Iindidi / ithishu ethambileyo-isarcoma / isigulana / unyango lwe-rhabdomyosarcoma-pdq

Unyango lweRhabdomyosarcoma yoBuntwana (®) -Ingxelo yePatient

Ulwazi ngokubanzi malunga neRhabdomyosarcoma yobuntwana

I-rhabdomyosarcoma yobuntwana sisifo apho iiseli ezibi (zomhlaza) zeeseli zomzimba.

IRhabdomyosarcoma luhlobo lwesarcoma. I-Sarcoma ngumhlaza wezicubu ezithambileyo (ezinje ngemisipha), izicwili ezinxibelelanayo (ezinje ngethenda okanye intlala), okanye ithambo. IRhabdomyosarcoma ihlala iqala kwimisipha encanyathiselwe emathanjeni kwaye inceda umzimba ukuba uhambe. I-Rhabdomyosarcoma lolona hlobo luqhelekileyo lwe-sarcoma yethishu ethambileyo ebantwaneni. Inokuqala kwiindawo ezininzi emzimbeni.

Zintathu iintlobo eziphambili zerhabdomyosarcoma:

• I-Embryonal: Olu hlobo luvela rhoqo entloko nasentanyeni okanye kwilungu lobufazi okanye kumchamo, kodwa lunokwenzeka naphi na emzimbeni. Luhlobo oluqhelekileyo lwe-rhabdomyosarcoma.

• I-Alveolar: Olu hlobo luhlala luhlala rhoqo kwiingalo okanye emilenzeni, esifubeni, esiswini, kumalungu obuni, okanye kwindawo yempundu.

• I-Anaplastic: Olu lolona hlobo luqhelekileyo lwe-rhabdomyosarcoma ebantwaneni.

Jonga ezi zishwankathelo zonyango zilandelayo ze- zolwazi malunga nezinye iintlobo zesarcoma yethishu ethambileyo:

• Amathambo eSoftue Sarcoma ebuntwaneni

• Tissue Sarcoma yabantu abadala

Iimeko ezithile zofuzo zonyusa umngcipheko wokuba rhabdomyosarcoma yobuntwana.

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

Izinto ezinobungozi kwi-rhabdomyosarcoma zibandakanya ukuba nezifo zilandelayo:

• Isifo seLi-Fraumeni.

• IPleuropulmonary blastoma.

• Uhlobo lwe-Neurofibromatosis 1 (NF1).

• ICostello syndrome.

• Isifo se-Beckwith-Wiedemann.

• Isifo sikaNoonan.

Abantwana abanobunzima bokuzalwa obuphezulu okanye babebakhulu kunokuba bekulindelwe ekuzalweni banokuba nomngcipheko okhulayo we-embryonal rhabdomyosarcoma.

Kwiimeko ezininzi, unobangela we-rhabdomyosarcoma awaziwa.

Umqondiso wobuntwana rhabdomyosarcoma sisigaqa okanye ukudumba okuhlala kukhula.

Iimpawu kunye neempawu zinokubangelwa yi-rhabdomyosarcoma yobuntwana okanye ngezinye iimeko. Iimpawu kunye neempawu ezenzekayo zixhomekeka apho umhlaza wenzeka khona. Jonga kugqirha womntwana wakho ukuba umntwana wakho unayo nayiphi na kwezi zinto zilandelayo:

• Isigaxa okanye ukudumba okuhlala kukhula okanye kungapheli. Kusenokuba buhlungu.

• Ukudumba kweliso.

• Intloko ebuhlungu.

• Ingxaki yokuchama okanye ukuhamba kwamathumbu.

• Igazi kumchamo.

• Ukopha empumlweni, emqaleni, kwilungu lobufazi, okanye kwi-rectum.

Uvavanyo lokuchonga kunye ne-biopsy zisetyenziselwa ukufumanisa (ukufumana) kunye nokuchonga i-rhabdomyosarcoma yobuntwana.

Uvavanyo lokuqonda olwenziwe luxhomekeke kwinxalenye apho umhlaza wenzeka khona. 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.

• IX-reyi: X-reyi yamalungu kunye namathambo ngaphakathi komzimba, njengesifuba. IX-reyi luhlobo lwe-beam yamandla enokuhamba emzimbeni nakwifilimu, yenza umfanekiso weendawo ezingaphakathi komzimba.

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

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

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo zomzimba, ezinje ngokakayi, ngengqondo, kunye ne-lymph node. 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-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo.

Ukuskena i-Positron emission tomography (PET). Umntwana ulele phezu kwetafile etyibilika kwisikena sePET. Ukuphumla kwentloko kunye nomtya omhlophe kunceda umntwana ukuba alale. Inani elincinci leswekile ene-radioactive (iswekile) itofwe emthanjeni womntwana, kwaye iskena senza umfanekiso apho iswekile isetyenziswa khona emzimbeni. Iiseli zomhlaza zibonakala ziqaqambile emfanekisweni kuba zithatha iswekile eninzi kuneseli eziqhelekileyo.

• 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.

• Umnqweno wethambo lomnqweno kunye ne-biopsy: Ukususwa komongo wethambo, igazi, kunye nesiqwenga samathambo ngokufaka inaliti engenanto kumqolo. Iisampulu zisuswe kuwo omabini amathambo. Ugqirha wezifo ujonga umongo wethambo, igazi kunye nethambo phantsi kwemicroscope ukukhangela iimpawu zomhlaza.

Umnqweno wethambo lomnqweno kunye ne-biopsy. Emva kokuba indawo encinci yolusu iphonyiwe, inaliti yomongo wethambo ifakwa kwithambo lesinqe somntwana. Iisampulu zegazi, ithambo, kunye nomongo wethambo ziyasuswa ukuze zihlolwe phantsi kwemicroscope.

• Ukugqobhoza iLumbar: Inkqubo esetyenziselwa ukuqokelela i-cerebrospinal fluid (CSF) ukusuka kumqolo womqolo. Oku kwenziwa ngokubeka inaliti phakathi kwamathambo amabini emqolo kunye nakwi-CSF ejikeleze intambo yomqolo kunye nokususa isampulu yolwelo. Isampulu ye-CSF ihlolwe phantsi kwemicroscope kwimpawu zeseli zomhlaza. Le nkqubo ikwabizwa ngokuba yi-LP okanye impompo yomqolo.

Ukuba ezi mvavanyo zibonisa ukuba kunokubakho i-rhabdomyosarcoma, kwenziwa i-biopsy. I-biopsy kukususwa kweeseli okanye izicwili ukuze zijongwe phantsi kwemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Ngenxa yokuba unyango luxhomekeke kuhlobo lwe-rhabdomyosarcoma, iisampulu ze-biopsy kufuneka zihlolwe ngugqirha wezifo onamava ekuchongeni i-rhabdomyosarcoma.

Enye yezi ndlela zilandelayo zinokusetyenziswa:

• Fine-inaliti aspiration (FNA) biopsy: Ukususwa kwethishu okanye ulwelo kusetyenziswa inaliti encinci.

• I-biopsy yenaliti: Ukususwa kwezicubu kusetyenziswa inaliti ebanzi. Le nkqubo inokukhokelwa kusetyenziswa i-ultrasound, CT scan, okanye iMRI.

• Vula i-biopsy: Ukususwa kwethishu ngokusikwa (ukusika) okwenziwe kulusu.

• I-Sentinel lymph node biopsy: Ukususwa kwe-sentinel lymph node ngexesha lotyando. I-lymph node ye-sentinel yindawo yokuqala ye-lymph kwiqela le-lymph node ukufumana i-lymphatic drainage kwi-tumor yokuqala. Yeyona nkovu node yokuqala ukuba umhlaza kunokwenzeka ukuba usasazeke ukusuka kwithumba lokuqala. Into ene-radioactive kunye / okanye idayi eblowu ifakwe kwisitofu kufutshane nethumba. Isixhobo okanye idayi ihamba ngee-lymph ducts ukuya kwii-lymph nodes. I-lymph node yokuqala yokufumana into okanye idayi isuswe. Ugqirha wezifo ujonga izicwili phantsi kwemicroscope ukukhangela iiseli zomhlaza. Ukuba iiseli zomhlaza azifumaneki, kusenokungabikho mfuneko yokususa ii-lymph node. Ngamanye amaxesha, i-lymph node ye-sentinel ifunyanwa ngaphezulu kweqela elinye lendawo.

Olu vavanyo lulandelayo lunokwenziwa kwisampulu yethishu esusiweyo:

• Imicroscopy ekhanyayo: Uvavanyo lwaselebhu apho iiseli ezikwisampulu yethishu zijongwa phantsi kwemicroscopes eqhelekileyo kunye nephakamileyo ukujonga utshintsho oluthile kwiiseli.

• I-Immunohistochemistry: Uvavanyo olusebenzisa izilwa-buhlungu ukujonga iiantigen ezithile kwisampulu yethishu. I-antibody ihlala inxulunyaniswa nezinto ezinemitha yeathom okanye idayi ebangela ukuba izicwili zikhanyise phantsi kwemicroscope. Olu hlobo lovavanyo lunokusetyenziselwa ukuxelela umahluko phakathi kweentlobo ezahlukeneyo zomhlaza.

• I-FISH (i-fluorescence in situ hybridization): Uvavanyo lwaselebhu olusetyenziselwa ukujonga iijini okanye ii-chromosomes kwiiseli nakwizicubu. Amacandelo e-DNA aqukethe idayi ye-fluorescent yenziwa elebhu kwaye yongezwa kwiiseli okanye izicwili kwisilayidi seglasi. Xa ezi ziqwenga ze-DNA zinamathela kwiintlobo ezithile zemfuza okanye kwimimandla yee-chromosomes kwisilayidi, ziyakhanya xa zijongwa ngemicroscope enokukhanya okukhethekileyo. Olu hlobo lovavanyo lusetyenziselwa ukufumana utshintsho oluthile kwimfuza.

• Ukubuyela umva kuvavanyo lwe-polymerase chain reaction (RT-PCR) Uvavanyo lwaselebhu apho iiseli ezikwisampulu yethishu zifundwa kusetyenziswa iikhemikhali ukujonga utshintsho oluthile kubume okanye ekusebenzeni kwemfuza.

• Uhlalutyo lweCytogenetic: Uvavanyo lwaselebhu apho iiseli kwisampulu yethishu zijongwa phantsi kwemicroscope ukujonga utshintsho oluthile kwii-chromosomes.

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

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

• Iminyaka yesigulana.

• Apho emzimbeni laqala khona ithumba.

• Ubungakanani be-tumor ngexesha lokuxilongwa.

• Nokuba ithumba lisuswe ngokupheleleyo ngoqhaqho.

• Uhlobo lwe-rhabdomyosarcoma (embryonal, alveolar, okanye anaplastic).

• Nokuba kukho utshintsho oluthile kwimfuza.

• Nokuba ithumba lalinwenwele kwamanye amalungu omzimba ngexesha lokuchongwa.

• Nokuba ithumba lalikwi-lymph node ngexesha lokuchongwa.

• Nokuba ithumba liyaphendula kwi-chemotherapy kunye / okanye kunyango lwe-radiation.

Kwizigulana ezinomhlaza ophindaphindiweyo, isifo kunye nonyango luxhomekeke koku kulandelayo:

• Apho emzimbeni laphinda labuya ithumba (labuya).

• Lingakanani ixesha elidlulileyo phakathi kokuphela konyango lomhlaza kwaye umhlaza uphinde wabuya.

• Nokuba ithumba lanyangwa ngonyango lwemitha.

Amanqanaba eRhabdomyosarcoma yobuntwana

IINGONGOMA EZIPHAMBILI

• Emva kokuba i-rhabdomyosarcoma ebuntwaneni ifunyenwe, unyango lusekwe kwinxalenye yomhlaza kwaye ngamanye amaxesha lusekwe ekubeni wonke umhlaza ususwe ngotyando.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• Inqanaba le-rhabdomyosarcoma yobuntwana yenziwa kwiindawo ezintathu.

• Inkqubo yokulinganisa isekwe kubungakanani bethumba, apho likho emzimbeni, nokuba sele linwenwele kwamanye amalungu omzimba:

• Inqanaba 1

• Inqanaba 2

• Inqanaba 3

• Inqanaba 4

• Inkqubo yokubeka ngokwamaqela isekwe ekubeni umhlaza usasazekile na nokuba wonke umhlaza ususwe ngotyando:

• Iqela I

• Iqela II

• Iqela III

• Iqela IV

• Iqela lomngcipheko lisekwe kwinkqubo yeqonga nakwinkqubo yokubeka ngokwamaqela.

• Umngcipheko wobuntwana obunobungozi kwi-rhabdomyosarcoma

• Umngcipheko ophakathi wobuntwana rhabdomyosarcoma

• Umngcipheko wokuba ngumntwana kumngcipheko wokuba rhabdomyosarcoma

Emva kokuba i-rhabdomyosarcoma ebuntwaneni ifunyenwe, unyango lusekwe kwinxalenye yomhlaza kwaye ngamanye amaxesha lusekwe ekubeni wonke umhlaza ususwe ngotyando.

Inkqubo esetyenziselwa ukufumanisa ukuba ngaba umhlaza usasazekile ngaphakathi kwithishu okanye kwamanye amalungu omzimba kuthiwa yistage. Kubalulekile ukwazi inqanaba ukuze ucwangcise unyango. Ugqirha uza kusebenzisa iziphumo zovavanyo lokuqonda ukunceda ukufumanisa inqanaba lesi sifo.

Unyango lwe-rhabdomyosarcoma yobuntwana lusekwe kwinqanaba kwaye ngamanye amaxesha kwinani lomhlaza elisele emva kotyando lokususa ithumba. Isazi ngezifo siya kusebenzisa imicroscope ukujonga izicwili ezisusiweyo ngexesha lotyando, kubandakanya iisampulu zethishu emaphethelweni eendawo apho umhlaza ususwe kunye ne-lymph node. Oku kwenzelwa ukubona ukuba zonke iiseli zomhlaza zikhutshiwe ngexesha lotyando.

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 i-rhabdomyosarcoma isasazeka emiphungeni, iiseli zomhlaza emiphungeni ziiseli ze-rhabdomyosarcoma. Esi sifo siyi-metastatic rhabdomyosarcoma, hayi umhlaza wemiphunga.

Inqanaba le-rhabdomyosarcoma yobuntwana yenziwa kwiindawo ezintathu.

I-rhabdomyosarcoma yobuntwana ibekwa ngokusebenzisa iindlela ezintathu ezahlukeneyo zokuchaza umhlaza:

• Inkqubo yokubeka esiteji.
• Inkqubo yokubeka ngokwamaqela.
• Iqela lomngcipheko.

Inkqubo yokulinganisa isekwe kubungakanani bethumba, apho likho emzimbeni, nokuba sele linwenwele kwamanye amalungu omzimba:

Inqanaba 1

Kwinqanaba loku-1, eli thumba nabuphi na ubungakanani, kusenokwenzeka ukuba linwenwele kwii-lymph node, kwaye lifunyanwa kuphela kwezi ndawo zilandelayo: "zilungile":

• Iliso okanye indawo ejikeleze iliso.

• Intloko nentamo (kodwa hayi kwizicwili ecaleni kwengqondo kunye nomqolo).

• I-gallbladder kunye ne-bile ducts.

• Ama-Ureters okanye urethra.

• Uvavanyo, isibeleko, ubufazi, okanye isibeleko.

I-Rhabdomyosarcoma eyakha indawo "efanelekileyo" ine-prognosis engcono. Ukuba indawo apho umhlaza uvela khona ayisiyiyo enye yeziza ezithandwayo ezidweliswe apha ngasentla, kuthiwa yindawo "engathandekiyo".

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

Inqanaba 2

Kwinqanaba lesi-2, umhlaza ufunyanwa kwindawo "engathandekiyo" (nayiphi na indawo engachazwanga njenge "intle" kwinqanaba 1). Ithumba alikho ngaphezulu kweesentimitha ezi-5 kwaye alisasazekanga kwii-lymph node.

Inqanaba 3

Kwinqanaba lesi-3, umhlaza ufunyanwa kwindawo "engathandekiyo" (nayiphi na indawo engachazwanga njenge "intle" kwinqanaba 1) kwaye enye yezi zinto zilandelayo iyinyani:

• Ithumba alikho ngaphezulu kweesentimitha ezi-5 kwaye umhlaza usasazeke kwii-lymph node ezikufutshane.

• Ithumba likhulu kuneesentimitha ezi-5 kwaye umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

Inqanaba 4

Kwinqanaba le-4, ithumba inokuba nabuphi na ubungakanani kwaye umhlaza usenokusasazeka kwii-lymph node ezikufutshane. Umhlaza unwenwele kwiindawo ezikude zomzimba, ezinje ngemiphunga, umongo wethambo, okanye ithambo.

Inkqubo yokubeka ngokwamaqela isekwe ekubeni umhlaza usasazekile na nokuba wonke umhlaza ususwe ngotyando:

Iqela I

Umhlaza wafunyanwa kuphela kwindawo eyaqala kuyo kwaye wasuswa ngokupheleleyo ngotyando. Izicubu zazithathwa kwimiphetho apho lalisuswe khona ithumba. Izicubu zajongwa phantsi kwemicroscope ngugqirha wezifo kwaye akukho iiseli zomhlaza zafunyanwa.

Iqela II

Iqela II lahlulwe laba ngamaqela IIA, IIB, kunye ne-IIC.

• I-IIA: Umhlaza wasuswa ngotyando kodwa iiseli zomhlaza zabonwa xa izicwili, zithathwe kwimiphetho yesifo apho sasuswe khona, yajongwa phantsi kwemicroscope ngugqirha wezifo.

• IIB: Umhlaza wawusasazeke kwii-lymph node ezikufutshane kwaye umhlaza kunye ne-lymph node zisuswe ngotyando.

• IIC: Umhlaza ubusasazeke kwii-lymph node ezikufuphi, umhlaza kunye ne-lymph node zisuswe ngotyando, kwaye ubuncinci kwezi zilandelayo ziyinyani:

• Izicubu ezithathwe kwimiphetho apho lalisuswe khona ithumba lajongwa phantsi kwemicroscope ngugqirha wezifo kwaye iiseli zomhlaza zabonwa.

• I-lymph node ephezulu kakhulu evela kwi-tumor eyasuswayo yahlolwa phantsi kwe-microscope yi-pathologist kunye neeseli zomhlaza zabonwa.

Iqela III

Umhlaza wawususwe ngokuyinxalenye yi-biopsy okanye ngoqhaqho kodwa kukho ithumba eliseleyo elinokubonwa ngamehlo.

Iqela IV

• Umhlaza wawusasazeke kwiindawo ezikude zomzimba xa kwafunyanwa umhlaza.

• Iiseli zomhlaza zifunyanwa ngovavanyo lokucinga; okanye

Kukho iiseli zomhlaza kulwelo olujikeleze ingqondo, umnqonqo, okanye imiphunga, okanye kulwelo esiswini; okanye amathumba afumaneka kwezo ndawo.

Iqela lomngcipheko lisekwe kwinkqubo yeqonga nakwinkqubo yokubeka ngokwamaqela.

Iqela lomngcipheko lichaza ithuba lokuba i-rhabdomyosarcoma iphinde ibuye (ibuye). Wonke umntwana ophathwe i-rhabdomyosarcoma kufuneka afumane ichemotherapy yokunciphisa amathuba okuba umhlaza uphinde ubuye. Uhlobo lweziyobisi ze-anticancer, idosi, kunye nenani lonyango olunikiweyo luxhomekeke ekubeni umntwana unobungozi obuphantsi, umngcipheko ophakathi, okanye i-rhabdomyosarcoma ephezulu.

La maqela omngcipheko alandelayo asetyenziswa:

Umngcipheko wobuntwana obunobungozi kwi-rhabdomyosarcoma

• I-rhabdomyosarcoma esemngciphekweni wobuntwana yenye yezi zinto zilandelayo:

Ithumba elibelekileyo lobuphi na ubungakanani obufumaneka kwindawo "elungileyo". Kunokubakho ithumba eliseleyo emva kotyando olunokubonwa kunye okanye ngaphandle kwemakroskopu. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane. Ezi ndawo zilandelayo "zilungile" iisayithi:

• Iliso okanye indawo ejikeleze iliso.

• Intloko okanye intamo (kodwa hayi kwizicubu ezikufutshane nendlebe, impumlo, iisono, okanye isiseko solukakayi).

• I-gallbladder kunye ne-bile ducts.

• Ureter okanye urethra.

• Uvavanyo, isibeleko, ubufazi, okanye isibeleko.

Ithumba elibelekweyo lobuphi na ubungakanani elingafumaneki kwindawo "elungileyo". Kunokubakho ithumba eliseleyo emva kotyando olunokubonwa kuphela ngemicroscope. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

Umngcipheko ophakathi wobuntwana rhabdomyosarcoma

Umngcipheko ophakathi wobuntwana rhabdomyosarcoma yenye yezi zinto zilandelayo:

• Ithumba eliselibeleni lobuphi na ubungakanani elingafumanekiyo kwenye yeendawo "ezilungileyo" ezidweliswe apha ngasentla. Kukho ithumba elisele emva kotyando, elinokubonwa kunye okanye ngaphandle kwemakroskopu. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

• Ithumba eline-alveolar nabuphi na ubungakanani kwindawo "ethandekayo" okanye "engathandekiyo". Kunokubakho ithumba eliseleyo emva kotyando olunokubonwa kunye okanye ngaphandle kwemakroskopu. Umhlaza usenokusasazeka kwii-lymph node ezikufutshane.

Umngcipheko wokuba ngumntwana kumngcipheko wokuba rhabdomyosarcoma

Umngcipheko wokuba ngumntwana kwi-rhabdomyosarcoma inokuba luhlobo lwe-embryonal okanye uhlobo lwe-alveolar. Inokuthi isasazeka kwii-lymph node ezikufutshane kwaye isasazeke kwenye okanye ngaphezulu kwezi zilandelayo:

• Amanye amalungu omzimba angekho kufutshane nalapho kuqala khona ithumba.

• Ulwelo olujikeleze ingqondo okanye umnqonqo.

• Ulwelo kumphunga okanye esiswini.

Ukuphinda aphume ebuntwaneni iRhabdomyosarcoma

I-rhabdomyosarcoma ebuntwaneni ngumhlaza ophindaphindiweyo (ubuyile) emva kokuba unyangiwe. Umhlaza ungabuya ubuye endaweni enye okanye kwamanye amalungu omzimba, njengomphunga, ithambo, okanye umongo wethambo. Ngaphantsi kakhulu, i-rhabdomyosarcoma inokubuya ibele kubasetyhini abafikisayo okanye esibindini.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezine-rhabdomyosarcoma yobuntwana.

• Abantwana abane-rhabdomyosarcoma kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

• Unyango lwe-rhabdomyosarcoma yobuntwana kunokubangela iziphumo ebezingalindelekanga.

• Zintathu iintlobo zonyango olusetyenziswayo:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lwe-Immunotherapy

• 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 ezine-rhabdomyosarcoma yobuntwana.

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-rhabdomyosarcoma kufuneka unyango lwabo lucwangciswe liqela lababoneleli ngezempilo abaziingcali kunyango lomhlaza ebantwaneni.

Ngenxa yokuba i-rhabdomyosarcoma inokubumba kwiindawo ezininzi ezahlukeneyo zomzimba, iintlobo ezahlukeneyo zonyango zisetyenziswa. Unyango luya kujongwa yi-oncologist yabantwana, ugqirha ogxile ekunyangeni abantwana abanomhlaza. I-oncologist yabantwana isebenza nabanye ababoneleli ngezempilo abaziingcali ekunyangeni abantwana abane-rhabdomyosarcoma kwaye abagxile kwiindawo ezithile zamayeza. Oku kunokubandakanya ezi ngcali zilandelayo:

• Ugqirha wabantwana.

• Ugqirha wabantwana.

• Imitha ye-oncologist.

• I-hematologist yezilwanyana.

• Ingcali yezonyango yabantwana.

• Ingcali yomongikazi wabantwana.

• Umcebisi ngemfuza okanye umcebisi ngemfuza ngomngcipheko.

• Unontlalontle.

• Ingcali yokuvuselela.

Unyango lwe-rhabdomyosarcoma yobuntwana 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 zokugqibela zonyango lomhlaza kwi-rhabdomyosarcoma inokubandakanya:

• 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.)

Zintathu iintlobo zonyango olusetyenziswayo:

Ugqirha

Utyando (ukususa umhlaza ekusebenzeni) kusetyenziselwa ukunyanga i-rhabdomyosarcoma ebuntwaneni. Uhlobo lotyando ekuthiwa lubanzi kukolulwa kwendawo lwenziwa rhoqo. Ukusikwa okubanzi kwendawo kukususa ithumba kunye nezinye izicubu ezijikelezileyo, kubandakanya ne-lymph node. Utyando lwesibini lunokufuneka ukuze ususe wonke umhlaza. Nokuba utyando lwenziwe kwaye uhlobo lotyando olwenziwe luxhomekeke koku kulandelayo:

• Apho emzimbeni laqala khona ithumba.

• Iziphumo zotyando ziya kubakho kwindlela umntwana ajongeka ngayo.

• Iziphumo zotyando ziya kuba nalo kwimisebenzi ebalulekileyo yomzimba yomntwana.

• Indlela ithumba elaphendula ngayo kwi-chemotherapy okanye kunyango lwe-radiation olunokuthi lunikwe kuqala.

Uninzi lwabantwana abane-rhabdomyosarcoma, akunakwenzeka ukuba basuse lonke ithumba ngotyando.

I-Rhabdomyosarcoma inokwenza kwiindawo ezininzi ezahlukeneyo emzimbeni kwaye utyando luya kwahluka kwisiza ngasinye. Utyando lokunyanga i-rhabdomyosarcoma yamehlo okanye iindawo zangasese zihlala zi-biopsy. I-Chemotherapy, kwaye ngamanye amaxesha unyango lwe-radiation, lunokunikwa ngaphambi kotyando ukunciphisa amathumba amakhulu.

Emva kokuba ugqirha ewususile wonke umhlaza onokubonakala ngexesha lotyando, izigulana ziya kunikwa ichemotherapy emva kotyando ukubulala naziphi na iiseli zomhlaza ezisele. Unyango ngemitha lunokunikwa. Unyango olunikezwe emva kotyando, ukunciphisa umngcipheko wokuba umhlaza ubuye kwakhona, lubizwa ngokuba lunyango oluncedisayo.

Unyango ngemitha

Unyango ngemitha lunyango lomhlaza olusebenzisa amandla amakhulu e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzinqanda ekukhuleni. Zimbini iintlobo zonyango lwe-radiation:

• Unyango lwangaphandle lwemitha lusebenzisa umatshini ngaphandle komzimba ukuthumela imitha kumhlaza. Iindlela ezithile zokunika unyango ngemitha kunokunceda ukugcina imitha ingonakalisi izicubu ezisempilweni ezikufutshane. Ezi ntlobo zonyango lwangaphandle lwemitha zibandakanya oku kulandelayo:

• Unyango lwe-radiation oluguquguqukayo: Unyango lwe-radiation oluguquguqukayo luhlobo lonyango lwangaphandle lwemitha olusebenzisa ikhompyuter ukwenza umfanekiso we-3-dimensional (3-D) yesisu kunye nokuma kwemitha yemitha ukuze ilingane nethumba. Oku kuvumela idosi ephezulu yemitha ukuba ifikelele kwithumba kwaye ibangele umonakalo omncinci kwizicubu ezisempilweni ezikufutshane.

• Unyango lwe-radiation ye-intension-modulated (IMRT): I-IMRT luhlobo lonyango lwe-3-dimensional (3-D) olusebenzisa ikhompyuter ukwenza imifanekiso yobukhulu kunye nemilo yethumba. Iintsika ezincinci zemitha yokuqina okuhlukeneyo (amandla) zijolise kwithumba kumacala amaninzi.

• Unyango lwe-arc olumiselweyo lweVolumetrical (VMAT): I-VMAT luhlobo lonyango lwe-3-D olusebenzisa ikhompyuter ukwenza imifanekiso yobukhulu kunye nemilo yethumba. Umatshini we-radiation uhamba kwisangqa esijikeleze isigulana kube kanye ngexesha lonyango kwaye uthumele imitha emxinwa yemitha yeendlela ezahlukeneyo (amandla) kwi-tumor. Unyango nge-VMAT luziswa ngokukhawuleza kunonyango lwe-IMRT.

• Unyango lwe-stereotactic radiation: Unyango lwe-stereotactic radiation luhlobo lonyango lwangaphandle lwemitha. Izixhobo ezikhethekileyo zisetyenziselwa ukubeka isigulana kwindawo enye kunyango ngalunye lwemitha. Kanye ngemini kangangeentsuku ezininzi, umatshini wemitha ujolise kwidosi enkulu kunesiqhelo yemitha ngokuthe ngqo kwi-tumor. Ngokuba nesigulana kwindawo efanayo kunyango ngalunye, akukho monakalo mncinci kwizicubu ezisempilweni ezikufutshane. Le nkqubo ikwabizwa ngokuba yinyango ye-stereotactic yangaphandle ye-radiation kunye nonyango lwe-stereotaxic radiation.

• Unyango lwe-Proton beam radiation: Unyango lwe-Proton-beam luhlobo lwamandla amakhulu, unyango lwangaphandle lwemitha. Umatshini wonyango wemitha ujolise kwimilambo yeeproton (ezincinci, ezingabonakaliyo, amasuntswana ahlawuliswe ngokuqinisekileyo) kwiiseli zomhlaza ukuze zibabulale. Olu hlobo lonyango lubangela umonakalo omncinci kwizicubu ezisempilweni ezikufutshane.

• Unyango lwangaphakathi lwemitha lusebenzisa into enemitha ye-radio etywinwe kwiinaliti, iimbewu, iingcingo, okanye iicatheters ezibekwe ngqo okanye kufutshane nomhlaza. Isetyenziselwa ukunyanga umhlaza kwiindawo ezinje ngesini, ubufazi, isibeleko, isinyi, iprostate, intloko, okanye intamo. Unyango lwangaphakathi lwemitha lukwabizwa ngokuba yi-brachytherapy, imitha yangaphakathi, ukufakwa kwemitha, okanye unyango lwangaphakathi lwemitha.

Uhlobo kunye nenani lonyango lwe-radiation kwaye xa unikwa luxhomekeke kubudala bomntwana, uhlobo lwe-rhabdomyosarcoma, apho emzimbeni waqala khona ithumba, ukuba lisele kangakanani ithumba emva kotyando, nokuba likhona na ithumba kwii-lymph node ezikufutshane .

Unyango lwangaphandle lwemitha luhlala lusetyenziselwa ukunyanga i-rhabdomyosarcoma yobuntwana kodwa kwezinye iimeko kusetyenziswa unyango lwangaphakathi lwemitha.

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).

I-Chemotherapy inokunikezelwa ukunciphisa i-tumor ngaphambi kokuhlinzwa ukuze kugcinwe izicubu ezinempilo kangangoko kunokwenzeka. Oku kubizwa ngokuba yi-neoadjuvant chemotherapy.

Wonke umntwana ophathwe i-rhabdomyosarcoma kufuneka afumane inkqubo ye-chemotherapy ukunciphisa amathuba okuba umhlaza uphinde ubuye. Uhlobo lweziyobisi ze-anticancer, idosi, kunye nenani lonyango olunikiweyo luxhomekeke ekubeni umntwana unobungozi obuphantsi, umngcipheko ophakathi, okanye i-rhabdomyosarcoma ephezulu.

Jonga iziyobisi ezivunyiweyo zeRhabdomyosarcoma ngolwazi oluthe kratya.

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 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 lonyango lwe-biologic okanye i-biotherapy.

Kukho iintlobo ezahlukeneyo ze-immunotherapy:

• Unyango lwe-Vaccine lunyango lomhlaza olusebenzisa into okanye iqela lezinto ukukhuthaza amajoni omzimba ukuba afumane ithumba alibulale. Unyango lwe-vaccine luyafundwa ukunyanga i-rhabdomyosarcoma ye-metastatic.

• Unyango lwe-immune checkpoint inhibitor isebenzisa amajoni omzimba ukubulala iiseli zomhlaza. Iindidi ezimbini ze-immune checkpoint inhibitors ziyafundwa kunyango lwe-rhabdomyosarcoma yabantwana ebuyileyo emva konyango:

• I-CTLA-4 yiprotein ebusweni beeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-CTLA-4 incamathele kwenye iprotein ebizwa ngokuba yi-B7 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. I-CTLA-4 inhibitors inamathela kwi-CTLA-4 kwaye ivumela iiseli ze-T ukuba zibulale iiseli zomhlaza. I-Ipilimumab luhlobo lwe-CTLA-4 inhibitor.

Isithinteli sokujonga ukungasebenzi komzimba. Iiproteni zokujonga, ezinje nge-B7-1 / B7-2 kwiiseli ezibonisa i-antigen (APC) kunye ne-CTLA-4 kwiiseli ze-T, zinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-T-cell receptor (TCR) ibophelela kwi-antigen kunye ne-histocompatibility complex (MHC) protein kwi-APC kunye ne-CD28 ebopha kwi-B7-1 / B7-2 kwi-APC, iseli ye-T inokusebenza. Nangona kunjalo, ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 kugcina iiseli ze-T zikwimeko yokungasebenzi ukuze bangakwazi ukubulala iiseli zethumba emzimbeni (iphaneli yasekhohlo). Ukuthintela ukubopha kwe-B7-1 / B7-2 ukuya kwi-CTLA-4 nge-immune checkpoint inhibitor (anti-CTLA-4 antibody) ivumela iiseli ze-T ukuba zisebenze kwaye zibulale iiseli zesisu (iphaneli esekunene).

• I-PD-1 yiprotein kumphezulu weeseli ze-T ezinceda ukugcina iimpendulo zomzimba zomzimba zijongiwe. Xa i-PD-1 incamathele kwenye iprotein ebizwa ngokuba yi-PDL-1 kwiseli yomhlaza, iyeka i-T cell ekubulaleni iseli yomhlaza. PD-1 inhibitors zinamathele kwi-PDL-1 kwaye zivumele iiseli ze-T ukuba zibulale iiseli zomhlaza. I-Nivolumab kunye ne-pembrolizumab zii-PD-1 inhibitors.

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

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuhlasela iiseli zomhlaza. Unyango ekujoliswe kulo lubangela ukwenzakala okuncinci kwiiseli eziqhelekileyo kunakwichemotherapy okanye kwimitha. Kukho iintlobo ezahlukeneyo zonyango olujolisiweyo:

• I-mTOR inhibitors iyeka iprotheni enceda iiseli zahlule kwaye zisinde. I-Sirolimus luhlobo lwe-MTOR inhibitor yonyango efundwayo kunyango lwe-rhabdomyosarcoma ephindaphindayo.

• I-Tyrosine kinase inhibitors ngamachiza amancinci eemolekyuli ahamba ngenwebu yeseli kwaye asebenze ngaphakathi kwiiseli zomhlaza ukuvimba imiqondiso yokuba iiseli zomhlaza kufuneka zikhule kwaye zahlule. I-MK-1775 kunye ne-cabozantinib-s-malate zi-tyrosine kinase inhibitors ezifundwayo kunyango lwe-rhabdomyosarcoma ephindaphindayo.

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 lweRhabdomyosarcoma yobuntwana

Kweli Candelo

• Ngaphambili iRhabdomyosarcoma yabantwana enganyangekiyo

• I-Refractory okanye iRhabdomyosarcoma yaBantwana eQhelekileyo

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

Ngaphambili iRhabdomyosarcoma yabantwana enganyangekiyo

Unyango lwe-rhabdomyosarcoma yobuntwana ihlala ibandakanya utyando, unyango ngemitha, kunye nekhemotherapy. Umyalelo wokuba olu nyango lunikiwe luxhomekeke ekubeni umzimba uqalile phi emzimbeni, ubungakanani besisu, uhlobo lwethumba, nokuba eli thumba lisasazekile kwii-lymph node okanye amanye amalungu omzimba. Jonga icandelo loNyango loKhetho loNyango kwesi sishwankathelo ngolwazi oluthe kratya malunga notyando, unyango ngemitha, kunye nekhemotherapy esetyenziselwa ukunyanga abantwana abane-rhabdomyosarcoma.

IRhabdomyosarcoma yengqondo kunye nentloko nentamo

• Amathumba engqondo: Unyango lunokubandakanya utyando lokususa ithumba, unyango ngemitha, kunye nonyango ngamayeza.

• Kwizilonda zentloko nentamo ezikufuphi neliso: Unyango lunokubandakanya ichemotherapy kunye nonyango lwemitha. Ukuba ithumba lihlala okanye libuya emva konyango nge-chemotherapy kunye nonyango lwe-radiation, utyando lokususa iliso kunye nezinye izicwili ezirhangqe iliso kunokufuneka.

• Kwizilonda zentloko nentamo ezikufutshane nendlebe, impumlo, iisono, okanye isiseko solukakayi kodwa hayi ngaphakathi okanye kufutshane neliso: Unyango lunokubandakanya unyango lwemitha kunye ne-chemotherapy.

• Kwiithumba zentloko nentamo ezingekho ngaphakathi okanye kufutshane neliso kwaye zingasondeli kwindlebe, impumlo, iisono, okanye isiseko sokhakhayi: Unyango lunokubandakanya i-chemotherapy, unyango lwe-radiation, kunye notyando lokususa ithumba.

• Amathumba entloko nasentanyeni angenakususwa ngotyando: Unyango lunokubandakanya i-chemotherapy kunye nonyango lwe-radiation kubandakanya unyango lwe-radiation stereotactic.

• Kwizilonda zelarynx (ibhokisi yelizwi): Unyango lunokubandakanya ichemotherapy kunye nonyango lwemitha. Utyando lokususa umqala aluqhele ukwenziwa, ukuze ilizwi lingonzakaliswa.

IRhabdomyosarcoma yeengalo okanye yemilenze

• I-Chemotherapy elandelwa lutyando lokususa ithumba. Ukuba ithumba alizange lisuswe ngokupheleleyo, kungenziwa utyando lwesibini ukususa ithumba. Unyango ngemitha lunokunikwa.

• Kwizilonda zesandla okanye seenyawo, unyango ngemitha kunye nekhemotherapy lunokunikwa. Ithumba alinakususwa kuba liyakuchaphazela ukusebenza kwesandla okanye unyawo.

• I-lymph node dissection (enye okanye ngaphezulu kwee-lymph nodes zisuswe kwaye isampuli yesicubu ihlolwe phantsi kwe-microscope kwiimpawu zomhlaza).

• Kwizidudla ezingalweni, iiseli ezikufutshane nethumba kunye nasekhwapheni ziyasuswa.

• Kwizilonda emilenzeni, ii-lymph node ezikufutshane nethumba kunye nendawo ye-groin ziyasuswa.

IRhabdomyosarcoma yesifuba, isisu, okanye isinqe

• Kwizidudla esifubeni okanye esiswini (kubandakanya udonga lwesifuba okanye udonga lwesisu): Utyando (indawo ebanzi yokusasaza) inokwenziwa. Ukuba ithumba likhulu, unyango lwe-chemotherapy kunye nonyango lwemitha lunikezelwa ukunciphisa ithumba ngaphambi kotyando.

• Amathumba esinqe: Utyando (ukubonwa ngokubanzi kwendawo) kunokwenziwa. Ukuba ithumba likhulu, i-chemotherapy inikwa ukunciphisa ithumba ngaphambi kotyando. Unyango ngemitha lunokunikwa emva kotyando.

• Kwizidudla zesithambo: I-biopsy yethumba ilandelwa yichemotherapy kunye nonyango lwemitha yokunciphisa ithumba. Ugqirha lunokwenziwa kamva ukususa naziphi na iiseli zomhlaza ezisele.

• Kwizidudla ze-gallbladder okanye i-bile ducts: I-biopsy yethumba ilandelwa yichemotherapy kunye nonyango lwemitha.

• Kwizidudla zemisipha okanye izicwili ezijikeleze i-anus okanye phakathi kwe-vulva kunye ne-anus okanye i-scrotum kunye ne-anus: Utyando lwenziwa ukuze kususwe uninzi lwethumba ngokukuko kunye nezinye iindawo ezikufuphi ze-lymph node, zilandelwe yichemotherapy kunye nonyango lwemitha.

IRhabdomyosarcoma yezintso

• Kwizidudla zezintso: Utyando lokususa ithumba kangangoko kunokwenzeka. Unyango lweChemotherapy kunye nonyango lwemitha lunokunikwa.

IRhabdomyosarcoma yesinyi okanye eyeprostate

• Kwizidudla ezisencochoyini yesinyi kuphela: Utyando (ukucandwa kwendawo ngokubanzi) lwenziwa.

• Kwiithumba zeprostate okanye isinyi (ngaphandle komphezulu wesinyi):

• I-Chemotherapy kunye nonyango lwemitha zinikezelwa kuqala ukunciphisa ithumba. Ukuba iiseli zomhlaza zihlala emva konyango kunye nonyango lwemitha, ithumba lisuswa ngotyando. Utyando lunokubandakanya ukususwa kweprostate, inxenye yesinyi, okanye ukukhutshwa kwe-pelvic ngaphandle kokususwa kwe-rectum. (Oku kunokubandakanya ukususwa kwekholoni esezantsi kunye nesinyi. Kumantombazana, umlomo wesibeleko, ubufazi, amaqanda, kunye neendawo ezikufuphi ezinokuthi zisuswe).

• I-Chemotherapy inikwa kuqala ukunciphisa ithumba. Utyando lokususa ithumba, kodwa hayi isinyi okanye iprotrate, yenziwe. Unyango lwangaphakathi okanye lwangaphandle lwemitha lunokunikwa emva kotyando.

• Utyando lokususa ithumba, kodwa hayi isinyi okanye iprotrate. Unyango lwangaphakathi lwemitha lunikezelwa emva kotyando.

IRhabdomyosarcoma yommandla okufuphi namasende

• Utyando lokususa ityhalarha kunye nentambo yesidoda. Ii-lymph node ngasemva kwesisu zinokujongwa njengomhlaza, ngakumbi ukuba ii-lymph node zikhulu okanye umntwana uneminyaka eli-10 okanye ngaphezulu.

• Unyango ngemitha lunokunikwa ukuba ithumba alinakususwa ngokupheleleyo ngotyando.

IRhabdomyosarcoma yelungu lobufazi, lobufazi, isibeleko, umlomo wesibeleko, okanye i-ovary

• Amathumba e-vulva kunye nelungu lobufazi: Unyango lunokubandakanya i-chemotherapy elandelwa lutyando lokususa ithumba. Unyango lwangaphakathi okanye lwangaphandle lwemitha lunokunikwa emva kotyando.

• Kwizilonda zesibeleko: Unyango lunokubandakanya i-chemotherapy kunye okanye ngaphandle kwonyango lwemitha. Ngamanye amaxesha utyando lunokufuneka ukuze kususwe iiseli zomhlaza ezisele.

• Kwizilonda zomlomo wesibeleko: Unyango lunokubandakanya ichemotherapy elandelwa lutyando lokususa naliphi na ithumba elisele.

• Amathumba e-ovary: Unyango lunokubandakanya i-chemotherapy elandelwa lutyando lokususa naliphi na ithumba elisele.

I-rhabdomyosarcoma yemetastatic

Unyango, olunje nge-chemotherapy, unyango ngemitha, okanye utyando lokususa ithumba, unikwa indawo apho laqala khona ithumba. Ukuba umhlaza usasazekile waya kwingqondo, umnqonqo, okanye imiphunga, unyango lwemitha lunokunikwa nakwiindawo apho umhlaza usasazeke khona.

Olu nyango lulandelayo lufundwa kwi-rhabdomyosarcoma ye-metastatic:

• Uvavanyo lweklinikhi lwe-immunotherapy (unyango lokugonya).

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-Refractory okanye iRhabdomyosarcoma yaBantwana eQhelekileyo

Ukhetho kunyango lwe-rhabdomyosarcoma yobuntwana obuphikisayo okanye ephindaphindayo isekwe kwizinto ezininzi, kubandakanya apho emzimbeni umhlaza ubuyile, luhlobo luni lonyango umntwana ebenalo ngaphambili, kunye neemfuno zomntwana.

Unyango lwe-rhabdomyosarcoma ephikisayo okanye engaqhelekanga inokubandakanya enye okanye ngaphezulu koku kulandelayo:

• Ugqirha.

• Unyango ngemitha.

• Unyango ngamayeza.

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo okanye i-immunotherapy (sirolimus, ipilimumab, nivolumab, okanye pembrolizumab).

• Uvavanyo lweklinikhi yonyango ekujoliswe kulo kunye ne-tyrosine kinase inhibitor (MK-1775 okanye i-cabozantinib-s-malate) kunye ne-chemotherapy.

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

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 neRhabdomyosarcoma yobuntwana

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga ne-rhabdomyosarcoma yabantwana, jonga oku kulandelayo:

• Iphepha lasekhaya leTissue Tissue Sarcoma

• Ikhompyuter yeTomography (CT) kunye noMhlaza

• Iziyobisi ezivunyiweyo zeRhabdomyosarcoma

• Iithagethi zoMhlaza ezijolise kuko

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