Izinhlobo / ithambo / isiguli / i-osteosarcoma-treatment-pdq

I-Osteosarcoma ne-Malignant Fibrous Histiocytoma ye-Bone Treatment (®) -Patient Version

Imininingwane ejwayelekile Nge-Osteosarcoma ne-Malignant Fibrous Histiocytoma ye-Bone

AMAPHUZU ASEMQOKA

• I-Osteosarcoma ne-malignant fibrous histiocytoma (MFH) yethambo yizifo lapho amangqamuzana amabi (umdlavuza) akha khona emathanjeni.

• Ukuba nokwelashwa kwangaphambilini ngemisebe kungakhuphula ubungozi be-osteosarcoma.

• Izimpawu nezimpawu ze-osteosarcoma ne-MFH zifaka ukuvuvukala ngaphezu kwethambo noma ingxenye yomzimba kanye nobuhlungu obuhlangene.

• Ukuhlolwa kokufanekisa kusetshenziselwa ukuthola (ukuthola) i-osteosarcoma ne-MFH.

• I-biopsy yenziwa ukuthola i-osteosarcoma.

• Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

I-Osteosarcoma ne-malignant fibrous histiocytoma (MFH) yethambo yizifo lapho amangqamuzana amabi (umdlavuza) akha khona emathanjeni.

I-Osteosarcoma ivame ukuqala kuma-osteoblasts, okuluhlobo lwethambo leseli eliba izicubu ezintsha zethambo. I-Osteosarcoma ivame kakhulu entsheni. Imvamisa yakha ekugcineni kwamathambo amade omzimba, afaka phakathi amathambo ezingalo nemilenze. Ezinganeni nasebusheni, kuvame ukwakheka emathanjeni amade, eduze kwedolo. Akuvamile ukuthi i-osteosarcoma itholakale ezicutshini ezithambile noma ezithweni esifubeni noma esiswini.

I-Osteosarcoma uhlobo oluvame kakhulu lomdlavuza wamathambo. I-malignant fibrous histiocytoma (MFH) yethambo iyisimila esingavamile sethambo. Iphathwa njenge-osteosarcoma.

I-Ewing sarcoma kungenye indlela yomdlavuza wamathambo, kepha ayihlanganisiwe kulesi sifinyezo. Bona isifinyezo se- mayelana ne-Ewing Sarcoma Treatment ukuthola eminye imininingwane.

Ukuba nokwelashwa kwangaphambilini ngemisebe kungakhuphula ubungozi be-osteosarcoma.

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wengane yakho uma ucabanga ukuthi ingane yakho ingaba sengcupheni. Izici zobungozi be-osteosarcoma zifaka okulandelayo:

• Ukwelashwa kwangaphambilini ngemithi yokwelashwa ngemisebe.

• Ukwelashwa kwangaphambilini ngemithi elwa nomdlavuza ebizwa ngama-alkylating agents.

• Ukuba noshintsho oluthile kuhlobo lwe-RB1.

• Ukuba nezimo ezithile, njengokulandelayo:

• I-Bloom syndrome.

• I-anemia ye-Diamond-Blackfan.

• Isifo se-Li-Fraumeni.

• Isifo sePaget.

• I-retinoblastoma eyifa.

• Isifo seRothmund-Thomson.

• Isifo seWerner.

Izimpawu nezimpawu ze-osteosarcoma ne-MFH zifaka ukuvuvukala ngaphezu kwethambo noma ingxenye yomzimba kanye nobuhlungu obuhlangene.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa i-osteosarcoma noma i-MFH noma ezinye izimo. Buza nodokotela wakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Ukuvuvukala ngaphezu kwethambo noma ingxenye yamathambo omzimba.

• Ubuhlungu ethanjeni noma ekuhlanganyeleni.

• Ithambo eliphuka ngaphandle kwesizathu esaziwayo.

Ukuhlolwa kokufanekisa kusetshenziselwa ukuthola (ukuthola) i-osteosarcoma ne-MFH.

Ukulingwa kokuhlolwa kwenziwa ngaphambi kokuhlolwa kwe-biopsy. Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• I-X-ray: I-x-ray yezitho namathambo ngaphakathi komzimba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

I-biopsy yenziwa ukuthola i-osteosarcoma.

Amaseli nezicubu kuyasuswa ngesikhathi se-biopsy ukuze zibukwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuze ahlole izimpawu zomdlavuza. Kubalulekile ukuthi i-biopsy yenziwe ngudokotela ohlinzayo onguchwepheshe wokwelapha umdlavuza wethambo. Kungcono uma lowo dokotela ohlinzayo futhi kunguyena osusa isimila. I-biopsy kanye nokuhlinzwa okususa isimila kuhlelwa ndawonye. Indlela okwenziwa ngayo i-biopsy ithinta ukuthi yiluphi uhlobo lokuhlinzwa olungenziwa kamuva.

Uhlobo lwe-biopsy olwenziwe luzosuselwa kubukhulu besimila nokuthi sikuphi emzimbeni. Kunezinhlobo ezimbili ze-biopsy ezingasetshenziswa:

• I-Core biopsy: Ukususwa kwezicubu kusetshenziswa inaliti ebanzi.

• I-incisional biopsy: Ukususwa kwengxenye yesigaxa noma isampula lezicubu ezingabukeki zijwayelekile.

Ukuhlolwa okulandelayo kungenziwa ezicutshini ezisusiweyo:

• I-Electron microscopy: Isivivinyo selabhorethri lapho amaseli esampula yezicubu abukwa khona ngaphansi kwama-microscopes avamile futhi anamandla aphezulu ukubheka ushintsho oluthile kumaseli.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Isibikezelo (ithuba lokululama) sithinteka yizici ezithile ngaphambi nangemva kokwelashwa.

Isibikezelo se-osteosarcoma esingalashwa kanye ne-MFH sincike kulokhu okulandelayo:

• Lapho isimila sisemzimbeni nokuthi izicubu zakheka emathanjeni angaphezu kwelilodwa.

• Usayizi wesimila.

• Ukuthi umdlavuza ususabalele nakwezinye izingxenye zomzimba nalapho usabalale khona.

• Uhlobo lwesimila (ngokuya ngokuthi amangqamuzana omdlavuza abukeka kanjani ngaphansi kwesibonakhulu).

• Iminyaka nesisindo sesiguli ngesikhathi sokuxilongwa.

• Ukuthi isiguli sithole ukwelashwa komdlavuza ohlukile.

• Ukuthi isimila sesidale ikhefu yini ethanjeni.

• Ukuthi isiguli sinezifo ezithile zofuzo.

Ngemuva kokuphathwa kwe-osteosarcoma noma i-MFH, isibikezelo sibuye sincike kokulandelayo:

• Ungakanani umdlavuza owabulawa ngamakhemikhali.

• Singakanani isimila esakhishwa ngokuhlinzwa.

• Ukuthi umdlavuza usuphindile (buyela emuva) kungakapheli iminyaka emibili utholakele.

Izinketho zokwelashwa kwe-osteosarcoma ne-MFH zincike kulokhu okulandelayo:

• Lapho isimila sikhona emzimbeni.

• Usayizi wesimila.

• Isigaba nebanga lomdlavuza.

• Ukuthi amathambo asakhula yini.

• Iminyaka yesiguli nempilo ejwayelekile.

• Isifiso sesiguli nomndeni sokuthi isiguli sikwazi ukubamba iqhaza emisebenzini efana nezemidlalo noma ukubheka indlela ethile.

• Noma ngabe umdlavuza usanda kutholakala noma ubuye wabuya ngemuva kokwelashwa.

Izigaba ze-Osteosarcoma neMalignant Fibrous Histiocytoma ye-Bone

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kwe-osteosarcoma noma i-malignant fibrous histiocytoma (MFH), kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekele kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• I-Osteosarcoma ne-MFH bachazwa njengabendawo noma imastastatic.

Ngemuva kokutholakala kwe-osteosarcoma noma i-malignant fibrous histiocytoma (MFH), kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekele kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza ususabalele kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Kwi-osteosarcoma ne-malignant fibrous histiocytoma (MFH), iziguli eziningi zihlelwe ngokuya ngokuthi ngabe umdlavuza utholakala engxenyeni eyodwa kuphela yomzimba (owenziwe endaweni ethile) noma usakaze (metastatic).

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• I-X-ray: I-x-ray yezitho, njengesifuba, namathambo ngaphakathi komzimba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba. Kuzothathwa ama-X-ray esifubeni nasendaweni lapho kwakhiwa khona isimila.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengesifuba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography. Izithombe zizothathwa esifubeni nasendaweni lapho kwakhiwa khona isimila.

• I-PET-CT scan: Inqubo ehlanganisa izithombe kusuka kuskena se-positron emission tomography (PET) kanye nokuskena kwe-computed tomography (CT). Izikena ze-PET ne-CT zenziwa ngasikhathi sinye emshinini ofanayo. Izithombe ezivela kuzo zombili izikena zihlanganisiwe ukwenza isithombe esinemininingwane eminingi kunalokho ukuhlolwa obekungakwenza ngokwakho. Ukuskena i-PET kuyinqubo yokuthola amangqamuzana amabi esigaxa emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• Ukuskena kwamathambo: Inqubo yokubheka ukuthi kunamaseli ahlukanisa ngokushesha yini, njengamaseli womdlavuza, ethanjeni. Inani elincane kakhulu lezinto ezinomsakazo lifakwa emthanjeni futhi lihambe phakathi kwegazi. Izinto ezinemisebe eqoqa emathanjeni ezinomdlavuza futhi zitholwa isithwebuli.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

• Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.

• Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.

• Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

• Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

• Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lomdlavuza njengesimila sokuqala. Isibonelo, uma i-osteosarcoma isakazeka emaphashini, amangqamuzana omdlavuza emaphashini empeleni angamaseli e-osteosarcoma. Lesi sifo yi-metastatic osteosarcoma, hhayi umdlavuza wamaphaphu.

I-Osteosarcoma ne-MFH bachazwa njengabendawo noma imastastatic.

• I-osteosarcoma yasendaweni noma i-MFH ayizange isabalale ethanjeni lapho umdlavuza waqala khona. Kungaba nendawo eyodwa noma ngaphezulu yomdlavuza ethanjeni engasuswa ngesikhathi sokuhlinzwa.

• I-Metastatic osteosarcoma noma i-MFH isabalale ethanjeni lapho umdlavuza waqala khona kwezinye izingxenye zomzimba. Umdlavuza uvame ukusabalala uye emaphashini. Kungasakazeka nakwamanye amathambo.

I-Osteosarcoma ephindaphindayo ne-Malignant Fibrous Histiocytoma ye-Bone

I-osteosarcoma ephindaphindayo ne-malignant fibrous histiocytoma (MFH) yethambo yimidlavuza ebuye yabuya (ibuya) ngemuva kokwelashwa. Umdlavuza ungabuya emathanjeni noma kwezinye izingxenye zomzimba. I-Osteosarcoma ne-MFH zivame ukubuyela emaphashini, emathanjeni, noma kokubili. Lapho i-osteosarcoma iphinda ibuya, imvamisa kungakapheli izinyanga eziyi-18 ukwelashwa kuqediwe.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-osteosarcoma noma i-malignant fibrous histiocytoma (MFH) yethambo.

• Izingane ezine-osteosarcoma noma i-MFH kufanele zihlelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni umdlavuza ezinganeni.

• Ukwelashwa kwe-osteosarcoma noma i-histiocytoma ebulalayo kungadala imiphumela emibi.

• Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngamakhemikhali

• Ukwelashwa ngemisebe

• I-Samarium

• Ukwelashwa okuhlosiwe

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-osteosarcoma noma i-malignant fibrous histiocytoma (MFH) yethambo.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezine-osteosarcoma noma i-malignant fibrous histiocytoma (MFH) yethambo. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile.

Ngoba umdlavuza ezinganeni uyivelakancane, ukubamba iqhaza esivivinyweni somtholampilo kufanele kubhekwe. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izingane ezine-osteosarcoma noma i-MFH kufanele zihlelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni umdlavuza ezinganeni.

Ukwelashwa kuzobhekwa ngudokotela wezingane oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. I-oncologist yezingane isebenza nabanye abahlinzeki bezokunakekelwa kwempilo yezingane abangongoti ekwelapheni i-osteosarcoma ne-MFH futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• Udokotela wezingane.

• Udokotela ohlinzayo wamathambo onolwazi lokwelapha izicubu zethambo.

• I-radiation oncologist.

• Uchwepheshe wokuvuselelwa.

• Umhlengikazi ongumhlengikazi.

• Usonhlala kahle.

• Ingcweti kwezempilo yengane.

• Isazi sokusebenza kwengqondo.

Ukwelashwa kwe-osteosarcoma noma i-histiocytoma ebulalayo kungadala imiphumela emibi.

Ngemininingwane ngemiphumela emibi eqala ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Imiphumela emibi yokwelashwa komdlavuza eqala ngemuva kokwelashwa futhi iqhubeke izinyanga noma iminyaka ibizwa ngemiphumela ephuzile. Imiphumela yamuva yokwelashwa komdlavuza ingafaka okulandelayo:

• Izinkinga zomzimba.

• Izinguquko zemizwa, imizwa, ukucabanga, ukufunda, noma inkumbulo.

• Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza).

Eminye imiphumela yesikhashana ingalashwa noma ilawulwe. Kubalulekile ukukhuluma nodokotela bengane yakho ngemiphumela yokwelashwa komdlavuza engaba nayo enganeni yakho. (Bheka isifinyezo se- ngemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane).

Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa ukususa lonke isimila kuzokwenziwa lapho kungenzeka. I-Chemotherapy inganikezwa ngaphambi kokuhlinzwa ukwenza isimila sibe sincane. Lokhu kubizwa ngokuthi yi-neoadjuvant chemotherapy. I-Chemotherapy inikezwa izicubu zamathambo ezingaphansi kakhulu okudingeka zisuswe futhi kunezinkinga ezimbalwa ngemuva kokuhlinzwa.

Izinhlobo ezilandelayo zokuhlinzwa zingenziwa:

• Ukusikwa kwendawo okubanzi: Ukuhlinzwa ukuze kususwe umdlavuza kanye nezicubu ezithile ezinempilo ezizungezile.

• Ukuhlinzwa okonga amalunga: Ukususwa kwesimila esithweni (ingalo noma umlenze) ngaphandle kokunqunywa, ngakho-ke ukusetshenziswa nokubukeka kwesitho kuyagcinwa. Iningi leziguli ezine-osteosarcoma emlenzeni zingelashwa ngokuhlinzwa okugcina izitho. Isigaxa sisuswa ukusikwa okubanzi kwendawo. Izicubu namathambo okususiwe kungashintshwa kufakwe okuxhunywe kusetshenziswa izicubu namathambo athathwe kwenye ingxenye yomzimba wesiguli, noma ngokufakwa okufana nethambo lokufakelwa. Uma kutholakala ukuphuka ngesikhathi sokuxilongwa noma ngesikhathi se-chemotherapy ngaphambi kokuhlinzwa, ukuhlinzeka ngezitho zomzimba kusengaba khona kwezinye izimo. Uma udokotela ohlinzayo engakwazi ukususa sonke isimila nezicubu ezanele ezizungezile, kungenziwa ukunqunywa.

• Ukunqunywa: Ukuhlinzwa ukususa ingxenye noma yonke ingalo noma umlenze. Lokhu kungenziwa lapho kungenzeki ukuthi kususwe sonke isimila ekuhlinzweni kokuvikela izitho. Isiguli singafakelwa isitho sokufakelwa (isitho sokufakelwa) ngemuva kokunqunywa.

• Rotationplasty: Ukuhlinzwa ukususa isimila kanye nokuhlangana kwamadolo. Ingxenye yomlenze esele ngaphansi kwedolo ibese inamathiselwa engxenyeni yomlenze eqhubeka ngenhla kwedolo, unyawo lubheke emuva neqakala lisebenza njengedolo. Ngemuva kwalokho kungenziwa kunamathiselwe unyawo enyaweni.

Ucwaningo lukhombisile ukuthi ukusinda kuyafana noma ngabe ukuhlinzwa kokuqala okwenziwe kungukuhlinza izitho noma ukunqunywa.

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, iziguli zinikezwa i-chemotherapy ukubulala noma yimaphi amangqamuzana omdlavuza asele endaweni lapho kukhishwe khona isimila noma asenabele kwezinye izingxenye zomzimba. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda).

Inhlanganisela yokwelashwa ngamakhemikhali ukusetshenziswa kwezidakamizwa ezingaphezu kweyodwa ze-antiticancer

I-chemotherapy ejwayelekile isetshenziselwa ukwelapha i-osteosarcoma ne-MFH yethambo. I-Chemotherapy ivame ukunikezwa ngaphambi nangemva kokuhlinzwa ukuze kususwe isimila sokuqala.

Bheka Izidakamizwa ezivunyelwe umdlavuza wamathambo ukuthola eminye imininingwane.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Kunezinhlobo ezimbili zokwelashwa ngemisebe:

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha i-osteosarcoma ne-MFH yethambo.

Amaseli e-Osteosarcoma ne-MFH awabulawa kalula ukwelashwa kwemisebe yangaphandle. Ingasetshenziswa lapho inani elincane lomdlavuza lishiywa ngemuva kokuhlinzwa noma lisetshenziswe kanye nezinye izindlela zokwelapha.

I-Samarium

I-Samarium yisidakamizwa esikhipha imisebe esikhomba ezindaweni lapho amangqamuzana amathambo ekhula khona, njengamaseli wesimila ethanjeni. Kuyasiza ukuqeda izinhlungu ezidalwa ngumdlavuza ethanjeni futhi kubulala namaseli egazi emnkantsheni wethambo. Ibuye isetshenziselwe ukwelapha i-osteosarcoma ebuyile ngemuva kokwelashwa ethanjeni elihlukile.

Ukwelashwa nge-samarium kungalandelwa ukufakelwa kwe-stem cell. Ngaphambi kokwelashwa nge-samarium, amaseli ama-stem (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo lesiguli futhi aqandiswe futhi agcinwe. Ngemuva kokuphela kokwelashwa nge-samarium, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe ukwelashwa okusebenzisa izidakamizwa noma ezinye izinto ukuthola nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. Kunezinhlobo ezahlukahlukene zokwelashwa okuqondisiwe okusetshenziselwa ukwelapha i-osteosarcoma noma kufundwe ekuhlolweni kwemitholampilo:

• Ukwelashwa kwe-Kinase inhibitor kuvimba iprotheni edingekayo ukuze amangqamuzana omdlavuza ahlukane. I-Sorafenib uhlobo lwe-kinase inhibitor therapy esetshenziselwa ukwelapha i-osteosarcoma ephindaphindwayo.

• Umgomo waseMammalia we-rapamycin (mTOR) inhibitors uvimba iprotheni ebizwa nge-mTOR, engagcina amangqamuzana omdlavuza angakhuli futhi avimbele ukukhula kwemithambo yegazi emisha okudingeka ukuthi izicubu zikhule. I-Everolimus iyi-mTOR inhibitor esetshenziselwa ukwelapha i-osteosarcoma ephindaphindwayo.

• I-monoclonal antibody therapy iyindlela yokwelapha umdlavuza esebenzisa amasosha omzimba enziwe elebhu, evela ohlotsheni olulodwa lwamaseli omzimba. La ma-antibody angakhomba izinto kumaseli womdlavuza noma ezintweni ezijwayelekile ezingasiza amangqamuzana omdlavuza ukuthi akhule. Amasosha omzimba anamathela ezintweni futhi abulale amangqamuzana omdlavuza, avimbe ukukhula kwawo, noma awagcine ekusakazekeni. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza. I-Denosumab ne-dinutuximab ngama-antibody monoclonal afundelwa ukwelashwa kwe-osteosarcoma ephindaphindwayo.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo okuqhubekayo iyatholakala kuwebhusayithi ye-NCI.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sengane yakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho Zokwelapha ze-Osteosarcoma ne-Malignant Fibrous Histiocytoma ye-Bone

Kulesi Sigaba

• I-Osteosarcoma kanye ne-Malignant Fibrous Histiocytoma ye-Bone

• I-Metastatic Osteosarcoma ne-Malignant Fibrous Histiocytoma ye-Bone

• I-Osteosarcoma ephindaphindayo ne-Malignant Fibrous Histiocytoma ye-Bone

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

I-Osteosarcoma kanye ne-Malignant Fibrous Histiocytoma ye-Bone

Ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila sokuqala.

• I-Chemotherapy inganikezwa ngaphambi noma ngemuva kokuhlinzwa ukuze kususwe isimila sokuqala.

• Ukwelashwa ngemisebe uma ukuhlinzwa kungenziwa noma uma isimila singasuswanga ngokuphelele ngokuhlinzwa.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

I-Metastatic Osteosarcoma ne-Malignant Fibrous Histiocytoma ye-Bone

Amaphaphu Metastasis

Lapho i-osteosarcoma noma isifo esibi esine-fibrous histiocytoma (MFH) sisakazeka, ivame ukusabalala emaphashini. Ukwelashwa kwe-osteosarcoma ne-MFH nge-metastasis yamaphaphu kungafaka okulandelayo:

• I-Chemotherapy ilandelwa ukuhlinzwa ukuze kususwe umdlavuza oyinhloko kanye nomdlavuza osusabalele emaphashini.

I-Bone Metastasis noma i-Bone ene-Lung Metastasis

I-Osteosarcoma kanye ne-histiocytoma ebulalayo enobungozi ingasakazeka ithambo elikude kanye / noma iphaphu. Ukwelashwa kungafaka okulandelayo:

• I-Chemotherapy ilandelwa ukuhlinzwa ukuze kususwe isimila sokuqala kanye nomdlavuza osusabalele kwezinye izingxenye zomzimba. Ukwelashwa ngamakhemikhali okuningi kunikezwa ngemuva kokuhlinzwa.

• Ukuhlinzwa kususwe isimila sokuqala, kulandelwe ukwelashwa ngamakhemikhali kanye nokuhlinzwa ukuze kususwe umdlavuza osudlulele kwezinye izingxenye zomzimba.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

I-Osteosarcoma ephindaphindayo ne-Malignant Fibrous Histiocytoma ye-Bone

Ukwelashwa kwe-osteosarcoma ephindaphindiwe kanye ne-histiocytoma yamathambo emibi kungafaka okulandelayo:

• Ukuhlinzwa ukususa umdlavuza osudlulele kwezinye izingxenye zomzimba.

• Ukwelashwa ngamakhemikhali.

• Kwezimila eziphinde zabuya ethanjeni kuphela, i-samarium ene-stem cell ukufakelwa noma ngaphandle kwayo kusetshenziswa ama-stem cell wesiguli, njengokwelashwa okunciphisayo ukudambisa izinhlungu nokwenza ngcono impilo.

• Ukwelashwa okuhlosiwe (i-sorafenib noma i-everolimus).

• Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• Isivivinyo somtholampilo esihlola isampula lesimila sesiguli ukuthola izinguquko ezithile zofuzo. Uhlobo lokwelashwa okuqondisiwe oluzonikezwa isiguli kuncike ohlotsheni lokushintsha kofuzo.

• Isivivinyo somtholampilo sezinhlobo ezintsha zokwelashwa kweziguli ezinomdlavuza ongenakususwa ngokuhlinzwa. Lokhu kungafaka ukwelashwa okuqondisiwe okufana nokwelashwa kwe-monoclonal antibody.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukuze ufunde kabanzi nge-Osteosarcoma ne-Malignant Fibrous Histiocytoma ye-Bone

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana ne-osteosarcoma kanye ne-malignant fibrous histiocytoma of bone, bheka okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza Wamathambo

• I-Computed Tomography (CT) Iskena Nomdlavuza

• Izidakamizwa zivunyelwe umdlavuza wamathambo

• Izindlela Zokwelapha Zomdlavuza

• Umdlavuza Wamathambo

Ngemininingwane eminingi yomdlavuza wezingane nezinye izinsiza zomdlavuza ezijwayelekile, bheka okulandelayo:

• Mayelana Nomdlavuza

• Umdlavuza Wezingane

• I-CureSearch ye-Cancer YezinganePhuma Ukuzikhulula

• Imiphumela Emuva Yokwelapha Yomdlavuza Wezingane

• Intsha kanye nabantu abadala abancane abaneCancer

• Izingane Ezinomdlavuza: Umhlahlandlela Wabazali

• Umdlavuza Ezinganeni Nasebusheni

• Isiteji

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli