Types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq

Inguqulo yeNasopharyngeal Cancer Treatment (Adult)

Imininingwane Jikelele Ngomdlavuza weNasopharyngeal

AMAPHUZU ASEMQOKA

• Umdlavuza weNasopharyngeal yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-nasopharynx.

• Isizinda sobuhlanga nokuvezwa igciwane le-Epstein-Barr kungathinta ingozi yomdlavuza we-nasopharyngeal.

• Izimpawu zomdlavuza we-nasopharyngeal zifaka phakathi inkinga yokuphefumula, ukukhuluma, noma ukuzwa.

• Izivivinyo ezihlola ikhala, umphimbo, nezitho eziseduze zisetshenziselwa ukuthola (ukuthola), ukuxilonga, kanye nokwakha umdlavuza we-nasopharyngeal.

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

Umdlavuza weNasopharyngeal yisifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu ze-nasopharynx.

I-nasopharynx yingxenye ephezulu yepharynx (umphimbo) ngemuva kwekhala. Ipharynx yishubhu elingenalutho elingaba ngamasentimitha ama-5 ubude eliqala ngemuva kwempumu bese liphelela phezulu kothayela (i-windpipe) ne-esophagus (ishubhu elisuka emphinjeni liye esiswini). Umoya nokudla kudlula kwi-pharynx endleleni eya ku-trachea noma i-esophagus. Amakhala aholela ku-nasopharynx. Imbobo ohlangothini ngalunye lwe-nasopharynx iholela endlebeni. Umdlavuza weNasopharyngeal uvame ukuqala kumaseli we-squamous aqonde ku-nasopharynx.

I-anatomy yepharynx (umphimbo). Umphimbo uyishubhu elingenalutho eliqala ngemuva kwekhala, lehle entanyeni, bese liphelela phezulu koqhoqhoqho nomphimbo. Izingxenye ezintathu ze-pharynx yi-nasopharynx, i-oropharynx, ne-hypopharynx.

Umdlavuza weNasopharyngeal wuhlobo lomdlavuza wekhanda nowentamo.

Isizinda sobuhlanga nokuvezwa igciwane le-Epstein-Barr kungathinta ingozi yomdlavuza we-nasopharyngeal.

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. Izici zobungozi zomdlavuza we-nasopharyngeal zifaka okulandelayo:

• Ukuba nozalo lwamaShayina noma lwase-Asia.

• Ukudalulwa yigciwane le-Epstein-Barr: Igciwane le-Epstein-Barr lihlotshaniswa nomdlavuza othile, kufaka phakathi umdlavuza we-nasopharyngeal namanye ama-lymphomas.

• Ukuphuza kakhulu utshwala.

• Izimpawu zomdlavuza we-nasopharyngeal zifaka phakathi inkinga yokuphefumula, ukukhuluma, noma ukuzwa.

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

• Isigaxa emakhaleni noma entanyeni.

• Umphimbo obuhlungu.

• Inkinga yokuphefumula noma ukukhuluma.

• Ukopha ngamakhala.

• Inkinga yokuzwa.

• Ubuhlungu noma ukukhala endlebeni.

• Ukuphathwa ikhanda.

Izivivinyo ezihlola ikhala, umphimbo, nezitho eziseduze zisetshenziselwa ukuthola (ukuthola), ukuxilonga, kanye nokwakha umdlavuza we-nasopharyngeal.

Izinqubo ezenza izithombe zekhala nomphimbo zisiza ukuxilonga umdlavuza we-nasopharyngeal. Inqubo esetshenzisiwe ukuthola ukuthi ngabe amangqamuzana omdlavuza asenabele yini kwezinye izingxenye zomzimba ibizwa nge-staging. Ukuhlolwa nezinqubo zokuthola, ukuxilonga, kanye nesigaba somdlavuza we-nasopharyngeal kwenziwa ngaphambi kokuhlela ukwelashwa.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi ukuhlola izimpawu zesifo, njengokuvuvukala kwama-lymph node entanyeni 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-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Isampula lezicubu liyasuswa phakathi kwalezi zinqubo ezilandelayo:

• I-Nasoscopy: Inqubo yokubheka ngaphakathi kwamakhala ezindaweni ezingavamile. I-nasoscope ifakwa ngamakhala. I-nasoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa amasampula wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

• I-endoscopy ephezulu: Inqubo yokubheka ingaphakathi lekhala, umphimbo, isopha, isisu, ne-duodenum (ingxenye yokuqala yamathumbu amancane, eduze kwesisu). I-endoscope ifakwa ngomlomo nangaphakathi komphimbo, isisu, ne-duodenum. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa amasampula wezicubu. Amasampula wezicubu ahlolwa ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

• 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-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, njengesifuba nesisu esingenhla, 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-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. Ukuskena kwe-PET kungasetshenziselwa ukuthola umdlavuza we-nasopharyngeal osabalalele ethanjeni. Kwesinye isikhathi kwenziwa i-PET scan ne-CT scan ngasikhathi sinye. Uma kukhona umdlavuza, lokhu kwandisa amathuba okuthi utholakale.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amagagasi omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izitho esiswini bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

• I-x-ray yesifuba: I-x-ray yezitho namathambo ngaphakathi kwesifuba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.

• 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.

• Qedela ukubalwa kwegazi (i-CBC): Inqubo lapho kukhishwa khona isampula legazi futhi lihlolwe lokhu okulandelayo:

• Inani lamaseli abomvu egazi, amaseli amhlophe egazi, nama-platelets.

• Inani le-hemoglobin (iprotheni ethwala umoya-mpilo) kumaseli abomvu egazi.

• Ingxenye yesampula yegazi eyenziwe ngamaseli abomvu egazi.

• Ukuhlolwa kwegciwane le-Epstein-Barr (EBV): Ukuhlolwa kwegazi ukuhlola amasosha omzimba egciwane le-Epstein-Barr kanye nezimpawu ze-DNA zegciwane le-Epstein-Barr. Lezi zitholakala egazini leziguli ezitheleleke nge-EBV.

• Ukuhlolwa kwe-HPV (ukuhlolwa kwe-human papillomavirus test): Ukuhlolwa kwaselabhorethri okusetshenziselwa ukuhlola isampula lezicubu zezinhlobo ezithile zokutheleleka nge-HPV. Lokhu kuhlolwa kwenziwa ngoba umdlavuza we-nasopharyngeal ungabangelwa yi-HPV.

• Ukuhlolwa kokuzwa: Inqubo yokubheka ukuthi ngabe imisindo ethambile futhi enomsindo nemisindo ephansi naphezulu izwakala yini. Indlebe ngayinye ihlolwe ngokwehlukana.

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Usayizi wesimila.

• Isigaba somdlavuza, kufaka phakathi ukuthi umdlavuza ususabalalise yini kuma-lymph node eyodwa noma amaningi entanyeni.

• Izinga eliphakeme lama-antibodies e-EBV kanye nezimpawu ze-EBV-DNA egazini ngaphambi nangemva kokwelashwa.

Ezinye izinto ezingathinta ukubikezelwa zibandakanya:

• Ubudala.

• Isikhathi eside phakathi kwe-biopsy nokuqala kokwelashwa ngemisebe.

• Umlando womndeni.

• Ukubhema ugwayi.

• Inhlanzi enosawoti ekudleni.

Izigaba Zomdlavuza weNasopharyngeal

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala komdlavuza we-nasopharyngeal, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile ngaphakathi kwe-nasopharynx 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-nasopharyngeal:

• Isigaba 0

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

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

Ngemuva kokutholakala komdlavuza we-nasopharyngeal, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile ngaphakathi kwe-nasopharynx noma kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza usabalale ngaphakathi kwe-nasopharynx noma kwezinye izingxenye zomzimba ibizwa nge-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa. Imiphumela yokuhlolwa okusetshenziselwa ukuxilonga umdlavuza we-nasopharyngeal ivame ukusetshenziselwa ukufaka lesi sifo. (Bheka isigaba semininingwane ejwayelekile.)

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-nasopharyngeal usakazeka uye emaphashini, amangqamuzana omdlavuza asephashini empeleni angamaseli omdlavuza we-nasopharyngeal. Lesi sifo umdlavuza we-metastatic nasopharyngeal, hhayi umdlavuza wamaphaphu.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza we-nasopharyngeal:

Isigaba 0

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

Isiteji I

Esigabeni I, umdlavuza wakhekile nomdlavuza:

• itholakala ku-nasopharynx kuphela; noma

• isabalale kusukela ku-nasopharynx kuya ku-oropharynx kanye / noma emgodini wamakhala.

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).

Isigaba II

Esigabeni II, okunye kokulandelayo kuyiqiniso:

• Umdlavuza usabalalele ku-lymph node eyodwa noma amaningi ohlangothini olulodwa lwentamo kanye / noma kolunye noma ngaphezulu ama-lymph node kolunye noma ezinhlangothini zombili zangemuva komphimbo. Ama-lymph node athintekile angamasentimitha ayisithupha noma amancane. Umdlavuza uyatholakala:

• ku-nasopharynx kuphela noma kusabalale kusuka ku-nasopharynx kuya ku-oropharynx kanye / noma emgodini wamakhala; noma

• kuma-lymph node kuphela entanyeni. Amaseli womdlavuza kuma-lymph node atheleleke ngegciwane le-Epstein-Barr (igciwane elixhumene nomdlavuza we-nasopharyngeal).

• Umdlavuza usabalalele esikhaleni se-parapharyngeal kanye / noma emisipheni eseduze. Umdlavuza kungenzeka ukuthi usabalalele nakwelilodwa noma ngaphezulu ama-lymph node ohlangothini olulodwa lwentamo kanye / noma kolunye noma ngaphezulu ama-lymph node kolunye noma ezinhlangothini zombili zangemuva komqala. Ama-lymph node athintekile angamasentimitha ayisithupha noma amancane.

Isigaba III

Esigabeni III, okukodwa kokulandelayo kuyiqiniso:

• Umdlavuza usabalalele ku-lymph node eyodwa noma ngaphezulu ezinhlangothini zombili zentamo. Ama-lymph node athintekile angamasentimitha ayisithupha noma amancane. Umdlavuza uyatholakala:

• ku-nasopharynx kuphela noma kusabalale kusuka ku-nasopharynx kuya ku-oropharynx kanye / noma emgodini wamakhala; noma

• kuma-lymph node kuphela entanyeni. Amaseli womdlavuza kuma-lymph node atheleleke ngegciwane le-Epstein-Barr (igciwane elixhumene nomdlavuza we-nasopharyngeal).

• Umdlavuza usabalalele esikhaleni se-parapharyngeal kanye / noma emisipheni eseduze. Umdlavuza ubuye usabalalele ku-lymph node eyodwa noma ngaphezulu ezinhlangothini zombili zentamo. Ama-lymph node athintekile angamasentimitha ayisithupha noma amancane.

• Umdlavuza usabalalele emathanjeni ezansi kogebhezi, amathambo asentanyeni, imisipha yomhlathi, kanye / noma amasono azungeze ikhala namehlo. Umdlavuza kungenzeka ukuthi ubuye usabalalele ku-lymph node eyodwa noma ngaphezulu kolunye noma ezinhlangothini zombili zentamo kanye / noma ngemuva komphimbo. Ama-lymph node athintekile angamasentimitha ayisithupha noma amancane.

Isigaba IV

Isigaba IV sihlukaniswe ngezigaba ze-IVA ne-IVB.

• Esigabeni IVA:

• Umdlavuza usabalalele ebuchosheni, emithanjeni ye-cranial, i-hypopharynx, indlala yamathe ephambi kwendlebe, ithambo elizungeze iso, kanye / noma nezicubu ezithambile zomhlathi. Umdlavuza kungenzeka ukuthi ubuye usabalalele ku-lymph node eyodwa noma ngaphezulu kolunye noma ezinhlangothini zombili zentamo kanye / noma ngemuva komphimbo. Ama-lymph node athintekile angamasentimitha ayisithupha noma amancane; noma

• Umdlavuza usabalalele ku-lymph node eyodwa noma ngaphezulu kolunye noma ezinhlangothini zombili zentamo. Ama-lymph node athintekile makhulu kunamasentimitha ayi-6 kanye / noma atholakala engxenyeni ephansi kakhulu yentamo.

• Esigabeni IVB: Umdlavuza usabalale wadlulela ngaphesheya kwama-lymph node entanyeni kuya kuma-lymph node akude, njengalawo aphakathi kwamaphaphu, ngaphansi kwekhola, noma ekhwapheni noma emgodini, noma kwezinye izingxenye zomzimba, njengephaphu ithambo, noma isibindi.

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 kubangela ushintsho esigabeni somdlavuza nokwelashwa okwengeziwe ngemuva kokuhlinzwa.

Umdlavuza Ophindaphindiwe weNasopharyngeal

Umdlavuza ophindaphindiwe we-nasopharyngeal umdlavuza obuye wabuya (ubuye) ngemuva kokuba welashwe. Umdlavuza ungabuya ku-nasopharynx noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezinomdlavuza we-nasopharyngeal.

• Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Ukuhlinzwa

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa komdlavuza we-nasopharyngeal 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 kweziguli ezinomdlavuza we-nasopharyngeal.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza we-nasopharyngeal. 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 ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukwelashwa ngemisebe

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

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.

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.

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

• 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. Uma kuqhathaniswa nokwelashwa okujwayelekile kwemisebe, ukwelashwa ngemisebe okunamandla angahle abe namathuba amancane okubanga umlomo owomile.

• Ukwelashwa kwemisebe ye-stereotactic: Uhlaka lwekhanda oluqinile lunamathiselwe kugebhezi ukugcina ikhanda limile ngesikhathi sokwelashwa ngemisebe. Umshini uhlose ukukhishwa kwemisebe ngqo esihlahleni. Umthamo ophelele wemisebe uhlukaniswe ngamanani amancane amancane anikezwe ezinsukwini ezimbalwa. Le nqubo ibizwa nangokuthi i-stereotactic external-beam radiation therapy kanye ne-stereotaxic radiation therapy.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuya ngohlobo nesigaba somdlavuza owelashwa. Ukwelashwa kwemisebe yangaphandle neyangaphakathi kusetshenziselwa ukwelapha umdlavuza we-nasopharyngeal.

Ukwelashwa kwemisebe yangaphandle kwi-thyroid noma i-pituitary gland kungashintsha indlela indlala yegilo esebenza ngayo. Ukuhlolwa kwegazi ukuhlola izinga le-hormone yegilo egazini kwenziwa ngaphambi nangemva kokwelashwa ukuqinisekisa ukuthi indlala yegilo isebenza kahle. Kubalulekile futhi ukuthi udokotela wamazinyo ahlole amazinyo, izinsini nomlomo wesiguli, bese elungisa noma yiziphi izinkinga ezikhona ngaphambi kokuba kuqale ukwelashwa ngemisebe.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa.

I-Chemotherapy inganikezwa ngemuva kokwelapha ngemisebe ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwa ngemuva kokwelashwa ngemisebe, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

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

Ukuhlinzwa

Ukuhlinzwa kuyindlela yokuthola ukuthi ngabe umdlavuza ukhona yini, ukukhipha umdlavuza emzimbeni, noma ukulungisa ingxenye yomzimba. Futhi kubizwa ngokuhlinzwa. Ukuhlinzwa kwesinye isikhathi kusetshenziselwa umdlavuza we-nasopharyngeal ongaphenduli ekwelashweni ngemisebe. Uma umdlavuza usabalalele kuma-lymph node, udokotela angasusa ama-lymph node nezinye izicubu entanyeni.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa komdlavuza we-nasopharyngeal 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.

Izinketho Zokwelapha ngeStage

Kulesi Sigaba

• Isigaba I Cancer Nasopharyngeal

• Umdlavuza Wesigaba II Nasopharyngeal

• Umdlavuza weSigaba III Nasopharyngeal

• Umdlavuza weSigaba IV Nasopharyngeal

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

Isigaba I Cancer Nasopharyngeal

Ukwelashwa kwesigaba I somdlavuza we-nasopharyngeal imvamisa ukwelashwa ngemisebe ku-tumor nase-lymph node entanyeni.

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.

Umdlavuza Wesigaba II Nasopharyngeal

Ukwelashwa kwesigaba II somdlavuza we-nasopharyngeal kungafaka okulandelayo:

• I-Chemotherapy enikezwa nge-radiation therapy, ilandelwa ukwelashwa ngamakhemikhali amaningi.

• Ukwelashwa ngemisebe ku-tumor nase-lymph node entanyeni.

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.

Umdlavuza weSigaba III Nasopharyngeal

Ukwelashwa komdlavuza wesigaba se-nasopharyngeal kungafaka okulandelayo:

• I-Chemotherapy enikezwa nge-radiation therapy, engalandelwa ukwelashwa ngamakhemikhali amaningi.

• Ukwelashwa ngemisebe.

• Ukwelashwa ngemisebe kulandelwa ukuhlinzwa ukuze kususwe ama-lymph node aqukethe umdlavuza entanyeni ahlala noma abuye ngemuva kokwelashwa ngemisebe.

• Isivivinyo somtholampilo se-chemotherapy esinikezwe ngaphambi, noma, noma ngemuva kokwelashwa ngemisebe.

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.

Umdlavuza weSigaba IV Nasopharyngeal

Ukwelashwa komdlavuza wesigaba IV nasopharyngeal kungafaka okulandelayo:

• I-Chemotherapy enikezwa nge-radiation therapy, ilandelwa ukwelashwa ngamakhemikhali amaningi.

• Ukwelashwa ngemisebe.

• Ukwelashwa ngemisebe kulandelwa ukuhlinzwa ukuze kususwe ama-lymph node aqukethe umdlavuza entanyeni ahlala noma abuye ngemuva kokwelashwa ngemisebe.

• I-Chemotherapy yomdlavuza osetshenzisiwe (usakazeke) kwezinye izingxenye zomzimba.

• Isivivinyo somtholampilo se-chemotherapy esinikezwe ngaphambi, noma, noma ngemuva kokwelashwa ngemisebe.

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.

Izinketho Zokwelapha Umdlavuza Ophindaphindiwe weNasopharyngeal

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

Ukwelashwa komdlavuza ophindaphindiwe we-nasopharyngeal kungafaka okulandelayo:

• Ukwelashwa kwemisebe ye-intension-modulated, stereotactic radiation therapy, noma ukwelashwa ngemisebe kwangaphakathi.

• Ukuhlinzwa.

• Ukwelashwa ngamakhemikhali.

• Isivivinyo somtholampilo se-chemotherapy.

• Isivivinyo somtholampilo sokwelashwa kwemisebe ye-stereotactic.

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 weNasopharyngeal

Ngeminye imininingwane evela ku-National Cancer Institute mayelana nomdlavuza we-nasopharyngeal, bheka okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza Wekhanda Nentamo

• Izinkinga zomlomo zeChemotherapy kanye neNhloko / Intamo Yemisebe

• Izidakamizwa zivunyelwe i-Head and Neck Cancer

• Umdlavuza Wekhanda Nentamo

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