Izinhlobo / ikhanda-nentamo / isiguli / umuntu omdala / i-laryngeal-treatment-pdq

Inguqulo Yokwelapha I-Laryngeal Cancer (Adult)

Imininingwane Jikelele Ngomdlavuza We-Laryngeal

AMAPHUZU ASEMQOKA

• Umdlavuza weLaryngeal yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zomphimbo.

• Ukusetshenziswa kwemikhiqizo kagwayi nokuphuza kakhulu utshwala kungaphazamisa ingozi yomdlavuza wamalakahla.

• Izimpawu nezimpawu zomdlavuza we-laryngeal zifaka phakathi ubuhlungu bomphimbo nezindlebe.

• Izivivinyo ezihlola umphimbo nentamo zisetshenziselwa ukusiza ukuxilonga nokukala umdlavuza wamalumbo.

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

Umdlavuza weLaryngeal yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zomphimbo.

Umphimbo uyingxenye yomphimbo, phakathi kwesisekelo solimi noqhoqhoqho. Umphimbo unemisipha yezwi, edlidlizelayo futhi ezwakalayo lapho umoya uqondiswe kuyo. Umsindo unanela ngokusebenzisa umphimbo, umlomo, namakhala ukwenza izwi lomuntu.

Kunezingxenye ezintathu eziyinhloko zelarynx:

• I-Supraglottis: Ingxenye engenhla yomphimbo ngaphezu kwezintambo zezwi, kufaka phakathi i-epiglottis.

• IGlottis: Ingxenye emaphakathi yomphimbo lapho kutholakala khona izintambo zezwi.

• I-Subglottis: Ingxenye engezansi yomphimbo phakathi kwezintambo zezwi kanye ne-trachea (i-windpipe).

Amafomu omdlavuza we-Laryngeal ezicubu zomphimbo (indawo yomphimbo equkethe izintambo zezwi). I-larynx ifaka phakathi i-supraglottis, i-glottis (izintambo zezwi), ne-subglottis. Umdlavuza ungadlulela ezicutshini eziseduze noma e-thyroid, trachea, noma esophagus. Kungasakazeka nakuma-lymph node entanyeni, umthambo we-carotid, ingxenye ephezulu yekholomu yomgogodla, isifuba, nakwezinye izingxenye zomzimba (ezingakhonjisiwe).

Iningi lomdlavuza we-laryngeal wakheka kumaseli abucayi, amangqamuzana amancane, ayizicaba angena ngaphakathi komphimbo.

Umdlavuza weLaryngeal wuhlobo lomdlavuza wekhanda nowentamo.

Ukusetshenziswa kwemikhiqizo kagwayi nokuphuza kakhulu utshwala kungaphazamisa ingozi yomdlavuza wamalakahla.

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini.

Izimpawu nezimpawu zomdlavuza we-laryngeal zifaka phakathi ubuhlungu bomphimbo nezindlebe.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa umdlavuza we-laryngeal noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Umphimbo obuhlungu noma ukukhwehlela okungapheli.

• Inkinga noma ubuhlungu lapho ugwinya.

• Ubuhlungu bendlebe.

• Isigaxa entanyeni noma emphinjeni.

• Ushintsho noma ukushuba kwezwi.

Izivivinyo ezihlola umphimbo nentamo zisetshenziselwa ukusiza ukuxilonga nokukala umdlavuza wamalumbo.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa ngokomzimba komphimbo nentamo: Ukuhlolwa kokubheka umphimbo nentamo ezindaweni ezingejwayelekile. Udokotela uzozwa ingaphakathi lomlomo ngomunwe ofakwe igilavu ​​bese ehlola umlomo nomphimbo ngesibuko esincane esiphathwe isikhathi eside nokukhanya. Lokhu kuzobandakanya ukuhlola ingaphakathi lezihlathi nezindebe; izinsini; ingemuva, uphahla nesitezi somlomo; phezulu, phansi, nezinhlangothi zolimi; nomphimbo. Intamo izozwakala ngama-lymph node avuvukile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula okwedlule kanye nokwelashwa.

• I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Isampula lezicubu lingasuswa ngesikhathi senqubo elandelayo:

• I-Laryngoscopy: Inqubo lapho udokotela ehlola i-larynx (ibhokisi lezwi) ngesibuko noma nge-laryngoscope ukubheka izindawo ezingejwayelekile. I-laryngoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka ingaphakathi lomphimbo nebhokisi lezwi. Kungaba futhi nethuluzi lokususa amasampula wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

• I-Endoscopy: Inqubo yokubheka izitho nezicubu ngaphakathi komzimba, ezifana nomphimbo, isopha, kanye noqhoqhoqho ukuhlola izindawo ezingajwayelekile. I-endoscope (ishubhu elincane, elikhanyisiwe elinokukhanya nelensi yokubuka) lifakwa ngembobo emzimbeni, njengomlomo. Ithuluzi elikhethekile ku-endoscope lingasetshenziswa ukususa amasampula ezicubu.

• 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-computerized tomography, noma i-computer axial tomography.

Iskena sekhompiyutha (CT) sekhanda nentamo. Isiguli silele etafuleni elishibilika ngesithwebuli se-CT, esithatha izithombe ze-x-ray ezingaphakathi kwekhanda nentamo.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• I-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.

• I-PET-CT scan: Inqubo ehlanganisa izithombe kusuka kuskena se-positron emission tomography (PET) kanye nokuskena kwe-computed tomography (CT). Izikena ze-PET ne-CT zenziwa ngasikhathi sinye ngomshini ofanayo. Izikena ezihlanganisiwe zinikeza izithombe ezinemininingwane eminingi yezindawo ezingaphakathi komzimba kunalokho ukuskena okunikezayo ngokwakho. Ukuskena kwe-PET-CT kungasetshenziselwa ukuxilonga izifo, njengomdlavuza, ukuhlela ukwelashwa, noma ukuthola ukuthi ukwelashwa kusebenza kahle kangakanani.

• 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.

• Ukugwinya kwe-Barium: Uchungechunge lwama-x-ray we-esophagus nesisu. Isiguli siphuza uketshezi oluqukethe i-barium (insimbi eyinsimbi emhlophe). Uketshezi kugqoka umphimbo nesisu, nama-x-ray ayathathwa. Le nqubo ibizwa nangokuthi uchungechunge oluphezulu lwe-GI.

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

Isibikezelo sincike kulokhu okulandelayo:

• Isigaba sesifo.

• Indawo nobukhulu besimila.

• Ibanga lesimila.

• Iminyaka yesiguli, ubulili, nempilo ejwayelekile, kufaka phakathi ukuthi isiguli sinesifo segazi yini.

Izinketho zokwelashwa zincike kokulandelayo:

• Isigaba sesifo.

• Indawo nobukhulu besimila.

• Ukugcina ikhono lesiguli lokukhuluma, ukudla, nokuphefumula njengokujwayelekile ngangokunokwenzeka.

• Ukuthi umdlavuza ubuyile (uphinde wabuya).

Ukubhema ugwayi nokuphuza utshwala kunciphisa ukusebenza kokwelashwa komdlavuza wamalaka. Iziguli ezinomdlavuza we-laryngeal eziqhubeka nokubhema nokuphuza mancane amathuba okuthi zelapheke futhi zisethubeni lokuba nesimila sesibili. Ngemuva kokwelashwa komdlavuza we-laryngeal, ukulandelwa kaningi nokucophelela kubalulekile.

Izigaba Zomdlavuza We-Laryngeal

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala komdlavuza we-laryngeal, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi komphimbo noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-laryngeal:

• Isigaba 0 (I-Carcinoma eSitu)

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

• Ngemuva kokuhlinzwa, isigaba somdlavuza singashintsha futhi kungadingeka ukwelashwa okwengeziwe.

• Umdlavuza ophindaphindayo welaryngeal wumdlavuza obuye emuva kokwelashwa.

Ngemuva kokutholakala komdlavuza we-laryngeal, kwenziwa ukuhlolwa ukuthola ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi komphimbo noma kwezinye izingxenye zomzimba.

Inqubo esetshenziselwa ukuthola ukuthi umdlavuza ususabalele ngaphakathi komphimbo noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba sesifo ukuze uhlele ukwelashwa. Imiphumela yolunye uvivinyo olusetshenziselwa ukuxilonga umdlavuza wamaphaphu libuye lisetshenziselwe ukufaka lesi sifo.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

• Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.

• Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.

• Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

• Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

• Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lomdlavuza njengesimila sokuqala. Isibonelo, uma umdlavuza we-laryngeal usakazeka uye emaphashini, amangqamuzana omdlavuza asephashini empeleni angamaseli omdlavuza we-laryngeal. Lesi sifo umdlavuza we-laryngeal we-metastatic, hhayi umdlavuza wamaphaphu.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-laryngeal:

Isigaba 0 (I-Carcinoma eSitu)

Esigabeni 0, amangqamuzana angajwayelekile atholakala emgqeni we-larynx. Lawa maseli angajwayelekile angaba ngumdlavuza futhi asabalale abe izicubu ezijwayelekile eziseduze. Isigaba 0 sibizwa nangokuthi i-carcinoma in situ.

Isiteji I

Esigabeni I, umdlavuza wakhe endaweni ephakeme ye-supraglottis, glottis, noma subglottis yomphimbo:

• I-Supraglottis: I-Cancer isendaweni eyodwa ye-supraglottis futhi izintambo zezwi zisebenza ngokujwayelekile.

• IGlottis: Umdlavuza ungowodwa noma zombili izintambo zezwi futhi izintambo zezwi zisebenza ngokujwayelekile.

• I-Subglottis: Umdlavuza uku-subglottis kuphela.

Isigaba II

Esigabeni II, umdlavuza wakhe endaweni ephakeme ye-supraglottis, glottis, noma subglottis yomphimbo:

• I-Supraglottis: I-Cancer isendaweni engaphezu kweyodwa ye-supraglottis noma isakaze endaweni engaphansi kolimi noma ezicutshini eziseduze nezintambo zezwi. Imisipha yezwi isebenza ngokujwayelekile.

• IGlottis: Umdlavuza usabalalele kuma-supraglottis, subglottis, noma womabili, futhi / noma izintambo zezwi azisebenzi ngokujwayelekile.

• I-Subglottis: Umdlavuza usabalalele entanjeni eyodwa noma zombili futhi izintambo zezwi kungenzeka zingasebenzi ngokujwayelekile.

Isigaba III

Esigabeni III, umdlavuza wakhe endaweni ephakeme ye-supraglottis, glottis, noma subglottis yomphimbo:

Osayizi bezicubu bavame ukulinganiswa ngamasentimitha (cm) noma amasentimitha. Izinto zokudla ezijwayelekile ezingasetshenziswa ukukhombisa usayizi wesimila ngo-cm zifaka: ipea (1 cm), iphenathi (2 cm), umvini (3 cm), i-walnut (4 cm), umcako (5 cm noma 2) amasentimitha), iqanda (6 cm), ipentshisi (7 cm), ne-grapefruit (10 cm noma 4 inches).

Esigabeni sesithathu somdlavuza we-supraglottis:

• Umdlavuza uku-larynx kuphela futhi izintambo zamagama azisebenzi, futhi / noma umdlavuza usabalale wasondela eduze noma ngaphakathi kwengxenye ye-cartilage ye-thyroid. Umdlavuza kungenzeka ukuthi usabalalele nakwelinye i-lymph node ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane; noma

• umdlavuza usendaweni eyodwa yama-supraglottis futhi izintambo zezwi zisebenza ngokujwayelekile. Umdlavuza usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane; noma

• umdlavuza usendaweni engaphezu kweyodwa ye-supraglottis noma usakaze endaweni engezansi kolimi noma ezicutshini eziseduze nemisipha yezwi. Imisipha yezwi isebenza ngokujwayelekile. Umdlavuza ubuye usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane.

Esigabeni sesithathu somdlavuza we-glottis:

• Umdlavuza uku-larynx kuphela futhi izintambo zamagama azisebenzi, futhi / noma umdlavuza usabalale wasondela eduze noma ngaphakathi kwengxenye ye-cartilage ye-thyroid. Umdlavuza kungenzeka ukuthi usabalalele nakwelinye i-lymph node ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane; noma

• umdlavuza ukunye noma zombili izintambo zezwi futhi izintambo zezwi zisebenza ngokujwayelekile. Umdlavuza usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane; noma

• umdlavuza usabalalele kuma-supraglottis, ama-subglottis, noma womabili, futhi / noma izintambo zezwi azisebenzi ngokujwayelekile. Umdlavuza ubuye usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane.

Esigabeni sesithathu somdlavuza we-subglottis:

• Umdlavuza uku-larynx kuphela futhi izintambo zamagama azisebenzi, futhi / noma umdlavuza usabalale wasondela eduze noma ngaphakathi kwengxenye ye-cartilage ye-thyroid. Umdlavuza kungenzeka ukuthi usabalalele nakwelinye i-lymph node ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane; noma

• umdlavuza uku-subglottis kuphela. Umdlavuza usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane; noma

• umdlavuza usabalalele entanjeni eyodwa noma zombili futhi imisipha yezwi kungenzeka ingasebenzi ngokujwayelekile. Umdlavuza ubuye usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane.

Isigaba IV

Isigaba IV sihlukaniswe ngezigaba IVA, isigaba IVB, nesigaba IVC. Indawo ngayinye encane iyafana nomdlavuza ku-supraglottis, glottis, noma subglottis.

• Esigabeni IVA:

• Umdlavuza usabalale ngoqwanga lwegilo kanye / noma usabalalele ezicutshini ezingaphezulu komphimbo, njengentamo, i-trachea, i-thyroid, noma i-esophagus. Umdlavuza kungenzeka ukuthi usabalalele nakwelinye i-lymph node ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane; noma

• Umdlavuza kungenzeka ukuthi usabalale kusuka ku-supraglottis, glottis, noma subglottis kuya ezicutshini ezingaphezulu komphimbo, njengentamo, i-trachea, i-thyroid, noma i-esophagus. Izintambo zezwi kungenzeka zingasebenzi ngokujwayelekile. Umdlavuza usabalale:

• kunombolo eyodwa e-lymph ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kungamasentimitha ama-3 noma amancane. Umdlavuza usabalale ngesembozo sangaphandle se-lymph node; noma

• kufinyelela ku-lymph node eyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kukhulu kunamasentimitha ama-3 kepha hhayi kukhulu kunamasentimitha ayi-6. Umdlavuza awusabalalanga ngesembozo sangaphandle se-lymph node; noma

• kuma-lymph node angaphezu kweyodwa ohlangothini olufanayo lwentamo njengoba isimila sokuqala nama-lymph node kungabi kukhulu kunamasentimitha ayi-6. Umdlavuza awusakazekanga ngesembozo sangaphandle samankinga; noma

• kuma-lymph node ezinhlangothini zombili zentamo noma ohlangothini lwentamo olubhekene nesimila sokuqala futhi ama-lymph node awekho ngaphezu kwamasentimitha ayi-6. Umdlavuza awusabalalanga ngesembozo sangaphandle sama-lymph node.

• Esigabeni IVB:

• Umdlavuza kungenzeka ukuthi usakazeke usuka kwi-supraglottis, i-glottis, noma i-subglottis uye esikhaleni esiphambi komgogodla, indawo ezungeze umthambo we-carotid, noma indawo ephakathi kwamaphaphu. Izintambo zezwi kungenzeka zingasebenzi ngokujwayelekile. Umdlavuza usabalale:

• ku-lymph node eyodwa enkulu kunamasentimitha ayi-6. Umdlavuza awusabalalanga ngesembozo sangaphandle se-lymph node; noma

• kunombolo eyodwa e-lymph ohlangothini olufanayo lwentamo njengoba isimila sokuqala kanye ne-lymph node kukhulu kunamasentimitha ama-3. Umdlavuza usabalale ngesembozo sangaphandle se-lymph node; noma

• kuma-lymph node angaphezu kweyodwa noma kuphi entanyeni. Umdlavuza usabalale ngokumboza kwangaphandle kwama-lymph node; noma

• ku-lymph node eyodwa yanoma iluphi usayizi ohlangothini lwentamo olubhekene nesimila sokuqala. Umdlavuza usabalale ngesembozo sangaphandle se-lymph node;

noma

• Umdlavuza usabalale kusuka ku-supraglottis, glottis, noma subglottis uye esikhaleni esiphambi komgogodla, indawo ezungeze umthambo we-carotid, noma indawo ephakathi kwamaphaphu. Umdlavuza kungenzeka ukuthi usabalalele nakwelilodwa noma ngaphezulu ama-lymph node noma kuphi entanyeni kanti ama-lymph node angaba yinoma yimuphi usayizi.

• Esigabeni IVC, umdlavuza usabalalele kwezinye izingxenye zomzimba, njengamaphaphu, isibindi noma ithambo.

Ngemuva kokuhlinzwa, isigaba somdlavuza singashintsha futhi kungadingeka ukwelashwa okwengeziwe.

Uma umdlavuza ususwa ngokuhlinzwa, udokotela wezifo uyohlola isampula lezicubu zomdlavuza ngaphansi kwesibonakhulu. Kwesinye isikhathi, ukubuyekezwa kwe-pathologist kuzoholela ekuguqulweni kwesigaba somdlavuza nokwelashwa okwengeziwe ngemuva kokuhlinzwa.

Umdlavuza ophindaphindayo welaryngeal wumdlavuza obuye emuva kokwelashwa.

Lapho umdlavuza we-laryngeal ubuya ngemuva kokwelashwa, ubizwa ngokuthi umdlavuza ophindaphindiwe we-laryngeal. Umdlavuza kungenzeka ubuye eminyakeni emibili kuya kwemithathu yokuqala. Ingabuya emuva ngomphimbo noma kwezinye izingxenye zomzimba, njengamaphaphu, isibindi noma ithambo.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza we-laryngeal.

• Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

• Ukwelashwa ngemisebe

• Ukuhlinzwa

• Ukwelashwa ngamakhemikhali

• I-Immunotherapy

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa okuhlosiwe

• Ama-Radiosensitizers

• Ukwelashwa komdlavuza we-laryngeal 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 ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza we-laryngeal.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza wamalaka. 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. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo ezine zokwelashwa ezijwayelekile zisetshenzisiwe:

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.

Ukwelashwa kwemisebe yangaphandle yegundane lekhanda nentamo. Kusetshenziswa umshini ukukhomba imisebe ephezulu yamandla emdlavuza. Umshini ungazungeza isiguli, uhambise imisebe evela ezinhlangothini eziningi ezahlukahlukene ukuhlinzeka ukwelashwa okufana kakhulu. Isifihla mesh sisiza ukugcina ikhanda nentamo yesiguli kunganyakazi ngesikhathi sokwelashwa. Omaki abancane bakayinki bafakwa kumaskhi. Amaki oyinki asetshenziselwa ukulinganisa umshini wemisebe endaweni efanayo ngaphambi kokwelashwa ngakunye.

Ukwelashwa ngemisebe kungasebenza kangcono ezigulini eziyeke ukubhema ngaphambi kokuqala ukwelashwa. Ukwelashwa kwemisebe yangaphandle kwi-thyroid noma i-pituitary gland kungashintsha indlela indlala yegilo esebenza ngayo. Ukuhlolwa kwegazi ukuhlola izinga le-hormone yegilo emzimbeni kungenziwa ngaphambi nangemva kokwelashwa ukuqinisekisa ukuthi indlala yegilo isebenza kahle.

Ukwelashwa kwemisebe ye-Hyperfractionated kungasetshenziswa ukwelapha umdlavuza we-laryngeal. Ukwelashwa kwemisebe ye-Hyperfractionated ukwelashwa ngemisebe lapho isilinganiso esincane sansuku zonke semisebe sihlukaniswa ngemithamo emibili kanti ukwelashwa kunikezwa kabili ngosuku. Ukwelashwa kwemisebe ye-hyperfraction kunikezwa ngesikhathi esifanayo (izinsuku noma amasonto) njengokwelashwa okujwayelekile kwemisebe. Izinhlobo ezintsha zokwelashwa ngemisebe ziyacutshungulwa ekwelapheni umdlavuza wamalaka.

Ukuhlinzwa

Ukuhlinzwa (ukususa umdlavuza lapho usebenza) kuyindlela ejwayelekile yokwelashwa kwazo zonke izigaba zomdlavuza womlomo wesibeletho. Izinqubo ezilandelayo zokuhlinza zingasetshenziswa:

• I-Cordectomy: Ukuhlinzwa ukususa imicu yezwi kuphela.

• I-laryngectomy ye-Supraglottic: Ukuhlinzwa ukususa i-supraglottis kuphela.

• I-Hemilaryngectomy: Ukuhlinzwa ukukhipha uhhafu we-larynx (ibhokisi lezwi). I-hemilaryngectomy isindisa izwi.

• I-laryngectomy engaphelele: Ukuhlinzwa ukususa ingxenye yomphimbo (ibhokisi lezwi). I-laryngectomy engaphelele isiza ukugcina amandla esiguli okukhuluma.

• Ingqikithi ye-laryngectomy: Ukuhlinzwa ukukhipha wonke umphimbo. Phakathi nalokhu kusebenza, kwenziwa imbobo ngaphambili kwentamo ukuze isiguli sikwazi ukuphefumula. Lokhu kubizwa ngokuthi yi-tracheostomy.

• I-Thyroidectomy: Ukususwa kwawo wonke noma ingxenye yendlala yegilo.

• Ukuhlinzwa nge-Laser: Inqubo yokuhlinza esebenzisa umsebe we-laser (umsebe omncane wokukhanya okukhulu) njengommese ukwenza ukusikeka ngaphandle kwegazi ezicutshini noma ukususa isilonda esingaphezulu njengesimila ku-larynx.

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.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuvimba amaseli ukuthi angahlukani. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy).

Bheka Izidakamizwa ezivunyelwe i-Head and Neck Cancer ukuthola eminye imininingwane. (Umdlavuza weLaryngeal uhlobo lomdlavuza wekhanda nentamo.)

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.

• Ukwelashwa kwe-inhibitor yokuhlola amasosha omzimba: I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba wokuzivikela. Lapho i-PD-1 inamathela kwenye iprotheni ebizwa nge-PDL-1 kuseli lomdlavuza, iyeka i-T cell ekubulaleni iseli lomdlavuza. Ama-PD-1 inhibitors anamathisela ku-PDL-1 futhi avumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. I-Nivolumab ne-pembrolizumab yizinhlobo zama-immune checkpoint inhibitors asetshenziselwa ukwelapha umdlavuza we-lastngeal noma owenzeka njalo.

Isithiyo sokuhlola izivikeli mzimba. Amaprotheni wokuhlola, njenge-PD-L1 kumaseli we-tumor ne-PD-1 kumaseli we-T, asiza ukugcina izimpendulo ze-immune zihlolwe. Ukubopha kwe-PD-L1 kuya ku-PD-1 kugcina amaseli we-T ekubulaleni amangqamuzana omzimba emzimbeni (iphaneli engakwesobunxele). Ukuvimba ukubopha kwe-PD-L1 kuya ku-PD-1 nge-immune checkpoint inhibitor (i-anti-PD-L1 noma i-anti-PD-1) ivumela amaseli we-T ukuthi abulale amangqamuzana wesimila (iphaneli elifanele).

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

• Ama-antibody e-monoclonal: Le ndlela yokwelapha isebenzisa amasosha omzimba enziwe elebhu evela ohlotsheni olulodwa lwamaseli omzimba. La ma-antibody angakhomba izinto kumaseli womdlavuza noma ezintweni ezijwayelekile egazini noma kwizicubu ezingasiza amangqamuzana omdlavuza ukuthi akhule. Amasosha omzimba anamathela ezintweni futhi abulale amangqamuzana omdlavuza, avimbe ukukhula kwawo, noma awagcine ekusakazekeni. Ama-antibody e-monoclonal anikezwa ngokumnika. Zingasetshenziswa zodwa noma ukuphatha izidakamizwa, ubuthi, noma okokukhipha imisebe ngqo emangqamuzaneni omdlavuza. I-Cetuximab ifundelwa ekwelapheni umdlavuza wamalaka.

Ama-Radiosensitizers

Ama-radiosensitizers yizidakamizwa ezenza amangqamuzana ama-tumor azwele kakhulu ekwelashweni kwemisebe. Ukuhlanganisa ukwelashwa ngemisebe ngama-radiosensitizers kungabulala amangqamuzana amaningi wesimila.

Ukwelashwa komdlavuza we-laryngeal kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

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 sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Ukwelashwa Kwe-Stage I Cancer Laryngeal

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

Ukwelashwa kwesigaba esisanda kutholakala somdlavuza we-laryngeal kuncike lapho umdlavuza utholakala khona emphinjeni.

Uma umdlavuza uku-supraglottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngemisebe.

• I-laryngectomy ye-Supraglottic.

Uma umdlavuza uku-glottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngemisebe.

• Ukuhlinzwa kwe-Laser.

• I-Cordectomy.

• I-laryngectomy engaphelele, i-hemilaryngectomy, noma i-laryngectomy ephelele.

Uma umdlavuza uku-subglottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngemisebe ngokuhlinzwa noma ngaphandle kokuhlinzwa.

• Ukuhlinzwa wedwa.

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.

Ukwelashwa Kwe-Cancer Laryngeal Cancer

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

Ukwelashwa komdlavuza osanda kutholakala wesigaba II somdlavuza womlomo kuncike ekutheni umdlavuza utholakalaphi ku-larynx.

Uma umdlavuza uku-supraglottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa kwemisebe ku-tumor kanye nama-lymph node aseduze.

• I-laryngectomy ye-Supraglottic engalandelwa ukwelashwa ngemisebe.

Uma umdlavuza uku-glottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngemisebe.

• Ukuhlinzwa kwe-Laser.

• I-laryngectomy engaphelele, i-hemilaryngectomy, noma i-laryngectomy ephelele.

Uma umdlavuza uku-subglottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngemisebe ngokuhlinzwa noma ngaphandle kokuhlinzwa.

• Ukuhlinzwa wedwa.

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.

Ukwelashwa Kwe-Cancer Laryngeal Cancer

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

Ukwelashwa komdlavuza osanda kutholakala wesigaba III somdlavuza womlomo wesibeletho kuncike lapho umdlavuza utholakala khona emphinjeni.

Uma umdlavuza uku-supraglottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali nokwelashwa ngemisebe kunikezwe ndawonye

• I-Chemotherapy ilandelwa ukwelashwa ngamakhemikhali nokwelashwa ngemisebe okunikezwe ndawonye. I-Laryngectomy ingenziwa uma umdlavuza uhlala.

• Ukwelashwa ngemisebe kuphela kweziguli ezingakwazi ukwelashwa ngamakhemikhali nokuhlinzwa.

• Ukuhlinzwa, okungalandelwa ukwelashwa ngemisebe.

Uma umdlavuza uku-glottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali nokwelashwa ngemisebe kunikezwe ndawonye.

• I-Chemotherapy ilandelwa ukwelashwa ngamakhemikhali nokwelashwa ngemisebe okunikezwe ndawonye. I-Laryngectomy ingenziwa uma umdlavuza uhlala.

• Ukwelashwa ngemisebe kuphela kweziguli ezingakwazi ukwelashwa ngamakhemikhali nokuhlinzwa.

• Ukuhlinzwa, okungalandelwa ukwelashwa ngemisebe.

• Isivivinyo somtholampilo sokwelapha ngemisebe sisodwa uma kuqhathaniswa nemisebe kanye nokwelashwa okuqondisiwe (i-cetuximab).

• Isivivinyo somtholampilo se-immunotherapy, chemotherapy, radiosensitizers, noma i-radiation therapy.

Uma umdlavuza uku-subglottis, ukwelashwa kungafaka okulandelayo:

• I-Laryngectomy kanye ne-thyroidectomy ephelele nokususwa kwama-lymph node emphinjeni, imvamisa kulandelwa ukwelashwa ngemisebe.

• Ukwelashwa ngemisebe kulandelwa ukuhlinzwa uma umdlavuza ubuya endaweni efanayo.

• Ukwelashwa ngemisebe kuphela kweziguli ezingakwazi ukwelashwa ngamakhemikhali nokuhlinzwa.

• I-Chemotherapy ilandelwa ukwelashwa ngamakhemikhali nokwelashwa ngemisebe okunikezwe ndawonye. I-Laryngectomy ingenziwa uma umdlavuza uhlala.

• Isivivinyo somtholampilo sokwelapha ngemisebe sisodwa uma kuqhathaniswa nemisebe kanye nokwelashwa okuqondisiwe (i-cetuximab).

• Isivivinyo somtholampilo se-immunotherapy, chemotherapy, radiosensitizers, noma i-radiation therapy.

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.

Ukwelashwa Kwe-Cancer Laryngeal Cancer

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

Ukwelashwa kwesigaba somdlavuza esisanda kutholakala se-IVA, IVB, kanye ne-IVC laryngeal kuncike lapho umdlavuza utholakala khona ku-larynx.

Uma umdlavuza uku-supraglottis noma i-glottis, ukwelashwa kungafaka okulandelayo:

• Ukwelashwa ngamakhemikhali nokwelashwa ngemisebe kunikezwe ndawonye.

• I-Chemotherapy ilandelwa ukwelashwa ngamakhemikhali nokwelashwa ngemisebe okunikezwe ndawonye. I-Laryngectomy ingenziwa uma umdlavuza uhlala.

• Ukwelashwa ngemisebe kuphela kweziguli ezingakwazi ukwelashwa ngamakhemikhali nokuhlinzwa.

• Ukuhlinzwa kulandelwa ukwelashwa ngemisebe. I-Chemotherapy inganikezwa nge-radiation therapy.

• Isivivinyo somtholampilo sokwelapha ngemisebe sisodwa uma kuqhathaniswa nemisebe kanye nokwelashwa okuqondisiwe (i-cetuximab).

• Isivivinyo somtholampilo se-immunotherapy, chemotherapy, radiosensitizers, noma i-radiation therapy.

Uma umdlavuza uku-subglottis, ukwelashwa kungafaka okulandelayo:

• I-Laryngectomy kanye ne-thyroidectomy ephelele nokususwa kwama-lymph node emphinjeni, imvamisa kulandelwa ukwelashwa ngemisebe nge-chemotherapy noma ngaphandle kwayo.

• Ukwelashwa ngamakhemikhali nokwelashwa ngemisebe kunikezwe ndawonye.

• Isivivinyo somtholampilo sokwelapha ngemisebe sisodwa uma kuqhathaniswa nemisebe kanye nokwelashwa okuqondisiwe (i-cetuximab).

• Isivivinyo somtholampilo se-immunotherapy, chemotherapy, radiosensitizers, noma i-radiation therapy.

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.

Ukwelashwa Komdlavuza We-Laryngeal weMetastatic and Recurrent

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

Ukwelashwa komdlavuza we-laryngeal we-metastatic futhi ophindaphindiwe kungafaka okulandelayo:

• Ukuhlinzwa noma ngaphandle kwemithi yokwelashwa ngemisebe.

• Ukwelashwa ngemisebe.

• Ukwelashwa ngamakhemikhali.

• I-Immunotherapy nge-pembrolizumab noma i-nivolumab.

• Isivivinyo somtholampilo sokwelapha okusha.

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.

Ukuze ufunde kabanzi Ngomdlavuza weLaryngeal

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nomdlavuza wamaphimbo, bheka okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza Wekhanda Nentamo

• Izinkinga zomlomo zeChemotherapy kanye neNhloko / Intamo Yemisebe

• Ama-Lasers ekwelashweni komdlavuza

• Izidakamizwa zivunyelwe i-Head and Neck Cancer

• Izindlela Zokwelapha Zomdlavuza

• I-Immunotherapy Yokwelapha Umdlavuza

• Umdlavuza Wekhanda Nentamo

• Ugwayi (uhlanganisa usizo ngokuyeka)

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

• Mayelana Nomdlavuza

• Isiteji

• I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli