Izinhlobo / ubuchopho / isiguli / ingane-astrocytoma-treament-pdq

Ukwelashwa Kwe-Astrocytomas Childhood (®) –Patient Version

Imininingwane ejwayelekile Mayelana ne-Astrocytomas Yezingane

AMAPHUZU ASEMQOKA

• I-astrocytoma yobuntwana yisifo lapho amangqamuzana anobungozi (angenawo umdlavuza) noma amabi (umdlavuza) akha izicubu zobuchopho.

• I-Astrocytomas ingaba yingozi (hhayi umdlavuza) noma ebulalayo (umdlavuza).

• Isistimu yezinzwa ephakathi ilawula imisebenzi eminingi ebalulekile yomzimba.

• Ayaziwa imbangela yamathumba amaningi ebuchosheni ebuntwaneni.

• Izimpawu nezimpawu ze-astrocytomas azifani kuzo zonke izingane.

• Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) ama-astrocytomas ebuntwana.

• Ama-astrocytomas ebuntwana ngokuvamile atholakala futhi asuswe lapho ehlinzwa.

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

I-astrocytoma yobuntwana yisifo lapho amangqamuzana anobungozi (angenawo umdlavuza) noma amabi (umdlavuza) akha izicubu zobuchopho.

Ama-astrocytomas izicubu eziqala kumaseli obuchopho abunjengezinkanyezi abizwa ngama-astrocyte. I-astrocyte uhlobo lweseli le-glial. Amaseli omzimba agcina amangqamuzana ezinzwa endaweni yawo, aletha ukudla ne-oxygen kuwo, futhi awasize awavikele ezifweni, ezinjengokutheleleka. Ama-gliomas yizicubu ezakha kusuka kumaseli we-glial. I-astrocytoma uhlobo lwe-glioma.

I-Astrocytoma uhlobo oluvame kakhulu lwe-glioma olutholakala ezinganeni. Ingakha noma yikuphi ohlelweni oluphakathi lwezinzwa (ubuchopho nomgogodla).

Lesi sifinyezo simayelana nokwelashwa kwezimila eziqala kuma-astrocyte ebuchosheni (izicubu eziyinhloko zobuchopho). Izicubu zobuchopho ze-Metastatic zakhiwa ngamangqamuzana omdlavuza aqala kwezinye izingxenye zomzimba futhi asabalale aye ebuchosheni. Ukwelashwa kwezimila zobuchopho ze-metastatic akuxoxwa ngakho lapha.

Izicubu zobuchopho zingenzeka ezinganeni nakubantu abadala. Kodwa-ke, ukwelashwa kwezingane kungahluka kunokwelashwa kwabantu abadala. Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane mayelana nezinye izinhlobo zamathumba obuchopho ezinganeni nakubantu abadala:

• Ingqondo Yobuntwana kanye ne-Spinal Cord Tumors Treatment Overview

• Ukwelashwa Kwe-Adult Central Nervous System Tumors

I-Astrocytomas ingaba yingozi (hhayi umdlavuza) noma ebulalayo (umdlavuza).

Izicubu zobuchopho zeBenign ziyakhula futhi zicindezele ezindaweni eziseduze zobuchopho. Akuvamile ukusabalala kwezinye izicubu. Izicubu zobuchopho ezimbi zingakhula ngokushesha futhi zisabalale ziye kwezinye izicubu zobuchopho. Lapho isimila sikhula sibe noma sicindezela endaweni yobuchopho, singamisa leyo ngxenye yobuchopho ukuthi isebenze ngendlela okufanele isebenze ngayo. Kokubili izicubu zobuchopho ezinobungozi nezimbi zingadala izimpawu nezimpawu futhi cishe zonke zidinga ukwelashwa.

Isistimu yezinzwa ephakathi ilawula imisebenzi eminingi ebalulekile yomzimba.

I-Astrocytomas ivame kakhulu kulezi zingxenye zesistimu yezinzwa emaphakathi (CNS):

• I-Cerebrum: Ingxenye enkulu kakhulu yobuchopho, phezulu kwekhanda. I-cerebrum ilawula ukucabanga, ukufunda, ukuxazulula izinkinga, ukukhuluma, imizwa, ukufunda, ukubhala nokunyakaza ngokuzithandela.

• I-Cerebellum: Ingxenye engezansi, engemuva yobuchopho (eduze nendawo maphakathi nekhanda). I-cerebellum ilawula ukunyakaza, ibhalansi, nokuma komzimba.

• Isiqu sobuchopho: Ingxenye exhumanisa ubuchopho nentambo yomgogodla, engxenyeni ephansi kakhulu yobuchopho (ngenhla nje ngemuva kwentamo). Isiqu sobuchopho silawula ukuphefumula, ukushaya kwenhliziyo, izinzwa nemisipha esetshenziselwa ukubona, ukuzwa, ukuhamba, ukukhuluma nokudla.

• I-Hypothalamus: Indawo ephakathi nendawo yesisekelo sobuchopho. Ilawula ukushisa komzimba, indlala nokoma.

• Indlela ebonakalayo: Iqembu lezinzwa ezixhuma iso nengqondo.

• Intambo yomgogodla: Ikholomu yezicubu zemizwa egijima ebuchosheni yehla maphakathi nendawo engemuva. Imbozwe izingqimba ezincanyana ezintathu zezicubu ezibizwa ngokuthi ulwelwesi. Umgogodla nolwelwesi kuzungezwe amathambo omgogodla (amathambo angemuva). Izinzwa zomgogodla zithwala imiyalezo phakathi kobuchopho nawo wonke umzimba, njengomyalezo ovela ebuchosheni odala ukuthi imisipha inyakaze noma umyalezo osuka esikhunjeni uye ebuchosheni ukuzwa ukuthinta.

I-anatomy yobuchopho. Indawo ye-supratentorial (ingxenye ephezulu yobuchopho) iqukethe i-cerebrum, i-lateral ventricle ne-ventricle yesithathu (ene-cerebrospinal fluid ekhonjiswe ku-blue), i-choroid plexus, i-pineal gland, i-hypothalamus, i-pituitary gland, ne-optic nerve. Indawo engemuva kwe-fossa / infratentorial (ingxenye engezansi engemuva yobuchopho) iqukethe i-cerebellum, i-tectum, i-ventricle yesine, kanye nesiqu sobuchopho (i-midbrain, i-pons, ne-medulla). I-tentorium ihlukanisa i-supratentorium ne-infratentorium (iphaneli yesokudla). Ugebhezi namamenyu kuvikela ubuchopho nomgogodla (iphaneli engakwesobunxele).

Ayaziwa imbangela yamathumba amaningi ebuchosheni ebuntwaneni.

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 ezingaba yingozi ye-astrocytoma zifaka:

• Ukwelashwa kwemisebe edlule ebuchosheni.

• Ukuba nezinkinga ezithile zofuzo, njenge-neurofibromatosis type 1 (NF1) noma i-tuberous sclerosis.

Izimpawu nezimpawu ze-astrocytomas azifani kuzo zonke izingane.

Izimpawu nezimpawu zincike kokulandelayo:

• Lapho okuvela khona isimila ebuchosheni noma emgogodleni.

• Usayizi wesimila.

• Sikhula ngokushesha kangakanani isimila.

• Iminyaka yengane nokukhula kwayo.

Ezinye izicubu azibangeli zimpawu noma zimpawu. Izimpawu nezimpawu zingabangelwa yi-astrocytomas yobuntwana noma ngezinye izimo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Ukuphathwa ikhanda ekuseni noma ikhanda elihamba ngemuva kokuhlanza.

• Isicanucanu nokuhlanza.

• Izinkinga zokubona, zokuzwa nezokukhuluma.

• Ukulahlekelwa ibhalansi nenkinga yokuhamba.

• Ukubhalwa kwesandla okwandayo noma inkulumo ephuzayo.

• Ubuthakathaka noma ukuguquka kokuzwa ohlangothini olulodwa lomzimba.

• Ukulala okungavamile.

• Amandla amaningi noma amancane kunokujwayelekile.

• Shintsha ebuntwini noma ekuziphatheni.

• Ukuquleka.

• Ukwehla kwesisindo noma ukuzuza kwesisindo ngaphandle kwesizathu esaziwayo.

• Khulisa ngosayizi wekhanda (ezinganeni).

Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) ama-astrocytomas ebuntwana.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

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

• Ukuhlolwa kwe-Neurological: Uchungechunge lwemibuzo novivinyo lokuhlola ubuchopho, umgogodla nokusebenza kwe-nerve. Isivivinyo sihlola isimo somuntu somqondo, ukusebenzisana, kanye nekhono lokuhamba ngokujwayelekile, nokuthi izicubu, izinzwa, nokucabanga kusebenza kahle kangakanani. Lokhu kungabizwa nangokuthi ukuhlolwa kwe-neuro noma ukuhlolwa kwe-neurologic.

• Ukuhlolwa kwensimu ebonakalayo: Isivivinyo sokubheka inkambu yombono womuntu (indawo ephelele lapho izinto zingabonakala khona). Lokhu kuhlolwa kukala umbono ophakathi nendawo (ukuthi umuntu angabona kangakanani lapho ebheka phambili ngqo) kanye nombono wangaphandle (ukuthi umuntu angabona kangakanani kuzo zonke ezinye izinkomba ngenkathi ebheke phambili ngqo). Amehlo ahlolwa ngamunye ngamunye. Iso elingavivinywa limboziwe.

• I-MRI (imaging resonance imaging) ene-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe eziningiliziwe zobuchopho nomgogodla. Into ebizwa ngokuthi i-gadolinium ijojowe emthanjeni. I-gadolinium iqoqa izungeze amangqamuzana omdlavuza ukuze akhanye ngokugqamile esithombeni. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI). Kwesinye isikhathi i-magnetic resonance spectroscopy (MRS) yenziwa ngesikhathi sokuskena okufanayo kwe-MRI ukubheka ukwakheka kwamakhemikhali kwezicubu zobuchopho.

Ama-astrocytomas ebuntwana ngokuvamile atholakala futhi asuswe lapho ehlinzwa.

Uma odokotela becabanga ukuthi kungenzeka kube ne-astrocytoma, i-biopsy ingenziwa ukuze kususwe isampula lezicubu. Kuma-tumors ebuchosheni, kukhishwa ingxenye yogebhezi kusetshenziswe inaliti ukususa izicubu. Kwesinye isikhathi, inaliti iqondiswa ikhompyutha. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza. Uma kutholakala amangqamuzana omdlavuza, udokotela angasusa isimila esiningi ngangokunokwenzeka ngesikhathi sokuhlinzwa okufanayo. Ngoba kungaba nzima ukutshela umehluko phakathi kwezinhlobo zezicubu zobuchopho, ungahle uthande ukuthi isampula lezicubu zengane yakho lihlolwe ngudokotela wezifo onolwazi lokuthola izicubu zobuchopho.

I-Craniotomy: Kuvulwa imbobo kugebhezi bese kukhishwa ucezu logebhezi ukukhombisa ingxenye yobuchopho.

Ukuhlolwa okulandelayo kungenziwa kuzicubu ezisuswe:

• I-Immunohistochemistry: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukubheka ama-antigen (amakaki) athile kusampula yezicubu zesiguli. Amasosha omzimba avamise ukuhlanganiswa ne-enzyme noma udayi we-fluorescent. Ngemuva kokuthi ama-antibody abophele kwi-antigen ethile kusampula yezicubu, i-enzyme noma idayi iyasebenza, bese kuthi i-antigen ibonakale ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukuxilonga umdlavuza nokusiza ukutshela uhlobo oluthile lomdlavuza kolunye uhlobo lomdlavuza. Ukuhlolwa kwe-MIB-1 uhlobo lwe-immunohistochemistry oluhlola izicubu zesimila se-antigen ebizwa nge-MIB-1. Lokhu kungakhombisa ukuthi isimila sikhula ngokushesha kangakanani.

Kwesinye isikhathi izicubu zakheka endaweni ezenza kube nzima ukukhipha. Uma ukukhipha isimila kungadala izinkinga ezinzima ngokomzimba, ngokomzwelo noma ngokufunda, kwenziwa i-biopsy bese kunikezwa ukwelashwa okuningi ngemuva kwe-biopsy.

Izingane ezine-NF1 zingakha i-astrocytoma esezingeni eliphansi endaweni yobuchopho elawula ukubona futhi engahle ingadingi i-biopsy. Uma isimila singaqhubeki ukukhula noma izimpawu zingenzeki, ukuhlinzwa ukuze kususwe isimila kungenzeka kungadingeki.

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Ukuthi isimila siyi-astrocytoma esezingeni eliphansi noma eliphakeme.

• Lapho isimila sakhe khona ku-CNS futhi uma sesisabalalele ezicutshini eziseduze noma kwezinye izingxenye zomzimba.

• Sikhula ngokushesha kangakanani isimila.

• Iminyaka yengane.

• Kungabe amaseli omdlavuza ahlala ngemuva kokuhlinzwa.

• Ukuthi kukhona yini ukushintsha kwezakhi zofuzo ezithile.

• Ukuthi ingane ine-NF1 noma i-tuberous sclerosis.

• Ukuthi ingane inesifo se-diencephalic syndrome (isimo esinciphisa ukukhula komzimba).

• Ukuthi ingane ine-hypertension engasebenzi yini (ingcindezi ye-cerebrospinal fluid ngaphakathi kogebhezi iphezulu) ngesikhathi sokuxilongwa.

• Ukuthi ngabe i-astrocytoma isanda kutholakala noma isiphindile (buyela emuva).

Kwi-astrocytoma ephindaphindayo, ukubikezela nokwelashwa kuncike ekutheni kudlule isikhathi esingakanani phakathi kokuphela kwesikhathi ukwelashwa nesikhathi lapho i-astrocytoma ibuye khona.

Izigaba Zama-Astrocytomas Wezingane

AMAPHUZU ASEMQOKA

• Izinga lesimila lisetshenziselwa ukuhlela ukwelashwa komdlavuza.

• Ama-astrocytomas aphansi

• Ama-astrocytomas aphezulu

• I-MRI yenziwa ngemuva kokuhlinzwa.

Izinga lesimila lisetshenziselwa ukuhlela ukwelashwa komdlavuza.

Isiteji inqubo esetshenziswayo ukuthola ukuthi mningi kangakanani umdlavuza nokuthi umdlavuza ususabalele yini. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa.

Akunasistimu ejwayelekile yokuqalwa kwe-astrocytoma yobuntwana. Ukwelashwa kusekelwe kokulandelayo:

• Ukuthi isimila sisezingeni eliphansi noma eliphakeme.

• Ukuthi isimila sisanda kutholakala yini noma siyaphindeka (sibuya emuva kokwelashwa).

Izinga lesimila lichaza ukuthi amaseli omdlavuza abukeka ngendlela engavamile kanjani ngaphansi kwesibonakhulu nokuthi kungenzeka kanjani ukuthi isimila sikhule futhi sisakazeke ngokushesha.

Kusetshenziswa amamaki alandelayo:

Ama-astrocytomas aphansi

Ama-astrocytomas asezingeni eliphansi akhula kancane futhi awavamile ukusabalala kwezinye izingxenye zobuchopho nentambo yomgogodla noma ezinye izitho zomzimba. Kunezinhlobo eziningi ze-astrocytomas ezisezingeni eliphansi. Ama-astrocytomas asezingeni eliphansi angaba:

• Izicubu zeBanga I-pilocytic astrocytoma, i-subependymal giant cell tumor, noma i-angiocentric glioma.

• Izimila zebanga lesibili-ukusabalalisa i-astrocytoma, i-pleomorphic xanthoastrocytoma, noma i-choroid glioma ye-ventricle yesithathu.

Izingane ezine-neurofibromatosis yohlobo 1 zingaba nesimila esingaphezu kwesisodwa ebangeni eliphansi ebuchosheni. Izingane ezine-tuberous sclerosis zinobungozi obandayo be-subependymal giant cell astrocytoma.

Ama-astrocytomas aphezulu

Ama-astrocytomas ebanga eliphakeme akhula ngokushesha futhi kaningi asakazeka ngaphakathi kobuchopho nomgogodla. Kunezinhlobo eziningana zama-astrocytomas aphezulu. Ama-astrocytomas ebanga eliphakeme angaba:

• Izicubu zebanga lesithathu-i-anaplastic astrocytoma noma i-anaplastic pleomorphic xanthoastrocytoma.

• Izimila zebanga le-IV – glioblastoma noma i-midline glioma ebhebhetheka.

Ama-astrocytomas ebuntwana ngokuvamile awasakazeki kwezinye izingxenye zomzimba.

I-MRI yenziwa ngemuva kokuhlinzwa.

I-MRI (imaging resonance imaging) yenziwa ezinsukwini ezimbalwa zokuqala ngemuva kokuhlinzwa. Lokhu ukuthola ukuthi ngabe kusele kangakanani isimila, uma sikhona, ngemuva kokuhlinzwa nokuhlela ukwelashwa okuqhubekayo.

Ama-Astrocytomas Wezingane Aphindaphindayo

I-astrocytoma yobuntwana ephindaphindwayo iyi-astrocytoma ephindaphindeke (yabuya) ngemuva kokuba selashwe. Umdlavuza ungabuya endaweni efanayo nesimila sokuqala noma kwezinye izingxenye zomzimba. Ama-astrocytomas asezingeni eliphakeme avame ukubuyela ngaphakathi kweminyaka emi-3 kungaba lapho umdlavuza waqala khona noma kwenye indawo ku-CNS.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-astrocytoma yobuntwana.

• Izingane ezine-astrocytomas kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni izicubu zobuchopho ezinganeni.

• Izicubu zobuchopho bengane zingadala izimpawu noma izimpawu eziqala ngaphambi kokuba umdlavuza utholwe futhi uqhubeke izinyanga noma iminyaka.

• Ukwelashwa kwe-astrocytomas ebuntwaneni kungadala imiphumela emibi.

• Izinhlobo eziyisithupha zokwelashwa zisetshenzisiwe:

• Ukuhlinzwa

• Ukuqaphela

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• I-chemotherapy ephezulu ene-stem cell transplant

• Ukwelashwa okuhlosiwe

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Olunye ukwelashwa kwezidakamizwa

• I-Immunotherapy

• Uma uketshezi lwakha luzungeze ubuchopho nomgogodla, inqubo yokuphambukisa oketshezi lwe-cerebrospinal ingenziwa.

• 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-astrocytoma yobuntwana.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezine-astrocytomas. 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-astrocytomas kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni izicubu zobuchopho ezinganeni.

Ukwelashwa kuzobhekwa ngudokotela wezingane oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. I-oncologist yezingane isebenza nabanye abahlinzeki bezempilo abangongoti ekwelapheni izingane ezinamathumba ebuchosheni futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• Udokotela wezingane.

• I-neurosurgeon yezingane.

• Isazi sezinzwa.

• Isazi se-Neuropathologist.

• Isazi se-Neuroradiologist.

• Uchwepheshe wokuvuselelwa.

• I-radiation oncologist.

• Isazi se-endocrinologist.

• Isazi sokusebenza kwengqondo.

Izicubu zobuchopho bengane zingadala izimpawu noma izimpawu eziqala ngaphambi kokuba umdlavuza utholwe futhi uqhubeke izinyanga noma iminyaka.

Izimpawu noma izimpawu ezibangelwa isimila zingaqala ngaphambi kokuxilongwa. Lezi zimpawu noma izimpawu zingaqhubeka izinyanga noma iminyaka. Kubalulekile ukukhuluma nodokotela bengane yakho ngezimpawu noma izimpawu ezibangelwa isimila esingaqhubeka ngemuva kokwelashwa.

Ukwelashwa kwe-astrocytomas ebuntwaneni 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 eziyisithupha zokwelashwa zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa kusetshenziselwa ukuxilonga nokwelapha i-astrocytoma yobuntwana, njengoba kuxoxwe esigabeni soLwazi olujwayelekile kulesi sifinyezo. Uma amangqamuzana omdlavuza ahlala ngemuva kokuhlinzwa, ukwelashwa okuqhubekayo kuya ngo:

• Lapho amaseli omdlavuza asele ekhona.

• Ibanga lesimila.

• Iminyaka yengane.

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa i-chemotherapy noma i-radiation therapy ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

Ukuqaphela

Ukuqaphelisisa kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu noma ushintsho. Ukuqaphela kungasetshenziswa:

• Uma isiguli singenazo izimpawu, njengeziguli ezine-neurofibromatosis type1.

• Uma isimila sincane futhi sitholakala lapho kunenkinga ehlukile yezempilo etholakala noma yelashwa.

• Ngemuva kokuthi isimila sisuswe ngokuhlinzwa kuze kuvele izimpawu noma izimpawu noma ushintsho.

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. Izindlela ezithile zokunikeza ukwelashwa ngemisebe kungasiza ukugcina imisebe ekulimaleni izicubu ezinempilo eziseduze. Lezi zinhlobo zokwelashwa ngemisebe zifaka okulandelayo:

• Ukwelashwa kwemisebe eguquguqukayo: Ukwelashwa kwemisebe eguquguqukayo kuwuhlobo lokwelashwa kwemisebe yangaphandle okusebenzisa ikhompyutha ukwenza isithombe esingu-3-dimensional (3-D) sesimila futhi kulolonge imishayo yemisebe ukuze ilingane nalesi sifo.

• Ukwelashwa kwemisebe ye-intension-modulated (IMRT): I-IMRT uhlobo lokwelashwa kwemisebe yangaphandle kwe-3-dimensional (3-D) esebenzisa ikhompyutha ukwenza izithombe zosayizi nokuma kwesimila. Imishayo emincane yemisebe yamandla ahlukene (amandla) ihloselwe isimila ezinhlangothini eziningi.

• Ukwelashwa kwemisebe ye-stereotactic: Ukwelashwa kwemisebe ye-stereotactic uhlobo lwezokwelapha ngemisebe yangaphandle. Uhlaka lwekhanda oluqinile luxhunywe kugebhezi ukugcina ikhanda linganyakazi ngesikhathi sokwelashwa ngemisebe. Umshini uhlose ukukhishwa kwemisebe ngqo esihlahleni. Umthamo ophelele wemisebe uhlukaniswe ngamanani amancane amancane anikezwe ezinsukwini ezimbalwa. Le nqubo ibizwa nangokuthi i-stereotactic external-beam radiation therapy kanye ne-stereotaxic radiation therapy.

• Ukwelashwa kwemisebe ye-Proton beam: Ukwelashwa kwe-Proton-beam uhlobo lwamandla amakhulu, ukwelashwa kwemisebe yangaphandle. Umshini wokwelapha ngemisebe uhlose imifudlana yama-proton (izinhlayiya ezincane, ezingabonakali, ezishajwa kahle) kumaseli womdlavuza ukuwabulala.

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

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuncike ohlotsheni lwesimila nalapho isimila sakhiwa khona ebuchosheni noma emgogodleni. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha ama-astrocytomas ebuntwana.

Ukwelashwa ngemisebe ebuchosheni kungathinta ukukhula nentuthuko, ikakhulukazi ezinganeni ezisencane. Ezinganeni ezingaphansi kweminyaka emithathu, i-chemotherapy inganikezwa esikhundleni salokho, ukubambezela noma ukunciphisa isidingo sokwelapha ngemisebe.

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-anticancer.

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni lwesimila nalapho isimila sakhiwa khona ebuchosheni noma emgogodleni. I-systemic combination chemotherapy isetshenziswa ekwelapheni izingane ezine-astrocytoma. I-chemotherapy ephakeme kakhulu ingasetshenziswa ekwelapheni izingane ezine-astrocytoma esanda kutholakala ephezulu.

I-chemotherapy ephezulu ene-stem cell transplant

Imithamo ephezulu yokwelashwa ngamakhemikhali inikezwa ukubulala amangqamuzana omdlavuza. Amaseli aphilile, kufaka phakathi amaseli akha igazi, nawo abhujiswa ukwelashwa komdlavuza. Ukufakelwa kwe-stem cell ukwelashwa ukufaka amaseli akha igazi. Ama-stem cells (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo wesiguli noma womnikeli futhi afriziwe futhi agcinwe. Ngemuva kokuthi isiguli siqede i-chemotherapy, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

Kwi-astrocytoma esezingeni eliphakeme ebuyile ngemuva kokwelashwa, i-chemotherapy ephezulu ene-stem cell transplant isetshenziswa uma kunesilinganiso esincane kuphela sesimila.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile.

Kunezinhlobo ezahlukene zokwelashwa okuqondisiwe:

• I-monoclonal antibody therapy isebenzisa amasosha omzimba enziwe elebhu, evela ohlotsheni olulodwa lwamaseli omzimba, ukumisa amangqamuzana omdlavuza. 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 ngokufakwa ngaphakathi emthanjeni. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza.

Ukwelashwa kwe-inhibitor endothelial factor factor (VEGF) inhibitor therapy uhlobo lwe-monoclonal antibody therapy:

• Ukwelashwa kwe-VEGF inhibitor: Amaseli womdlavuza enza into ebizwa nge-VEGF, edala ukwakheka kwemithambo yegazi emisha (angiogenesis) futhi esiza umdlavuza ukuthi ukhule. Ama-VEGF inhibitors avimba i-VEGF futhi amise imithambo yegazi emisha ukuba yakheke. Lokhu kungabulala amangqamuzana omdlavuza ngoba adinga imithambo emisha yegazi ukuze ikhule. I-Bevacizumab iyi-VEGF inhibitor ne-angiogenesis inhibitor esetshenziselwa ukwelapha i-astrocytoma yobuntwana.

• Amaphrotheni kinase inhibitors asebenza ngezindlela ezahlukene. Kunezinhlobo eziningi zama-protein kinase inhibitors.

• I-mTOR inhibitors imisa amaseli ekuhlukaniseni futhi ingavimbela ukukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule. I-Everolimus ne-sirolimus yi-mTOR inhibitors esetshenziselwa ukwelapha i-subocompymal giant cell astrocytomas. I-mTOR inhibitors nayo isafundelwa ukwelapha i-astrocytoma esezingeni eliphansi ephinde yabuya.

• Ama-BRAF inhibitors avimba amaprotheni adingekayo ekukhuleni kwamaseli futhi angabulala amangqamuzana omdlavuza. Uhlobo lwe-BRAF lutholakala efomini eliguquliwe (eliguquliwe) kwamanye ama-gliomas futhi ukulivimba kungasiza ukugcina amangqamuzana omdlavuza angakhuli. I-BRAF inhibitor dabrafenib isafundelwa ukwelapha i-astrocytoma esezingeni eliphansi ephinde yabuya. Amanye ama-BRAF inhibitors, afaka i-vemurafenib ne-trametinib, afundelwa izingane.

• Ama-MEK inhibitors avimba amaprotheni adingekayo ekukhuleni kwamaseli futhi angabulala amangqamuzana omdlavuza. Ama-MEK inhibitors afana ne-selumetinib afundelwa ukwelapha i-astrocytoma esezingeni eliphansi ephinde yabuya.

• I-PARP inhibitors ivimba i-enzyme ebizwa nge-PARP ebandakanyeka emisebenzini eminingi yamaseli. Ukuvimba i-PARP kungasiza ukugcina amangqamuzana omdlavuza angalungisi i-DNA yawo eyonakele, abangele ukuthi bafe. I-Veliparib iyi-inhibitor ye-PARP efundwa ihlangene ne-radiation therapy kanye ne-chemotherapy yokwelapha i-glioma esanda kutholakala ukuthi ayinazinguquko (ushintsho) kuhlobo lwe-BRAF.

Bheka Izidakamizwa Kuvunyelwe Izicubu Zobuchopho ukuthola eminye imininingwane.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Olunye ukwelashwa kwezidakamizwa

I-Lenalidomide uhlobo lwe-angiogenesis inhibitor. Kuvimbela ukukhula kwemithambo yegazi emisha edingwa isimila ukuze sikhule.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy.

• Ukwelashwa kwe-inhibitor yokuhlola amasosha omzimba: I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba wokuzivikela. Lapho i-PD-1 inamathela kwenye iprotheni ebizwa nge-PDL-1 kuseli lomdlavuza, iyeka i-T cell ekubulaleni iseli lomdlavuza. Ama-PD-1 inhibitors anamathisela ku-PDL-1 futhi avumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. Ama-PD-1 inhibitors afundelwa ukwelapha i-astrocytoma esezingeni eliphakeme ebuye yabuya.

Isithiyo sokuhlola izivikeli mzimba. Amaprotheni wokuhlola, njenge-PD-L1 kumaseli we-tumor ne-PD-1 kumaseli we-T, asiza ukugcina izimpendulo ze-immune zihlolwe. Ukubopha kwe-PD-L1 kuya ku-PD-1 kugcina amaseli we-T ekubulaleni amangqamuzana omzimba emzimbeni (iphaneli engakwesobunxele). Ukuvimba ukubopha kwe-PD-L1 kuya ku-PD-1 nge-immune checkpoint inhibitor (i-anti-PD-L1 noma i-anti-PD-1) ivumela amaseli we-T ukuthi abulale amangqamuzana wesimila (iphaneli elifanele).

Uma uketshezi lwakha luzungeze ubuchopho nomgogodla, inqubo yokuphambukisa oketshezi lwe-cerebrospinal ingenziwa.

Ukuphambukisa uketshezi lweCerebrospinal kuyindlela esetshenziselwa ukukhipha uketshezi olwakhiwe eduze kobuchopho nentambo yomgogodla. I-shunt (ithubhu ende, ezacile) ibekwa ku-ventricle (isikhala esigcwele uketshezi) ebuchosheni bese ifakwa ngaphansi kwesikhumba kwenye ingxenye yomzimba, imvamisa isisu. I-shunt ithwala uketshezi oluthe xaxa ukusuka ebuchosheni ngakho-ke ingangena kwenye indawo emzimbeni.

Ukuphambukiswa kweCerebrospinal fluid (CSF). I-CSF eyengeziwe isuswa kwi-ventricle ebuchosheni nge-shunt (ithubhu) futhi ithululelwa esiswini. I-valve ilawula ukuhamba kwe-CSF.

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. (Bheka isigaba soLwazi Jikelele ukuthola uhlu lwezivivinyo.) Ezinye izivivinyo zizophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ama-MRIs ajwayelekile azoqhubeka ukwenziwa ngemuva kokuphela kokwelashwa. Imiphumela ye-MRI ingakhombisa ukuthi ngabe isimo sengane yakho sishintshile noma uma i-astrocytoma isibuyile (buyela emuva). Uma imiphumela ye-MRI ikhombisa isisindo ebuchosheni, kungenziwa i-biopsy ukuthola ukuthi ngabe yakhiwe ngamangqamuzana ama-tumor afile noma ukuthi amangqamuzana omdlavuza amasha ayakhula yini.

Izinketho Zokwelapha Zama-Astrocytomas Wezingane

Kulesi Sigaba

• Ama-Astrocytomas Asanda Kutholwa Obuntwana

• I-Astrocytomas Yezingane Ephansi Ephansi

• Ama-Astrocytomas asanda kutholakala ebuntwaneni

• I-Astrocytomas Yezingane Ephakeme Ephindaphindiwe

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

Ama-Astrocytomas Asanda Kutholwa Obuntwana

Lapho kutholakala isimila kuqala, ukwelashwa kwe-astrocytoma esezingeni eliphansi ebuntwaneni kuncike ekutheni lesi sifo sikuphi, futhi kuvame ukuhlinzwa. I-MRI yenziwa ngemuva kokuhlinzwa ukubona ukuthi asisekho yini isimila.

Uma isimila sisuswe ngokuphelele ngokuhlinzwa, kungenzeka ukuthi ukwelashwa okungaphezulu kungadingeki futhi ingane ibhekwe kakhulu ukubona ukuthi izimpawu noma izimpawu ziyavela noma ziyashintsha. Lokhu kubizwa ngokuthi ukubuka.

Uma kukhona isimila esisele ngemuva kokuhlinzwa, ukwelashwa kungafaka okulandelayo:

• Ukuqaphela.

• Ukuhlinzwa kwesibili ukukhipha isimila.

• Ukwelashwa ngemisebe, okungabandakanya ukwelashwa ngemisebe okufana nalokho, ukwelashwa kwemisebe okunamandla, ukwelashwa ngemisebe yeproton, noma ukwelashwa kwemisebe ye-stereotactic, lapho isimila siqala ukukhula futhi.

• Inhlanganisela yamakhemikhali noma ngaphandle kwemithi yokwelashwa ngemisebe.

• Isivivinyo somtholampilo sokwelapha okuhlosiwe ngenhlanganisela ye-BRAF inhibitors (dabrafenib ne-trametinib) ezigulini ezinokuguquka kwezakhi zofuzo kuhlobo lwe-BRAF.

Kwezinye izimo, ukubuka kusetshenziselwa izingane ezine-visual pathway glioma. Kwezinye izimo, ukwelashwa kungafaka ukuhlinzwa ukuze kususwe isimila, ukwelashwa ngemisebe, noma i-chemotherapy. Inhloso yokwelashwa ukugcina umbono omkhulu ngangokunokwenzeka. Umphumela wokukhula kwesimila kumbono wengane uzolandelwa eduze ngesikhathi sokwelashwa.

Izingane ezine-neurofibromatosis yohlobo 1 (NF1) kungenzeka zingadingi ukwelashwa ngaphandle kokuthi isimila sikhule noma izimpawu noma izimpawu, njengezinkinga zombono, zivele. Lapho isimila sikhula noma kuvela izimpawu noma izimpawu, ukwelashwa kungafaka ukuhlinzwa ukususa isimila, ukwelashwa ngemisebe, kanye / noma i-chemotherapy.

Izingane ezine-tuberous sclerosis zingahle zibe nezicubu ezinobungozi (hhayi umdlavuza) ebuchosheni obubizwa nge-subependymal giant cell astrocytomas (SEGAs). Ukwelashwa okuhlosiwe nge-everolimus noma i-sirolimus kungasetshenziswa esikhundleni sokuhlinzwa, ukunciphisa izicubu.

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-Astrocytomas Yezingane Ephansi Ephansi

Lapho i-astrocytoma esezingeni eliphansi ibuyela emuva ngemuva kokwelashwa, imvamisa ibuya lapho kuqala khona isimila. Ngaphambi kokuba kunikezwe ukwelashwa okwengeziwe komdlavuza, kwenziwa ukuhlolwa kwe-imaging, i-biopsy, noma ukuhlinzwa ukuthola ukuthi ukhona yini umdlavuza nokuthi kungakanani.

Ukwelashwa kwe-astrocytoma esezingeni eliphansi ebuntwaneni kungafaka okulandelayo:

• Ukuhlinzwa kwesibili ukukhipha isimila, uma ukuhlinzwa bekungukuphela kokwelapha okwanikezwa lapho isimila sitholwa okokuqala.

• Ukwelashwa ngemisebe ku-tumor kuphela, uma ukwelashwa ngemisebe bekungasetshenziswanga lapho isimila sitholwa okokuqala. Ukwelashwa ngemisebe okuguqukayo kunganikezwa.

• I-Chemotherapy, uma isimila siphinde sabuya lapho singeke sisuswe khona ngokuhlinzwa noma isiguli sathola imisebe yokwelashwa ngemisebe lapho isimila sitholwa okokuqala.

• Ukwelashwa okuhlosiwe nge-monoclonal antibody (bevacizumab) nge-chemotherapy noma ngaphandle kwayo.

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

• Isivivinyo somtholampilo sokwelapha okuhlosiwe nge-BRAF inhibitor (dabrafenib), i-mTOR inhibitor (everolimus), noma i-MEK inhibitor (selumetinib).

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.

Ama-Astrocytomas asanda kutholakala ebuntwaneni

Ukwelashwa kwe-astrocytoma esezingeni eliphakeme lobuntwana kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila, kulandelwe ukwelashwa ngamakhemikhali kanye / noma ukwelashwa ngemisebe.

• Isivivinyo somtholampilo sokwelapha okusha.

• Isivivinyo somtholampilo sokwelashwa okuqondisiwe nge-PARP inhibitor (veliparib) kuhlanganiswe nokwelashwa ngemisebe kanye nokwelashwa ngamakhemikhali ukwelapha i-glioma esanda kutholakala ukuthi ayinawo ushintsho (ushintsho) kuhlobo lwe-BRAF.

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-Astrocytomas Yezingane Ephakeme Ephindaphindiwe

Lapho i-astrocytoma esezingeni eliphakeme ibuya emuva kokwelashwa, imvamisa ibuya lapho kuqala khona isimila. Ngaphambi kokuba kunikezwe ukwelashwa okwengeziwe komdlavuza, kwenziwa ukuhlolwa kwe-imaging, i-biopsy, noma ukuhlinzwa ukuthola ukuthi ukhona yini umdlavuza nokuthi kungakanani.

Ukwelashwa kwe-astrocytoma esezingeni eliphakeme ebuntwaneni kungafaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila.

• I-chemotherapy ephezulu ene-stem cell transplant.

• Ukwelashwa okuhlosiwe nge-BRAF inhibitor (vemurafenib noma i-dabrafenib).

• Isivivinyo somtholampilo se-immunotherapy esine-immune checkpoint inhibitor.

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

• Isivivinyo somtholampilo sokwelapha okuhlosiwe ngenhlanganisela ye-BRAF inhibitors (dabrafenib ne-trametinib) ezigulini ezinokuguquka kwezakhi zofuzo kuhlobo lwe-BRAF.

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.

Ukufunda Okwengeziwe Nge-Astrocytomas Yobuntwana

Ukuthola eminye imininingwane ngama-astrocytomas ebuntwana, bona okulandelayo:

• Izindlela Zokwelapha Zomdlavuza

• I-Pediatric Brain Tumor Consortium (PBTC) Phuma Disclaimer

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