Izinhlobo / izinhlobo zomdlavuza / i-hp / ezingavamile-umdlavuza-ebuntwaneni-pdq
Umdlavuza Ovamile Wokwelashwa Kwezingane
Imininingwane ejwayelekile Mayelana Nomdlavuza Ongajwayelekile Wobuntwana
Kulesi Sigaba
- Isingeniso
Isingeniso
Umdlavuza ezinganeni nasebusheni uyivelakancane, yize izehlakalo zomdlavuza wezingane bezilokhu zanda kancane kusukela ngo-1975. [1] Ukudluliselwa ezikhungweni zezokwelapha ezinamaqembu ahlukahlukene ochwepheshe bomdlavuza abanolwazi ekwelapheni umdlavuza owenzeka ebuntwaneni nasebusheni kufanele kubhekelwe izingane nentsha enomdlavuza. Le ndlela yeqembu elihlukahlukene ehlanganisa amakhono odokotela bokunakekelwa okuyinhloko, odokotela abahlinzayo bezingane, ama-oncologists emisebe, odokotela bezokwelapha oncologists / ama-hematologists, ochwepheshe bezokwelapha, ochwepheshe bezinesi zezingane, abasebenzi bezenhlalakahle, nabanye ukuqinisekisa ukuthi izingane zithola ukwelashwa, ukunakekelwa okusekelayo, nokuvuselelwa ukuthi izofinyelela ukusinda okulungile nekhwalithi yempilo.
Imihlahlandlela yezikhungo zomdlavuza wezingane nendima yazo ekwelapheni iziguli ezinomdlavuza ichazwe yi-American Academy of Pediatrics. [2] Kulezi zikhungo zomdlavuza wezingane, izivivinyo zokwelashwa ziyatholakala ezinhlotsheni eziningi zomdlavuza ezenzeka ezinganeni nasebusheni, futhi nethuba lokubamba iqhaza kulezi zivivinyo linikezwa iziguli eziningi nemindeni yazo. Izilingo zomtholampilo zezingane nentsha etholakale inomdlavuza ngokuvamile zenzelwe ukuqhathanisa ukwelashwa okungaba ngcono nokwelashwa okwamukelwa njengokwejwayelekile. Iningi lenqubekela phambili elenziwe ekuhlonzeni ukwelashwa okwelashwa komdlavuza wezingane litholwe ngokuhlolwa komtholampilo. Imininingwane mayelana nokuhlolwa kwemitholampilo okuqhubekayo iyatholakala kuwebhusayithi ye-NCI.
Ukuthuthuka okumangazayo ekusindeni kutholakele izingane nentsha enomdlavuza. Phakathi kuka-1975 no-2010, ukufa komdlavuza wezingane kwehle ngaphezu kwama-50%. [3] Abasindile bomdlavuza wezingane nentsha badinga ukuqashwa okusondele ngoba imiphumela emibi yokwelashwa komdlavuza ingaqhubeka noma ithuthuke izinyanga noma iminyaka ngemuva kokwelashwa. .
Umdlavuza wezingane uyisifo esingajwayelekile, lapho kutholakala khona amacala angaba ngu-15 000 ngonyaka e-United States kubantu abangaphansi kweminyaka engama-20. [4] Umthetho Wezifo Ezingajwayelekile wase-US ka-2002 uchaza isifo esingajwayelekile njengesifo esithinta abantu abancane kunabantu abangama-200,000. Ngakho-ke, wonke umdlavuza wezingane uthathwa njengokungajwayelekile.
Ukuqokwa kwesimila esingavamile akufani phakathi kwamaqembu ezingane nawabantu abadala. Imidlavuza yabantu abadala engavamile ichazwa njengaleyo eba nezigameko zonyaka ezingaphansi kwezigameko eziyisithupha kubantu abayi-100,000, futhi kulinganiselwa ukuthi ibalelwa kuma-24% awo wonke umdlavuza otholwe e-European Union futhi cishe u-20% wawo wonke umdlavuza otholwe e-United States . [5,6] Futhi, ukuqokwa kwesimila ezingavamile ezinganeni akufani phakathi kwamaqembu omhlaba, ngokulandelayo:
- Iphrojekthi yokubambisana yase-Italiya yezicubu ezingavamile zezingane (i-Tumori Rari e-Eta Pediatrica [TREP]) ichaza isimila ezingavamile sezingane njengesinye esinezigameko ezingaphansi kwamabili ezigidini zabantu abayisigidi esisodwa ngonyaka futhi asifakiwe kolunye uvivinyo lomtholampilo. [7 ]
- I-Children's Oncology Group (COG) ikhethe ukuchaza umdlavuza wezingane ongajwayelekile njengalowo obhalwe ku-International Classification of Childhood Cancer subgroup XI, okubandakanya umdlavuza we-thyroid, i-melanoma kanye ne-nonmelanoma umdlavuza wesikhumba, nezinhlobo eziningi ze-carcinomas (isib. Adrenocortical carcinoma, nasopharyngeal i-carcinoma, kanye nama-carcinomas amaningi ohlobo lwabantu abadala njengomdlavuza webele, umdlavuza obala, njll.). [8] Lokhu kuhlolwa kuthinta cishe u-4% womdlavuza otholwe ezinganeni ezineminyaka engu-0 kuya kwengu-14, uma kuqhathaniswa no-20% womdlavuza otholwe ezinganeni ezineminyaka yobudala eyi-15 kuya kwengu-19 (bheka Amanani 1 no-2). [9]
Iningi lomdlavuza ngaphakathi kweqembu elincane i-XI kungaba yi-melanomas noma umdlavuza we-thyroid, kanti izinhlobo zomdlavuza ze-XI ezisele zibalwa kuphela ngama-1.3% omdlavuza ezinganeni ezineminyaka engu-0 kuya kwengu-14 no-5.3% womdlavuza ezinganeni ezineminyaka yobudala eyi-15 kuya kwengu-19.
Le mikhamo engavamile iyinselele enkulu ukuyifunda ngenxa yezigameko eziphansi zeziguli ezinokutholakala ngakunye, ubukhulu bomdlavuza ongavamile kubantu abasebasha, kanye nokuntuleka kokuhlolwa kwemitholampilo kwabasha abanomdlavuza ongajwayelekile njenge-melanoma.
Abanye abaphenyi basebenzise imininingwane emikhulu, efana ne-Surveillance, Epidemiology, ne-End Results (SEER) kanye ne-National Cancer Database, ukuthola ukuqonda okwengeziwe ngale mdlavuza wezingane ongandile. Noma kunjalo, lezi zifundo ze-database zikhawulelwe. Izindlela eziningana zokutadisha umdlavuza wezingane ezingandile zenziwe yi-COG namanye amaqembu omhlaba, kubandakanya i-International Society of Pediatric Oncology (Société Internationale D'Oncologie Pédiatrique [SIOP]). I-Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) engavamile yesimila iphrojekthi yasungulwa eJalimane ngo-2006. [10] I-TREP yethulwa ngo-2000, [7] kwathi iqembu lePolish Pediatric Rare Tumor Study Group lasungulwa ngonyaka we-2002. [11] EYurophu, amaqembu angavamile okufunda isimila avela eFrance, eJalimane, e-Italy, ePoland, futhi i-United Kingdom ijoyine i-European Cooperative Study Group on Pediatric Rare Tumors (EXPeRT), igxile ekubambisaneni kwamazwe omhlaba nasekuhlaziyweni kwezinhlaka ezithile zezimila ezingavamile. [12] Ngaphakathi kwe-COG, imizamo igxile ekwandiseni okwandayo kokubhaliswa kwe-COG (iProjekhthi Yonke Ingane) kanye nezivumelwano zebhange lesimila, ukuthuthukisa izivivinyo zomthambo wesandla esisodwa, nokwandisa ukubambisana nokwenziwa kwezivivinyo zeqembu labantu abadala. [13] Okufeziwe nezinselelo zalesi sinyathelo kuchazwe ngokuningiliziwe. [8,14] kanye nokwanda kokubambisana nokuhlolwa kweqembu labantu abadala. [13] Okufeziwe nezinselelo zalesi sinyathelo kuchazwe ngokuningiliziwe. [8,14] kanye nokwanda kokubambisana nokuhlolwa kweqembu labantu abadala. [13] Okufeziwe nezinselelo zalesi sinyathelo kuchazwe ngokuningiliziwe. [8,14]
Izimila ezibalulwe kulesi sifinyeto ziyahlukahluka kakhulu; zihlelwe ngokwehla kwe-anatomic oda, kusuka kumathumba angavamile ekhanda nasentanyeni kuya kwizimila ezingavamile zomgudu womchamo nesikhumba. Wonke lawa mdlavuza ayivelakancane ngokwanele ukuthi izibhedlela eziningi zezingane zingabona okuncane kunamanye ama-histologies eminyakeni eminingana. Iningi lama-histologies abhalwe lapha avela kaningi kubantu abadala. Imininingwane mayelana nalezi zicubu ingatholwa futhi emithonjeni efanele abantu abadala abanomdlavuza.
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