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Unyango lomhlaza wesibindi somntwana

Ulwazi ngokubanzi malunga nomhlaza wesibindi somntwana

IINGONGOMA EZIPHAMBILI

• Umhlaza wesibindi somntwana sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu zesibindi.

• Kukho iintlobo ezahlukeneyo zomhlaza wesibindi wobuntwana.

• Izifo ezithile kunye neemeko zinokunyusa umngcipheko womhlaza wesibindi somntwana.

• Iimpawu kunye neempawu zomhlaza wesibindi wobuntwana zibandakanya iqhuma okanye iintlungu esiswini.

• Iimvavanyo ezivavanya isibindi kunye negazi zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa umhlaza wesibindi sobuntwana kunye nokufumanisa ukuba umhlaza usasazekile na.

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

Umhlaza wesibindi somntwana sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicubu zesibindi.

Isibindi lelinye lawona malungu makhulu emzimbeni. Inamacala amabini kwaye igcwalisa icala lasekunene lesisu ngaphakathi kwimbambo. Emithathu yemisebenzi emininzi ebalulekileyo yesibindi yile:

• Ukucoca izinto eziyingozi egazini ukuze zidluliswe zisuka emzimbeni kwilindle nasemchameni.

• Ukwenza i-bile yokunceda ukwetyisa amafutha ekutyeni.

• Ukugcina i-glycogen (iswekile), esetyenziswa ngumzimba ukwenza amandla.

Umzimba wesibindi. Isibindi sisesiswini esingasentla kufuphi nesisu, amathumbu, i-gallbladder kunye ne-pancreas. Isibindi sine-lobe yasekunene kunye ne-lobe yasekhohlo. I-lobe nganye yahlulwe yangamacandelo amabini (ayiboniswanga).

Umhlaza wesibindi unqabile ebantwaneni nakwishumi elivisayo.

Kukho iintlobo ezahlukeneyo zomhlaza wesibindi wobuntwana.

Zimbini iintlobo eziphambili zomhlaza wesibindi wobuntwana:

• I-Hepatoblastoma: I-Hepatoblastoma lolona hlobo luqhelekileyo lomhlaza wesibindi somntwana. Ihlala ichaphazela abantwana abangaphantsi kweminyaka emi-3 ubudala.

Kwi-hepatoblastoma, i-histology (indlela iiseli zomhlaza ezibukeka ngayo phantsi kwemicroscope) ichaphazela indlela ophathwa ngayo umhlaza. I-histology ye-hepatoblastoma inokuba yenye yezi zinto zilandelayo:

• Umahluko okhoyo kakuhle kosana olungekazalwa (olungekazalwa olungekazalwa) olwembali.

• Iseli encinci engafaniyo nembali.

• I-histology engeyiyo eyahlukileyo engafaniyo neyomntwana, iseli engeyiyo encinci engafaniyo nembali.

• I-Hepatocellular carcinoma: I-Hepatocellular carcinoma ihlala ichaphazela abantwana abadala kunye nolutsha. Kuqheleke kakhulu kwiindawo zaseAsia ezinamazinga aphezulu osulelo lwe-hepatitis B kunase-US

Ezinye iintlobo ezingaqhelekanga zomhlaza wesibindi ebuntwaneni zibandakanya oku kulandelayo:

• I-embryonal sarcoma yesibindi: Olu hlobo lomhlaza wesibindi luhlala luvela kubantwana abaphakathi kweminyaka emi-5 ukuya kweli-10 ubudala. Ihlala isasazeka kwisibindi kunye / okanye kwimiphunga.

• I-choriocarcinoma yentsana yesibindi: Esi sisifo esinqabileyo kakhulu esiqala kwi-placenta kwaye sisasazeka kwimveku. I-tumor ihlala ifumaneka kwiinyanga ezimbalwa zokuqala zobomi. Unina womntwana unokufumanisa ukuba une-choriocarcinoma. I-Choriocarcinoma luhlobo lwesifo se-trophoblastic. Jonga isishwankathelo se- kuGestational Trophoblastic Disease Treatment ngolwazi oluthe kratya kunyango lwe-choriocarcinoma kumama womntwana.

• Izidumba zesibindi semithambo: Ezi zilonda zenzeka esibindini ukusuka kwiiseli ezenza imithambo yegazi okanye izitya ze-lymph. Izidumba zesibindi semithambo zinokuba zilungile (hayi umhlaza) okanye isifo esibi (umhlaza). Jonga isishwankathelo se kunyango lweeVascular Tumors Treatment ngolwazi oluthe kratya malunga nezidumba zesibindi semithambo.

Esi sishwankathelo simalunga nokunyangwa komhlaza wokuqala wesibindi (umhlaza oqala esibindini). Unyango lomhlaza wesibindi we-metastatic, ongumhlaza oqala kwamanye amalungu omzimba kwaye usasazeka kwisibindi, awuxutyushwanga kwesi sishwankathelo.

Umhlaza wesibindi wokuqala unokwenzeka kubantu abadala nakubantwana. Nangona kunjalo, unyango lwabantwana lwahlukile kunyango lwabantu abadala. Jonga isishwankathelo se- kunyango lweCancer Cancer yaBadala ukuze ufumane ulwazi oluthe kratya kunyango lwabantu abadala.

Izifo ezithile kunye neemeko zinokunyusa umngcipheko womhlaza wesibindi somntwana.

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

Imiba yomngcipheko we-hepatoblastoma ibandakanya ezi syndromes okanye iimeko zilandelayo:

• Isifo seAicardi.

• Isifo se-Beckwith-Wiedemann.

• Hemihyperplasia.

• I-adenomatous polyposis eqhelekileyo (FAP).

• Isifo sokugcina iGlycogen.

• Ubunzima obuphantsi kakhulu ekuzalweni.

• Isifo sikaSimpson-Golabi-Behmel.

• Olunye utshintsho kwimfuza, njengeTrisomy 18.

Abantwana abasemngciphekweni we-hepatoblastoma banokuvavanywa ukujonga umhlaza ngaphambi kokuba kuvele naziphi na iimpawu. Rhoqo emva kweenyanga ezi-3 de umntwana abe neminyaka emi-4 ubudala, uvavanyo lwesisu olwenziwa esiswini lwenziwa kwaye inqanaba le-alpha-fetoprotein egazini liyahlolwa.

Imiba yomngcipheko we-hepatocellular carcinoma ibandakanya ii-syndromes okanye iimeko ezilandelayo:

• Isifo seAlagille.

• Isifo sokugcina iGlycogen.

• Usulelo lwe-Hepatitis B lwe-virus olwadluliselwa ukusuka kumama ukuya kumntwana ekuzalweni.

• Ukuqhubela phambili kwesifo se-intrahepatic.

• Ityrosinemia.

Ezinye izigulana ezine-tyrosinemia ziya kufakelwa isibindi ukunyanga esi sifo ngaphambi kokuba kubekho imiqondiso okanye umhlaza.

Iimpawu kunye neempawu zomhlaza wesibindi wobuntwana zibandakanya iqhuma okanye iintlungu esiswini.

Iimpawu zixhaphake kakhulu emva kokuba ithumba likhulu. Ezinye iimeko zinokubangela iimpawu kunye neempawu ezifanayo. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Isigaxa esiswini esinokuba buhlungu.

• Ukudumba esiswini.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukuphelelwa ngumdla wokutya.

• Isicaphucaphu nokugabha.

Iimvavanyo ezivavanya isibindi kunye negazi zisetyenziselwa ukukhangela (ukufumana) kunye nokufumanisa umhlaza wesibindi sobuntwana kunye nokufumanisa ukuba umhlaza usasazekile na.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Uvavanyo lwe-serum tumor marker: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini ngamalungu, izicwili, okanye iiseli zethumba emzimbeni. Izinto ezithile zinxulunyaniswa neentlobo ezithile zomhlaza xa zifunyenwe kumanqanaba anyukayo egazini. Oku kubizwa ngokuba kukuphawula amathumba. Igazi labantwana abanomhlaza wesibindi linokuba nokwanda kwehomoni ebizwa ngokuba yi-beta-human chorionic gonadotropin (beta-hCG) okanye iprotein ebizwa ngokuba yi-alpha-fetoprotein (AFP). Eminye imihlaza, izilonda zesibindi ezinobungozi, kunye neemeko ezithile ezingacacanga, kubandakanya i-cirrhosis kunye ne-hepatitis, nazo zinokunyusa amanqanaba e-AFP.

• 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 lomsebenzi wesibindi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile ezikhutshelwe egazini sisibindi. Ixabiso elingaphezulu kwesiqhelo kwento inokuba luphawu lomonakalo wesibindi okanye umhlaza.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinjenge-bilirubin okanye i-lactate dehydrogenase (LDH), ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Uvavanyo lwe-Epstein-Barr virus (EBV): Uvavanyo lwegazi ukukhangela izilwa-buhlungu kwi-EBV nakwiimpawu ze-DNA ze-EBV. Ezi zifumaneka egazini lezigulana ezine-EBV.

Uvavanyo lwe- Hepatitis: Inkqubo apho kuvavanywa isampulu yegazi ngamaqhekeza e-hepatitis virus.

• I-MRI (imaging resonance imaging) enegadolinium: Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha yeendawo eziphakathi kwesibindi. 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.

• 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. Ebuntwaneni bomhlaza wesibindi, ukuhlolwa kwe-CT kwesifuba kunye nesisu kuhlala kwenziwa.

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

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

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).

• I-x-ray yesisu: IX-reyi yamalungu esiswini. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni ifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

• I-Biopsy: Ukususwa kwesampulu yeeseli okanye izicwili ukuze zijongwe phantsi kwemicroscope ukujonga imiqondiso yomhlaza. Isampulu inokuthathwa ngexesha lotyando ukususa okanye ukujonga ithumba. Ugqirha wezifo ujonga isampulu phantsi kwemicroscope ukufumana uhlobo lomhlaza wesibindi.

Olu vavanyo lulandelayo lunokwenziwa kwisampulu yethishu esusiweyo:

• I-Immunohistochemistry: Uvavanyo lwaselebhu olusebenzisa ii-antibodies ukukhangela ii-antigen ezithile (iimpawu) kwisampulu yesicwili somguli. Amachiza omzimba ahlala enxulunyaniswa ne-enzyme okanye idayi ye-fluorescent. Emva kokuba ii-antibodies zibophelela kwi-antigen ethile kwisampulu yethishu, i-enzyme okanye idayi iyasebenza, kwaye i-antigen iya kuthi emva koko ibonwe phantsi kwemicroscope. Olu hlobo lovavanyo lusetyenziselwa ukukhangela utshintsho oluthile, ukunceda ukufumanisa umhlaza, kunye nokunceda uxelele olunye uhlobo lomhlaza kolunye uhlobo lomhlaza.

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

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho kunyango lwe-hepatoblastoma luxhomekeke koku kulandelayo:

• Iqela PRETEXT.

• Ubungakanani bethumba.

• Nokuba ngaba uhlobo lwe-hepatoblastoma luhluke kakuhle kwimveku (umntwana osulungekileyo) okanye iseli encinci engafaniyo.

• Nokuba umhlaza unwenwele nakwezinye iindawo emzimbeni, ezifana nediaphragm, imiphunga, okanye imithambo ethile yegazi emikhulu.

• Nokuba kukho ngaphezulu kwethumba kwesinye esibindini.

• Nokuba isigubungelo sangaphandle esijikeleze ithumba siqhekekile.

• Uphendula njani umhlaza kwi-chemotherapy.

• Nokuba umhlaza ungasuswa ngokupheleleyo ngotyando.

• Nokuba isigulana sinokufakelwa isibindi.

• Nokuba amanqanaba egazi e-AFP ayehla emva konyango.

• Ubudala bomntwana.

• Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona.

Ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho kunyango lwe-hepatocellular carcinoma kuxhomekeke koku kulandelayo:

• Iqela PRETEXT.

• Nokuba umhlaza unwenwele nakwezinye iindawo emzimbeni, ezinje ngemiphunga.

• Nokuba umhlaza ungasuswa ngokupheleleyo ngotyando.

• Uphendula njani umhlaza kwi-chemotherapy.

• Nokuba umntwana unesifo se-hepatitis B.

• Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona.

Ngomhlaza wesibindi somntwana ophindayo (ubuya umva) emva konyango lokuqala, isifo kunye nokukhethwa kunyango kuxhomekeke:

• Apho emzimbeni laphinda lavela ithumba.

• Uhlobo lonyango olusetyenziselwa ukunyanga umhlaza wokuqala.

Umhlaza wesibindi somntwana unokunyangeka ukuba ithumba lincinci kwaye linokususwa ngokupheleleyo ngoqhaqho. Ukususwa ngokupheleleyo kunokwenzeka rhoqo kwi-hepatoblastoma kune-hepatocellular carcinoma.

Amanqanaba omhlaza wesibindi somntwana

IINGONGOMA EZIPHAMBILI

• Emva kokuba kufunyenwe isifo somhlaza wesibindi ebuntwaneni, kwenziwa iimvavanyo zokufumanisa ukuba ngaba iiseli zomhlaza zisasazekile ngaphakathi kwesibindi okanye kwamanye amalungu omzimba.

• Zimbini iinkqubo zokubeka amaqela kumhlaza wesibindi wobuntwana.

• Kukho amaqela ama-PRETEXT kunye ne-POSTTEXT:

• I-PRETEXT kunye ne-POSTTEXT Iqela I

• I-PRETEXT kunye ne-POSTTEXT Group II

• I-PRETEXT kunye ne-POSTTEXT Group III

• I-PRETEXT kunye ne-POSTTEXT Group IV

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Emva kokuba kufunyenwe isifo somhlaza wesibindi ebuntwaneni, kwenziwa iimvavanyo zokufumanisa ukuba ngaba iiseli zomhlaza zisasazekile ngaphakathi kwesibindi okanye kwamanye amalungu omzimba.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphakathi kwesibindi, ukuya kwizicubu ezikufuphi okanye amalungu, okanye kwamanye amalungu omzimba kuthiwa yistage. Kumhlaza wesibindi wobuntwana, amaqela e-PRETEXT kunye ne-POSTTEXT asetyenziswa endaweni yeqonga lokucwangcisa unyango. Iziphumo zovavanyo kunye neenkqubo ezenziweyo zokufumanisa, ukufumanisa isifo, kunye nokufumanisa ukuba umhlaza usasazekile usetyenziselwa ukumisela amaqela e-PRETEXT kunye ne-POSTTEXT.

Zimbini iinkqubo zokubeka amaqela kumhlaza wesibindi wobuntwana.

Iinkqubo ezimbini zokubeka amaqela zisetyenziselwa umhlaza wesibindi somntwana ukuthatha isigqibo sokuba ngaba isisu sinokususwa ngotyando:

• Iqela le-PRETEXT lichaza ithumba ngaphambi kokuba isiguli sifumane unyango.

• Iqela le-POSTTEXT lichaza ithumba emva kokuba isiguli sifumene unyango olufana neoadjuvant chemotherapy.

Kukho amaqela ama-PRETEXT kunye ne-POSTTEXT:

Isibindi sahlulwe sangamacandelo amane. I-PRETEXT kunye ne-POSTTEXT amaqela axhomekeke kumacandelo esibindi anomhlaza.

I-PRETEXT kunye ne-POSTTEXT Iqela I

Isibindi PRETEXT I. Umhlaza ufumaneka kwicandelo elinye lesibindi. Amacandelo amathathu esibindi asondeleleneyo angenawo umhlaza kubo.

Kwiqela I, umhlaza ufumaneka kwicandelo elinye lesibindi. Amacandelo amathathu esibindi asondeleleneyo angenawo umhlaza kubo.

I-PRETEXT kunye ne-POSTTEXT Group II

Isibindi PRETEXT II. Umhlaza ufumaneka kwicandelo elinye okanye amabini esibindi. Amacandelo amabini esibindi asondeleleneyo angenawo umhlaza kubo.

Kwiqela II, umhlaza ufumaneka kwicandelo elinye okanye amabini esibindi. Amacandelo amabini esibindi asondeleleneyo angenawo umhlaza kubo.

I-PRETEXT kunye ne-POSTTEXT Group III

Isibindi PRETEXT III. Umhlaza ufumaneka kumacandelo amathathu esibindi kwaye elinye alinawo umhlaza, okanye umhlaza ufunyanwa kumacandelo amabini esibindi kunye namacandelo amabini angadibananga akanalo umhlaza kuwo.

Kwiqela III, enye yezi zinto iyinyani:

• Umhlaza ufumaneka kumacandelo amathathu esibindi kwaye elinye icandelo alinawo umhlaza.

• Umhlaza ufumaneka kumacandelo amabini esibindi kunye namacandelo amabini angangqinelaniyo angenawo umhlaza kubo.

I-PRETEXT kunye ne-POSTTEXT Group IV

Isibindi PRETEXT IV. Umhlaza ufumaneka kuwo omane amacandelo esibindi.

Kwiqela IV, umhlaza ufumaneka kuwo omane amacandelo esibindi.

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 wesibindi wobuntwana unwenwela emiphungeni, iiseli zomhlaza emiphungeni ziiseli zomhlaza wesibindi. Esi sifo sisifo somhlaza wesibindi, hayi umhlaza wemiphunga.

Umhlaza wesiqhelo somhlaza wesibindi

Umhlaza ophindaphindiweyo wesibindi somhlaza ngumhlaza ophindaphindiweyo (ubuyile) emva kokuba unyangiwe. Umhlaza ungabuya ubuye esibindini okanye kwamanye amalungu omzimba. Umhlaza okhulayo okanye uya usiba mandundu ngexesha lonyango sisifo esiqhubela phambili.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza wesibindi wobuntwana.

• Abantwana abanomhlaza wesibindi kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza onqabileyo wobuntwana.

• Unyango lomhlaza wesibindi wobuntwana kunokubangela iziphumo ebezingalindelekanga.

• Iindidi ezintandathu zonyango zisetyenziswa:

• Ugqirha

• Ukulinda ulindile

• Unyango ngamayeza

• Unyango ngemitha

• Unyango lwe-Ablation

• Unyango lwe-Antiviral

• 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 ezinomhlaza wesibindi wobuntwana.

Iindidi ezahlukeneyo zonyango ziyafumaneka kubantwana abanomhlaza wesibindi. 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.

Ukuthatha inxaxheba kuvavanyo lweklinikhi kufuneka kuthathelwe ingqalelo kubo bonke abantwana abanomhlaza wesibindi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Abantwana abanomhlaza wesibindi kufuneka ukuba unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza onqabileyo wobuntwana.

Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngezempilo abaziingcali ekunyangeni abantwana abanomhlaza wesibindi kwaye abagxile kwiindawo ezithile zamayeza. Kubaluleke ngakumbi ukuba ube no gqirha wotyando lwabantwana onamava kotyando lwesibindi onokuthi athumele izigulana kwinkqubo yokufakelwa kwesibindi xa kufuneka njalo. Ezinye iingcali zinokubandakanya oku kulandelayo:

• Ugqirha wabantwana.

• Imitha ye-oncologist.

• Ingcali yomongikazi wabantwana.

• Ingcali yokuvuselela.

• Ingcali yeengqondo.

• Unontlalontle.

Unyango lomhlaza wesibindi wobuntwana kunokubangela 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:

• Iingxaki zomzimba.

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

• Umhlaza wesibini (iintlobo ezintsha zomhlaza).

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).

Iindidi ezintandathu zonyango zisetyenziswa:

Ugqirha

Xa kunokwenzeka, umhlaza uyasuswa ngotyando.

• Inxalenye ye-hepatectomy: Ukususwa kwenxalenye yesibindi apho umhlaza ufumaneka khona. Inxalenye esusiweyo inokuba sisuntswana leethishu, ilobe, okanye inxalenye enkulu yesibindi, kunye nexabiso elincinci leethishu elijikelezileyo.

• Iyonke i-hepatectomy kunye nokufakelwa kwesibindi: Ukususwa kwesibindi sonke kulandele ukufakelwa kwesibindi esisempilweni kumxhasi. Ukufakelwa kwesibindi kunokwenzeka xa umhlaza ungasasazekanga ngaphaya kwesibindi kwaye isibindi esinikelweyo sinokufunyanwa. Ukuba isigulana kufuneka silinde isibindi esinikelwe, olunye unyango luyanikwa xa kufuneka njalo.

• Ukufunyanwa kwakhona kwemastastase: Utyando lokususa umhlaza osasazeke ngaphandle kwesibindi, ezinje ngezicubu ezikufuphi, imiphunga, okanye ingqondo.

Uhlobo lotyando olunokwenziwa luxhomekeke koku kulandelayo:

• Iqela le-PRETEXT kunye neqela le-POSTTEXT.

• Ubungakanani be-tumor yokuqala.

• Nokuba kukho ngaphezulu kwethumba kwesinye esibindini.

• Nokuba umhlaza unwenwele kwimithambo yegazi emikhulu ekufuphi.

• Inqanaba le-alpha-fetoprotein (AFP) egazini.

• Nokuba ithumba linokuncitshiswa yichemotherapy ukuze lisuswe ngotyando.

• Nokuba ukufakelwa isibindi kuyafuneka.

I-Chemotherapy ngamanye amaxesha inikwa ngaphambi kotyando ukunciphisa ithumba kwaye kube lula ukulisusa. Oku kubizwa ngokuba lonyango lwe-neoadjuvant.

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.

Ukulinda ulindile

Ukuhlala ulindile kubeka esweni imeko yesigulana ngaphandle kokunikezela ngonyango de kuvele iimpawu okanye utshintsho. Kwi-hepatoblastoma, olu nyango lusetyenziselwa kuphela amathumba amancinci asuswe ngokupheleleyo ngoqhaqho.

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). Unyango olusebenzisa ngaphezulu kwesiyobisi esinye somhlaza lubizwa ngokuba yindibaniselwano yemichiza.

I-Chemoembolization ye-hepatic artery (owona mthamo uphambili unikezela igazi esibindini) luhlobo lwe-chemotherapy yengingqi esetyenziselwa ukunyanga umhlaza wesibindi somntwana ongenakususwa ngotyando. Iyeza elichaphazela umhlaza lifakwe kwimithambo ye-hepatic ngokusebenzisa ityhubhu (ityhubhu ebhityileyo). Ichiza lixutywe nento ethintela umthambo, isika ukuhamba kwegazi kwi-tumor. Uninzi lweziyobisi ze-anticancer zibanjelwe kufutshane nethumba kwaye kuphela sisixa esincinci sesiyobisi esifikelela kwamanye amalungu omzimba. Ukuvalelwa kunokuba yinto yethutyana okanye esisigxina, kuxhomekeke kwinto esetyenzisiweyo ukuvimba umthambo. Ithumba lithintelwe ekufumaneni ioksijini kunye nezondlo ekufuneka zikhule. Isibindi siyaqhubeka nokufumana igazi kwi-hepatic portal vein, ephethe igazi esiswini kunye namathumbu esiya esibindini.

Indlela i-chemotherapy enikwa ngayo ixhomekeke kuhlobo lomhlaza ophathwayo kunye ne-PRETEXT okanye iqela le-POSTTEXT.

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.

I-Radioembolization ye-hepatic artery (owona mthambo uphambili unikezela igazi esibindini) luhlobo lonyango lwangaphakathi lwemitha olusetyenziselwa ukunyanga i-hepatocellular carcinoma. Inani elincinci kakhulu le-radioactive liqhotyoshelwe kwiincinci ezincinci ezifakwe kwi-hepatic artery nge-catheter (ityhubhu encinci). Amaso axutywe nento ethintela umthambo, esika ukuhamba kwegazi kwithumba. Uninzi lwemitha lubotshelelwe kufutshane nethumba ukubulala iiseli zomhlaza. Oku kwenziwa ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi kubantwana abane-hepatocellular carcinoma.

Indlela unyango lwe-radiation olunikezelwa ngayo ixhomekeke kuhlobo lomhlaza ophathwayo kunye ne-PRETEXT okanye iqela le-POSTTEXT. Unyango lwangaphandle lwemitha lusetyenziselwa ukunyanga i-hepatoblastoma engenakususwa ngotyando okanye isasazeke kwamanye amalungu omzimba.

Unyango lwe-Ablation

Unyango lwe-Ablation lususa okanye lutshabalalise izicwili. Iindidi ezahlukeneyo zonyango lokunyanga zisetyenziselwa umhlaza wesibindi:

• Ukurhoxiswa kweRadiofrequency: Ukusetyenziswa kweinaliti ezizodwa ezifakwe ngqo kulusu okanye ngokusebenzisa isisu esiswini ukufikelela kwisisu. Amandla amaza erediyo aphezulu afudumeza iinaliti kunye nethumba elibulala iiseli zomhlaza. Ukurhoxiswa kwemitha kusetyenziselwa ukunyanga i-hepatoblastoma ephindaphindayo.

• Inaliti ye-ethanol: Inaliti encinci isetyenziselwa ukutofa i-ethanol (i-alcohol engaxutywanga) ngqo kwi-tumor ukubulala iiseli zomhlaza. Unyango lunokufuna iinaliti ezininzi. Inaliti ye-ethanol esetyenziswayo ukunyanga i-hepatoblastoma ephindaphindayo.

Unyango lwe-Antiviral

I-hepatocellular carcinoma edibene ne-hepatitis B inokuthi inyangwe ngamachiza antiviral.

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 lweTyrosine kinase inhibitor (TKI) luhlobo lonyango ekujoliswe kulo. Iimpawu zebhloko ze-TKIs ezifunekayo ukuze amathumba akhule. I-Sorafenib kunye ne-pazopanib zii-TKIs ezifundwayo kunyango lwe-hepatocellular carcinoma ebuyileyo kunye ne-embryonal sarcoma yesibindi esandula ukufunyanwa.

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.

Olunye uvavanyo olwenziweyo ukufumanisa umhlaza okanye ukufumanisa iqela lonyango lunokuphindwa. Olunye uvavanyo luya kuphindwa ukuze lubone 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 kunyango lomhlaza wesibindi somntwana

Kweli Candelo

• IHepatoblastoma

• IHepatocellular Carcinoma

• I-Embryonal Sarcoma yesibindi

• Usana lweChoriocarcinoma yesibindi

• Ukudumba kwesibindi

• Umhlaza wesiqhelo somhlaza wesibindi

• Ukhetho kunyango kwizilingo zonyango

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

IHepatoblastoma

Izinketho zonyango lwe-hepatoblastoma ezinokususwa ngophando ngexesha lokuxilongwa zingabandakanya oku kulandelayo:

• Utyando lokususa ithumba, kulandelwe ukudityaniswa kwe-chemotherapy ye-hepatoblastoma engafaniyo kakuhle nembali yomntwana. Kwi-hepatoblastoma eneseli encinci engafaniyo, ichemotherapy enochuku inikwa.

• Utyando lokususa ithumba, kulandele ukulinda okubukhali okanye i-chemotherapy, ye-hepatoblastoma ene-histology eyahlukileyo.

Izinketho zonyango lwe-hepatoblastoma ezingenakususwa ngophando okanye zingasuswa ngexesha lokuxilongwa zingabandakanya oku kulandelayo:

• Umdibaniso wekhemotherapy ukunciphisa ithumba, kulandele utyando ukususa ithumba.

• Ukudityaniswa kwekhemotherapy, kulandele ukufakelwa kwesibindi.

• I-Chemoembolization ye-hepatic artery yokunciphisa ithumba, kulandele utyando lokususa ithumba.

• Ukuba ithumba esibindini ayinakususwa ngotyando kodwa akukho zimpawu zomhlaza kwamanye amalungu omzimba, unyango lungafakelwa isibindi.

Kwi-hepatoblastoma ethe yasasazeka kwamanye amalungu omzimba ngexesha lokufumanisa isifo, indibaniselwano ye-chemotherapy inikezelwa ukunciphisa amathumba esibindini kunye nomhlaza osasazeke kwamanye amalungu omzimba. Emva konyango ngamakhemikhali, iimvavanyo zokucinga zenziwa ukujonga ukuba amathumba angasuswa ngotyando.

Izinketho zonyango zingabandakanya oku kulandelayo:

• Ukuba ithumba esesibindini kunye namanye amalungu omzimba (ngesiqhelo amaqhuqhuva emiphungeni) angasuswa, kuya kwenziwa utyando ukususa amathumba alandelwe yi-chemotherapy ukubulala naziphi na iiseli zomhlaza ezinokuhlala.

• Ukuba ithumba kwamanye amalungu omzimba ayinakususwa okanye ukufakelwa isibindi akunakwenzeka, i-chemotherapy, i-chemoembolization ye-hepatic artery, okanye unyango lwe-radiation lunokunikwa.

• Ukuba ithumba kwamanye amalungu omzimba alinakususwa okanye isigulana asifuni kuqhaqho, kunokunikezelwa nge-radiofrequency ablation.

Izinketho zonyango kwizilingo zeklinikhi kwi-hepatoblastoma esanda kufunyaniswa zibandakanya:

• Uvavanyo lweklinikhi lwe-chemotherapy kunye notyando.

IHepatocellular Carcinoma

Izinketho zonyango lwe-hepatocellular carcinoma enokususwa ngophando ngexesha lokuxilongwa kunokubandakanya oku kulandelayo:

• Utyando ndedwa ukususa ithumba.

• Utyando lokususa ithumba, kulandele ichemotherapy.

• Ukudityaniswa kwekhemotherapy, kulandele utyando lokususa ithumba.

Izinketho zonyango lwe-hepatocellular carcinoma ezingenakususwa ngotyando kwaye zingasasazeki kwamanye amalungu omzimba ngexesha lokuchongwa zinokubandakanya oku kulandelayo:

• I-Chemotherapy yokunciphisa ithumba, ilandelwe ngotyando ukuze lisuswe ngokupheleleyo eli thumba.

• I-Chemotherapy ukunciphisa ithumba. Ukuba utyando lokukhupha ngokupheleleyo ithumba alunakwenzeka, olunye unyango lunokubandakanya oku kulandelayo:

• Ukufakelwa kwesibindi.

• I-Chemoembolization ye-hepatic artery yokunciphisa ithumba, kulandele utyando ukususa ithumba okanye ukufakelwa kwesibindi.

• I-Chemoembolization ye-hepatic artery yodwa.

• Chemoembolization elandelwa kukufakelwa kwesibindi.

• I-Radioembolization ye-hepatic artery njengonyango lokunyanga ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi.

Unyango lwe-hepatocellular carcinoma ethe yasasazeka kwamanye amalungu omzimba ngexesha lokuchongwa kunokubandakanya:

• Umdibaniso wekhemotherapy ukunciphisa ithumba, kulandele utyando lokususa ithumba kangangoko kwisibindi nakwezinye iindawo apho umhlaza usasazeke khona. Izifundo khange zibonise ukuba olu nyango lusebenza kakuhle kodwa ezinye izigulana zinokufumana izibonelelo ezithile.

Ukhetho kunyango lwe-hepatocellular carcinoma enxulumene nosulelo lwe-hepatitis B (HBV) lubandakanya:

• Utyando lokususa ithumba.

• Amachiza antiviral anyanga usulelo olubangelwa yintsholongwane ye-hepatitis B.

Ukhetho kunyango kwizilingo zeklinikhi kwi-hepatocellular carcinoma esandula ukufunyanwa lubandakanya:

• Uvavanyo lweklinikhi lwe-chemotherapy kunye notyando.

I-Embryonal Sarcoma yesibindi

Ukhetho kunyango lwe-embryonal sarcoma yesibindi inokubandakanya oku kulandelayo:

• Ukudityaniswa kwekhemotherapy ukunciphisa ithumba, kulandele utyando lokususa ithumba kangangoko kunokwenzeka. I-Chemotherapy inokunikwa emva kotyando ukususa ithumba.

• Utyando lokususa ithumba, kulandele ichemotherapy. Utyando lwesibini lunokwenziwa ukususa i-tumor eseleyo, elandelwa yi-chemotherapy engaphezulu.

• Ukufakelwa kwesibindi ukuba utyando lokususa ithumba alunakwenzeka.

• Uvavanyo lweklinikhi yerejimeni yonyango entsha enokuthi ibandakanye unyango ekujolise kulo (pazopanib), ichemotherapy kunye / okanye unyango lwemitha ngaphambi kotyando.

Usana lweChoriocarcinoma yesibindi

Ukhetho kunyango lwe-choriocarcinoma yesibindi kwiintsana kunokubandakanya oku kulandelayo:

• Umdibaniso wekhemotherapy ukunciphisa ithumba, kulandele utyando ukususa ithumba.

• Utyando lokususa ithumba.

Ukudumba kwesibindi

Jonga isishwankathelo se kunyango lweeVascular Tumors Treatment ngolwazi malunga nonyango lwezihlunu zesibindi semithambo.

Umhlaza wesiqhelo somhlaza wesibindi

Unyango lwe-hepatoblastoma eqhubekayo okanye eqhubekayo inokubandakanya oku kulandelayo:

• Ugqirha lokususa amathumba abodwa (ahlukeneyo kwaye ahlukeneyo) e-metastatic kunye okanye ngaphandle kwe-chemotherapy.

• Ukupheliswa kwemitha rhoqo.

• Ukudibanisa i-chemotherapy.

• Ukufakelwa kwesibindi.

• Unyango lwe-Ablation.

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

Unyango lwe-hepatocellular carcinoma eqhubekayo okanye eqhubekayo inokubandakanya oku kulandelayo:

• I-Chemoembolization ye-hepatic artery yokunciphisa i-tumor ngaphambi kokufakelwa kwesibindi.

• Ukufakelwa kwesibindi.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo (i-sorafenib).

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

Unyango lwe-embarconal sarcoma yesibindi inokubandakanya oku kulandelayo:

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

Unyango lwe-choriocarcinoma ephindaphindayo yesibindi kwiintsana kunokubandakanya oku kulandelayo:

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

Ukhetho kunyango kwizilingo zonyango

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 weSibindi soBuntwana

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

• Iphepha lasekhaya lesifo somhlaza kunye nesibilini

• Ikhompyuter yeTomography (CT) kunye noMhlaza

• I-MyPART-Unxibelelwano lwam lwaBantwana kunye naBantu abaDala abaNinzi

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