Izinhlobo / ubuchopho / isiguli / ingane-cranio-treatment-pdq

Ukwelashwa Kwe-Craniopharyngioma Childhood (®) –Patient Version

Imininingwane ejwayelekile Mayelana Ne-Childhood Craniopharyngioma

AMAPHUZU ASEMQOKA

• Ama-craniopharyngiomas ebuntwana yizicubu ezinobuchopho ezinobungozi ezitholakala eduze kwendlala ye-pituitary.

• Azikho izinto eziyingozi ezaziwa nge-craniopharyngioma yobuntwana.

• Izimpawu ze-craniopharyngioma yobuntwana zifaka phakathi izinguquko zombono nokukhula okuhamba kancane.

• Ukuhlolwa okuhlola amazinga obuchopho, ukubona, kanye nama-hormone kusetshenziselwa ukuthola (ukuthola) ama-craniopharyngiomas ebuntwana.

• Ama-craniopharyngiomas ebuntwana atholakala futhi angasuswa ekuhlinzweni okufanayo.

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

Ama-craniopharyngiomas ebuntwana yizicubu ezinobuchopho ezinobungozi ezitholakala eduze kwendlala ye-pituitary.

Ama-craniopharyngiomas ebuntwana yizicubu ezingavamile ezivame ukutholakala eduze kwendlala ye-pituitary (isitho esilingana nepea ezansi kobuchopho esilawula ezinye izindlala) kanye ne-hypothalamus (isitho esincane esimise okwengqamuzana esixhunywe kwi-pituitary gland ngemizwa).

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

I-Craniopharyngiomas imvamisa iyingxenye yesisindo esiqinile futhi iyingxenye ye-cyst egcwele uketshezi. Ziyingozi (hhayi umdlavuza) futhi azisabalali ziye kwezinye izingxenye zobuchopho noma kwezinye izingxenye zomzimba. Kodwa-ke, zingakhula futhi zicindezele ezingxenyeni eziseduze zobuchopho noma ezinye izindawo, kufaka phakathi i-pituitary gland, i-optic chiasm, izinzwa ze-optic, nezikhala ezigcwele uketshezi ebuchosheni. I-Craniopharyngiomas ingathinta imisebenzi eminingi yobuchopho. Kungathinta ukwenziwa kwama-hormone, ukukhula, nokubona. Izicubu zobuchopho zeBenign zidinga ukwelashwa.

Lesi sifinyezo simayelana nokwelashwa kwezicubu eziyinhloko zobuchopho (izicubu eziqala ebuchosheni). Ukwelashwa kwezimila zobuchopho ze-metastatic, okuyizicubu ezakhiwa amangqamuzana omdlavuza aqala kwezinye izingxenye zomzimba futhi asabalale aye ebuchosheni, akuhlanganisiwe kulesi sifinyezo. Bona isifinyezo sokwelashwa se- ku-Childhood Brain and Spinal Cord Tumors Treatment Overview ukuthola imininingwane ngezinhlobo ezahlukahlukene zobuchopho bengane kanye nezicubu zomgogodla.

Izicubu zobuchopho zingenzeka ezinganeni nakubantu abadala; kodwa-ke, ukwelashwa kwezingane kungahluka kunokwelashwa kwabantu abadala. (Bheka isifinyezo se- ku-Adult Central Nervous System Tumors Treatment ukuthola eminye imininingwane.)

Azikho izinto eziyingozi ezaziwa nge-craniopharyngioma yobuntwana.

I-Craniopharyngiomas ayitholakali ezinganeni ezingaphansi kweminyaka engu-2 ubudala futhi zivame ukutholakala ezinganeni ezineminyaka engu-5 kuya kwengu-14. Akwaziwa ukuthi zibangelwa yini lezi zicubu.

Izimpawu ze-craniopharyngioma yobuntwana zifaka phakathi izinguquko zombono nokukhula okuhamba kancane.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yi-craniopharyngiomas noma ezinye izimo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Ukuphathwa yikhanda, kufaka phakathi ukuphathwa ikhanda ekuseni noma ikhanda elihamba ngemuva kokuhlanza.

• Umbono uyashintsha.

• Isicanucanu nokuhlanza.

• Ukulahlekelwa ibhalansi noma ukuhamba kanzima.

• Khulisa ukoma noma ukuchama.

• Ukulala okungavamile noma ushintsho ezingeni lamandla.

• Izinguquko ebuntwini noma ekuziphatheni.

• Isiqu esifushane noma ukukhula kancane.

• Ukulahlekelwa ukuzwa.

• Ukuzuza kwesisindo.

Ukuhlolwa okuhlola amazinga obuchopho, ukubona, kanye nama-hormone kusetshenziselwa ukuthola (ukuthola) ama-craniopharyngiomas ebuntwana.

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.

• 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). Noma ikuphi ukulahleka kombono kungaba uphawu lwesimila esilimele noma sicindezelwe ezingxenyeni zobuchopho ezithinta ukubona.

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

• I-MRI (imaging resonance imaging) yobuchopho nomgogodla nge-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi kobuchopho. Into ebizwa ngokuthi i-gadolinium ijojowe emthanjeni. I-gadolinium iqoqa izungeze amangqamuzana e-tumor ukuze abonakale ekhanya esithombeni. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (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) lento kungaba uphawu lwesifo esithweni noma esikhunjeni esisenzayo. Isibonelo, igazi lingahlolwa amazinga angajwayelekile wehomoni ekhuthaza i-thyroid (TSH) noma i-adrenocorticotropic hormone (ACTH). I-TSH ne-ACTH zenziwa yindlala yobuchopho ebuchosheni.

Ama-craniopharyngiomas ebuntwana atholakala futhi angasuswa ekuhlinzweni okufanayo.

Odokotela bangacabanga ukuthi isisindo yi-craniopharyngioma ngokuya ngokuthi sikuphi ebuchosheni nokuthi sibukeka kanjani kwi-CT scan noma kwi-MRI. Ukuze uqiniseke, kudingeka isampula lezicubu.

Enye yezinhlobo ezilandelayo zezinqubo ze-biopsy ingasetshenziswa ukuthatha isampula lezicubu:

• I-biopsy evulekile: Inaliti engenalutho ifakwa ngembobo yogebhezi iye ebuchosheni.

• Inaliti eqondiswa ngekhompyutha: Inaliti engenalutho eholwa yikhompyutha ifakwa emgodini omncane okhakhayini ungene ebuchosheni.

• I-Transsphenoidal biopsy: Izinsimbi zifakwa emakhaleni nasethanjeni le-sphenoid (ithambo elenziwe njengovemvane ngaphansi kogebhezi) nasebuchosheni.

Udokotela wezifo ubheka izicubu ngaphansi kwesibonakhulu ukuze afune amangqamuzana ezinzwa. Uma kutholakala amangqamuzana e-tumor, kungenzeka kususwe isimila esiningi ngendlela ephephile ngesikhathi sokuhlinzwa okufanayo.

Ukuhlolwa okulandelayo kwelabhorethri kungenziwa kusampula yezicubu 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 kokulandelayo:

• Usayizi wesimila.

• Lapho okukhona isimila ebuchosheni.

• Ukuthi kunamaseli ama-tumor asele ngemuva kokuhlinzwa.

• Iminyaka yengane.

• Imiphumela engemihle engahle ivele izinyanga noma iminyaka ukwelashwa.

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

Izigaba ze-Craniopharyngioma yobuntwana

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza usakaze ngaphakathi ebuchosheni noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Alukho uhlelo olujwayelekile lokubeka i-craniopharyngioma yobuntwana. I-Craniopharyngioma ichazwa njengesifo esisanda kutholakala noma isifo esiphindaphindayo.

Imiphumela yezivivinyo nezinqubo ezenziwe ukuxilonga i-craniopharyngioma zisetshenziselwa ukusiza ukwenza izinqumo mayelana nokwelashwa.

I-Craniopharyngioma Yezingane Ephindaphindayo

I-craniopharyngioma ephindaphindayo iyisimila esibuye sabuya (sibuya) ngemuva kokwelashwa. Isimila singabuya endaweni efanayo yobuchopho lapho satholwa khona okokuqala.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kwezingane ezine-craniopharyngioma.

• Izingane ezine-craniopharyngioma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni ubuchopho

izimila ezinganeni.

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

• Ukwelashwa kwe-craniopharyngioma yobuntwana kungadala imiphumela emibi.

• Izinhlobo ezinhlanu zokwelashwa zisetshenzisiwe:

• Ukuhlinzwa (resection)

• Ukwelashwa nokuhlinzwa ngemisebe

• Ukuhlinzwa nge-cyst drainage

• Ukwelashwa ngamakhemikhali

• I-Immunotherapy

• 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.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa kwezingane ezine-craniopharyngioma.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezine-craniopharyngioma. Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo sokwelashwa isifundo socwaningo esenzelwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela ezintsha zokwelapha iziguli ezinamathumba. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile.

Ngoba izicubu ezinganeni azivamile, ukubamba iqhaza esivivinyweni somtholampilo kufanele kubhekwe. Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo okuqhubekayo iyatholakala kuwebhusayithi ye-NCI. Ukukhetha ukwelashwa okufanelekile kakhulu kuyisinqumo esithinta kahle isiguli, umndeni kanye neqembu lokunakekelwa kwezempilo.

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

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

• Udokotela wezingane.

• I-Neurosurgeon.

• I-radiation oncologist.

• Isazi sezinzwa.

• Isazi se-endocrinologist.

• Udokotela wezifo zamehlo.

• Uchwepheshe wokuvuselelwa.

• Isazi sokusebenza kwengqondo.

• Usonhlala kahle.

• Isazi somhlengikazi.

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

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

Ukwelashwa kwe-craniopharyngioma yobuntwana kungadala imiphumela emibi.

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

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

• Izinkinga zomzimba ezifana nokuquleka.

• Izinkinga zokuziphatha.

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

• Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza).

Izinkinga zomzimba ezilandelayo zingenzeka uma i-pituitary gland, i-hypothalamus, i-optic nerves, noma i-carotid artery kuthinteka ngesikhathi sokuhlinzwa noma ukwelashwa ngemisebe:

• Ukukhuluphala ngokweqile.

• I-Metabolic syndrome, kufaka phakathi isifo sesibindi esinamafutha esingabangelwa ukuphuza utshwala.

• Izinkinga zombono, kufaka phakathi ukungaboni.

• Izinkinga zomthambo wegazi noma isifo sohlangothi.

• Ukulahleka kwekhono lokwenza ama-hormone athile.

Eminye imiphumela yesikhashana ingalashwa noma ilawulwe. Ukwelashwa okuthatha impilo isikhathi eside ngemithi eminingana kungadingeka. Kubalulekile ukukhuluma nodokotela bengane yakho ngemiphumela ukwelashwa kwesimila okungaba nayo enganeni yakho. (Bheka isifinyezo se- ngemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane).

Izinhlobo ezinhlanu zokwelashwa zisetshenzisiwe:

Ukuhlinzwa (resection)

Indlela okwenziwa ngayo ukuhlinzwa incike kubukhulu besimila nokuthi sikuphi ebuchosheni. Kuya futhi ngokuthi ngabe isimila sesikhule saba izicubu esiseduze ngendlela efana nomunwe futhi kulindelwe imiphumela ngemuva kwesikhathi ngemuva kokuhlinzwa.

Izinhlobo zokuhlinzwa ezingasetshenziswa ukususa sonke isimila esingabonakala ngeso zifaka okulandelayo:

• Ukuhlinzwa kweTranssphenoidal: Uhlobo lokuhlinzwa lapho izinsimbi zifakwa engxenyeni yobuchopho ngokudlula (ukusika) okwenziwe ngaphansi kwendebe engenhla noma ezansi kwekhala phakathi kwamakhala bese kudlula ngethambo le-sphenoid (uvemvane ithambo elenziwe ngaphansi kogebhezi) ukufinyelela isimila eduze kwendlala ye-pituitary ne-hypothalamus.

Ukuhlinzwa kweTranssphenoidal. I-endoscope ne-curette kufakwa emakhaleni nasonqeni lwe-sphenoid ukukhipha isimila.

• I-Craniotomy: Ukuhlinzwa ukukhipha isimila ngokuvula okwenziwe kugebhezi.

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

Kwesinye isikhathi sonke isimila esibonwayo siyasuswa lapho sihlinzwa futhi akukho okunye ukwelashwa okudingekayo. Ngezinye izikhathi, kunzima ukususa isimila ngoba siyakhula noma sicindezela ezithweni eziseduze. Uma kukhona isimila esisele ngemuva kokuhlinzwa, ukwelashwa ngemisebe kuvamise ukunikezwa ukubulala noma yimaphi amangqamuzana esigaxa asele. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

Ukwelashwa nokuhlinzwa ngemisebe

Ukuthengiswa okuyingxenye kusetshenziselwa ukwelapha amanye ama-craniopharyngiomas. Isetshenziselwa ukuxilonga isimila, isuse uketshezi ku-cyst, futhi ikhulule ingcindezi emithanjeni ye-optic. Uma isimila siseduze ne-pituitary gland noma i-hypothalamus, asisuswa. Lokhu kunciphisa inani lemiphumela emibi ngemuva kokuhlinzwa. Ukuthengiswa okuncane kulandelwa ukwelashwa ngemisebe.

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

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe maqondana nesimila.

• Ukwelashwa kwemisebe yangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, imbewu, izintambo, noma ama-catheters abekwa ngqo ngaphakathi noma eduze kwesimila.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuncike ohlotsheni lwesimila, noma ngabe isimila sisanda kutholakala noma sesibuyile, nokuthi isimila sakhiwa kuphi ebuchosheni. Ukwelashwa kwemisebe yangaphandle neyangaphakathi kusetshenziselwa ukwelapha i-craniopharyngioma yobuntwana.

Ngoba ukwelashwa ngemisebe ebuchosheni kungathinta ukukhula nokuthuthuka ezinganeni ezisencane, izindlela zokunikeza ukwelashwa ngemisebe ezinemiphumela emibi embalwa ziyasetshenziswa. Lokhu kufaka phakathi:

• Ama-radiosurgery we-stereotactic: Ama-craniopharyngiomas amancane kakhulu phansi kobuchopho, ama-radiosurgery we-stereotactic angasetshenziswa. Ama-radiosurgery we-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 yangaphakathi: Ukwelashwa kwemisebe yangaphakathi kuwuhlobo lokwelashwa kwemisebe yangaphakathi engasetshenziswa kwizicubu eziyingxenye yesisindo esiqinile nengxenye egcwele i-cyst egcwele uketshezi. Izinto ezinemisebe efakwa ngaphakathi kwesimila. Lolu hlobo lokwelashwa ngemisebe lubangela ukulimala okuncane kwi-hypothalamus eseduze nezinzwa ze-optic.

• I-intensity-modulated photon therapy: Uhlobo lokwelashwa ngemisebe olusebenzisa ama-x-ray noma ama-gamma ray aqhamuka emshinini okhethekile obizwa nge-linear accelerator (linac) ukubulala amangqamuzana e-tumor. Kusetshenziswa ikhompyutha ukukhomba ukwakheka kanye nendawo okukhona kuyo isimila. Imishayo emincane yama-photon ubukhulu obukhulu obuhlukile ihloselwe isimila kusuka ezinhlangothini eziningi. Lolu hlobo lwe-3-dimensional radiation therapy lungadala ukulimala okuncane kwizicubu ezinempilo ebuchosheni nakwezinye izingxenye zomzimba. Ukwelashwa kwe-Photon kuhlukile ekwelashweni nge-proton.

• Ukwelashwa kwe-proton-modulated Therapy: Uhlobo lokwelashwa ngemisebe olusebenzisa imifudlana yama-proton (izinhlayiya ezincane ezinecala elifanele) ukubulala amangqamuzana wesimila. Kusetshenziswa ikhompyutha ukukhomba ukwakheka kanye nendawo okukhona kuyo isimila. Imishayo emincane yamaphrotoni yamandla ahlukahlukene ihloselwe isimila kusuka ezinhlangothini eziningi. Lolu hlobo lwe-3-dimensional radiation therapy lungadala umonakalo omncane kwizicubu ezinempilo ebuchosheni nakwezinye izingxenye zomzimba. Imisebe yeProton yehlukile emisebeni ye-x-ray.

Ukuhlinzwa nge-cyst drainage

Ukuhlinzwa kungenziwa ukukhipha izicubu ezinama-cysts agcwele uketshezi. Lokhu kwehlisa ingcindezi ebuchosheni futhi kudambise izimpawu. Ipayipi (ithubhu elincanyana) lifakwa ku-cyst bese kubekwa isitsha esincane ngaphansi kwesikhumba. Uketshezi lungena esitsheni bese luyasuswa kamuva. Kwesinye isikhathi, ngemuva kokukhishwa kwe-cyst, umuthi ufakwa nge-catheter ungene ku-cyst. Lokhu kudala ukuthi udonga lwangaphakathi lwe-cyst lube nesibazi futhi kumise i-cyst ekwenzeni uketshezi noma kwandise inani lesikhathi elithathayo ukuze uketshezi luphinde lwakhiwe futhi. Ukuhlinzwa ukukhipha isimila kungenziwa ngemuva kokukhishwa kwe-cyst.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha esebenzisa imishanguzo yokuqeda umdlavuza ukunqanda ukukhula kwamangqamuzana ezinzwa, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaneni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli ezinwele emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid noma esithombeni, izidakamizwa zithinta kakhulu amaseli wesimila kulezo zindawo (i-chemotherapy yesifunda).

I-chemotherapy yangaphakathi uhlobo lwe-chemotherapy yesifunda ebeka izidakamizwa ngqo emgodini, njenge-cyst. Isetshenziselwa i-craniopharyngioma ebuyile ngemuva kokwelashwa.

I-Immunotherapy

I-Immunotherapy yimithi esebenzisa amasosha omzimba esiguli ukulwa nomdlavuza. Izinto ezenziwe ngumzimba noma ezenziwe elabhoratri zisetshenziselwa ukukhulisa, ukuqondisa, noma ukubuyisa izivikelo zemvelo zomzimba kumdlavuza. Lolu hlobo lokwelashwa komdlavuza lubizwa nangokuthi i-biotherapy noma i-biologic therapy. Nge-craniopharyngioma, umuthi we-immunotherapy (i-interferon-alpha) ubekwa emthanjeni (ngemithambo) noma ngaphakathi kwesimila usebenzisa ipayipi (i-intracavitary).

Ezinganeni ezisanda kutholakala, i-interferon-alpha ingafakwa ngqo ku-cyst (intracystic) ukubambezela isidingo sokuhlinzwa noma ukwelashwa ngemisebe. Ezinganeni ezinesigaxa esibuye sabuya (buyela emuva), i-intracavitary interferon-alpha isetshenziselwa ukwelapha i-cyst ingxenye yesimila.

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. Izindlela zokwelashwa ezihlosiwe zivame ukudala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe.

Ukwelashwa okuhlosiwe kuyafundwa ekwelapheni i-craniopharyngioma yobuntwana ebuye yabuya.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

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

Eziningi zezindlela zokwelapha ezijwayelekile zanamuhla zisuselwa ezivivinyweni zokwelashwa zangaphambili. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

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

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.

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

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izindlela zokwelashwa zivivinya iziguli ezingakathuthuki. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokumisa isifo ukuthi singaphindeki (sibuye) noma sinciphise imiphumela emibi yokwelashwa.

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 lesi sifo noma ukunquma ukuthi singaselapha kanjani 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 uma isimo sakho sishintshile. Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Ngemuva kokwelashwa, ukuhlolwa kokulandelwa nge-MRI kuzokwenziwa iminyaka eminingana ukubheka ukuthi isimila sesibuyile yini.

Izinketho zokwelashwa ze-Craniopharyngioma yobuntwana

Kulesi Sigaba

• I-Craniopharyngioma Yezingane Esanda Kutholwa

• I-Craniopharyngioma Yezingane Ephindaphindayo

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

I-Craniopharyngioma Yezingane Esanda Kutholwa

Ukwelashwa kwe-craniopharyngioma ebuntwaneni esanda kutholakala kungafaka okulandelayo:

• Ukuhlinzwa (resection ephelele) noma ngaphandle kwemithi yokwelashwa ngemisebe.

• Ukuthengiswa okuyingxenye okulandelwa ukwelashwa ngemisebe.

• I-cyst drainage noma ingekho i-radiation therapy noma ukuhlinzwa.

• I-immunotherapy yangaphakathi noma ye-intracystic (interferon-alpha).

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-Craniopharyngioma Yezingane Ephindaphindayo

I-Craniopharyngioma ingahle ibuye (ibuye) noma ngabe iphathwe kanjani okokuqala. Izinketho zokwelashwa kwe-craniopharyngioma ebuntwaneni ephindaphindwayo zixhomeke ohlotsheni lwezokwelapha olwalunikezwa lapho isimila sitholwa okokuqala nezidingo zengane.

Ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa (resection).

• Ukwelashwa kwemisebe yangaphandle.

• Ama-radiosurgery we-stereotactic.

• Ukwelashwa kwemisebe yangaphakathi.

• Ukwelashwa ngamakhemikhali angaphakathi.

• I-intravenous (systemic) noma i-intracavitary immunotherapy (interferon-alpha).

• Umsele wamanzi we-cyst.

• 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 Nge-Craniopharyngioma Yobuntwana kanye Namanye Ama-Brain Tumors Wezingane

Ngemininingwane engaphezulu mayelana ne-craniopharyngioma yobuntwana nezinye izicubu zobuchopho bengane, 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