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

Ukwelashwa Kwe-Childhood Central Nervous System Embryonal Tumors Treatment (®) –Patient Version

Imininingwane ejwayelekile Mayelana Nezinhlelo Zokukhula Ezingaphakathi Kwesistimu Yezinzwa Ezingumbumba

AMAPHUZU ASEMQOKA

• Izicubu zombungu zesistimu yezinzwa eziphakathi (CNS) zingaqala kumaseli e-embryonic (fetal) ahlala ebuchosheni ngemuva kokuzalwa.

• Kunezinhlobo ezahlukahlukene zamathumba we-CNS embryonal.

• I-Pineoblastomas yakha kumaseli we-pineal gland.

• Izimo ezithile zofuzo zandisa ubungozi bokukhulelwa kwe-CNS ebuntwaneni.

• Izimpawu nezimpawu zobuntwana be-CNS izicubu zomzimba noma i-pineoblastomas zixhomeke kubudala bengane nokuthi sikuphi isimila.

• Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) izicubu zomzimba ze-CNS embryonal noma i-pineoblastomas.

• I-biopsy ingenziwa ukuze kuqinisekiswe ukutholakala kwe-CNS embryonal tumor noma i-pineoblastoma.

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

Izicubu zombungu zesistimu yezinzwa eziphakathi (CNS) zingaqala kumaseli e-embryonic (fetal) ahlala ebuchosheni ngemuva kokuzalwa.

Isistimu yezinzwa emaphakathi (CNS) yezimila zomumbu ezakhiwe emangqamuzaneni ombungu ahlala ebuchosheni ngemuva kokuzalwa. Izicubu ze-CNS embryonal zivame ukusabalala nge-cerebrospinal fluid (CSF) ziye kwezinye izingxenye zobuchopho nentambo yomgogodla.

Izicubu zingaba yingozi (umdlavuza) noma zibe yingozi (hhayi umdlavuza). Izicubu eziningi ze-CNS embryonal ezinganeni ziyingozi. Izicubu zobuchopho ezinobungozi kungenzeka zikhule ngokushesha futhi zisabalale ziye kwezinye izingxenye zobuchopho. Lapho isimila sikhula sibe noma sicindezela endaweni yobuchopho, singamisa leyo ngxenye yobuchopho ukuthi isebenze ngendlela okufanele isebenze ngayo. Izicubu zobuchopho zeBenign ziyakhula futhi zicindezele ezindaweni eziseduze zobuchopho. Akuvamile ukusabalala kwezinye izingxenye zobuchopho. Kokubili izicubu zobuchopho ezinobungozi nezimbi zingadala izimpawu noma izimpawu futhi zidinga ukwelashwa.

Yize umdlavuza ungandile ezinganeni, izicubu zobuchopho ziwuhlobo lwesibili lomdlavuza wobuntwana olujwayelekile, ngemuva kwe-leukemia. Lesi sifinyezo simayelana nokwelashwa kwezicubu eziyinhloko zobuchopho (izicubu eziqala ebuchosheni). Ukwelashwa kwezimila zobuchopho ze-metastatic, eziqala kwezinye izingxenye zomzimba bese zisakazeka ebuchosheni, akuxoxwa ngakho kulesi sifinyeto. Ngemininingwane mayelana nezinhlobo ezahlukahlukene zobuchopho kanye nezicubu zomgogodla, bheka isifinyezo se- ku-Childhood Brain ne-Spinal Cord Tumors Treatment Overview.

Izicubu zobuchopho zenzeka ezinganeni nakubantu abadala. Ukwelashwa kwabantu abadala kungahluka ekwelashweni kwezingane. Bona isifinyezo se- ku-Adult Central Nervous System Tumors Treatment ukuthola eminye imininingwane ngokwelashwa kwabantu abadala.

Kunezinhlobo ezahlukahlukene zamathumba we-CNS embryonal.

I-anatomy yengaphakathi lobuchopho, ekhombisa izindlala zepineal nezama-pituitary, i-optic nerve, i-ventricles (ene-cerebrospinal fluid ekhonjiswe ngokuluhlaza okwesibhakabhaka), nezinye izingxenye zobuchopho.

Izinhlobo ezahlukene zamathumba we-CNS embryonal zifaka:

AmaMedulloblastomas

Izicubu eziningi ze-CNS embryonal yi-medulloblastomas. Ama-medulloblastomas yizicubu ezikhula ngokushesha ezakha amangqamuzana obuchopho ku-cerebellum. I-cerebellum isengxenyeni engezansi engemuva yobuchopho phakathi kwe-cerebrum nesiqu sobuchopho. I-cerebellum ilawula ukunyakaza, ibhalansi, nokuma komzimba. AmaMedulloblastomas kwesinye isikhathi asabalala aye emathanjeni, emnkantsheni, emaphashini, noma kwezinye izingxenye zomzimba, kepha lokhu akuvamile.

Izicubu ze-nonmedulloblastoma embryonal

Izicubu ze-nonmedulloblastoma embryonal izicubu ezikhula ngokushesha ezivame ukwakheka kumaseli obuchopho ku-cerebrum. I-cerebrum iphezulu kwekhanda futhi iyingxenye enkulu yobuchopho. I-cerebrum ilawula ukucabanga, ukufunda, ukuxazulula izinkinga, imizwa, ukukhuluma, ukufunda, ukubhala nokunyakaza ngokuzithandela. Izicubu ze-nonmedulloblastoma embryonal nazo zingakheka esiqwini sobuchopho noma emgogodleni.

Kunezinhlobo ezine zamathumba embryonal e-nonmedulloblastoma:

• Izicubu ze-embryonal ezinama-rosette amaningi

Izicubu ze-embryonal ezinama-rosetette amaningi (i-ETMR) yizicubu ezingavamile ezakha ebuchosheni nasentanyeni yomgogodla. I-ETMR ivame ukwenzeka ezinganeni ezincane futhi izicubu ezikhula ngokushesha.

• AmaMedulloepitheliomas

AmaMedulloepitheliomas yizicubu ezikhula ngokushesha ezijwayele ukwakheka ebuchosheni, emgogodleni noma emithanjeni ngaphandle kwekholomu lomgogodla. Zenzeka kakhulu ezinganeni nasezinganeni ezincane.

• I-CNS neuroblastomas

I-CNS neuroblastomas uhlobo olungajwayelekile kakhulu lwe-neuroblastoma eyakha izicubu zomzimba ze-cerebrum noma izingqimba zezicubu ezimboza ubuchopho nomgogodla. Ama-neuroblastomas e-CNS angaba makhulu futhi asakazeke kwezinye izingxenye zobuchopho noma umgogodla.

• Ama-ganglioneuroblastomas e-CNS

I-CNS ganglioneuroblastomas izicubu ezingavamile ezakha izicubu zomzimba zobuchopho nomgogodla. Zingakha endaweni eyodwa futhi zikhule ngokushesha noma zenze indawo engaphezu kweyodwa bese zikhula kancane.

Ubuntwana be-CNS i-atypical teratoid / rhabdoid tumor nayo iwuhlobo lwesimila se-embryonal, kepha iphathwa ngendlela ehlukile kunezinye izicubu zombungu ze-CNS zobuntwana. Bona isifinyezo se- ku-Childhood Central Nervous System Atypical Teratoid / Rhabdoid Tumor Treatment ukuthola eminye imininingwane.

I-Pineoblastomas yakha kumaseli we-pineal gland.

Indlala yepineal iyisitho esincane esisenkabeni yobuchopho. Indlala yenza i-melatonin, into esiza ukulawula umjikelezo wethu wokulala.

Ama-Pineoblastomas akha amangqamuzana e-pineal gland futhi ngokuvamile ayingozi. I-Pineoblastomas yizicubu ezikhula ngokushesha ezinamaseli abukeka ehluke kakhulu kumaseli ejwayelekile we-pineal gland. I-Pineoblastomas ayilona uhlobo lwesimila se-CNS embryonal kepha ukwelashwa kwazo kufana nokwelashwa kwezicubu ze-CNS embryonal.

I-Pineoblastoma ixhunyaniswe nezinguquko ezizuzwe ngofuzo ku-retinoblastoma (RB1) gene. Ingane enefomu le-retinoblastoma (umdlavuza kunezinhlobo zezicubu ze-retina) inengozi eyengeziwe ye-pineoblastoma. Lapho i-retinoblastoma yakha ngasikhathi sinye njenge-tumor ngaphakathi noma eduze kwe-gland ye-pineal, ibizwa ngokuthi i-retinoblastoma enxantathu. Ukuhlolwa kwe-MRI (magnetic resonance imaging) ezinganeni ezine-retinoblastoma kungathola i-pineoblastoma kusenesikhathi lapho ingalashwa ngempumelelo.

Izimo ezithile zofuzo zandisa ubungozi bokukhulelwa kwe-CNS ebuntwaneni.

Noma yini enyusa ingozi yokuthola 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 ezinobungozi zamathumba we-CNS embryonal zibandakanya ukuba nezifo ezilandelayo ezizuzwe njengefa:

• Isifo seTurcot.

• Isifo sikaRubinstein-Taybi.

• I-Nevoid basal cell carcinoma (Gorlin) syndrome.

• Isifo se-Li-Fraumeni.

• I-Fanconi anemia.

Izingane ezinezinguquko ezithile zofuzo noma umlando womndeni womdlavuza oxhunyaniswe nezinguquko kuhlobo lwe-BRCA zingacatshangelwa ukuhlolwa kofuzo. Noma kungavamile, lokhu kuhlolwe ukuthi ngabe ingane inesifo somdlavuza esibeka ingane engcupheni yokuthola ezinye izifo noma izinhlobo zomdlavuza.

Ezimweni eziningi, imbangela yamathumba we-CNS embryonal ayaziwa.

Izimpawu nezimpawu zobuntwana be-CNS izicubu zomzimba noma i-pineoblastomas zixhomeke kubudala bengane nokuthi sikuphi isimila.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yizingane ze-CNS embryonal tumors, i-pineoblastomas, noma ezinye izimo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Ukulahlekelwa ibhalansi, ukuhamba kanzima, ukuwohloka kokubhala ngesandla, noma ukukhuluma kancane.

• Ukuntuleka kokuxhumana.

• Ukuphathwa yikhanda, ikakhulukazi ekuseni, noma ikhanda elihamba ngemuva kokuhlanza.

• Ukubona kabili noma ezinye izinkinga zamehlo.

• Isicanucanu nokuhlanza.

• Ubuthakathaka obujwayelekile noma ubuthakathaka ohlangothini olulodwa lobuso.

• Ukulala okungavamile noma ushintsho ezingeni lamandla.

• Ukuquleka.

Izinsana nezingane ezincane ezinalezi zicubu kungenzeka zicasuke noma zikhule kancane. Futhi kungenzeka bangadli kahle noma bahlangabezane nezinyathelo zentuthuko njengokuhlala, ukuhamba nokukhuluma ngemisho.

Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) izicubu zomzimba ze-CNS embryonal noma i-pineoblastomas.

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. Ukuhlolwa kubheka isimo sengqondo sesiguli, ukusebenzisana, kanye nekhono lokuhamba ngokujwayelekile, nokuthi izicubu, izinzwa, kanye nokucabanga kusebenza kahle kangakanani. Lokhu kungabizwa nangokuthi ukuhlolwa kwe-neuro noma ukuhlolwa kwe-neurologic.

• I-MRI (imaging resonance imaging) yobuchopho nomgogodla nge-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi kobuchopho 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 kwe-MRI ukubheka amakhemikhali asezicubu zobuchopho.

• 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 zamangqamuzana wesimila. 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. 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.

I-biopsy ingenziwa ukuze kuqinisekiswe ukutholakala kwe-CNS embryonal tumor noma i-pineoblastoma.

Uma odokotela becabanga ukuthi ingane yakho ingahle ibe ne-CNS embryonal tumor noma i-pineoblastoma, i-biopsy ingenziwa. Ngezicubu zobuchopho, i-biopsy yenziwa ngokususa ingxenye yogebhezi bese kusetshenziswa inaliti ukususa isampula lezicubu. Kwesinye isikhathi, kusetshenziswa inaliti eqondiswa ikhompyutha ukususa isampula lezicubu. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza. Uma kutholakala amangqamuzana omdlavuza, udokotela angasusa isimila esiningi ngangokunokwenzeka ngesikhathi sokuhlinzwa okufanayo. Ingcezu yekhakhayi ivame ukubuyiselwa endaweni yayo ngemuva kwenqubo.

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.

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike ku:

• Uhlobo lwesimila nokuthi lukuphi ebuchosheni.

• Ukuthi umdlavuza ususabalele ngaphakathi kobuchopho nomgogodla lapho isimila sitholakala.

• Iminyaka yengane lapho kutholakala isimila.

• Kusala kangakanani isimila ngemuva kokuhlinzwa.

• Noma ngabe kukhona ushintsho oluthile kuma-chromosomes, izakhi zofuzo, noma amaseli obuchopho.

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

Isiteji Sezingane Ezisesiteji Esimaphakathi Sezinzwa Zomzimba

AMAPHUZU ASEMQOKA

• Ukwelashwa kwesistimu yezinzwa eziphakathi ebuntwaneni (CNS) embryonal tumors kanye ne-pineoblastomas kuya ngohlobo lwesimila kanye neminyaka yengane.

• Ukwelashwa kwe-medulloblastoma ezinganeni ezindala kuneminyaka engu-3 nakho kuya ngokuthi isisu siyingozi engakanani noma ingozi enkulu.

• Ubungozi obumaphakathi (ingane indala kuneminyaka emithathu ubudala)

• Ingcuphe enkulu (ingane ingaphezu kweminyaka emithathu ubudala)

• Imininingwane evela ezivivinyweni nasezinhlelweni ezenziwe ukuthola (ukuthola) izicubu zomzimba ze-CNS embryonal noma i-pineoblastomas isetshenziselwa ukuhlela ukwelashwa komdlavuza.

Ukwelashwa kwesistimu yezinzwa eziphakathi ebuntwaneni (CNS) embryonal tumors kanye ne-pineoblastomas kuya ngohlobo lwesimila kanye neminyaka yengane.

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

Alukho uhlelo olujwayelekile lokubeka izigaxa embryonal tumors kanye ne-pineoblastomas. Esikhundleni salokho, ukwelashwa kuncike ohlotsheni lwesimila nobudala bengane (iminyaka emithathu nangaphansi noma ngaphezulu kuneminyaka emi-3).

Ukwelashwa kwe-medulloblastoma ezinganeni ezindala kuneminyaka engu-3 nakho kuya ngokuthi isisu siyingozi engakanani noma ingozi enkulu.

Ubungozi obumaphakathi (ingane indala kuneminyaka emithathu ubudala)

Ama-medulloblastomas abizwa ngobungozi obuphakathi uma konke lokhu okuyiqiniso kuyiqiniso:

• Isimila sasuswa ngokuphelele ngokuhlinzwa noma kwakusele inani elincane kakhulu elalisele.

• Umdlavuza awusabalalanga kwezinye izingxenye zomzimba.

Ingcuphe enkulu (ingane ingaphezu kweminyaka emithathu ubudala)

AmaMedulloblastomas abizwa ngengozi enkulu uma kukhona okulandelayo okuyiqiniso:

• Esinye isimila asisuswanga ngokuhlinzwa.

• Umdlavuza ususabalele nakwezinye izingxenye zobuchopho noma umgogodla noma ezinye izitho zomzimba.

Ngokuvamile, umdlavuza unamathuba amaningi okuthi uphinde ubuye (ubuye) ezigulini ezinesigaxa esinobungozi obukhulu.

Imininingwane evela ezivivinyweni nasezinhlelweni ezenziwe ukuthola (ukuthola) izicubu zomzimba ze-CNS embryonal noma i-pineoblastomas isetshenziselwa ukuhlela ukwelashwa komdlavuza.

Ezinye zezivivinyo ezisetshenziselwa ukuthola izicubu zombungu ze-CNS noma i-pineoblastomas ziyaphindwa ngemuva kokuhlinzwa ukuze kususwe isimila. (Bheka isigaba soLwazi Jikelele.) Lokhu ukuthola ukuthi yimalini isimila esisele ngemuva kokuhlinzwa.

Olunye uvivinyo nezinqubo kungenziwa ukuthola ukuthi umdlavuza ususakazekile yini:

• 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. Ukulangazelela umnkantsha kanye ne-biopsy kwenziwa kuphela lapho kunezimpawu zokuthi umdlavuza ususabalalile emnkantsheni wethambo.

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.

• 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. Ukuhlolisiswa kwamathambo kwenziwa kuphela uma kunezimpawu noma izimpawu zokuthi umdlavuza ususabalalise amathambo.

• 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 zamangqamuzana wesimila. 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.

Ukuphindaphindeka Kwesistimu Yezinzwa Ezimaphakathi Zesisu Embryonal Tumors

Isimila sokuphindaphindeka sezinzwa zobuntwana esiphindaphindwayo (CNS) yisimila esiphindaphindayo (esibuyayo) ngemuva kokwelashwa. Izicubu zombungu ze-CNS zobuntwana zivame ukubuya kungakapheli iminyaka emi-3 ngemuva kokwelashwa kepha zingabuya emuva kweminyaka eminingi. Izicubu zombungu ze-CNS eziphindaphindayo zingabuya endaweni efanayo nesimila sokuqala kanye / noma endaweni ehlukile ebuchosheni noma emgogodleni. Izicubu ze-CNS embryonal azivame ukusabalala 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.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kwezingane ezinezicubu zomgogodla wesistimu yezinzwa (CNS).

• Izingane ezinezicubu ze-CNS embryonal kufanele ukuthi kuhlelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni izicubu zobuchopho ezinganeni.

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

• Ukwelashwa kwesistimu yezinzwa ezimaphakathi kwengane amathumba angumbala kungadala imiphumela emibi.

• Izinhlobo ezinhlanu zokwelashwa zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• I-chemotherapy ephezulu ene-stem cell Rescue

• 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 kwezingane ezinezicubu zomgogodla wesistimu yezinzwa (CNS).

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezinezicubu zombungu ezingaphakathi zesistimu yezinzwa (CNS). 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 ezinezicubu ze-CNS embryonal kufanele ukuthi kuhlelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni izicubu zobuchopho ezinganeni.

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

• Udokotela wezingane.

• I-Neurosurgeon.

• Isazi sezinzwa.

• Isazi se-Neuropathologist.

• Isazi se-Neuroradiologist.

• Uchwepheshe wokuvuselelwa.

• I-radiation oncologist.

• 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 kokuba umdlavuza utholwe futhi ziqhubeke izinyanga noma iminyaka. Kubalulekile ukukhuluma nodokotela bengane yakho ngezimpawu noma izimpawu ezibangelwa isimila esingaqhubeka ngemuva kokwelashwa.

Ukwelashwa kwesistimu yezinzwa ezimaphakathi kwengane amathumba angumbala 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).

Izingane ezitholwe zine-medulloblastoma zingaba nezinkinga ezithile ngemuva kokuhlinzwa noma ukwelashwa ngemisebe njengokushintsha kwekhono lokucabanga, ukufunda nokunaka. Futhi, i-cerebellar mutism syndrome ingenzeka ngemuva kokuhlinzwa. Izimpawu zalesi sifo zifaka okulandelayo:

• Amandla okubambezeleka okukhuluma.

• Inkinga yokugwinya nokudla.

• Ukulahlekelwa ibhalansi, ukuhamba kanzima, nokwenza umbhalo wesandla ube mibi

• Ukulahleka kwethoni yemisipha.

• Ukushintsha kwemizwelo nezinguquko ebuntwini.

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 zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa kusetshenziselwa ukuxilonga nokwelapha isimila se-CNS ebuntwaneni njengoba kuchaziwe esigabeni soLwazi Olujwayelekile kulesi sifinyeto.

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

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. Lokhu kuvumela umthamo omkhulu wemisebe ukuthi ufinyelele isimila futhi kubangele ukulimala okuncane ezicutshini eziseduze ezinempilo.

• 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 kulesimila, kudale umonakalo omncane ezicutshini eziseduze ezinempilo. 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 kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Ukwelashwa ngemisebe ebuchosheni kungathinta ukukhula nentuthuko ezinganeni ezisencane. Ngalesi sizathu, izivivinyo zomtholampilo zicwaninga izindlela ezintsha zokunikeza imisebe engaba nemiphumela emibi embalwa kunezindlela ezijwayelekile.

Indlela yokwelashwa ngemisebe enikezwa ngayo incike ohlotsheni lomdlavuza olashwa. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha izicubu ze-embryonal zobuntwana.

Ngoba ukwelashwa ngemisebe kungathinta ukukhula nokukhula kobuchopho ezinganeni ezincane, ikakhulukazi izingane ezineminyaka emithathu noma ngaphansi, i-chemotherapy inganikezwa 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 yamakhemikhali ukwelashwa kusetshenziswa izidakamizwa ezingaphezu kwesisodwa ze-anticancer. Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni lomdlavuza olashwa.

Imithi ejwayelekile yokulwa nomdlavuza enikezwa ngomlomo noma emthanjeni ukwelapha izicubu zesistimu yezinzwa emaphakathi ayikwazi ukweqa isithiyo segazi nobuchopho bese ingena kuketshezi oluzungeze ubuchopho nomgogodla. Esikhundleni salokho, umuthi olwa nomdlavuza ufakwa esikhaleni esigcwele uketshezi ukubulala amangqamuzana omdlavuza okungenzeka asabalale lapho. Lokhu kubizwa ngokuthi yi-intrathecal noma i-intraventricular chemotherapy.

Ukwelashwa ngamakhemikhali kwe-Intrathecal. Izidakamizwa ze-anticancer zifakwa esikhaleni se-intrathecal, okuyisikhala esiphethe i-cerebrospinal fluid (CSF, ekhonjiswe ngombala oluhlaza okwesibhakabhaka). Kunezindlela ezimbili ezihlukile zokwenza lokhu. Enye indlela, ekhonjiswe engxenyeni ephezulu yesibalo, ukujova izidakamizwa echibini lase-Ommaya (isitsha esimise okwedome esifakwa ngaphansi kwesikhumba lapho uhlinzwa; ibamba izidakamizwa njengoba zingena ngepayipi elincane zingena ebuchosheni ). Enye indlela, ekhonjiswe engxenyeni engezansi yesibalo, ukujova izidakamizwa ngqo kwi-CSF engxenyeni engezansi yekholomu lomgogodla, ngemuva kokuthi indawo encane engezansi ingemuva.

I-chemotherapy ephezulu ene-stem cell Rescue

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.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana omdlavuza. Izindlela zokwelashwa ezihlosiwe zivame ukudala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe.

Ama-inhibitors we-Signal transduction inhlobo yokwelashwa okuqondisiwe okusetshenziselwa ukwelapha i-medulloblastoma ephindaphindwayo. Ama-inhibitors wokudluliswa kwesiginali avimba amasiginali adluliswa esuka ku-molecule eyodwa aye kwenye ngaphakathi kweseli. Ukuvimba lezi zimpawu kungabulala amangqamuzana omdlavuza. IVismodegib uhlobo lwe-inhibitor yokudlulisa isiginali.

Ukwelashwa okuhlosiwe kuyacutshungulwa ekwelashweni kwezicubu zomzimba ze-CNS ezibuyile eziphinde zabuya (zabuya).

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo 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. (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. Lokhu kwesinye isikhathi kubizwa ngokuthi ukusetha kabusha.

Ezinye zezivivinyo zemifanekiso zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sengane yakho sishintshile noma uma isimila sobuchopho siphindile (buyela emuva). Uma ukuhlolwa kwe-imaging kubonisa izicubu ezingavamile ebuchosheni, i-biopsy nayo ingenziwa ukuthola ukuthi ngabe izicubu zakhiwe ngamangqamuzana ama-tumor afile noma uma amaseli omdlavuza amasha ekhula. Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho Zokwelashwa Kwesistimu Ephakathi Yezinzwa Ezisabekayo Embryonal Tumors kanye Nengane Pineoblastoma

Kulesi Sigaba

• I-Medulloblastoma Yezingane Esanda Kutholwa

• Izicubu Ezisanda Kutholwa Zobuntwana Ze-Nonmedulloblastoma Embryonal Tumors

• Isimila Esanda Kutholwa Sobuntwana Embryonal With Rosettes Eziningi noma iMedulloepithelioma

• I-Pineoblastoma Yezingane Esanda Kutholwa

• Isistimu Yezinzwa Ephakathi Kwezinsana Ezimaphakathi Nezidumbu NePineoblastomas

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

I-Medulloblastoma Yezingane Esanda Kutholwa

Ku-medulloblastoma yobuntwana esanda kutholakala, isimila uqobo asikelashwa. Ingane kungenzeka ukuthi ithole izidakamizwa noma ukwelashwa ukukhulula izimpawu noma izimpawu ezibangelwa isimila.

Izingane ezineminyaka engaphezu kwengu-3 ezine-medulloblastoma enobungozi obumaphakathi

Ukwelashwa okujwayelekile kwe-medulloblastoma enobungozi ezinganeni ezindala kuneminyaka engu-3 kufaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka. Lokhu kulandelwa ukwelashwa ngemisebe ebuchosheni nasemgogodleni. I-Chemotherapy nayo inikezwa ngesikhathi nangemva kokwelashwa ngemisebe.

• Ukuhlinzwa ukususa i-tumor, ukwelashwa ngemisebe, kanye ne-chemotherapy ephezulu ene-stem cell Rescue.

Izingane ezindala kuneminyaka engu-3 ezine-medulloblastoma enobungozi obukhulu

Ukwelashwa okujwayelekile kwe-medulloblastoma enobungozi ezinganeni ezindala kuneminyaka engu-3 kufaka lokhu okulandelayo:

• Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka. Lokhu kulandelwa umthamo omkhulu wemithi yokwelashwa ngemisebe ebuchosheni nasentanyeni yomgogodla kunedosi enikezwe i-medulloblastoma enobungozi obujwayelekile. I-Chemotherapy nayo inikezwa ngesikhathi nangemva kokwelashwa ngemisebe.

• Ukuhlinzwa ukususa i-tumor, ukwelashwa ngemisebe, kanye ne-chemotherapy ephezulu ene-stem cell Rescue.

• Isivivinyo somtholampilo senhlanganisela entsha yokwelashwa ngemisebe kanye nokwelashwa ngamakhemikhali.

Izingane ezineminyaka engu-3 nangaphansi

Ukwelashwa okujwayelekile kwe-medulloblastoma ezinganeni ezineminyaka engu-3 nangaphansi ngu:

• Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka, kulandelwe ukwelashwa ngamakhemikhali.

Ezinye izindlela zokwelashwa ezinganikezwa ngemuva kokuhlinzwa zifaka okulandelayo:

• I-Chemotherapy enokwelashwa ngemisebe noma ngaphandle kwayo endaweni lapho kususwe khona isimila.

• I-chemotherapy ephezulu ene-stem cell Rescue.

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.

Izicubu Ezisanda Kutholwa Zobuntwana Ze-Nonmedulloblastoma Embryonal Tumors

Ezingxenyeni ezisanda kutholakala zobuntwana ze-nonmedulloblastoma embryonal tumors, isimila ngokwaso asikelashwa. Ingane kungenzeka ukuthi ithole izidakamizwa noma ukwelashwa ukuqeda izimpawu ezibangelwa isimila.

Izingane ezindala kuneminyaka engu-3

Ukwelashwa okujwayelekile kwezicubu ze-nonmedulloblastoma embryonal ezinganeni ezindala kuneminyaka engu-3 yile:

• Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka. Lokhu kulandelwa ukwelashwa ngemisebe ebuchosheni nasemgogodleni. I-Chemotherapy nayo inikezwa ngesikhathi nangemva kokwelashwa ngemisebe.

Izingane ezineminyaka engu-3 nangaphansi

Ukwelashwa okujwayelekile kwezicubu ze-nonmedulloblastoma embryonal ezinganeni ezineminyaka engu-3 nangaphansi ngu:

• Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka, kulandelwe ukwelashwa ngamakhemikhali.

Ezinye izindlela zokwelashwa ezinganikezwa ngemuva kokuhlinzwa zifaka okulandelayo:

• I-Chemotherapy kanye nokwelashwa ngemisebe endaweni lapho kususwe khona isimila.

• I-chemotherapy ephezulu ene-stem cell Rescue.

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.

Isimila Esanda Kutholwa Sobuntwana Embryonal With Rosettes Eziningi noma iMedulloepithelioma

Esimeni esisanda kutholakala sobuntwana esine-rosettes enezinhlobonhlobo (i-ETMR) noma i-medulloepithelioma, isimila ngokwaso asikalashwa. Ingane kungenzeka ukuthi ithole izidakamizwa noma ukwelashwa ukuqeda izimpawu ezibangelwa isimila.

Izingane ezindala kuneminyaka engu-3

Ukwelashwa okujwayelekile kwe-ETMR noma i-medulloepithelioma ezinganeni ezineminyaka engaphezu kweminyaka emithathu kufaka lokhu okulandelayo:

• Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka. Lokhu kulandelwa ukwelashwa ngemisebe ebuchosheni nasemgogodleni. I-Chemotherapy nayo inikezwa ngesikhathi nangemva kokwelashwa ngemisebe.

• Ukuhlinzwa ukususa i-tumor, ukwelashwa ngemisebe, kanye ne-chemotherapy ephezulu ene-stem cell Rescue.

• Isivivinyo somtholampilo senhlanganisela entsha yokwelashwa ngemisebe kanye nokwelashwa ngamakhemikhali.

Izingane ezineminyaka engu-3 nangaphansi

Ukwelashwa okujwayelekile kwe-ETMR noma i-medulloepithelioma ezinganeni ezineminyaka engu-3 nangaphansi kufaka lokhu okulandelayo:

• Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka, kulandelwe ukwelashwa ngamakhemikhali.

• I-chemotherapy ephezulu ene-stem cell Rescue.

• Ukwelashwa ngemisebe, lapho ingane isikhulile.

• Isivivinyo somtholampilo senhlanganisela entsha kanye namashejuli we-chemotherapy noma inhlanganisela entsha ye-chemotherapy enokusindiswa kwe-stem cell.

Ukwelashwa kwe-ETMR noma i-medulloepithelioma ezinganeni ezineminyaka engu-3 nangaphansi kuvame ukuba sesivivinyo somtholampilo.

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-Pineoblastoma Yezingane Esanda Kutholwa

Ku-pineoblastoma ebuntwaneni esanda kutholakala, isimila ngokwaso asikelashwa. Ingane kungenzeka ukuthi ithole izidakamizwa noma ukwelashwa ukuqeda izimpawu ezibangelwa isimila.

Izingane ezindala kuneminyaka engu-3

Ukwelashwa okujwayelekile kwepineoblastoma ezinganeni ezindala kuneminyaka emithathu kufaka phakathi okulandelayo:

• Ukuhlinzwa ukukhipha isimila. Isimila ngokuvamile asikwazi ukususwa ngokuphelele ngenxa yokuthi sikuphi ebuchosheni. Ukuhlinzwa kuvame ukulandela ukwelashwa ngemisebe ebuchosheni nasemgogodleni nasekhemotherapy.

• Isilingo somtholampilo wamakhemikhali aphezulu we-chemotherapy ngemuva kokwelashwa ngemisebe nokusindiswa kwamaseli we-stem.

• Isivivinyo somtholampilo se-chemotherapy ngesikhathi sokwelapha ngemisebe.

Izingane ezineminyaka engu-3 nangaphansi

Ukwelashwa okujwayelekile kwepineoblastoma ezinganeni ezineminyaka engama-3 nangaphansi kufaka lokhu okulandelayo:

• I-Biopsy yokuxilonga i-pineoblastoma elandelwa yi-chemotherapy.

• Uma isimila siphendula ekwelashweni ngamakhemikhali, kwelashwa ngemisebe kunikezwa lapho ingane isikhulile.

• I-chemotherapy ephezulu ene-stem cell Rescue.

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.

Isistimu Yezinzwa Ephakathi Kwezinsana Ezimaphakathi Nezidumbu NePineoblastomas

Ukwelashwa kwezicubu zombungu zesistimu yezinzwa eziphakathi (CNS) kanye ne-pineoblastoma ephindayo (ebuya) incike ku:

• Uhlobo lwesimila.

• Ukuthi isimila siphinde sabuya lapho saqala ukwakheka noma sasakazekela kwezinye izingxenye zobuchopho, umgogodla noma umzimba.

• Uhlobo lokwelashwa olunikezwe esikhathini esedlule.

• Sesidlulile isikhathi esingakanani selokhu kwaphela ukwelashwa kokuqala.

• Ukuthi isiguli sinezimpawu noma izimpawu.

Ukwelashwa kwezimila zomzimba eziphindaphindwayo ze-CNS kanye ne-pineoblastomas kungafaka okulandelayo:

• Ezinganeni ezake zathola ukwelashwa ngemisebe nokwelashwa ngamakhemikhali, ukwelashwa kungafaka imisebe ephindaphindwayo endaweni lapho umdlavuza waqala khona nalapho isimila sisakaze khona. Ukwelashwa ngemisebe ye-stereotactic kanye / noma i-chemotherapy nakho kungasetshenziswa.

• Ezinganeni nasezinsaneni ezincane ezazithola ukwelashwa ngamakhemikhali phambilini kuphela futhi zibuye ziphinde zivele endaweni, ukwelashwa kungaba ukwelashwa ngamakhemikhali nokwelashwa ngemisebe kulesimila nendawo eseduze nayo. Ukuhlinzwa ukukhipha isimila nakho kungenziwa.

• Ezigulini ezake zathola ukwelashwa ngemisebe, i-high-dose chemotherapy kanye ne-stem cell Rescue ingasetshenziswa. Akwaziwa ukuthi ngabe le ndlela yokwelapha ithuthukisa ukusinda.

• Ukwelashwa okuhlosiwe nge-inhibitor transduction inhibitor yeziguli ezinomdlavuza onoshintsho oluthile kuzakhi zofuzo.

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

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 Ngobuntwana Olulukhuni Lwesistimu Yezimbumba Zamathumbu

Ngemininingwane engaphezulu mayelana ne-embryonal tumor system yobuntwana emaphakathi, bheka 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