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I-Wilms Tumor kunye nolunye Unyango lweZintso zeZintso zaBantwana (®) -Ingxelo yePatient

Ulwazi ngokubanzi malunga neWilms Tumor kunye nolunye uXolo lweZintso zoBuntwana

IINGONGOMA EZIPHAMBILI

  • Izidumba zezintso zobuntwana zizifo apho isifo somhlaza (somhlaza) senza iiseli zezintso.
  • Zininzi iintlobo zamathumba kwizintso zomntwana.
  • UWilms Tumor
  • Umhlaza weSeli weRenal (RCC)
  • IRhabdoid Tumor yeZintso
  • Cacisa i-Cell Sarcoma yeZintso
  • Isizalo seMesoblastic Nephroma
  • I-Ewing Sarcoma yeZintso
  • Iiprayimari ze-Renal Myoepithelial Carcinoma
  • ICystic eyahlukileyo yahlula iNephroblastoma
  • Imultilocular cystic Nephroma
  • I-Primary Renal Synovial Sarcoma
  • I-Anaplastic Sarcoma yezintso
  • I-Nephroblastomatosis ayisiwo umhlaza kodwa inokuba sisilonda seWilms.
  • Ukuba ne-syndromes ethile yemfuza okanye ezinye iimeko kunokunyusa umngcipheko we-Wilms tumor.
  • Uvavanyo lusetyenziselwa ukukrola ithumba leWilms.
  • Ukuba neemeko ezithile kunokunyusa umngcipheko womhlaza wesifo sezintso.
  • Unyango lwethumba leWilms kunye namanye amathumba kwizintso zabantwana anokubandakanya ukululekwa ngemfuza.
  • Iimpawu zethumba likaWilms kunye nezinye izidlo zezintso zobuntwana zibandakanya iqhuma esiswini kunye negazi kumchamo.
  • Uvavanyo oluvavanya izintso kunye negazi zisetyenziselwa ukufumanisa ithumba likaWilms kunye nezinye izidumba zezintso zobuntwana.
  • Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Izidumba zezintso zobuntwana zizifo apho isifo somhlaza (somhlaza) senza iiseli zezintso.

Kukho izintso ezimbini, elinye kwicala ngalinye lomqolo, ngaphezulu kwesinqe. Iityhubhu ezincinci kwizicoca izintso kwaye zicoca igazi. Bakhupha iimveliso zenkunkuma benze umchamo. Umchamo uvela kwizintso nganye ngetyhubhu ende ebizwa ngokuba yi-ureter kwisinyi. Isinyi sibamba umchamo de udlule kwi-urethra kwaye ushiye umzimba.

I-Anatomy yenkqubo yabasetyhini yokuchama ebonisa izintso, iidrenal gland, ureters, bladder, kunye urethra. Umchamo wenziwe ngee-tubules zezintso kwaye uqokelela kwi-renal pelvis yezintso nganye. Umchamo uqukuqela uphuma kwizintso udlula kwizicwili uze uye kwesinye. Umchamo ugcinwe esinyini de ushiye umzimba kwi-urethra.

Zininzi iintlobo zamathumba kwizintso zomntwana.

UWilms Tumor

Kwi-tumor yeWilms, inye okanye nangakumbi amathumba anokufumaneka kwizintso zombini okanye zombini. Ithumba leWilms linokusasazeka kwimiphunga, isibindi, ithambo, ingqondo, okanye iindawo ezikufutshane nee-lymph. Kubantwana nakwishumi elivisayo abangaphantsi kweminyaka eli-15 ubudala, uninzi lomhlaza wezintso zii-Wilms tumors.

Umhlaza weSeli weRenal (RCC)

Umhlaza wesifo sezintso unqabile ebantwaneni nakwishumi elivisayo abangaphantsi kweminyaka eli-15 ubudala. Kuqheleke ngakumbi kulutsha oluphakathi kweminyaka eli-15 neli-19 ubudala. Abantwana kunye nabaselula banokufumana ukuba bane-tumor enkulu yesifo somhlaza okanye umhlaza oye wasasazeka. Umhlaza wesifo somhlaza ungasasazeka kwimiphunga, isibindi, okanye ii-lymph node. Umhlaza wesifo somhlaza ungabizwa ngokuba yi-renal cell carcinoma.

IRhabdoid Tumor yeZintso

I-Rhabdoid tumor yezintso luhlobo lomhlaza wezintso olwenzeka ikakhulu kwiintsana nakubantwana abancinci. Ihlala iqhubela phambili ngexesha lokuchongwa. Isisu esihlaziyiweyo sezintso sikhula kwaye sisasazeka ngokukhawuleza, rhoqo kwimiphunga okanye kwingqondo.

Abantwana abanotshintsho oluthile kwi-gene ye-SMARCB1 bajongwa rhoqo ukuze babone ukuba ithumba le-rhabdoid lenziwe kwizintso okanye lisasazekile kwingqondo:

  • Abantwana abangaphantsi konyaka omnye ubudala bane-ultrasound yesisu rhoqo kwiinyanga ezimbini ukuya kwezintathu kunye ne-ultrasound yentloko inyanga nenyanga.
  • Abantwana abanonyaka omnye ukuya kwemine ubudala bane-ultrasound yesisu kunye neMRI yengqondo kunye nomqolo qho kwiinyanga ezintathu.

Cacisa i-Cell Sarcoma yeZintso

Cacisa i-cell sarcoma yezintso luhlobo lwesifo sezintso esinokusasazeka kwimiphunga, ithambo, ingqondo, okanye izicubu ezithambileyo. Inokuphinda ibuye (ibuye) ukuya kuthi ga kwi-14 leminyaka emva konyango, kwaye ihlala iphinda ibuye kwingqondo okanye emiphungeni.

Isizalo seMesoblastic Nephroma

I-mesoblastic nephroma ezelwe sisisu sezintso esihlala sifunyaniswa kunyaka wokuqala wobomi. Iyakwazi ukunyangeka.

I-Ewing Sarcoma yeZintso

I-Ewing sarcoma (eyayibizwa ngokuba yi-neuroepithelial tumor) yezintso inqabile kwaye ihlala ivela kubantu abadala abancinci. Ezi tumors zikhula kwaye zisasazeka kwamanye amalungu omzimba ngokukhawuleza.

Iiprayimari ze-Renal Myoepithelial Carcinoma

I-primary renal myoepithelial carcinoma luhlobo olunqabileyo lomhlaza oluhlala luchaphazela izicwili ezithambileyo, kodwa ngamanye amaxesha lwenza kumalungu angaphakathi (njengezintso). Olu hlobo lomhlaza lukhula kwaye lusasazeka ngokukhawuleza.

ICystic eyahlukileyo yahlula iNephroblastoma

I-cystic yahlulahlulwe ngokungafaniyo nephroblastoma luhlobo olunqabileyo lwe-Wilms ithumba elenziwa zii-cysts.

Imultilocular cystic Nephroma

I-multilocular cystic nephromas zizidumba ezinobungozi ezenziwe zii-cysts kwaye zixhaphake kakhulu kwiintsana, kubantwana abancinci nakwabasetyhini abadala. Ezi tumors zinokwenzeka kwelinye okanye zombini izintso.

Abantwana abanolu hlobo lwethumba banokuba ne-pleuropulmonary blastoma, ke iimvavanyo zokucinga ezijonga imiphunga kwii-cysts okanye izicubu eziqinileyo zenziwa. Kuba imicilocular cystic nephroma inokuba yimeko yelifa, ingcebiso ngemfuza kunye nokuvavanywa kwemfuzo kunokuqwalaselwa. Jonga isishwankathelo se- malunga nonyango lwe-Pleuropulmonary Blastoma yoNyango ngolwazi oluthe kratya.

I-Primary Renal Synovial Sarcoma

Isiseko se-renal synovial sarcoma sisisu esifana ne-cyst sezintso kwaye sixhaphake kakhulu kubantu abadala abancinci. Ezi tumors zikhula kwaye zisasazeka ngokukhawuleza.

I-Anaplastic Sarcoma yezintso

I-Anaplastic sarcoma yezintso sisifo esinqabileyo esixhaphakileyo ebantwaneni okanye kulutsha oluneminyaka engaphantsi kwe-15 ubudala. I-Anaplastic sarcoma yezintso ihlala isasazeka kwimiphunga, isibindi, okanye amathambo. Ukulinganisa iimvavanyo ezijonga imiphunga kwii-cysts okanye izicubu eziqinileyo zinokwenziwa. Kuba i-sarcoma ye-aplastic inokuba yimeko yelifa, ingcebiso ngemfuzo kunye nokuvavanywa kwemfuza kunokuqwalaselwa.

I-Nephroblastomatosis ayisiwo umhlaza kodwa inokuba sisilonda seWilms.

Ngamanye amaxesha, emva kokuba izintso zakha usana olungekazalwa, amaqela ezesifo sezintso ahlala kwenye okanye zombini izintso. Kwi-nephroblastomatosis (isasazeka i-perplob perilobar nephroblastomatosis), la maqela ezisele angaqhelekanga anokukhula kwiindawo ezininzi ngaphakathi kwizintso okanye enze umaleko otyebileyo ojikeleze izintso. Xa la maqela eeseli ezingaqhelekanga afunyanwa kwizintso emva kokuba isuswe ithumba leWilms, umntwana uba semngciphekweni wokunyuka kwethumba leWilms kolunye izintso. Uvavanyo olwenziwa rhoqo lubalulekile ubuncinci rhoqo kwiinyanga ezintathu, ubuncinci iminyaka esi-7 emva kokunyangwa komntwana.

Ukuba ne-syndromes ethile yemfuza okanye ezinye iimeko kunokunyusa umngcipheko we-Wilms tumor.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha womntwana wakho ukuba ucinga ukuba umntwana wakho usengozini.

Ithumba leWilms linokuba yinxalenye yesifo semfuza esichaphazela ukukhula okanye ukukhula. Isifo semvelo siseti yeempawu kunye neempawu okanye iimeko ezenzeka kunye kwaye zibangelwa lutshintsho oluthile kwimfuza. Iimeko ezithile zinokunyusa umngcipheko womntwana wokukhula kwethumba leWilms. Ezi kunye nezinye ii-syndromes zemfuza kunye neemeko zidityaniswe nethumba leWilms:

  • Isifo se-WAGR (ithumba leWilms, i-aniridia, inkqubo engaqhelekanga yokuza nolusu, kunye nokudodobala kwengqondo).
  • I-Denys-Drash syndrome (inkqubo engaqhelekanga yokuzalela).
  • Isifo iFrasier (inkqubo engaqhelekanga yobukrelekrele).
  • Isifo i-Beckwith-Wiedemann syndrome (ukukhula ngokungaqhelekanga kwelinye icala lomzimba okanye kwilungu lomzimba, ulwimi olukhulu, i-umbilical hernia xa kuzalwa, kunye nenkqubo engaqhelekanga ye-genitourinary system).
  • Imbali yosapho yethumba leWilms.
  • U-Aniridia (iris, icandelo elinombala wamehlo, alikho).
  • Ishemated hemihyperplasia (ukukhula ngokungaqhelekanga kwelinye icala lomzimba okanye kwilungu lomzimba).
  • Iingxaki zomchamo ezifana ne-cryptorchidism okanye i-hypospadias.

Uvavanyo lusetyenziselwa ukukrola ithumba leWilms.

Uvavanyo lokuvavanywa lwenziwa kubantwana abanomngcipheko okhulayo we-Wilms tumor. Olu vavanyo lunokunceda ekufumaneni umhlaza kwangoko kunye nokunciphisa ithuba lokufa ngumhlaza.

Ngokubanzi, abantwana abanomngcipheko okhulayo we-Wilms tumor kufuneka bahlolwe isifo se-Wilms rhoqo kwiinyanga ezintathu de babe baneminyaka eli-8 ubudala. Uvavanyo lwe-ultrasound yesisu luhlala lusetyenziselwa ukuhlolwa. Amathumba amancinci eWilms anokufunyanwa kwaye asuswe ngaphambi kokuvela kweempawu.

Abantwana abane-Beckwith-Wiedemann syndrome okanye i-hemihyperplasia baphinde bahlolwe isibindi kunye ne-adrenal tumors ezidibaniswe nale syndromes yemfuza. Uvavanyo lokujonga inqanaba le-alpha-fetoprotein (AFP) egazini kunye ne-ultrasound yesisu senziwa de umntwana abe neminyaka emi-4 ubudala. I-ultrasound yezintso yenziwe phakathi kweminyaka emi-4 no-7 ubudala. Uvavanyo lomzimba yingcali (i-geneticist okanye i-oncologist yabantwana) lwenziwa amatyeli amabini ngonyaka. Kubantwana abaneenguqu ezithile zofuzo, ishedyuli eyahlukileyo ye-ultrasound yesisu inokusetyenziswa.

Abantwana abane-aniridia kunye notshintsho oluthile lomfuziselo bayavavanywa ithumba leWilms rhoqo kwiinyanga ezintathu de babe neminyaka esi-8 ubudala. Uvavanyo lwe-ultrasound yesisu lusetyenziselwa ukuhlolwa.

Abanye abantwana bakhula ithumba leWilms kwizintso zombini. Ezi zihlala zivela xa ithumba likaWilms lifunyaniswa okokuqala, kodwa ithumba leWilms linokubakho kwizintso zesibini emva kokuba umntwana ephethwe ngempumelelo ithumba likaWilms kwizintso. Abantwana abanomngcipheko owandileyo wesibini ithumba leWilms kolunye izintso kufuneka bahlolwe ithumba likaWilms rhoqo kwiinyanga ezintathu ukuya kuthi ga kwiminyaka esibhozo. Uvavanyo lwe-ultrasound yesisu lunokusetyenziselwa ukuhlolwa.

Ukuba neemeko ezithile kunokunyusa umngcipheko womhlaza wesifo sezintso.

Umhlaza wesifo somhlaza unokuhambelana nale miqathango ilandelayo:

  • Isifo seVon Hippel-Lindau (imeko ezuzwe njengelifa ebangela ukukhula okungaqhelekanga kwemithambo yegazi). Abantwana abanesifo seVon Hippel-Lindau kufuneka bahlolwe minyaka le ukuba banomhlaza wesisele se-renal kunye ne-ultrasound yesisu okanye iMRI (imaging resonance imaging) eqala kwiminyaka eyi-8 ukuya kweli-11.
  • I-Tuberous sclerosis (isifo esizuzwe njengelifa esiphawulwe zii-cyst ezingenamafutha kwizintso).
  • Umhlaza wesifo sezintso (imeko ezuzwe njengelifa eyenzeka xa utshintsho oluthile kwimfuza ebangela umhlaza wezintso ludluliselwa kumzali luye emntwaneni).
  • Umhlaza we-renal medullary (umhlaza onqabileyo wezintso okhula kwaye usasaze ngokukhawuleza).
  • I-leiomyomatosis yelifa (isifo esizuzwe njengelifa esonyusa umngcipheko wokuba nomhlaza kwizintso, ulusu kunye nesibeleko).

Ngaphambi kokuba unyango lwe-chemotherapy okanye unyango lwe-radiation kumhlaza womntwana, njenge-neuroblastoma, i-soft sarcoma, i-leukemia, okanye i-tumor ye-Wilms inokunyusa umngcipheko womhlaza wesifo somhlaza. Jonga icandelo lesibini leCancer kwisishwankathelo se malunga neZiphumo zeXesha elizayo lonyango lweCancer yoMntwana ngolwazi oluthe kratya.

Unyango lwethumba leWilms kunye namanye amathumba kwizintso zabantwana anokubandakanya ukululekwa ngemfuza.

Ingcebiso ngezofuzo (ingxoxo kunye noochwephesha oqeqeshiweyo malunga nezifo zemfuzo kunye nokuba kuyafuneka ukuvavanywa kwemfuzo) kunokufuneka ukuba umntwana unenye yezi syndromes okanye iimeko zilandelayo:

  • Isifo semfuza okanye imeko eyonyusa umngcipheko wethumba leWilms.
  • Imeko yelifa eyonyusa umngcipheko womhlaza wesifo sezintso.
  • Ithumba Rhabdoid zezintso.
  • Imultilocular cystic nephroma.

Iimpawu zethumba likaWilms kunye nezinye izidlo zezintso zobuntwana zibandakanya iqhuma esiswini kunye negazi kumchamo.

Ngamanye amaxesha amathumba ebuntwaneni akabangeli zimpawu kwaye umzali ufumana ubunzima esiswini ngengozi okanye ubunzima bufunyenwe ngexesha lokuvavanywa kwempilo yomntwana olungileyo. Ezi kunye nezinye iimpawu kunye neempawu zinokubangelwa ziimpawu zezintso okanye ezinye iimeko. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

  • Isigaxa, ukudumba, okanye iintlungu esiswini.
  • Igazi kumchamo.
  • Uxinzelelo lwegazi (intloko ebuhlungu, ukuziva udiniwe kakhulu, iintlungu esifubeni, okanye unengxaki yokubona okanye ukuphefumla).
  • I-Hypercalcemia (ukulahleka kwesidlo, isicaphucaphu kunye nokugabha, ubuthathaka, okanye ukudinwa kakhulu).
  • Umkhuhlane ngaphandle kwesizathu esaziwayo.
  • Ukuphelelwa ngumdla wokutya.
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Ithumba leWilms eliye lasasazeka emiphungeni okanye kwisibindi kunokubangela ezi zimpawu zilandelayo:

  • Khohlela.
  • Igazi kwisikhohlela.
  • Ingxaki yokuphefumla.
  • Intlungu esiswini.

Uvavanyo oluvavanya izintso kunye negazi zisetyenziselwa ukufumanisa ithumba likaWilms kunye nezinye izidumba zezintso zobuntwana.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

  • Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.
  • 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.
  • 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. Olu vavanyo lwenziwa ukujonga ukuba isibindi kunye nezintso zisebenza njani.
  • Uvavanyo lomsebenzi we-renal: Inkqubo apho iisampulu zegazi okanye umchamo zijongwa khona ukulinganisa inani lezinto ezithile ezikhutshelwe egazini okanye kumchamo zizintso Inani eliphezulu okanye elingaphantsi kwesiqhelo kwinto leyo inokuba luphawu lokuba izintso azisebenzi njengoko kufanelekile.
  • Urinalysis: Uvavanyo lokujonga umbala womchamo kunye neziqulatho zawo, ezinje ngeswekile, iprotein, igazi kunye neebhaktiriya.
  • 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. I-ultrasound yesisu isenziwa ukufumanisa ithumba lezintso.
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).
  • Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesifuba, isisu, kunye nesinqe, esithathwe kwiimbombo ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi ifakwe ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicubu 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) enegadolinium: Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesisu. Into ebizwa ngokuba yi-gadolinium itofelwe emthanjeni. I-gadolinium iqokelela malunga neeseli zomhlaza ukuze zibonakale zikhanya emfanekisweni. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).
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.
  • IX-reyi: IX-reyi luhlobo lombane wamandla onokuthi uhambe emzimbeni nakwifilimu, wenze umfanekiso weendawo ezingaphakathi emzimbeni, ezifana nesifuba nesisu.
  • 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 ngexesha elinye kumatshini omnye. Imifanekiso evela kuzo zombini ezi skena zidityanisiwe ukwenza umfanekiso ogcwele ngakumbi kunaluphi na uvavanyo olunokuzenzela lona. Ukuskena i-PET yinkqubo 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.
  • Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Isigqibo sokuba kwenziwe i-biopsy sisekwe kwezi zinto zilandelayo:
  • Ubungakanani bethumba.
  • Inqanaba lomhlaza.
  • Nokuba umhlaza ukwenye okanye zezintso zombini.
  • Nokuba kuvavanyo lwe-imaging lubonisa ngokucacileyo umhlaza.
  • Ingaba i-tumor ingasuswa ngophando.
  • Nokuba isigulana sikulingo lwezonyango.

I-biopsy inokwenziwa ngaphambi kokuba kunikwe naluphi na unyango, emva kwekhemotherapy yokunciphisa ithumba, okanye emva kotyando ukususa ithumba.

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

Unyango kunye nokukhethwa kunyango lwesifo seWilms kuxhomekeke koku kulandelayo:

  • Zahluke njani iiseli zethumba kwiiseli zezintso eziqhelekileyo xa zijongwa ngemicroscope.
  • Inqanaba lomhlaza.
  • Uhlobo lwethumba.
  • Ubudala bomntwana.
  • Ingaba i-tumor ingasuswa ngokupheleleyo ngophando.
  • Nokuba kukho utshintsho oluthile kwii-chromosomes okanye kwimfuza.
  • Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona (buyela).

Ukuxelwa kwangaphambili komhlaza wesifo sezintso kuxhomekeke koku kulandelayo:

  • Inqanaba lomhlaza.
  • Nokuba umhlaza unwenwele kwii-lymph node.

Ukuxela kwangaphambili kwesifo se-rhabdoid sezintso kuxhomekeke kwezi zinto zilandelayo:

  • Ubudala bomntwana ngexesha lokuchongwa.
  • Inqanaba lomhlaza.
  • Nokuba umhlaza usasazekile waya kwingqondo okanye kumqolo womqolo.

Ukuxela kwangaphambili kwe-cell sarcoma ecacileyo yezintso kuxhomekeke kwezi zinto zilandelayo:

  • Ubudala bomntwana ngexesha lokuchongwa.
  • Inqanaba lomhlaza.

Amanqanaba eWilms Tumor

IINGONGOMA EZIPHAMBILI

  • Amathumba eWilms abekwa ngexesha lotyando kunye novavanyo lokucinga.
  • Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.
  • Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.
  • Ukongeza kumanqanaba, amathumba eWilms achazwa yimbali yawo.
  • La manqanaba alandelayo asetyenziselwa i-histology efanelekileyo kunye ne-anaplastic Wilms tumors:
  • Inqanaba I
  • Inqanaba II
  • Inqanaba III
  • Inqanaba IV
  • Inqanaba V
  • Unyango lwamanye amathumba kwizintso zomntwana kuxhomekeke kuhlobo lwethumba.
  • Ngamanye amaxesha ithumba leWilms kunye namanye amathumba ebuntwaneni abuya emva konyango.

Amathumba eWilms abekwa ngexesha lotyando kunye novavanyo lokucinga.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphandle kwezintso kwamanye amalungu omzimba kuthiwa yi-staging. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Ugqirha uza kusebenzisa iziphumo zovavanyo lokuqonda isifo kunye nokubeka esiteji ukunceda ukufumanisa inqanaba lesi sifo.

Olu vavanyo lulandelayo lunokwenziwa ukubona ukuba umhlaza usasazekile na kwezinye iindawo emzimbeni:

  • I-lymph node biopsy: Ukususwa kwayo yonke into okanye inxalenye ye-lymph node esiswini. Ugqirha wezifo ujonga izicubu ze-lymph node phantsi kwemicroscope ukujonga iiseli zomhlaza. Le nkqubo ikwabizwa ngokuba yi-lymphadenectomy okanye i-lymph node dissection.
  • Uvavanyo lomsebenzi wesibindi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini sisibindi. Ixabiso elingaphezulu kwesiqhelo kwento inokuba luphawu lokuba isibindi asisebenzi njengoko kufanelekile.
  • I-X-ray yesifuba namathambo: IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenze umfanekiso weendawo ezingaphakathi emzimbeni, ezifana nesifuba.
  • I-CT scan (i-CAT scan): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesisu, isinqe, isifuba kunye nengqondo, ethathwe kwiikona ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi ifakwe ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicubu zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yicompography tomography, ikhompyuter yeTomography, okanye ikhompyuter ye-axial tomography
  • 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 ngexesha elinye kumatshini omnye. Imifanekiso evela kuzo zombini ezi skena zidityanisiwe ukwenza umfanekiso ogcwele ngakumbi kunaluphi na uvavanyo olunokuzenzela lona. Ukuskena i-PET yinkqubo 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.
  • I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezinje ngesisu, isinqe kunye nengqondo. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).
  • 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.
Ukuskena amathambo. Inani elincinci lezinto ezinemitha eqhumayo lifakwe kumthambo womntwana kwaye lihamba ngegazi. Izinto ezinemitha yeathomathizi eziqokelela emathanjeni. Njengokuba umntwana elele phezu kwetafile eslayidayo phantsi kweskena, kufunyanwa into enemitha ye-radio kunye nemifanekiso yenziwe kwikhompyuter.
  • 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. I-ultrasound yeenqanawa ezinkulu zentliziyo yenziwa kwinqanaba le-Wilms tumor.
  • ICystoscopy: Inkqubo yokujonga ngaphakathi kwesinyi kunye nerethra ukujonga iindawo ezingaqhelekanga. I-cystoscope ifakwe kwi-urethra kwisinyi. I-cystoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Inokuba nesixhobo sokususa iisampulu zethishu, ezijongwa phantsi kwemicroscope kwimpawu zomhlaza.

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 leWilms lisasazeka emiphungeni, iiseli zomhlaza emiphungeni ziiseli zesisu zomzimba. Esi sifo sisifo somzimba seWilms, hayi umhlaza wemiphunga.

Ukongeza kumanqanaba, amathumba eWilms achazwa yimbali yawo.

I-histology (indlela iiseli ezibukeka ngayo phantsi kwemicroscope) yethumba ichaphazela isifo kunye nokunyanga ithumba likaWilms. I-histology inokuba yinto ethandekayo okanye i-anaplastic (ayithandeki) Amathumba nge-histology elungileyo anokuxela okungcono kwaye aphendule ngcono kwi-chemotherapy kunamathumba e-aplastic. Iiseli zetyumzi ezahlulwe nge-aplastic zahlula ngokukhawuleza kwaye phantsi kwemicroscope azijongi njengoluhlobo lweeseli ezivela kuzo. Amathumba e-Anaplastic kunzima ukunyanga nge-chemotherapy kunezinye izicubu ze-Wilms kwinqanaba elifanayo.

La manqanaba alandelayo asetyenziselwa i-histology efanelekileyo kunye ne-anaplastic Wilms tumors:

Inqanaba I

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

  • Umhlaza wafunyanwa kuphela kwizintso kwaye awuzange usasazeke kwimithambo yegazi kwi-renal sinus (icandelo lezintso apho lijoyina khona ureter) okanye kwii-lymph node.
  • Uluhlu lwangaphandle lwezintso aluzange luvuleke.
  • Ithumba alizange liqhekeke.
  • I-biopsy ayizange yenziwe ngaphambi kokuba kususwe ithumba.
  • Akukho maseli omhlaza afunyenwe emaphethelweni endawo esuswe kuyo ithumba.

Inqanaba II

Kwinqanaba II, ithumba lasuswa ngokupheleleyo ngoqhaqho kwaye akukho iiseli zomhlaza zafunyanwa kwimiphetho yendawo apho umhlaza wawususwe khona. Umhlaza awusasazekanga kwii-lymph node. Ngaphambi kokuba kususwe eli thumba, enye yezi zinto zilandelayo yayiyinyani:

  • Umhlaza ubusasazeke waya kwi-renal sinus (icandelo lezintso apho lijoyina khona i-ureter).
  • Umhlaza ubusasazeke kwimithambo yegazi ngaphandle kwendawo yezintso apho umchamo wenziwa khona, njenge-renal sinus.

Inqanaba III

Kwinqanaba lesithathu, umhlaza uhlala esiswini emva kotyando kwaye enye yezi zinto zilandelayo inokuba yinyani:

  • Umhlaza usasazeke kwii-lymph node esiswini okanye kwi-pelvis (indawo yomzimba phakathi kwesinqe).
  • Umhlaza usasazekile okanye ngaphezulu komphezulu we-peritoneum (umaleko wethishu eligcina isisu esiswini kwaye ligubungela uninzi lwamalungu esiswini).
  • I-biopsy yethumba yenziwe ngaphambi kokuba isuswe.
  • Ithumba laqhekeka ngaphambi okanye ngexesha lotyando ukuze lisuswe.
  • Ithumba lisuswe ngaphezulu kwesiqwenga esinye.
  • Iiseli zomhlaza zifumaneka emaphethelweni endawo esuswe kuyo ithumba.
  • Lonke ithumba alinakususwa kuba amalungu abalulekileyo okanye izicwili emzimbeni zinokonakala.

Inqanaba IV

Kwinqanaba IV, umhlaza usasazeke ngegazi ukuya kumalungu anje ngemiphunga, isibindi, ithambo, okanye ingqondo, okanye kwii-lymph node ezingaphandle kwesisu kunye ne-pelvis.

Inqanaba V

Kwinqanaba V, iiseli zomhlaza zifumaneka kwizintso zombini xa umhlaza uqala ukufunyanwa.

Unyango lwamanye amathumba kwizintso zomntwana kuxhomekeke kuhlobo lwethumba.

Ngamanye amaxesha ithumba leWilms kunye namanye amathumba ebuntwaneni abuya emva konyango.

Ithumba lobuntwana leWilms linokuphinda libuye (libuye) kwindawo yoqobo, okanye emiphungeni, esiswini, esibindini, okanye kwezinye iindawo emzimbeni.

Ubuntwana obucacileyo be-sarcoma yesintso inokuphinda ibuye kwindawo yoqobo, okanye kwingqondo, kwimiphunga, okanye kwezinye iindawo emzimbeni.

Ukuzalwa komntwana nge-mesoblastic nephroma kunokuvela kwizintso okanye kwezinye iindawo emzimbeni.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

  • Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinethumba leWilms kunye nezinye izicubu zezintso zobuntwana.
  • Abantwana abane-tumor yeWilms okanye ezinye izicubu zezintso zobuntwana kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.
  • Unyango lwethumba leWilms kunye nezinye izicubu zezintso zobuntwana zingadala iziphumo ebezingalindelekanga.
  • Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:
  • Ugqirha
  • Unyango ngemitha
  • Unyango ngamayeza
  • Unyango lwe-Immunotherapy
  • I-dose ephezulu ye-chemotherapy kunye nokuhlangulwa kweseli
  • Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.
  • 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 kwizigulana ezinethumba leWilms kunye nezinye izicubu zezintso zobuntwana.

Iindlela ezahlukeneyo zonyango ziyafumaneka kubantwana abane-Wilms kunye nezinye izicubu zezintso zobuntwana. 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 abane-tumor yeWilms okanye ezinye izicubu zezintso zobuntwana kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

Unyango lomntwana wakho luya kujongwa yi-oncologist yabantwana, ugqirha ogxile kunyango lwabantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngononophelo lwempilo yabantwana abaziingcali ekunyangeni abantwana abane-tumor yeWilms okanye ezinye izicubu zezintso zobuntwana kwaye bagxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

  • Ugqirha wabantwana.
  • Ugqirha wabantwana okanye ugqirha womchamo.
  • Imitha ye-oncologist.
  • Ingcali yokuvuselela.
  • Ingcali yomongikazi wabantwana.
  • Unontlalontle.

Unyango lwethumba leWilms kunye nezinye izicubu zezintso zobuntwana zingadala 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, ezinjengeengxaki zentliziyo, iingxaki zezintso, okanye iingxaki ngexesha lokukhulelwa.
  • Utshintsho kwiimvakalelo, iimvakalelo, ukucinga, ukufunda, okanye inkumbulo.
  • Umhlaza wesibini (iintlobo ezintsha zomhlaza), ezinje ngomhlaza wendlela yamathumbu okanye umhlaza webele.

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).

Uvavanyo lweklinikhi luyenziwa ukufumanisa ukuba ngaba iidosi ezisezantsi zekhemotherapy kunye nemitha ingasetyenziselwa ukunciphisa iziphumo zasemva kwexesha lonyango ngaphandle kokutshintsha ukuba lusebenza njani unyango.

Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

Iindidi ezimbini zotyando zisetyenziselwa ukunyanga izicubu zezintso:

  • I-Nephrectomy: Ithumba leWilms kunye nezinye izidumba zezintso zobuntwana zihlala ziphathwa nge-nephrectomy (utyando lokususa zonke izintso). I-lymph node ezikufutshane nazo zingasuswa kwaye zihlolwe iimpawu zomhlaza. Ngamanye amaxesha ukufakelwa kwezintso (ukwenza utyando ukususa izintso kwaye endaweni yezintso kumnikeli) kwenziwa xa umhlaza ukwizintso zombini kwaye izintso zingasebenzi kakuhle.
  • I-nephrectomy ekhethekileyo: Ukuba umhlaza ufumaneka kwizintso zombini okanye kunokwenzeka ukuba usasazeke kuzo zombini izintso, utyando lunokubandakanya i-nephrectomy (ukususwa komhlaza kwizintso kunye nenani elincinci lezicubu eziqhelekileyo). I-nephrectomy ekhethekileyo yenziwa ukugcina uninzi lwezintso lusebenza kangangoko. I-nephrectomy ekhethekileyo ikwabizwa ngokuba ngotyando lokulondoloza intso.

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. Ngamanye amaxesha, uqhaqho lokujonga okwesibini lwenziwa ukubona ukuba umhlaza uhleli emva konyango okanye ngemitha.

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 luxhomekeke kudidi kunye nenqanaba lomhlaza ophathwayo kunye nokuba ngaba kwenziwa i-biopsy ngaphambi kotyando lokususa ithumba. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga ithumba leWilms kunye nezinye izicubu zezintso zobuntwana.

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). Ukudibanisa i-chemotherapy yonyango kusetyenziswa amachiza amabini okanye nangaphezulu.

Indlela i-chemotherapy enikezelwa ngayo ixhomekeke kuhlobo kunye nenqanaba lomhlaza ophathwayo. I-chemotherapy yenkqubo isetyenziselwa ukunyanga ithumba leWilms kunye nezinye izicubu zezintso zobuntwana.

Ngamanye amaxesha ithumba alinakususwa ngotyando ngesinye sezi zizathu zilandelayo:

  • Ithumba lisondele kakhulu kumalungu abalulekileyo okanye kwimithambo yegazi.
  • Ithumba likhulu kakhulu ukuba lingasuswa.
  • Umhlaza ukwizintso zombini.
  • Kukho ukujiya kwegazi kwimithambo ecaleni kwesibindi.
  • Isigulana sinengxaki yokuphefumla kuba umhlaza usasazeke waya emiphungeni.

Kule meko, i-biopsy yenziwa kuqala. Ke i-chemotherapy inikezelwa ukunciphisa ubungakanani be-tumor ngaphambi kotyando, ukwenzela ukugcina izicubu ezinempilo kangangoko kunokwenzeka kunye nokunciphisa iingxaki emva kotyando. Oku kubizwa ngokuba yi-neoadjuvant chemotherapy. Unyango ngemitha lunikezelwa emva kotyando.

Jonga iziyobisi ezivunyiweyo ngeWilms Tumor kunye neminye imihlaza yezintso zezomntwana ngolwazi oluthe kratya.

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.

I-Interferon kunye ne-interleukin-2 (IL-2) ziindidi zonyango lwe-immunotherapy ezisetyenziselwa ukunyanga umhlaza wesifo somhlaza wabantwana. I-Interferon ichaphazela ukwahlulwa kweeseli zomhlaza kwaye inokunciphisa ukukhula kwethumba. I-IL-2 inyusa ukukhula kunye nokusebenza kweeseli ezininzi zomzimba, ngakumbi ii-lymphocyte (uhlobo lweseli emhlophe yegazi). I-lymphocyte inokuhlasela kwaye ibulale iiseli zomhlaza.

I-dose ephezulu ye-chemotherapy kunye nokuhlangulwa kweseli

Amanqanaba aphezulu e-chemotherapy anikezelwa ukubulala iiseli zomhlaza. Iiseli ezisempilweni, kubandakanya iiseli ezenza igazi, nazo ziyatshatyalaliswa lunyango lomhlaza. Ukuhlangulwa kweseli kwistem lunyango lokutshintsha iiseli ezenza igazi. Iiseli zesinti (iiseli zegazi ezingafakwanga) ziyasuswa egazini okanye kumongo wethambo wesigulana kwaye ziyabanda 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 oluphezulu lwe-chemotherapy kunye nokuhlangulwa kweseli ye-stem kunokusetyenziselwa ukunyanga ithumba eliphindaphindiweyo likaWilms.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo lunyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza ngaphandle kokonakalisa iiseli eziqhelekileyo. Unyango ekujoliswe kulo olusetyenziselwa ukunyanga izicubu zezintso zabantwana kunokubandakanya oku kulandelayo:

  • I-Kinase inhibitors: Olu nyango lujolise kuthintela umqondiso wokuba iiseli zomhlaza kufuneka zikhule kwaye zahlule. I-LOXO-101 kunye ne-entrectinib zii-kinase inhibitors ezifundwayo ukunyanga i-nephroma ye-congenital mesoblastic. I-Tyrosine kinase inhibitors, enje nge-sunitinib okanye i-cabozantinib, inokusetyenziselwa ukunyanga i-renal cell carcinoma. I-Axitinib yi-tyrosine kinase inhibitor efundwayo ukunyanga i-renal cell carcinoma engenakususwa ngotyando okanye isasazeke kwamanye amalungu omzimba.
  • Imbali ye-methyltransferase inhibitors: Olu nyango lujolise ekunciphiseni amandla eseli yomhlaza ukukhula kunye nokwahlulahlula. I-Tazemetostat yi-histone methyltransferase inhibitor efundwayo ukunyanga i-rhabdoid tumor yezintso.
  • Unyango lwe-monoclonal antibody: Olu nyango lujolisiweyo lusebenzisa ii-antibodies ezenziwe elebhu, ukusuka kuhlobo olunye lweeseli zomzimba. Ezi antibodies zinokuchonga izinto ezikumhlaza iiseli okanye izinto eziqhelekileyo ezinokunceda iiseli zomhlaza zikhule. Amachiza omzimba ancamathele kwizinto kwaye abulale iiseli zomhlaza, athintele ukukhula kwazo, okanye azigcine zisasazeka. Iintsholongwane zeMonoclonal zinikezelwa ngokufakwa. Zingasetyenziselwa zodwa okanye ukuphatha iziyobisi, ityhefu, okanye izinto ezinemitha yeathom ngqo kwiiseli zomhlaza. I-Nivolumab yi-monoclonal antibody efundwayo ukunyanga i-renal cell carcinoma engenakususwa ngotyando okanye isasazeke kwamanye amalungu omzimba.

Unyango ekujoliswe kulo lisafundelwa ukunyanga amathumbu abantwana kwizintso aphindaphindiweyo (abuye).

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.

Ukhetho kunyango lweWilms Tumor

Kweli Candelo

  • Isigaba I Wilms Tumor
  • Isigaba II Wilms Tumor
  • Isigaba III Wilms Tumor
  • Isigaba IV Wilms Tumor
  • Isigaba V Wilms Ukudumba kunye nezigulana ezisemngciphekweni omkhulu wokukhula kwamathumba e-Wilms

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

Isigaba I Wilms Tumor

Unyango lwenqanaba I-Wilms ithumba elinembali efanelekileyo inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node, zilandelwa ngokudityaniswa kwamayeza.
  • Uvavanyo lweklinikhi lwe-nephrectomy kuphela.

Unyango lwenqanaba Iaplastic Wilms ithumba inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node ezilandelwa ngokudityaniswa kwe-chemotherapy kunye nonyango lwemitha kwindawo yecala (naliphi na icala lomzimba phakathi kweembambo kunye nehipbone).

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 II Wilms Tumor

Unyango lwenqanaba lesibini le-Wilms ithumba elinembali efanelekileyo inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node, zilandelwa ngokudityaniswa kwamayeza.

Unyango lwenqanaba lesibini i-anaplastic Wilms tumor inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node, zilandelwe ngonyango lwe-radiation esiswini kunye nokudityaniswa kwekhemotherapy.

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 III Wilms Tumor

Unyango lwenqanaba lesithathu le-Wilms ithumba elinembali efanelekileyo inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node, zilandelwe ngonyango lwe-radiation esiswini kunye nokudityaniswa kwekhemotherapy.

Unyango lwenqanaba lesithathu le-aplastic Wilms tumor inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node, zilandelwe ngonyango lwe-radiation esiswini kunye nokudityaniswa kwekhemotherapy.
  • Ukudityaniswa kwekhemotherapy elandelwa yi-nephrectomy ngokususa ii-lymph node, kulandele unyango lwe-radiation esiswini.

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 Wilms Tumor

Unyango lwenqanaba le-IV Wilms ithumba elinembali efanelekileyo inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node, zilandelwe ngonyango lwe-radiation esiswini kunye nokudityaniswa kwekhemotherapy. Ukuba umhlaza usasazekile kwamanye amalungu omzimba, abaguli baya kufumana unyango lwemitha kuloo mimandla.

Unyango lwenqanaba IV I-aplastic Wilms ithumba inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node, zilandelwe ngonyango lwe-radiation esiswini kunye nokudityaniswa kwekhemotherapy. Ukuba umhlaza usasazekile kwamanye amalungu omzimba, abaguli baya kufumana unyango lwemitha kuloo mimandla.
  • Ukudityaniswa kwekhemotherapy enikezwe ngaphambi kwe-nephrectomy kunye nokususwa kwee-lymph node, kulandele unyango lwe-radiation esiswini. Ukuba umhlaza usasazekile kwamanye amalungu omzimba, abaguli baya kufumana unyango lwemitha kuloo mimandla.

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 V Wilms Ukudumba kunye nezigulana ezisemngciphekweni omkhulu wokukhula kwamathumba e-Wilms

Unyango lwenqanaba V Wilms ithumba inokwahluka kwisigulana ngasinye kwaye inokubandakanya:

  • Umdibaniso wekhemotherapy ukunciphisa ithumba, kulandele ukuphindaphinda imifanekiso kwiiveki ezi-4 ukuya kwezi-8 zokuthatha isigqibo kunyango olongezelelweyo (i-nephrectomy, i-biopsy, ukuqhubeka kwe-chemotherapy, kunye / okanye unyango lwe-radiation).
  • I-biopsy yezintso ilandelwa ngokudibanisa i-chemotherapy ukunciphisa i-tumor. Utyando lwesibini lwenziwa ukususa umhlaza kangangoko kunokwenzeka. Oku kunokulandelwa ngamachiza amaninzi kunye / okanye unyango lwe-radiation ukuba umhlaza uhlala emva kotyando.

Ukuba ukufakelwa kwezintso kuyafuneka ngenxa yeengxaki zezintso, kuyalibaziseka kude kube li-1 ukuya kwiminyaka emi-2 emva kokuba unyango lugqityiwe kwaye akukho zimpawu zomhlaza.

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 lwezinye iimvumba zezintso zabantwana

Kweli Candelo

  • Umhlaza weSeli weRenal (RCC)
  • IRhabdoid Tumor yeZintso
  • Cacisa i-Cell Sarcoma yeZintso
  • Isizalo seMesoblastic Nephroma
  • I-Ewing Sarcoma yeZintso
  • Iiprayimari ze-Renal Myoepithelial Carcinoma
  • ICystic eyahlukileyo yahlula iNephroblastoma
  • Imultilocular cystic Nephroma
  • I-Primary Renal Synovial Sarcoma
  • I-Anaplastic Sarcoma yezintso
  • I-Nephroblastomatosis (Ukusasaza iHyperplastic Perilobar Nephroblastomatosis)

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

Umhlaza weSeli weRenal (RCC)

Unyango lomhlaza wesifo sezintso unokubandakanya:

  • Utyando, olunokuba:
  • nephrectomy ngokususa iindawo nkovu; okanye
  • i-nephrectomy ekhethekileyo ngokususwa kwee-lymph node.
  • I-Immunotherapy (i-interferon kunye ne-interleukin-2) yomhlaza osasazeke kwamanye amalungu omzimba.
  • Unyango ekujolise kulo (i-tyrosine kinase inhibitors) yomhlaza osasazeke kwamanye amalungu omzimba.
  • Uvavanyo lweklinikhi yonyango ekujoliswe kulo kunye ne-tyrosine kinase inhibitor kunye / okanye unyango lwe-monoclonal antibody yomhlaza olunotshintsho oluthile lwendalo kwaye alunakususwa ngotyando okanye lusasazeke kwamanye amalungu omzimba.

Jonga isishwankathelo se- malunga nonyango lweCancer yeRenal Cell ngolwazi olungakumbi.

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.

IRhabdoid Tumor yeZintso

Akukho lunyango lusemgangathweni lwerhabhaid ithumba. Unyango lunokubandakanya:

  • Indibaniselwano yotyando, ichemotherapy, kunye / okanye unyango ngemitha.
  • Uvavanyo lweklinikhi yonyango ekujoliswe kulo (tazemetostat).

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.

Cacisa i-Cell Sarcoma yeZintso

Unyango lwe-cell sarcoma ecacileyo yezintso inokubandakanya:

  • I-Nephrectomy ngokususa ii-lymph node ezilandelwa ngokudityaniswa kwe-chemotherapy kunye nonyango lwemitha esiswini.
  • 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.

Isizalo seMesoblastic Nephroma

Unyango lwamanqanaba I, II, kunye nezigulana ezithile zenqanaba III lokuzalwa kwesifo se-mesoblastic nephroma sinokubandakanya:

  • Ugqirha.

Unyango lwezigulana ezithile ezinesigaba III se-mesoblastic nephroma sinokubandakanya:

  • Ugqirha olunokuthi lulandelwe yichemotherapy.

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.

I-Ewing Sarcoma yeZintso

Akukho lonyango luqhelekileyo lwe-Ewing sarcoma yezintso. Unyango lunokubandakanya:

  • Indibaniselwano yotyando, ichemotherapy, kunye nonyango lwemitha.

Inokunyangwa ngendlela efanayo ne-Ewing sarcoma ephathwa ngayo. Jonga isishwankathelo se- malunga ne-Ewing Sarcoma Treatment ngolwazi oluthe kratya.

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.

Iiprayimari ze-Renal Myoepithelial Carcinoma

Akukho lonyango luqhelekileyo lwe-renal myoepithelial carcinoma. Unyango lunokubandakanya:

  • Indibaniselwano yotyando, ichemotherapy, kunye nonyango lwemitha.

ICystic eyahlukileyo yahlula iNephroblastoma

Unyango lwe-cystic olwahlulwe ngokungafaniyo nephroblastoma lunokubandakanya:

  • Ugqirha olunokuthi lulandelwe yichemotherapy.

Imultilocular cystic Nephroma

Unyango lwe-cystic nephroma ye-multilocular cystic ihlala ibandakanya:

  • Ugqirha.

I-Primary Renal Synovial Sarcoma

Unyango lwe-renal synovial sarcoma ephambili ibandakanya:

  • Unyango ngamayeza.

I-Anaplastic Sarcoma yezintso

Akukho lunyango lusemgangathweni lwe-anaplastic sarcoma yezintso. Unyango luhlala lunyango olufanayo olunikezelweyo kwi-anaplastic Wilms tumor.

I-Nephroblastomatosis (Ukusasaza iHyperplastic Perilobar Nephroblastomatosis)

Unyango lwe-nephroblastomatosis luxhomekeke koku kulandelayo:

  • Nokuba umntwana unamaqela angaqhelekanga eseli kolunye okanye kokubini izintso.
  • Nokuba umntwana unesifo sikaWilms kwesinye sezintso kunye namaqela eeseli ezingaqhelekanga kolunye izintso.

Unyango lwe-nephroblastomatosis inokubandakanya:

  • I-Chemotherapy ilandelwa yi-nephrectomy. Ngamanye amaxesha i-nephrectomy ekhethekileyo ingenziwa ukugcina umsebenzi wezintso kangangoko kunokwenzeka.

Unyango lweeThumba eziPhindayo zoBuntwana

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

Unyango lwethumba eliqhelekileyo likaWilms linokubandakanya:

  • Ukudibanisa i-chemotherapy, utyando, kunye nonyango lwemitha.
  • Umdibaniso wekhemotherapy, utyando, kunye nonyango lwemitha, olandelwa kukuhlangulwa kweseli, kusetyenziswa iiseli zegazi lomntwana.
  • Uvavanyo lweklinikhi olujonga isampulu yethumba lesigulana kutshintsho oluthile kwimfuza. Uhlobo lonyango ekujoliswe kulo oluya kunikwa isigulana luxhomekeke kuhlobo lotshintsho lwemfuza.

Unyango lwethumba eliqhelekileyo le-rhabdoid lezintso linokubandakanya:

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

Unyango lwe-sarcoma yeseli ephindaphindayo ecacileyo inokubandakanya:

  • Umdibaniso wekhemotherapy, utyando lokususa ithumba (ukuba kunokwenzeka), kunye / okanye nonyango lwemitha.
  • Uvavanyo lweklinikhi olujonga isampulu yethumba lesigulana kutshintsho oluthile kwimfuza. Uhlobo lonyango ekujoliswe kulo oluya kunikwa isigulana luxhomekeke kuhlobo lotshintsho lwemfuza.

Unyango lwe-nephroma yokuzalwa ephindaphindiweyo ye-mesoblastic inokubandakanya:

  • Ukudibanisa i-chemotherapy, utyando, kunye nonyango lwemitha.
  • Uvavanyo lweklinikhi olujonga isampulu yethumba lesigulana kutshintsho oluthile kwimfuza. Uhlobo lonyango ekujoliswe kulo oluya kunikwa isigulana luxhomekeke kuhlobo lotshintsho lwemfuza.
  • Uvavanyo lweklinikhi yonyango ekujoliswe kulo (i-LOXO-101 okanye i-entrectinib).

Unyango lwamanye amathumba aphindaphindiweyo ebuntwaneni ahlala kuvavanyo lweklinikhi.

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 neWilms Tumor kunye nezinye iZintso zeNtso zaBantwana

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nethumba leWilms kunye nezinye izicubu zezintso zobuntwana, bona oku kulandelayo:

  • Ikhasi Lasekhaya Lomhlaza Wezintso
  • Ikhompyuter yeTomography (CT) kunye noMhlaza
  • Iziyobisi ezivunyiweyo ngeWilms Tumor kunye neminye imihlaza yezintso zabantwana
  • Unyango lwe-Immunotherapy ukunyanga uMhlaza
  • Uvavanyo lweMfuzo kwii-Syndromes eziSebenzayo zoMhlaza

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


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