonga, kunye nenqanaba lomhlaza wamanopharyngeal.

Iinkqubo ezenza imifanekiso yempumlo nomqala zinceda ukufumanisa isifo somhlaza. Inkqubo esetyenziselwa ukufumanisa ukuba ngaba iiseli zomhlaza zisasazekile kwamanye amalungu omzimba kuthiwa yi-staging. Uvavanyo kunye neenkqubo zokufumanisa, ukufumanisa isifo, kunye nenqanaba lomhlaza wamanopharyngeal zenziwa ngaphambi kokucwangcisela unyango.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukujonga iimpawu zempilo ngokubanzi, kubandakanya nokujonga imiqondiso yezifo, ezinje ngokuvuvukala kwezidumba entanyeni 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.

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

• I-Nasoscopy: Inkqubo yokujonga ngaphakathi kwempumlo kwiindawo ezingaqhelekanga. I-nasoscope ifakwe ngeempumlo. I-nasoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

• I-endoscopy ephezulu: Inkqubo yokujonga ngaphakathi kwempumlo, umqala, umqala, isisu, kunye ne-duodenum (icandelo lokuqala lamathumbu amancinci, kufutshane nesisu). I-endoscope ifakwe ngomlomo nakwi-esophagus, isisu, kunye ne-duodenum. I-endoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Isenokuba nesixhobo sokususa iisampulu zethishu. Iisampulu zethishu zijongwa phantsi kwemicroscope kwimpawu zomhlaza.

• 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-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesifuba kunye nesisu esisentla, esithathwe kwiimbombo 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.

• 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. Ukuvavanywa kwe-PET kunokusetyenziselwa ukufumana umhlaza we-nasopharyngeal osasazeke waya kwithambo. Ngamanye amaxesha i-PET scan kunye ne-CT scan zenziwa ngaxeshanye. Ukuba kukho nawuphi na umhlaza, oku kwandisa amathuba okuba kufumaneke.

• Uvavanyo lwe-Ultrasound: Inkqubo apho amaza esandi aphembelela amandla aphezulu (i-ultrasound) akhutshelwa ngaphandle kwamalungu esiswini kwaye enze i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Umfanekiso unokuprintwa ukuze ujongwe kamva.

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

• 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.

• Gcwalisa ubalo lwegazi (i-CBC): Inkqubo apho kuthathwa khona isampulu yegazi kwaye ihlolwe oku kulandelayo:

• Inani leeseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neeplatelets.

• Isixa sehemoglobin (iprotein ethwala ioksijini) kwiiseli ezibomvu zegazi.

• Inxalenye yesampulu yegazi eyenziwe ziiseli ezibomvu zegazi.

• Uvavanyo lwe-Epstein-Barr virus (EBV): Uvavanyo lwegazi ukukhangela ii-antibodies kwintsholongwane ka-Epstein-Barr kunye neempawu zeDNA zentsholongwane kaEpstein-Barr. Ezi zifumaneka egazini lezigulana ezine-EBV.

• Uvavanyo lwe-HPV (uvavanyo lwe-papillomavirus yabantu): Uvavanyo lwaselebhu olusetyenziselwa ukukhangela isampulu yethishu kwiintlobo ezithile zosulelo lwe-HPV. Olu vavanyo lwenziwa ngenxa yokuba umhlaza wasenopharyngeal unokubangelwa yi-HPV.

• Uvavanyo lokuva: Inkqubo yokujonga ukuba ingaba izandi ezithambileyo nezingxolayo nezandi ezisezantsi neziphezulu ziyavakala na. Indlebe nganye ihlolwe ngokwahlukeneyo.

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

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

• Ubungakanani bethumba.

• Isigaba somhlaza, kubandakanywa nokuba umhlaza usasazeke kwi-lymph node enye okanye ngaphezulu entanyeni.

• Inqanaba eliphezulu le-EBV antibodies kunye ne-EBV-DNA markers egazini ngaphambi nasemva konyango.

Ezinye izinto ezinokuchaphazela ukuqikelela kubandakanya:

• Ubudala.

• Ixesha elide phakathi kwe-biopsy kunye nokuqala kwonyango lwe-radiation.

• Imbali yosapho.

• Ukutshaya icuba.

• Intlanzi enetyuwa ekutyeni.

Amanqanaba omhlaza weNasopharyngeal

IINGONGOMA EZIPHAMBILI

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

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manyathelo alandelayo asetyenziselwa umhlaza wamanopharyngeal:

• Inqanaba 0

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

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

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

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza usasazekile ngaphakathi kwe-nasopharynx okanye kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Iziphumo zovavanyo ezisetyenziselwa ukufumanisa isifo somhlaza wamanopharyngeal zihlala zisetyenziselwa ukubeka isifo. (Jonga icandelo loLwazi ngokubanzi.)

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 wamanopharyngeal usasazeka ukuya emiphungeni, iiseli zomhlaza emiphungeni ziyiseli ezinomhlaza. Esi sifo ngumhlaza we-nasopharyngeal cancer, hayi umhlaza wemiphunga.

La manyathelo alandelayo asetyenziselwa umhlaza wamanopharyngeal:

Inqanaba 0

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

Inqanaba I

Kwinqanaba I, umhlaza wenziwe kunye nomhlaza:

• ifumaneka kwi-nasopharynx kuphela; okanye

• isasazekile ukusuka kwi-nasopharynx ukuya kwi-oropharynx kunye / okanye kwi-nasal cavity.

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).

Inqanaba II

Kwinqanaba II, enye yezi zinto zilandelayo iyinyani:

• Umhlaza usasazeke kwi-lymph node enye okanye nangaphezulu kwicala elinye lentamo kunye / okanye kwenye okanye kwi-lymph node enye okanye omabini amacala omva womqala. Iindawo ezinesifo esichaphazelekayo ziisentimitha ezi-6 okanye ezincinci Umhlaza ufumaneka:

• kwi-nasopharynx kuphela okanye sele isasazekile ukusuka kwi-nasopharynx ukuya kwi-oropharynx kunye / okanye kwi-nasal cavity; okanye

• kuphela kwiindawo nkovu entanyeni. Iiseli zomhlaza kwii-lymph node zosulelwe yintsholongwane ka-Epstein-Barr (intsholongwane enxulunyaniswa nomhlaza wamazinyo).

• Umhlaza usasazekile kwindawo yeparapharyngeal kunye / okanye kwezihlunu ezikufutshane. Umhlaza usenokuthi usasazeke kwenye okanye kwiindawo ezininzi ezikwimeko enye entanyeni kunye / okanye kwenye okanye kwenye i-lymph node kwelinye okanye kumacala omabini omqolo womqala. Iindawo ezinesifo esichaphazelekayo ziisentimitha ezi-6 okanye ezincinci

Inqanaba III

Kwinqanaba le-III, enye yezi zinto zilandelayo iyinyani:

• Umhlaza usasazeke kwilungu elinye okanye nangaphezulu kwiindawo zombini emqaleni. Iindawo ezinesifo esichaphazelekayo ziisentimitha ezi-6 okanye ezincinci Umhlaza ufumaneka:

• kwi-nasopharynx kuphela okanye sele isasazekile ukusuka kwi-nasopharynx ukuya kwi-oropharynx kunye / okanye kwi-nasal cavity; okanye

• kuphela kwiindawo nkovu entanyeni. Iiseli zomhlaza kwii-lymph node zosulelwe yintsholongwane ka-Epstein-Barr (intsholongwane enxulunyaniswa nomhlaza wamazinyo).

• Umhlaza usasazekile kwindawo yeparapharyngeal kunye / okanye kwezihlunu ezikufutshane. Umhlaza ukwasasazekile kwi-lymph node enye okanye nangaphezulu kumacala omabini entamo. Iindawo ezinesifo esichaphazelekayo ziisentimitha ezi-6 okanye ezincinci

• Umhlaza uye wanwenwela emathanjeni emazantsi okakayi, amathambo asentanyeni, izihlunu zomhlathi, kunye / okanye iisono ezijikeleze impumlo namehlo. Umhlaza usenokwasasazeka kwenye okanye kwiindawo ezininzi ezikwimeko enye okanye omabini amacala entamo kunye / okanye umva womqala. Iindawo ezinesifo esichaphazelekayo ziisentimitha ezi-6 okanye ezincinci

Inqanaba IV

Isigaba IV sahlulwe sangamanqanaba e-IVA kunye ne-IVB.

• Kwinqanaba le-IVA:

• Umhlaza usasazekile waya kwingqondo, imithambo-luvo ye-cranial, i-hypopharynx, i-salivary gland ngaphambili kwendlebe, ithambo elijikeleze iliso, kunye / okanye izicwili ezithambileyo zomhlathi. Umhlaza usenokwasasazeka kwenye okanye kwiindawo ezininzi ezikwimeko enye okanye omabini amacala entamo kunye / okanye umva womqala. Ii-lymph node ezichaphazelekayo ziisentimitha ezi-6 okanye ezincinci; okanye

• Umhlaza usasazeke kwi-lymph node enye okanye nangaphezulu kwelinye okanye kumacala omabini entamo. Ii-lymph node ezichaphazelekayo zikhulu kuneesentimitha ezi-6 kunye / okanye zifumaneka kwezona ndawo ziphantsi entanyeni.

• Kwinqanaba le-IVB: Umhlaza usasazeke ngaphaya kwe-lymph node entanyeni ukuya kwiindawo ezikude ze-lymph, ezinjengezo ziphakathi kwemiphunga, ngaphantsi kwekhola, okanye kwi-armpit okanye kwi-groin, okanye kwamanye amalungu omzimba, njengomphunga ithambo, okanye isibindi.

Emva kotyando, inqanaba lomhlaza linokutshintsha kwaye unyango oluninzi luyafuneka.

Ukuba umhlaza ususwe ngotyando, ugqirha wezonyango uya kuvavanya isampulu yethishu yomhlaza phantsi kwemicroscope. Ngamanye amaxesha, uphononongo lwezifo lukhokelela kutshintsho kwinqanaba lomhlaza kunye nonyango ngakumbi emva kotyando.

Umhlaza ophindaphindiweyo weNasopharyngeal Cancer

Umhlaza ophindaphindiweyo we-nasopharyngeal ngumhlaza ophindaphindiweyo (ubuye) emva kokuba unyangiwe. Umhlaza ungabuyela kwi-nasopharynx okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza wamanopharyngeal.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Unyango ngemitha

• Unyango ngamayeza

• Ugqirha

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-nasopharyngeal cancer lungadala 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 wamanopharyngeal.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza wamanopharyngeal. 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.

Zintathu iintlobo zonyango olusetyenziswayo:

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 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.

Iindlela ezithile zokunika unyango ngemitha kunokunceda ukugcina imitha ingonakalisi izicubu ezisempilweni ezikufutshane. Ezi ntlobo zonyango lwe-radiation zibandakanya oku kulandelayo:

• Unyango lwe-radiation ye-intension-modulated (IMRT): I-IMRT luhlobo lonyango lwe-3-dimensional (3-D) olusebenzisa ikhompyuter ukwenza imifanekiso yobukhulu kunye nemilo yethumba. Iintsika ezincinci zemitha yokuqina okuhlukeneyo (amandla) zijolise kwithumba kumacala amaninzi. Xa kuthelekiswa nonyango oluqhelekileyo lwe-radiation, unyango olunemilinganiselo ye-radiation olunokubakho kancinci kunokubangela umlomo owomileyo.

• Unyango lwe-stereotactic radiation: Isakhelo sentloko esomeleleyo siqhotyoshelwe kukhakhayi ukugcina intloko isamile ngexesha lonyango lwemitha. Umatshini ujolise kwimitha ngqo kwi-tumor. Idosi epheleleyo yemitha yohlulwe yaziidosi ezincinci ezinikezwe kwiintsuku ezininzi. Le nkqubo ikwabizwa ngokuba yinyango ye-stereotactic yangaphandle ye-radiation kunye nonyango lwe-stereotaxic radiation.

• 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 kunye nenqanaba lomhlaza ophathwayo. Unyango lwangaphandle nolwangaphakathi lusetyenziselwa ukunyanga umhlaza wamanopharyngeal.

Unyango lwangaphandle lwemitha kwi-thyroid okanye i-pituitary gland inokutshintsha indlela esebenza ngayo i-thyroid gland. Uvavanyo lwegazi lokujonga inqanaba lehomoni yegazi egazini lwenziwa ngaphambi nasemva konyango ukuze uqiniseke ukuba idlala lengqula lisebenza ngokufanelekileyo. Kukwabalulekile ukuba ugqirha wamazinyo ahlole amazinyo, iintsini, nomlomo wesigulana, kwaye alungise naziphi na iingxaki ezikhoyo ngaphambi kokuba kuqaliswe unyango ngemitha.

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.

I-Chemotherapy inokunikwa emva konyango lwe-radiation ukubulala nayiphi na iiseli zomhlaza ezisele. Unyango olunikezwe emva konyango lwe-radiation, ukunciphisa umngcipheko wokuba umhlaza uza kubuya, lubizwa ngokuba lonyango oluncedisayo.

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

Ugqirha

Utyando yinkqubo yokufumanisa ukuba umhlaza ukhona, ukususa umhlaza emzimbeni, okanye ukulungisa ilungu lomzimba. Ikwabizwa ngokuba ngumsebenzi. Utyando ngamanye amaxesha lusetyenziselwa umhlaza wamazinyo ongaphenduliyo kunyango lwe-radiation. Ukuba umhlaza usasazekile kwii-lymph node, ugqirha unokususa ii-lymph node kunye nezinye izicubu entanyeni.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lwe-nasopharyngeal cancer lungadala 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.

Ukhetho lonyango ngeSigaba

Kweli Candelo

• Isigaba I-Nasopharyngeal Cancer

• Inqanaba II Umhlaza weNasopharyngeal Cancer

• Inqanaba lesithathu leCasopharyngeal Cancer

• Isigaba IV seNasopharyngeal Cancer

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

Isigaba I-Nasopharyngeal Cancer

Unyango lwenqanaba lomhlaza wamanopharyngeal kuhlala kunyango lwe-radiation kwi-tumor kunye ne-lymph node entanyeni.

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.

Inqanaba II Umhlaza weNasopharyngeal Cancer

Unyango lwesigaba sesibini somhlaza wamanopharyngeal unokubandakanya oku kulandelayo:

• I-Chemotherapy enikezelwa ngonyango lwe-radiation, ilandelwa yi-chemotherapy engaphezulu.

• Unyango lwe-radiation kwi-tumor kunye ne-lymph node entanyeni.

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.

Inqanaba lesithathu leCasopharyngeal Cancer

Unyango lwesigaba sesithathu somhlaza wamanopharyngeal unokubandakanya oku kulandelayo:

• I-Chemotherapy enikezelwa ngonyango lwe-radiation, olunokuthi lulandelwe ngamachiza amaninzi.

• Unyango ngemitha.

• Unyango lwe-radiation olulandelwa lutyando lokususa ii-lymph node ezinomhlaza entanyeni ezihlala okanye zibuye emva konyango lwemitha.

• Uvavanyo lweklinikhi lwe-chemotherapy enikezwe ngaphambi, kunye, okanye emva konyango lwe-radiation.

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.

Isigaba IV seNasopharyngeal Cancer

Unyango lwesigaba IV somhlaza wamanopharyngeal unokubandakanya oku kulandelayo:

• I-Chemotherapy enikezelwa ngonyango lwe-radiation, ilandelwa yi-chemotherapy engaphezulu.

• Unyango ngemitha.

• Unyango lwe-radiation olulandelwa lutyando lokususa ii-lymph node ezinomhlaza entanyeni ezihlala okanye zibuye emva konyango lwemitha.

• I-Chemotherapy yomhlaza oye wasasazeka (usasazeka) kwamanye amalungu omzimba.

• Uvavanyo lweklinikhi lwe-chemotherapy enikezwe ngaphambi, kunye, okanye emva konyango lwe-radiation.

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.

Ukhetho kunyango lomhlaza ophindaphindiweyo weNasopharyngeal Cancer

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

Unyango lomhlaza ophindaphindiweyo we-nasopharyngeal unokubandakanya oku kulandelayo:

• Unyango lwe-radiation olunamandla, olunyangiweyo, okanye unyango lwangaphakathi lwemitha.

• Ugqirha.

• Unyango ngamayeza.

• Uvavanyo lweklinikhi lwe-chemotherapy.

• Uvavanyo lweklinikhi yonyango lwe-stereotactic radiation.

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.

Ukuze ufunde okungakumbi malunga noMhlaza weNasopharyngeal

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza wamazinyo, jonga oku kulandelayo:

• Ikhasi lasekhaya leNtloko kunye neCancer Neck

• Iingxaki zomlomo zeChemotherapy kunye neNtloko / iNtsholongwane yeNtsholongwane

• Iziyobisi ezivunyiweyo kwiNtloko kunye noMhlaza weNtamo

• Umhlaza weNtloko kunye neNtamo

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