Types/brain/patient/child-brain-treatment-pdq

Ingqondo Yobuntwana kanye ne-Spinal Cord Tumors Treatment Overview

Imininingwane ejwayelekile Ngobuchopho Bobuntwana kanye Nezimila Zomgogodla

AMAPHUZU ASEMQOKA

• Ingqondo yobuntwana noma isimila somgogodla yisifo lapho kwakheka amangqamuzana angajwayelekile ezicutshini zobuchopho noma umgogodla.

• Ubuchopho bulawula imisebenzi eminingi ebalulekile yomzimba.

• Umgogodla uxhuma ubuchopho nezinzwa ezingxenyeni eziningi zomzimba.

• Izicubu zobuchopho nomgogodla uhlobo oluvamile lomdlavuza wezingane.

• Imbangela yamathumba amaningi ebuchosheni nasemgogodleni ayaziwa.

• Izimpawu nezimpawu zobuchopho bengane kanye nezicubu zomgogodla azifani ezinganeni zonke.

• Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) izingqondo zobuntwana nezicubu zomgogodla.

• Iningi lezicubu zobuchopho ebuntwaneni liyatholakala futhi lisuswe lapho lihlinzwa.

• Ezinye izicubu zobuchopho nobuchopho bomgogodla zitholwa ngokuhlolwa kwe-imaging.

• Izici ezithile zithinta ukubikezela (ithuba lokululama).

Ingqondo yobuntwana noma isimila somgogodla yisifo lapho kwakheka amangqamuzana angajwayelekile ezicutshini zobuchopho noma umgogodla.

Kunezinhlobo eziningi zobuchopho bengane kanye nezicubu zomgogodla. Izicubu zakheka ngokukhula okungajwayelekile kwamaseli futhi zingaqala ezindaweni ezahlukahlukene zobuchopho noma umgogodla.

Izicubu zingase zibe nobungozi (hhayi umdlavuza) noma zibe yingozi (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 noma izimpawu futhi zidinga ukwelashwa.

Ngokubambisana, ubuchopho nomgogodla benza uhlelo oluphakathi lwezinzwa (CNS).

Ubuchopho bulawula imisebenzi eminingi ebalulekile yomzimba.

Ubuchopho bunezingxenye ezintathu ezinkulu:

• I-cerebrum yingxenye enkulu yobuchopho. Kusekhanda eliphezulu. I-cerebrum ilawula ukucabanga, ukufunda, ukuxazulula izinkinga, imizwa, ukukhuluma, ukufunda, ukubhala nokunyakaza ngokuzithandela.

• I-cerebellum ingemuva engezansi kobuchopho (eduze nendawo maphakathi nekhanda). Ilawula ukunyakaza, ukulinganisela, nokuma komzimba.

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

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).

Umgogodla uxhuma ubuchopho nezinzwa ezingxenyeni eziningi zomzimba.

Intambo yomgogodla iyikholamu yezicubu zemizwa egijima ebuchosheni igudla phakathi nendawo emuva. Imbozwe izingqimba ezincanyana ezintathu zezicubu ezibizwa ngokuthi ulwelwesi. Lezi zingqimba zizungezwe ama-vertebrae (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.

Izicubu zobuchopho nomgogodla uhlobo oluvamile lomdlavuza wezingane.

Yize umdlavuza ungandile ezinganeni, izicubu zobuchopho nomgogodla ziluhlobo lwesibili lomdlavuza wobuntwana, ngemuva kwe-leukemia. Izicubu zobuchopho zingenzeka ezinganeni nakubantu abadala. Ukwelashwa kwezingane kuvame ukwehluka kunokwelashwa kwabantu abadala. (Bheka isifinyezo se- ku-Adult Central Nervous System Tumors Treatment ukuthola eminye imininingwane mayelana nokwelashwa kwabantu abadala.)

Lesi sifinyezo sichaza ukwelashwa kwezimila zobuchopho kanye nomgogodla oyinhloko (izicubu eziqala ebuchosheni nakumgogodla). Ukwelashwa kwezicubu zobuchopho kanye nezicubu zomgogodla akuhlanganisiwe kulesi sifinyezo. Izicubu zemetastatic zakhiwa ngamangqamuzana omdlavuza aqala kwezinye izingxenye zomzimba futhi asabalale aye ebuchosheni noma emgogodleni.

Imbangela yamathumba amaningi ebuchosheni nasemgogodleni ayaziwa.

Izimpawu nezimpawu zobuchopho bengane kanye nezicubu zomgogodla azifani ezinganeni zonke.

Izimpawu nezimpawu zincike kokulandelayo:

• Lapho okuvela khona isimila ebuchosheni noma emgogodleni.

• Usayizi wesimila.

• Sikhula ngokushesha kangakanani isimila.

• Iminyaka yengane nokukhula kwayo.

Izimpawu nezimpawu zingadalwa yingqondo yobuntwana kanye nezicubu zomgogodla noma ngezinye izimo, kufaka phakathi umdlavuza osudlulele ebuchosheni. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

Izimpawu Nezimpawu Ze-Brain Tumor

• Ukuphathwa ikhanda ekuseni noma ikhanda elihamba ngemuva kokuhlanza.

• Isicanucanu njalo nokuhlanza.

• Izinkinga zokubona, zokuzwa nezokukhuluma.

• Ukulahlekelwa ibhalansi nenkinga yokuhamba.

• Ukulala okungavamile noma ushintsho ezingeni lomsebenzi.

• Izinguquko ezingajwayelekile ebuntwini noma ekuziphatheni.

• Ukuquleka.

• Khulisa usayizi wekhanda (ezinganeni).

Izimpawu Nezimpawu Ze-Spinal Cord Tumor

• Ubuhlungu beqolo noma ubuhlungu obusakazeka ukusuka emuva buye ezingalweni noma emilenzeni.

• Ukushintsha kwemikhuba yamathumbu noma inkinga yokuchama.

• Ubuthakathaka emilenzeni.

• Unenkinga yokuhamba.

Ngaphezu kwalezi zimpawu nezimpawu zesimila sobuchopho nomgogodla, ezinye izingane azikwazi ukufinyelela emigomweni ethile yokukhula nokuthuthuka njengokuhlala phansi, ukuhamba nokukhuluma ngemisho.

Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) izingqondo zobuntwana nezicubu zomgogodla.

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.

• 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.

• 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).

• Isivivinyo se-serum tumor marker: Inqubo lapho kuhlolwa khona isampula yegazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho, izicubu, noma amaseli wesimila emzimbeni. Izinto ezithile zixhunyaniswe nezinhlobo ezithile zomdlavuza lapho zitholakala emazingeni akhuphukile egazini. Lokhu kubizwa ngokuthi yizimpawu zesimila.

Iningi lezicubu zobuchopho ebuntwaneni liyatholakala futhi lisuswe lapho lihlinzwa.

Uma odokotela becabanga ukuthi kungahle kube nesimila ebuchosheni, kungenziwa i-biopsy ukususa isampula lezicubu. Kwezimila ebuchosheni, i-biopsy yenziwa ngokususa ingxenye yogebhezi bese kusetshenziswa inaliti ukususa isampula lezicubu. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza. Uma kutholakala amangqamuzana omdlavuza, udokotela angasusa isimila esiningi ngangokunokwenzeka ngesikhathi sokuhlinzwa okufanayo. I-pathologist ihlola amangqamuzana omdlavuza ukuthola uhlobo nobubanzi besimila sobuchopho. Izinga lesimila lincike ekutheni amangqamuzana omdlavuza abukeka ngendlela engavamile kanjani ngaphansi kwesibonakhulu nokuthi kungenzeka kanjani ukuthi isimila sikhule futhi sisakazeke ngokushesha.

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

Ukuhlolwa okulandelayo kungenziwa kusampula lezicubu ezisusiwe:

• 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.

Ezinye izicubu zobuchopho nobuchopho bomgogodla zitholwa ngokuhlolwa kwe-imaging.

Kwesinye isikhathi i-biopsy noma ukuhlinzwa akukwazi ukwenziwa ngokuphepha ngenxa yalapho isimila sakhiwa khona ebuchosheni noma emgogodleni. Lezi zicubu zitholakala ngokuya ngemiphumela yokuhlolwa kwe-imaging nezinye izinqubo.

Izici ezithile zithinta ukubikezela (ithuba lokululama).

Isibikezelo (ithuba lokululama) sincike kokulandelayo:

• Noma ngabe kukhona amaseli omdlavuza asele ngemuva kokuhlinzwa.

• Uhlobo lwesimila.

• Lapho isimila sikhona emzimbeni.

• Iminyaka yengane.

• Ukuthi isimila sisanda kutholakala yini noma sesiphindile (buyela emuva).

Isiteji sezingqondo zobuntwana kanye ne-Spinal Cord Tumors

AMAPHUZU ASEMQOKA

• Ebuchosheni bobuntwana kanye nezicubu zomgogodla, izinketho zokwelashwa zisuselwa ezicini ezithile.

• Imininingwane evela ezivivinyweni nasezinhlelweni ezenziwe ukuthola (ukuthola) izingqondo zobuntwana kanye nezicubu zomgogodla zisetshenziselwa ukuthola iqembu lobungozi besimila.

• Izicubu zobuchopho bezingane nezomgogodla zingaphinde zibuye (zibuye) ngemuva kokwelashwa.

Ebuchosheni bobuntwana kanye nezicubu zomgogodla, izinketho zokwelashwa zisuselwa ezicini ezithile.

Isiteji inqubo esetshenziswayo ukuthola ukuthi ungakanani umdlavuza okhona futhi uma umdlavuza usabalele ngaphakathi kobuchopho, umgogodla, noma kwezinye izingxenye zomzimba. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa komdlavuza.

Ebuchosheni bobuntwana kanye nezicubu zomgogodla, alukho uhlelo olujwayelekile lokubeka iziteji. Esikhundleni salokho, uhlelo lokwelashwa komdlavuza luxhomeke ezicini eziningana:

• Uhlobo lwesimila nalapho kwakhiwa khona isimila ebuchosheni.

• Ukuthi isimila sisanda kutholakala yini noma siphindaphindeka. Ingqondo esanda kutholakala yobuchopho noma isimila somgogodla yinto engakaze yelashwe. Ingqondo ephindaphindwayo yobuntwana noma isimila somgogodla yileyo ebuye yabuya (ibuya) ngemuva kokuthi yelashwe. Izicubu zobuchopho bomntwana nezomgogodla zingabuya endaweni efanayo noma kwenye ingxenye yobuchopho, noma umgogodla. Kwesinye isikhathi zibuya kwenye ingxenye yomzimba. Isimila singabuya emuva kweminyaka eminingi selashwe okokuqala. Ukuhlolwa nezinqubo, kufaka phakathi i-biopsy, ezenziwa ukuxilonga kanye nokubeka isimila kungenziwa ukuthola ukuthi isimila sesiphindile yini.

• Ibanga lesimila. Izinga lesimila lincike ekutheni amangqamuzana omdlavuza abukeka ngendlela engavamile kanjani ngaphansi kwesibonakhulu nokuthi kungenzeka kanjani ukuthi isimila sikhule futhi sisakazeke ngokushesha. Kubalulekile ukwazi izinga lesimila nokuthi ngabe abekhona yini amangqamuzana omdlavuza asele ngemuva kokuhlinzwa ukuze kuhlelwe ukwelashwa. Izinga lesimila alisetshenziselwa ukuhlela ukwelashwa kwazo zonke izinhlobo zezimila zobuchopho nezomgogodla.

• Iqembu elinobungozi besimila. Amaqembu obungozi angaba yingozi emaphakathi kanye nobungozi obubi noma aphansi, aphakathi nendawo futhi anengozi enkulu. Amaqembu engcupheni asuselwa enanini lesimila esisele ngemuva kokuhlinzwa, ukusabalala kwamangqamuzana omdlavuza ngaphakathi kobuchopho nomgogodla noma kwezinye izingxenye zomzimba, lapho isimila sakhe khona, kanye neminyaka yengane. Iqembu eliyingozi alisetshenziselwa ukuhlela ukwelashwa kwazo zonke izinhlobo zezimila zobuchopho nezomgogodla.

Imininingwane evela ezivivinyweni nasezinhlelweni ezenziwe ukuthola (ukuthola) izingqondo zobuntwana kanye nezicubu zomgogodla zisetshenziselwa ukuthola iqembu lobungozi besimila.

Ngemuva kokuthi isisu sisuswe lapho sihlinzwa, okunye kokuhlolwa okusetshenziselwa ukuthola ubuchopho bengane kanye nezicubu zomgogodla kuyaphindwa ukusiza ukuthola iqembu lobungozi (bheka isigaba soLwazi Olujwayelekile). Lokhu ukuthola ukuthi yimalini isimila esisele ngemuva kokuhlinzwa.

Olunye uvivinyo nezinqubo zingenziwa ukuthola ukuthi umdlavuza usakazekile yini:

• Ukubhoboza i-Lumbar: Inqubo esetshenziselwa ukuqoqa i-cerebrospinal fluid (CSF) kusuka kukholamu lomgogodla. Lokhu kwenziwa ngokubeka inaliti phakathi kwamathambo amabili emgogodleni naku-CSF ezungeze umgogodla nokususa isampula loketshezi. Isampula le-CSF lihlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zokuthi isimila sesisabalele ku-CSF. Isampula nayo ingahlolwa inani lamaprotheni noshukela. Inani eliphakeme kunelejwayelekile lamaprotheni noma inani eliphansi kunelejwayelekile le-glucose kungaba uphawu lwesimila. Le nqubo ibizwa nangokuthi i-LP noma umpompi womgogodla. Ukubhoboza i-lumbar imvamisa akusetshenziselwa ukufaka izicubu zomgogodla wobuntwana.

Ukubhoboza i-lumbar. Isiguli silele endaweni esigoqiwe etafuleni. Ngemuva kokuthi indawo encane engezansi ingemuva, inaliti yomgogodla (inaliti ende, ezacile) ifakwa engxenyeni engezansi yekholomu lomgogodla ukususa i-cerebrospinal fluid (CSF, ekhonjiswe ngombala oluhlaza okwesibhakabhaka). Uketshezi lungathunyelwa elabhorethri ukuze ihlolwe.

• 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.

• Isifiso somnkantsha we-Bone kanye ne-biopsy: Ukususwa komnkantsha wethambo, igazi, nocezu oluncane lwethambo ngokufaka inaliti engenalutho ethangeni noma emathanjeni esifuba. Isazi sezifo sibheka umnkantsha, igazi, nethambo ngaphansi kwesibonakhulu ukuze kubhekwe izimpawu zomdlavuza.

Ukufiswa komnkantsha we-Bone kanye ne-biopsy. Ngemuva kokuthi indawo encane yesikhumba iboshwe, kufakwa inaliti yomnkantsha ethanjeni lesinqe sengane. Amasampula egazi, amathambo, nomnkantsha uyasuswa ukuze kuhlolwe ngaphansi kwesibonakhulu.

Izicubu zobuchopho bezingane nezomgogodla zingaphinde zibuye (zibuye) ngemuva kokwelashwa.

Ingqondo ephindaphindwayo yobuntwana noma isimila somgogodla yileyo ebuye yabuya (ibuya) ngemuva kokuthi yelashwe. Izicubu zobuchopho bomntwana nezomgogodla zingabuya endaweni efanayo noma kwenye ingxenye yobuchopho. Kwesinye isikhathi zibuya kwenye ingxenye yomzimba. Isimila singabuya emuva kweminyaka eminingi selashwe okokuqala. Ukuhlolwa kanye nokuhlolwa kwesiteji kanye nezinqubo, kufaka phakathi i-biopsy, kungenziwa ukuqinisekisa ukuthi isimila siphindile.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kwezingane ezinamathumba obuchopho nawomgogodla.

• Izingane ezinezicubu zobuchopho noma zomgogodla kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe

• ukwelapha izicubu zobuchopho nobuchopho bomgogodla.

• Izicubu zobuchopho bezingane nezomgogodla zingadala izimpawu noma izimpawu eziqala ngaphambi kokuba umdlavuza utholwe futhi ziqhubeke izinyanga noma iminyaka.

• Ukwelashwa kwezicubu zobuchopho bezingane kanye nomgogodla kungadala imiphumela emibi.

• Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• I-chemotherapy ephezulu ene-stem cell transplant

• 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 kwezingane ezinamathumba obuchopho nawomgogodla.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezinezicubu zobuchopho nezomgogodla. 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. Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izingane ezinezicubu zobuchopho noma zomgogodla kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni izicubu zobuchopho kanye nomgogodla wezingane.

Ukwelashwa kuzobhekwa ngudokotela wezingane oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. Udokotela oncologist usebenza nabanye abahlinzeki bokunakekelwa kwempilo abangochwepheshe ekwelapheni izingane ezinamathumba ebuchosheni futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• Udokotela wezingane.

• I-Neurosurgeon.

• Isazi sezinzwa.

• Neuro-oncologist.

• Isazi se-Neuropathologist.

• Isazi se-Neuroradiologist.

• I-radiation oncologist.

• Isazi se-endocrinologist.

• Isazi sokusebenza kwengqondo.

• Udokotela wezifo zamehlo.

• Uchwepheshe wokuvuselelwa.

• Usonhlala kahle.

• Isazi somhlengikazi.

Izicubu zobuchopho bezingane nezomgogodla zingadala izimpawu noma izimpawu eziqala ngaphambi kokuba umdlavuza utholwe futhi ziqhubeke izinyanga noma iminyaka.

Izicubu zobuchopho bezingane nezomgogodla zingadala izimpawu noma izimpawu eziqhubeka izinyanga noma iminyaka. Izimpawu noma izimpawu ezibangelwa isimila zingaqala ngaphambi kokuxilongwa. Izimpawu noma izimpawu ezibangelwa ukwelashwa zingaqala ngesikhathi noma ngemuva nje kokwelashwa.

Ukwelashwa kwezicubu zobuchopho bezingane kanye nomgogodla 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 ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa kungasetshenziselwa ukuxilonga nokwelapha izicubu zobuchopho kanye nomgogodla wobuntwana. Bona isigaba soMniningwane Jikelele walesi sifinyezo.

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.

Indlela yokwelashwa ngemisebe enikezwa ngayo incike ohlotsheni lomdlavuza olashwa. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha izicubu zobuchopho kanye nomgogodla wezingane.

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). Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

Imithi elwa nomdlavuza enikezwa ngomlomo noma emthanjeni ukwelapha izicubu zobuchopho nomgogodla ayikwazi ukweqa isithiyo segazi-lobuchopho bese ingena kuketshezi oluzungeze ubuchopho nomgogodla. Esikhundleni salokho, umuthi olwa nomdlavuza ufakwa esikhaleni esigcwele uketshezi ukubulala amangqamuzana omdlavuza lapho. Lokhu kubizwa ngokuthi yi-intrathecal chemotherapy.

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.

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.

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.

Ukwelashwa Kwezimila Zengqondo Ezisanda Kuhlonza Neziphindaphindayo

Ubuchopho benziwe ngezinhlobo ezahlukene zamaseli. Izicubu zobuchopho bezingane ziqoqiwe futhi zelashwa ngokuya ngohlobo lweseli umdlavuza owakhelwe kuwo nalapho lesi sifo saqala khona ukukhula ku-CNS. Ezinye izinhlobo zamathumba zihlukaniswe ngama-subtypes ngokuya ngokuthi isimila sibukeka kanjani ngaphansi kwemicroscope nokuthi sinezinguquko ezithile zofuzo yini. Bona Ithebula 1 ukuthola uhlu lwezinhlobo zezimila nolwazi lokuqokwa nokwelashwa kwamaqhubu asanda kutholakala futhi aphindaphindiwe obuchopho bengane.

Ukwelashwa Kwamathumba Asanda Kuhlonza Nokuphindaphindeka Kwengane

Amaqhubu ezinhlobo eziningi zamaseli ahlukahlukene angakheka entanjeni yomgogodla. Izicubu zomgogodla ezisezingeni eliphansi ngokuvamile azisakazeki. Izicubu zomgogodla ezisezingeni eliphakeme zingasakazekela kwezinye izindawo emgogodleni noma ebuchosheni. Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane ngesiteji nokwelashwa kwezimila zomgogodla ezisanda kutholakala neziphindaphindwayo:

• Ukwelashwa kwe-Astrocytomas Childhood

• Ukwelashwa Kwe-Childhood Central Nervous System Embryonal Tumors

• Ukwelashwa Kwe-Ependymoma Ebuntwaneni

Ukufunda Okwengeziwe Ngobuchopho Bobuntwana kanye Nezimila Zomgogodla

Ngeminye imininingwane mayelana nengqondo yobuntwana kanye nezicubu zomgogodla, bona okulandelayo:

• 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