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

Ukwelashwa Kwe-Ependymoma Childhood (®) –Patient Version

Imininingwane ejwayelekile Mayelana ne-Ependymoma Yezingane

AMAPHUZU ASEMQOKA

• I-ependymoma yobuntwana yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zobuchopho kanye nomgogodla.

• Kunezinhlobo ezahlukahlukene ze-ependymomas.

• Ingxenye yobuchopho ethintekile incike ekutheni i-ependymoma yakha kuphi.

• Imbangela yamathumba amaningi obuchopho ebuntwaneni ayaziwa.

• Izimpawu nezimpawu zobuntwana i-ependymoma azifani kuyo yonke ingane.

• Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) i-ependymoma yobuntwana.

• I-ependymoma yobuntwana iyatholakala futhi isuswe lapho ihlinzwa.

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

I-ependymoma yobuntwana yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zobuchopho kanye nomgogodla.

Ubuchopho bulawula imisebenzi ebalulekile njengokukhumbula nokufunda, imizwa nezinzwa (ukuzwa, ukubona, ukuhogela, ukunambitha, nokuthinta). Intambo yomgogodla yakhiwe yizinqwaba zemicu yezinzwa exhumanisa ubuchopho nezinzwa ezingxenyeni eziningi zomzimba.

Amafomu e-Ependymomas avela kumaseli we-ependymal agudle ama-ventricles kanye nemigwaqo ebuchosheni nakumgogodla. Amaseli we-Ependymal enza i-cerebrospinal fluid (CSF).

Lesi sifinyezo simayelana nokwelashwa kwezicubu eziyinhloko zobuchopho (izicubu eziqala ebuchosheni). Ukwelashwa kwezimila zobuchopho ze-metastatic, okuyizicubu eziqala kwezinye izingxenye zomzimba bese kusakazeka ebuchosheni, akuxoxwa ngakho kulesi sifinyeto.

Kunezinhlobo eziningi zezimila zobuchopho. Izicubu zobuchopho zingenzeka ezinganeni nakubantu abadala. Kodwa-ke, ukwelashwa kwezingane kuhlukile kunokwelashwa kwabantu abadala. Bona izifinyezo ezilandelayo ze- ukuthola eminye imininingwane:

• Ingqondo Yobuntwana kanye ne-Spinal Cord Tumors Treatment Overview

• Ukwelashwa Kwe-Adult Central Nervous System Tumors

Kunezinhlobo ezahlukahlukene ze-ependymomas.

I-World Health Organization (WHO) iqoqa izicubu ze-ependymal zibe ama-subtypes ayisihlanu ayinhloko:

• I-Subependymoma (i-WHO grade I; akuvamile ezinganeni).

• I-Myxopapillary ependymoma (i-WHO grade I).

• I-Ependymoma (i-WHO grade II).

• I-RELA fusion – positive ependymoma (i-WHO grade II noma i-grade III enoshintsho kuhlobo lwe-RELA).

• I-Anaplastic ependymoma (i-WHO grade III).

Izinga lesimila lichaza ukuthi amaseli omdlavuza abukeka ngendlela engavamile kanjani ngaphansi kwemicroscope nokuthi kungenzeka kanjani ukuthi isimila sikhule futhi sisakazeke ngokushesha. Amaseli womdlavuza webanga eliphansi (grade I) abukeka njengamaseli ajwayelekile kunamaseli womdlavuza osezingeni eliphakeme (ibanga II no-III). Amaseli womdlavuza weBanga I nawo ajwayele ukukhula nokusabalala kancane kancane kunamaseli omdlavuza webanga lesibili no-III.

Ingxenye yobuchopho ethintekile incike ekutheni i-ependymoma yakha kuphi.

Ama-Ependymomas angakha noma yikuphi kuma-ventricles agcwele uketshezi nasemaphaseji ebuchosheni nakumgogodla. Iningi lama-ependymomas akha ku-ventricle wesine futhi lithinta i-cerebellum kanye nesiqu sobuchopho. I-Ependymomas yakha okuncane kakhulu ku-cerebrum futhi kuyaqabukela kuthambo lomgogodla.

I-anatomy yengaphakathi lobuchopho ekhombisa i-lateral ventricle, i-ventricle yesithathu, i-ventricle yesine, nemigwaqo ephakathi kwama-ventricles (ane-cerebrospinal fluid ekhonjiswe ngokuluhlaza okwesibhakabhaka). Ezinye izingxenye zobuchopho ezibonisiwe zifaka phakathi i-cerebrum, i-cerebellum, umgogodla, nesiqu sobuchopho (ama-pons ne-medulla).

Lapho amafomu e-ependymoma ethinta ukusebenza kobuchopho nentambo yomgogodla:

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

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

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

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

Imbangela yamathumba amaningi obuchopho ebuntwaneni ayaziwa.

Izimpawu nezimpawu zobuntwana i-ependymoma azifani kuyo yonke ingane.

Izimpawu nezimpawu zincike kokulandelayo:

• Iminyaka yengane.

• Lapho okwakheke khona isimila.

Izimpawu nezimpawu zingabangelwa i-ependymoma yobuntwana noma ezinye izimo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Ukuphathwa ikhanda njalo.

• Ukuquleka.

• Isicanucanu nokuhlanza.

• Ubuhlungu entanyeni noma emuva.

• Ukulahlekelwa ibhalansi noma ukuhamba kanzima.

• Ubuthakathaka emilenzeni.

• Umbono ofiphele.

• Ushintsho ekusebenzeni kwamathumbu.

• Inkinga yokuchama.

• Ukudideka noma ukucasuka.

Ukuhlolwa okuhlola ubuchopho nomgogodla kusetshenziselwa ukuthola (ukuthola) i-ependymoma yobuntwana.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

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

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

• I-MRI (imaging resonance imaging) ene-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi kobuchopho nomgogodla. Into ebizwa ngokuthi i-gadolinium ijojowe emthanjeni futhi ihambe egazini. 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. 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-ependymoma yobuntwana iyatholakala futhi isuswe lapho ihlinzwa.

Uma ukuhlolwa kokuxilongwa kukhombisa ukuthi kungenzeka kube nesimila ebuchosheni, i-biopsy yenziwa ngokususa ingxenye yogebhezi bese kusetshenziswa inaliti ukususa isampula lezicubu zobuchopho. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza bese sinquma ibanga lesimila. Uma kutholakala amangqamuzana omdlavuza, udokotela uzosusa isimila esiningi ngangokunokwenzeka ngesikhathi sokuhlinzwa okufanayo.

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

Ukuhlolwa okulandelayo kungenziwa kuzicubu ezisuswe:

• I-Immunohistochemistry: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukubheka ama-antigen (amakaki) athile kusampula yezicubu zesiguli. Amasosha omzimba avamise ukuhlanganiswa ne-enzyme noma udayi we-fluorescent. Ngemuva kokuthi ama-antibody abophele kwi-antigen ethile kusampula yezicubu, i-enzyme noma idayi iyasebenza, bese kuthi i-antigen ibonakale ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukuxilonga umdlavuza nokusiza ukutshela uhlobo oluthile lomdlavuza kolunye uhlobo lomdlavuza.

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

Izinketho zokubikezela nokwelashwa zincike ku:

• Lapho isimila sakhe khona ohlelweni oluphakathi lwezinzwa (CNS).

• Noma ngabe kukhona ushintsho oluthile kuzakhi zofuzo noma kuma-chromosomes.

• Noma ngabe kukhona amangqamuzana omdlavuza ahlala ngemuva kokuhlinzwa ukususa isimila.

• Uhlobo kanye nebanga le-ependymoma.

• Iminyaka yengane lapho kutholakala isimila.

• Ukuthi umdlavuza ususabalele kwezinye izingxenye zobuchopho noma umgogodla.

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

Isibikezelo futhi sincike ekutheni ngabe ukwelashwa ngemisebe kwanikezwa, uhlobo kanye nomthamo wokwelashwa, nokuthi ngabe i-chemotherapy iyodwa yanikezwa yini.

Izigaba ze-Ependymoma Yobuntwana

AMAPHUZU ASEMQOKA

• Alukho uhlelo olujwayelekile lwezigaba lwe-ependymoma yobuntwana.

• I-ependymoma ebuntwaneni ephindaphindayo iyisimila esibuye sabuya (sibuya) ngemuva kokuphathwa.

Alukho uhlelo olujwayelekile lwezigaba lwe-ependymoma yobuntwana.

Isiteji inqubo esetshenziswayo ukuthola ukuthi umdlavuza usale ngemuva kokuhlinzwa nokuthi umdlavuza ususabalele yini.

Ukwelashwa kwe-ependymoma kuncike kulokhu okulandelayo:

• Lapho umdlavuza ukuyo ingqondo noma umgogodla.

• Iminyaka yengane.

• Uhlobo kanye nebanga le-ependymoma.

I-ependymoma ebuntwaneni ephindaphindayo iyisimila esibuye sabuya (sibuya) ngemuva kokuphathwa.

I-ependymoma yobuntwana ivame ukubuya, imvamisa isendaweni yokuqala yomdlavuza. Isimila singabuya emuva kweminyaka eyi-15 noma ngaphezulu ngemuva kokwelashwa kokuqala.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kwezingane ezine-ependymoma.

• Izingane ezine-ependymoma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni izicubu zobuchopho ezinganeni.
• Izinhlobo ezintathu zokwelashwa zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa okuhlosiwe

• Ukwelashwa kwe-ependymoma yobuntwana kungadala imiphumela emibi.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

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

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukene zokwelashwa kwezingane ezine-ependymoma.

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

Ngoba umdlavuza ezinganeni uyivelakancane, ukubamba iqhaza esivivinyweni somtholampilo kufanele kubhekwe. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izingane ezine-ependymoma kufanele zihlelelwe 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:

• I-neurosurgeon yezingane.

• Isazi sezinzwa.

• Udokotela wezingane.

• I-radiation oncologist.

• I-oncologist yezokwelapha.

• Isazi se-endocrinologist.

• Uchwepheshe wokuvuselelwa.

• Isazi sokusebenza kwengqondo.

• Ingcweti kwezempilo yengane.

Izinhlobo ezintathu zokwelashwa zisetshenzisiwe:

Ukuhlinzwa

Uma imiphumela yokuhlolwa kokuxilongwa ikhombisa ukuthi kungenzeka kube nesimila ebuchosheni, i-biopsy yenziwa ngokususa ingxenye yogebhezi bese kusetshenziswa inaliti ukususa isampula lezicubu zobuchopho. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukuhlola amaseli omdlavuza. Uma kutholakala amangqamuzana omdlavuza, udokotela uzosusa isimila esiningi ngangokunokwenzeka ngesikhathi sokuhlinzwa okufanayo.

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

I-MRI ivame ukwenziwa ngemuva kokususwa kwesimila ukuthola ukuthi asikho yini isimila esisele. Uma i-tumor ihlala, ukuhlinzwa kwesibili ukukhipha isimila esisele ngangokunokwenzeka kungenziwa.

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 okunikezwa 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. Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke endaweni yomzimba enomdlavuza.

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

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

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

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

• 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.

Izingane ezincane ezithola ukwelashwa ngemisebe ebuchosheni zinengozi enkulu yezinkinga ngokukhula nentuthuko kunezingane ezindala. Ukwelashwa ngemisebe okufana nokwe-3-D kanye nokwelashwa kweproton-beam kuyafundwa ezinganeni ezincane ukubona ukuthi imiphumela yemisebe ekukhuleni nasentuthukweni inciphile yini.

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).

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-ependymoma yobuntwana ebuye yabuya (buyela).

Ukwelashwa kwe-ependymoma yobuntwana 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, kufaka phakathi izinkinga nge:

• Ukuthuthukiswa kwamazinyo.

• Umsebenzi wokuzwa.

• Ukukhula kwamathambo nemisipha nokukhula.

• Umsebenzi wegilo.

• Unhlangothi.

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

• Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza), njengomdlavuza wegilo noma umdlavuza wobuchopho.

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.)

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.

Ukuhlolwa kokulandelwa kwe-ependymoma yobuntwana kufaka phakathi i-MRI (imaging resonance imaging) yobuchopho nentambo yomgogodla ezikhathini ezilandelayo:

• Iminyaka emibili kuya kwengu-3 yokuqala ngemuva kokwelashwa: Njalo ezinyangeni ezi-3 kuya kwezi-4.

• Iminyaka emine kuya kwemihlanu ngemuva kokwelashwa: Njalo ezinyangeni eziyisithupha.

• Eminyakeni engaphezu kwengu-5 ngemuva kokwelashwa: Kanye ngonyaka.

Ukwelashwa Kwezingane I-Myxopapillary Ependymoma

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

Ukwelashwa kwengane esanda kutholakala i-myxopapillary ependymoma (ibanga I) yile:

• Ukuhlinzwa. Kwesinye isikhathi ukwelashwa ngemisebe kunikezwa ngemuva kokuhlinzwa.

Ukwelashwa kwe-Childhood Ependymoma, i-Anaplastic Ependymoma, ne-RELA Fusion-positive Ependymoma

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

Ukwelashwa kwe-ependymoma ebuntwaneni esanda kutholakala (ibanga lesibili), i-anaplastic ependymoma (ibanga lesithathu), ne-RELA fusion – positive ependymoma (ibanga lesibili noma ibanga lesithathu) yile:

• Ukuhlinzwa.

Ngemuva kokuhlinzwa, uhlelo lokuqhubeka nokwelashwa luncike kulokhu okulandelayo:

• Noma ngabe kukhona amangqamuzana omdlavuza ahlala ngemuva kokuhlinzwa.

• Ukuthi umdlavuza ususabalele kwezinye izingxenye zobuchopho noma umgogodla.

• Iminyaka yengane.

Lapho isimila sisuswe ngokuphelele futhi amangqamuzana omdlavuza engakasakazeki, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngemisebe.

Lapho ingxenye yesimila ihlala ngemuva kokuhlinzwa, kepha amangqamuzana omdlavuza engakasakazeki, ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa kwesibili ukukhipha isimila esisele ngangokunokwenzeka.

• Ukwelashwa ngemisebe.

• Ukwelashwa ngamakhemikhali.

Lapho amangqamuzana omdlavuza esakazeke ngaphakathi kobuchopho nomgogodla, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngemisebe ebuchosheni nasemgogodleni

• Ukwelashwa ngamakhemikhali.

Ukwelashwa kwezingane ezingaphansi konyaka owodwa ubudala kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali.

• Ukwelashwa ngemisebe. Ukwelashwa ngemisebe akunikezwa izingane kuze kube yilapho sezikhulile kunonyaka owodwa ubudala.

• Isivivinyo somtholampilo se-3-dimensional (3-D) yokwelapha ngemisebe ehambisanayo noma ukwelashwa ngemisebe ye-proton-beam radiation.

Ukwelashwa Kwe-Ependymoma Yengane Ephindaphindayo

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

Ukwelashwa kwe-ependymoma ebuntwaneni ephindaphindwayo kungafaka okulandelayo:

• Ukuhlinzwa.

• Ukwelashwa ngemisebe, okungafaka phakathi imisebe ye-stereotactic radiosurgery, i-intension-modulated radiation therapy, noma i-proton-beam radiation therapy.

• Ukwelashwa ngamakhemikhali.

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

Ukufunda Okwengeziwe Ngamathumba Engqondo Ebuntwaneni

Ukuthola eminye imininingwane ngamathumba obuchopho 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