Izinhlobo / ubuchopho / isiguli / ingane-cns-germ-cell-treatment-pdq

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

Imininingwane ejwayelekile mayelana ne-Childhood Central Nervous System (CNS) Germ Cell Tumors

AMAPHUZU ASEMQOKA

• Isimila sezinzwa zomntwana ophakathi nendawo (CNS) sakha amaseli wegciwane.

• Kunezinhlobo ezahlukahlukene zezicubu zesifo segciwane lesandulela ngculaza i-CNS.

• AmaGerminomas

• AmaNongerminomas

• Ama-Teratomas

• Imbangela yamathumba amaningi wegciwane lesandulela ngculazi i-CNS ayaziwa.

• Izimpawu nezimpawu zezinsumpa zegciwane lesandulela ngculaza ze-CNS zifaka ukoma okungajwayelekile, ukuchama njalo, noma ushintsho lombono.

• Izifundo zokufanekisa nezinye izivivinyo zisetshenziselwa ukuthola (ukuthola) nokuxilonga izicubu zesifo segciwane lesandulela ngculaza i-CNS.

• I-biopsy ingenziwa ukuze kuqinisekiswe ukutholakala kwesimila segciwane leseli le-CNS.

• Izici ezithile zithinta ukubikezela (ithuba lokululama).

Isimila sezinzwa zomntwana ophakathi nendawo (CNS) sakha amaseli wegciwane.

Amaseli wamagciwane yizinhlobo ezikhethekile zamaseli akhona njengoba umbungu (umntwana ongakazalwa) eba. Lawa maseli ajwayele ukuba yisidoda emasendeni noma amaqanda angenazimbumba kuma-ovari njengoba ingane ivuthwa. Iningi lesimila segciwane lakha amasende noma amaqanda. Kwesinye isikhathi amangqamuzana egciwane aya noma eza kwezinye izingxenye zombungu njengoba ekhula futhi kamuva abe izimila zamangqamuzana egciwane. Izicubu zeseli zeGerm ezakha ebuchosheni noma emgogodleni zibizwa ngokuthi i-CNS (uhlelo oluphakathi lwezinzwa) izicubu zamagciwane.

Izicubu zeseli segciwane le-CNS zenzeka kakhulu ezigulini ezineminyaka eyi-10 kuye kwengu-19 futhi kaningi kwabesilisa kunabesifazane. Izindawo ezivame kakhulu ukwakheka kwezimila zamangqamuzana zegciwane lesandulela ngculazi eyodwa noma ngaphezulu ukwakheka ebuchosheni obusondelene nendlala ye-pineal nasendaweni yobuchopho efaka indlala yesikhumba kanye nezicubu ezingenhla nje kwayo. Kwesinye isikhathi kwakheka izicubu zamangqamuzana egciwane kwezinye izindawo zobuchopho.

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

Lesi sifinyezo simayelana nezicubu zamangqamuzana egciwane eziqala ohlelweni oluphakathi lwezinzwa (ubuchopho nomgogodla). Izimila zamangqamuzana egciwane nazo zingakheka kwezinye izingxenye zomzimba. Bona isifinyezo se- ku-Childhood Extracranial Germ Cell Tumors Treatment ukuze uthole imininingwane ngamagciwane amangqamuzana amangqamuzana angaphandle (ngaphandle kobuchopho).

Izicubu zeseli segciwane le-CNS zivame ukuvela ezinganeni kepha zingavela kubantu abadala. Ukwelashwa kwezingane kungahluka kunokwelashwa kwabantu abadala. Bona izifinyezo ezilandelayo ze- ngolwazi mayelana nokwelashwa kwabantu abadala:

• Ukwelashwa Kwe-Adult Central Nervous System Tumors

• Ukwelashwa kwe-Extragonadal Germ Cell Tumors

Ngemininingwane mayelana nezinye izinhlobo zobuchopho bengane kanye nezicubu zomgogodla, bheka isifinyezo se- ku-Childhood Brain kanye ne-Spinal Cord Tumors Treatment Overview.

Kunezinhlobo ezahlukahlukene zezicubu zesifo segciwane lesandulela ngculaza i-CNS.

Izinhlobo ezahlukahlukene zezimila zamangqamuzana egciwane le-CNS zingakha kusuka kumaseli akhethekile athi kamuva abe yisidoda noma amaqanda angenanzalo. Uhlobo lwesimila segciwane lesandulela ngculaza i-CNS elitholakele lincike ekutheni amaseli abukeka kanjani ngaphansi kwesibonakhulu kanye nemiphumela yokuhlolwa kwelabhorethri okuhlola amazinga omaki wesimila.

Lesi sifinyezo simayelana nokwelashwa kwezinhlobo eziningana zamathumba wegciwane leseli le-CNS:

AmaGerminomas

AmaGerminomas awuhlobo oluvame kakhulu lwesimila segciwane lesandulela ngculaza i-CNS futhi anokulindela okuhle. Amanothi wokumaka awasetshenziswanga ukuthola ama-germinomas.

AmaNongerminomas

Amanye ama-nongerminomas enza ama-hormone, afana ne-alpha-fetoprotein (AFP) ne-beta-human chorionic gonadotropin (beta-hCG). Izinhlobo zama-nongerminomas zifaka okulandelayo:

• Ama-carcinomas e-Embryonal enza ama-hormone i-AFP ne-beta-hCG.

• Izicubu ze-Yolk sac zenza i-hormone i-AFP.

• Ama-Choriocarcinomas enza i-hormone beta-hCG.

• Izicubu zeseli zamagciwane ezixutshiwe zenziwa ngohlobo olungaphezu kolulodwa lwengqamuzana legciwane. Bangenza i-AFP ne-beta-hCG.

Ama-Teratomas

Ama-teratomas e-CNS achazwa njengavuthiwe noma angavuthiwe, ngokuya ngokuthi amaseli abukeka ejwayelekile kanjani ngaphansi kwesibonakhulu. Ama-teratomas avuthiwe abukeka njengamaseli ajwayelekile ngaphansi kwesibonakhulu futhi enziwe ngezinhlobo ezahlukahlukene zezicubu, ezinjengezinwele, imisipha namathambo. Ama-teratomas angavuthiwe abukeka ehluke kakhulu kumaseli ajwayelekile ngaphansi kwesibonakhulu futhi enziwa ngamaseli abukeka njengamaseli ombungu. Amanye ama-teratomas angavuthiwe ayingxube yamaseli avuthiwe futhi angavuthiwe. Amanothi wokumaka awasetshenziswanga ukuxilonga ama-teratomas.

Imbangela yamathumba amaningi wegciwane lesandulela ngculazi i-CNS ayaziwa.

Izimpawu nezimpawu zezinsumpa zegciwane lesandulela ngculaza ze-CNS zifaka ukoma okungajwayelekile, ukuchama njalo, noma ushintsho lombono.

Izimpawu nezimpawu zincike kokulandelayo:

• Lapho okwakheke khona isimila.

• Usayizi wesimila.

• Ukuthi isimila noma umzimba wenza ama-hormone amaningi kakhulu.

Izimpawu nezimpawu zingadalwa yizimila zegciwane lesandulela ngculaza le-CNS noma ngezinye izimo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Ukoma kakhulu.

• Ukwenza inani elikhulu lomchamo ocacile noma ocishe ucace.

• Ukuchama njalo.

• Umbhede umanzisa noma uvuke ebusuku ukuyochama.

• Inkinga yokuhambisa amehlo, ukukhathazeka ukubona kahle, noma ukubona okuphindwe kabili.

• Ukuphelelwa isifiso sokudla.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukuthomba ngaphambi kwesikhathi noma sekwephuzile.

• Isiqu esifushane (sibe sifushane kunokujwayelekile).

• Ukuphathwa ikhanda.

• Isicanucanu nokuhlanza.

• Ukuzizwa ngikhathele kakhulu.

• Ukuba nezinkinga ngomsebenzi wesikole.

Izifundo zokufanekisa nezinye izivivinyo zisetshenziselwa ukuthola (ukuthola) nokuxilonga izicubu zesifo segciwane lesandulela ngculaza i-CNS.

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 ngokomqondo, ukusebenzisana, kanye nekhono lokuhamba ngokujwayelekile, nokuthi izicubu zomzimba, izingqondo, nezinzwa zisebenza kanjani. 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 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).

• 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 futhi lihlolwe izimpawu zomzimba. Inani lamaprotheni noshukela kusampula nakho kungahlolwa. 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.

• Ukuhlolwa kwesimila: Inqubo lapho kuhlolwe khona isampula yegazi noma i-cerebrospinal fluid (CSF) ukukala inani lezinto ezithile ezikhishwe egazini naku-CSF ngezitho, izicubu, noma amaseli wesimila emzimbeni. Izinto ezithile zixhunyaniswe nezinhlobo ezithile zomdlavuza lapho zitholakala emazingeni akhuphukile egazini. Lokhu kubizwa ngokuthi yizimpawu zesimila.

Omaka abalandelayo be-tumor basetshenziselwa ukuxilonga ezinye izicubu zeseli zegciwane le-CNS:

• I-Alpha-fetoprotein (AFP).

• I-beta-chorionic gonadotropin (beta-hCG).

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• Izifundo zehomoni yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lamahomoni athile akhishwe egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lwento kungaba uphawu lwesifo esithweni noma esikhunjeni esisenzayo. Igazi lizohlolwa amazinga ama-hormone enziwa yi-pituitary gland nezinye izindlala.

I-biopsy ingenziwa ukuze kuqinisekiswe ukutholakala kwesimila segciwane leseli le-CNS.

Uma odokotela becabanga ukuthi ingane yakho ingahle ibe nesimila segciwane lesandulela ngculaza i-CNS, kungenziwa i-biopsy. Ngezicubu zobuchopho, i-biopsy yenziwa ngokususa ingxenye yogebhezi bese kusetshenziswa inaliti ukususa isampula lezicubu. Kwesinye isikhathi, inaliti eqondiswa yikhompyutha isetshenziselwa 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.

Kwesinye isikhathi ukuxilongwa kungenziwa ngokuya ngemiphumela yokuhlolwa kwe-imaging kanye ne-tumor marker futhi i-biopsy ayidingeki.

Izici ezithile zithinta ukubikezela (ithuba lokululama).

Isibikezelo (ithuba lokululama) sincike kokulandelayo:

• Uhlobo lwesimila segciwane lesigciwane.

• Uhlobo kanye nezinga lanoma iziphi izimpawu zesimila.

• Lapho isimila sisebuchosheni noma emgogodleni.

• Ukuthi umdlavuza usabalale ngaphakathi kobuchopho nomgogodla noma kwezinye izingxenye zomzimba.

• Ukuthi isimila sisanda kutholakala yini noma sike sabuya (sabuya) ngemuva kokwelapha.

Izigaba Zobuntwana be-CNS Germ Cell Tumors

AMAPHUZU ASEMQOKA

• Isimila segciwane lesandulela ngculazi (CNS) lesimila samangqamuzana egciwane akuvamile ukuthi sisabalale ngaphandle kobuchopho nomgogodla.

Isimila segciwane lesandulela ngculazi (CNS) lesimila samangqamuzana egciwane akuvamile ukuthi sisabalale ngaphandle kobuchopho nomgogodla.

Isiteji inqubo esetshenziswayo ukuthola ukuthi ungakanani umdlavuza okhona nokuthi umdlavuza ususabalalisile yini. Alukho uhlelo olujwayelekile lokubeka izigaxa zegciwane lesistimu yobuntwana (CNS).

Uhlelo lokwelashwa luncike kulokhu okulandelayo:

• Uhlobo lwesimila segciwane lesigciwane.

• Ukuthi isimila sisabalale ngaphakathi kobuchopho nomgogodla noma kwezinye izingxenye zomzimba, njengephaphu noma ithambo.

• Imiphumela yokuhlolwa kanye nezinqubo ezenziwayo zokuxilonga izicubu zegciwane lesandulela ngculaza ze-CNS.

• Ukuthi isimila sisanda kutholakala yini noma sike sabuya (sabuya) ngemuva kokwelapha.

Ama-Tumor Cell Cell Tumors Aphindayo

Izicubu zesifo segciwane eliphakathi nendawo zobuntwana zingaphinde zibuye (zibuye) ngemuva kokuba selashwe. Izimila zivame ukubuya lapho kuqala khona isimila. Isimila naso singabuya sibuye kwezinye izindawo kanye / noma kuma-meninges (izingqimba ezincanyana zezicubu ezimboza futhi zivikele ubuchopho nomgogodla).

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinesimila segciwane lesandulela ngculazi ebuntwaneni (CNS).

• Izingane ezinesifo segciwane lesandulela ngculaza i-CNS kufanele ukuthi imithi yazo ihlelelwe iqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza ezinganeni.

• Ukwelashwa kwezicubu zesifo segciwane lesandulela ngculaza i-CNS kungadala imiphumela emibi.

• Izinhlobo ezine zokwelashwa zisetshenzisiwe:

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Ukuhlinzwa

• I-chemotherapy ephezulu ene-stem cell Rescue

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa okuhlosiwe

• 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 ezinesimila segciwane lesandulela ngculazi ebuntwaneni (CNS).

Izinhlobo ezahlukahlukene zokwelashwa ziyatholakala ezinganeni ezinesimila segciwane lesandulela ngculazi ebuntwaneni (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 ezinesifo segciwane lesandulela ngculaza i-CNS kufanele ukuthi imithi yazo ihlelelwe iqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza ezinganeni.

Ukwelashwa kuzobhekwa i-oncologist yezingane kanye / noma i-oncologist yemisebe. Udokotela oncologist ungudokotela ogxile ekwelapheni izingane ezinomdlavuza. I-radiation oncologist igxile ekwelapheni umdlavuza ngokwelashwa ngemisebe. Labodokotela basebenzisana nabanye abahlinzeki bezokunakekelwa kwezempilo abangabachwepheshe ekwelapheni izingane ezinamathumba amangqamuzana egciwane lesandulela ngculazi e-CNS futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• Udokotela wezingane.

• I-neurosurgeon yezingane.

• Isazi sezinzwa.

• Isazi se-endocrinologist.

• Udokotela wezifo zamehlo.

• Umhlengikazi ongumhlengikazi.

• Uchwepheshe wokuvuselelwa.

• Isazi sokusebenza kwengqondo.

• Usonhlala kahle.

Ukwelashwa kwezicubu zesifo segciwane lesandulela ngculaza i-CNS 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 engaba khona sekwephuzile ebangelwe ukwelashwa okuthile. (Bheka isifinyezo se- ngemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane).

Izinhlobo ezine zokwelashwa zisetshenzisiwe:

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. Lolu hlobo lokwelashwa ngemisebe lungafaka okulandelayo:

• Ama-radiosurgery e-stereotactic: Ama-radiosurgery e-stereotactic uhlobo lokwelashwa kwemisebe yangaphandle. Uhlaka lwekhanda oluqinile luxhunywe kugebhezi ukugcina ikhanda linganyakazi ngesikhathi sokwelashwa ngemisebe. Umshini uhlose isilinganiso esisodwa semisebe ngqo esikhunjeni. Le nqubo ayibandakanyi ukuhlinzwa. Ibizwa nangokuthi i-stereotaxic radiosurgery, i-radiosurgery, kanye nokuhlinzwa ngemisebe.

• 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 zesifo segciwane lesandulela ngculaza i-CNS. Ukwelashwa ngemisebe ebuchosheni kungathinta ukukhula nentuthuko ezinganeni ezisencane. Izindlela ezithile zokunikeza ukwelashwa ngemisebe kunganciphisa ukulimala kwezicubu zobuchopho ezinempilo. Ezinganeni ezingaphansi kweminyaka emithathu, i-chemotherapy inganikezwa esikhundleni salokho. Lokhu kungalibazisa noma kunciphise 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).

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni lomdlavuza olashwa. I-chemotherapy ejwayelekile isetshenziselwa ukwelapha izicubu zegciwane le-CNS.

Ukuhlinzwa

Ukuthi kungenziwa yini ukuhlinzwa kukhishwe isimila kuncike ekutheni isisu sikuphi ebuchosheni. Ukuhlinzwa ukukhipha isimila kungadala imiphumela emibi, emibi yesikhathi eside.

Ukuhlinzwa kungenziwa ukususa ama-teratomas futhi kungasetshenziselwa izicubu zamagciwane ezibuyela emuva. 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.

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.

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.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana omdlavuza.

Ukwelashwa okuhlosiwe kuyacutshungulwa ekwelashweni kwezimila zamangqamuzana egciwane lesandulela ngculazi ze-CNS eziphinde zabuya (zabuya).

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.

Izingane ezinomdlavuza ezithinte indlala yazo lapho kutholakala umdlavuza kuzodingeka zihlolwe amazinga azo ama-hormone egazi. Uma izinga lamahomoni egazi liphansi, kunikezwa umuthi wokushintsha ama-hormone.

Izingane ezazinezinga eliphakeme lokumaka isimila (i-alpha-fetoprotein noma i-beta-human chorionic gonadotropin) lapho umdlavuza utholakala ukuthi uvame ukudinga ukuhlolwa kwezimpawu zawo zesimila segazi. Uma izinga lomaka we-tumor likhuphuka ngemuva kokwelashwa kokuqala, kungenzeka ukuthi isimila saphinde sabuya.

Izinketho Zokwelapha Okwezingane Ezisanda Kuhlonza I-CNS Germ Cell Tumors

Kulesi Sigaba

• AmaGerminomas Asanda Kutholwa

• I-CNS esanda kutholakala yeNongerminomas

• I-CNS Teratomas Esanda Kutholwa

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

AmaGerminomas Asanda Kutholwa

Ukwelashwa kwama-germinomas asanda kutholakala wesistimu yezinzwa (CNS) kungafaka okulandelayo:

• Ukwelashwa ngemisebe ebuchosheni bonke kubandakanya ama-ventricles (izikhala ezigcwele uketshezi lobuchopho) nentambo yomgogodla. Umthamo ophakeme wemisebe unikezwa isimila kunendawo ezungeze isimila.

• I-Chemotherapy ilandelwa ukwelashwa ngemisebe.

• Isivivinyo somtholampilo se-chemotherapy esilandelwa ukwelashwa ngemisebe okunikezwa ngemithamo ephansi kuya ngokuthi isimila siphendula kanjani ekwelashweni.

• Isivivinyo somtholampilo sohlobo olusha lokwelashwa olususelwa ekutheni kungenzeka kanjani ukuthi isimila sibuyele emuva kokwelashwa.

I-CNS esanda kutholakala yeNongerminomas

Akucaci ukuthi yikuphi ukwelashwa okungcono kakhulu kuma-nongerminomas asanda kutholakala wesistimu yezinzwa (CNS).

Ukwelashwa kwe-choriocarcinoma, i-embryonal carcinoma, i-yolk sac tumor, noma isimila esixubene segciwane leseli kungafaka okulandelayo:

• I-Chemotherapy ilandelwa ukwelashwa ngemisebe.

• Ukuhlinzwa. Uma isisindo sihlala ngemuva kwe-chemotherapy eqhubeka ikhula futhi amazinga we-tumor mark ajwayelekile (abizwa ngokuthi yi-growing teratoma syndrome), ukuhlinzwa kungadingeka ukuze kuhlolwe ukuthi ngabe ubukhulu buyingxenye ye-teratoma, i-fibrosis, noma i-tumor ekhulayo.

• Uma isisindo siyi-teratoma evuthiwe noma i-fibrosis, ukwelashwa ngemisebe kunikezwa.

• Uma isisindo siyisigaxa esikhulayo, kunganikezwa ezinye izindlela zokwelapha.

I-CNS Teratomas Esanda Kutholwa

Ukwelashwa kwama-teratomas asanda kutholakala ukuthi avuthiwe futhi angavuthiwe (CNS) angafaka okulandelayo:

Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka. Uma kukhona isimila esisele ngemuva kokuhlinzwa, ukwelashwa okuningi kunganikezwa:

• Ukwelashwa ngemisebe ku-tumor noma kuma-radiosurgery e-stereotactic; kanye / noma

• Ukwelashwa ngamakhemikhali.

Izinketho Zokwelapha Okwezingane Eziphindaphindayo Zase-CNS Germ Cell Tumors

Ukwelashwa kwesimila segciwane lesandulela ngculazi (CNS) lesimila segciwane kungafaka okulandelayo:

• I-Chemotherapy ilandelwa ukwelashwa ngemisebe, yama-germinomas.

• Ukwelashwa ngamakhemikhali okuphuza kakhulu okusindisa ama-stem cell kusetshenziswa ama-stem cell wesiguli, noma ngaphandle kwemithi yokwelashwa ngemisebe, yama-germinomas kanye nama-nongerminomas.

• Isivivinyo somtholampilo sokwelapha okusha.

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

Izilingo Zamanje Zemitholampilo

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 be-CNS Germ Cell Tumors

Ngemininingwane engaphezulu mayelana nezinsumpa zamangqamuzana egciwane lesistimu yobuntwana, 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