Izinhlobo / ikhanda-nentamo / isiguli / umuntu omdala / amathe-unyango-indlala-pdq

Uhlobo lwe-Salivary Gland Cancer Treatment (Adult)

Imininingwane ejwayelekile Mayelana neSalivary Gland cancer

AMAPHUZU ASEMQOKA

• Umdlavuza we-salivary gland yisifo esingajwayelekile lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zezindlala zamathe.

• Ukuvezwa ezinhlotsheni ezithile zemisebe kungakhuphula ubungozi besifo somdlavuza wamathe.

• Izimpawu zomdlavuza wendlala yamathe zifaka phakathi isigaxa noma inkinga yokugwinya.

• Ukuhlolwa okuhlola ikhanda, intamo, nengaphakathi lomlomo kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wendlala yamathe.

• Izici ezithile zithinta izinketho zokwelashwa nokubikezela (ithuba lokululama).

Umdlavuza we-salivary gland yisifo esingajwayelekile lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zezindlala zamathe.

Izindlala ezakha amathe zenza amathe bese ziyidedela zingene emlonyeni. I-sali ine-enzyme esiza ukugaya ukudla kanye nama-antibody asiza ukuvikela ezifweni zomlomo nomphimbo. Kunezimbhangqwana ezi-3 zezindlala ezinkulu zamathe:

• Izindlala zeParotid: Lezi yizindlala ezinkulu kakhulu futhi zitholakala ngaphambili nangaphansi nje kwendlebe ngayinye. Izicubu eziningi ezinkulu zamathe eziqala kule ndlala.

• Izindlala ezingezansi: Lezi zindlala zitholakala ngaphansi kolimi phansi komlomo.

• Izindlala ze-Submandibular: Lezi zindlala zitholakala ngaphansi komhlathi.

I-anatomy yezindlala zamathe. Izinhlayiya ezintathu eziyinhloko zezindlala eziswelayo yizindlala ze-parotid, izindlala ezingaphansi, nezindlala ze-submandibular.

Kukhona namakhulu amadlala amancane (amancane) amathe afaka izingxenye zomlomo, impumulo, ne-larynx ezingabonakala nge-microscope kuphela. Izicubu eziningi zezindlala ezincane ziqala enkalweni (ophahleni lomlomo).

Izicubu ezingaphezu kwesigamu sawo wonke amadlala endlala yamathe ziyingozi (hhayi umdlavuza) futhi azisabalali ziye kwezinye izicubu.

Umdlavuza wendlala yesalivary uhlobo lomdlavuza wekhanda nowentamo.

Ukuvezwa ezinhlotsheni ezithile zemisebe kungakhuphula ubungozi besifo somdlavuza wamathe.

Noma yini enyusa amathuba okuthola 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. Yize kungaziwa imbangela yomdlavuza omkhulu wamathe we-salivary, izici zobungozi zifaka okulandelayo:

• Ukuguga.

• Ukwelashwa nge-radiation therapy ekhanda nasentanyeni.

• Ukuvezwa ezintweni ezithile emsebenzini.

Izimpawu zomdlavuza wendlala yamathe zifaka phakathi isigaxa noma inkinga yokugwinya.

Umdlavuza wendlala yesalivary kungenzeka ungabangi zimpawu. Ingatholakala ngesikhathi sokuhlolwa kwamazinyo okuvamile noma ukuhlolwa komzimba. Izimpawu nezimpawu zingabangelwa umdlavuza wendlala yamathe noma ezinye izimo. Buza nodokotela wakho uma unokunye kwalokhu okulandelayo:

• Isigaxa (imvamisa asibuhlungu) endaweni yendlebe, isihlathi, umhlathi, udebe, noma emlonyeni.

• Ukukhipha uketshezi kusuka endlebeni.

• Inkinga yokugwinya noma ukuvula umlomo kabanzi.

• Ukuba ndikindiki noma ubuthakathaka ebusweni.

• Ubuhlungu ebusweni obungapheli.

• Ukuhlolwa okuhlola ikhanda, intamo, nengaphakathi lomlomo kusetshenziselwa ukuthola (ukuthola) nokuthola umdlavuza wendlala yamathe.

Izinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo. Ikhanda, intamo, umlomo, nomphimbo kuzohlolwa izimpawu zesifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• 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 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-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-Endoscopy: Inqubo yokubheka izitho nezicubu ngaphakathi komzimba ukubheka izindawo ezingajwayelekile. Komdlavuza wendlala yamathe, kufakwa i-endoscope emlonyeni ukubheka umlomo, umphimbo, nomphimbo. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka.

• I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza.

• I-Fine needle aspiration (FNA) biopsy: Ukususwa kwezicubu noma uketshezi kusetshenziswa inaliti ezacile. I-FNA uhlobo oluvame kakhulu lwe-biopsy olusetshenziselwa umdlavuza wendlala yamathe.

• I-incisional biopsy: Ukususwa kwengxenye yesigaxa noma isampula lezicubu ezingabukeki zijwayelekile.

• Ukuhlinzwa: Uma umdlavuza ungenakutholakala kusampula yezicubu ezisuswe ngesikhathi se-FNA biopsy noma i-incisional biopsy, ubukhulu bungasuswa futhi buhlolwe izimpawu zomdlavuza.

Ngoba umdlavuza wendlala yamathe ungaba nzima ukuwuthola, iziguli kufanele zibuze ukuthi amasampula ezicubu ahlolwe ngudokotela wezifo onolwazi lokuthola umdlavuza wendlala yamathe.

Izici ezithile zithinta izinketho zokwelashwa nokubikezela (ithuba lokululama).

Izinketho zokwelashwa nokubikezela (ithuba lokululama) kuncike kokulandelayo:

• Isigaba somdlavuza (ikakhulukazi ubukhulu besimila).

• Uhlobo lwendlala yamathe umdlavuza okuyo.

• Uhlobo lwamaseli womdlavuza (abukeka kanjani ngaphansi kwesibonakhulu).

• Iminyaka yesiguli nempilo ejwayelekile.

Izigaba zeSalivary Gland Cancer

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala komdlavuza we-salivary gland, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwendlala yamathe noma kwezinye izingxenye zomzimba.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wendlala yamathe ethinta ama-parotid, submandibular, kanye nezindlala ezingaphansi:

• Isigaba 0 (i-carcinoma in situ)

• Isiteji I

• Isigaba II

• Isigaba III

• Isigaba IV

• Izindlala zamathe ezincane zihlelwe ngokwehlukile kunalezo ezibizwa ngokuthi yi-parotid, submandibular, kanye nezindlala ezincane.

Ngemuva kokutholakala komdlavuza we-salivary gland, kwenziwa ukuhlolwa ukuze kutholakale ukuthi ngabe amangqamuzana omdlavuza asakazekile ngaphakathi kwendlala yamathe noma kwezinye izingxenye zomzimba.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwezindlala zamathe noma kwezinye izingxenye zomzimba ibizwa nge-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa. Izinqubo ezilandelayo zingasetshenziswa kunqubo yokubeka iziteji:

• 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 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.

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 wendlala yamathe usakazeka uye emaphashini, amangqamuzana omdlavuza asephashini empeleni angamaseli omdlavuza wendlala yamathe. Lesi sifo umdlavuza wendlala yamathevishini, hhayi umdlavuza wamaphaphu.

Lezi zigaba ezilandelayo zisetshenziselwa umdlavuza wendlala yamathe ethinta ama-parotid, submandibular, kanye nezindlala ezingaphansi:

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 0 (i-carcinoma in situ)

Esigabeni 0, amangqamuzana angajwayelekile atholakala kulwelwesi lwemigudu yamathe noma amasaka amancane akha indlala yamathe. 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. Isimila sisendlala yamathe kuphela futhi singamasentimitha ama-2 noma sincane.

Isigaba II

Esigabeni II, isimila sisezindebeni zamathe kuphela futhi sikhulu kunamasentimitha ama-2 kepha asisikhulu kunamasentimitha ama-4.

Isigaba III

Esigabeni III, okukodwa kokulandelayo kuyiqiniso:

• Isimila sikhulu kunamasentimitha ama-4 kanye / noma umdlavuza ususabalele ezicutshini ezithambile ezungeze indlala yamathe; noma

• Isimila sinanoma yisiphi isayizi kanti umdlavuza kungenzeka ukuthi usabalalele ezicutshini ezithambile ezungeze indlala yamathe. Umdlavuza usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwekhanda noma kwentamo njengesimila. I-lymph node ingamasentimitha ama-3 noma amancane kanti umdlavuza awukakhuli ngaphandle kwe-lymph node.

Isigaba IV

Isigaba IV sihlukaniswe ngezigaba ze-IVA, IVB, ne-IVC ngokulandelayo:

• Isigaba IVA:

• Umdlavuza usabalalele esikhunjeni, emhlathini, emgodini wendlebe, kanye / noma emithanjeni yobuso. Umdlavuza kungenzeka usabalalele ku-lymph node eyodwa ohlangothini olufanayo lwekhanda noma kwentamo njengesimila. I-lymph node ingamasentimitha ama-3 noma amancane kanti umdlavuza awukakhuli ngaphandle kwe-lymph node; noma

• Isimila sinanoma yisiphi isayizi futhi umdlavuza kungenzeka ukuthi usabalalele ezicutshini ezithambile ezungeze indlala yamathe noma esikhumbeni, emhlathini, emgodini wendlebe, kanye / noma emithanjeni yobuso. Umdlavuza usabalale:

• ku-lymph node eyodwa ohlangothini olufanayo lwekhanda noma kwentamo njengesimila; i-lymph node ingamasentimitha ama-3 noma amancane kanti umdlavuza ukhule ngaphandle kwe-lymph node; noma

• ku-lymph node eyodwa ohlangothini olufanayo lwekhanda noma kwentamo njengesimila; i-lymph node inkulu kunamasentimitha ama-3 kepha ayinkulu kunamasentimitha ayi-6 kanti umdlavuza awukakhuli ngaphandle kwe-lymph node; noma

• kuma-lymph node angaphezu kweyodwa ohlangothini olufanayo lwekhanda noma entanyeni njengesimila; ama-lymph node angamasentimitha ayi-6 noma amancane kanti umdlavuza awukakhuli ngaphandle kwama-lymph node; noma

• kuma-lymph node ezinhlangothini zombili zekhanda noma entanyeni noma ohlangothini olubhekene nesimila sokuqala; ama-lymph node angamasentimitha ayi-6 noma amancane kanti umdlavuza awukakhuli ngaphandle kwama-lymph node.

• Isigaba IVB:

• Isimila sinanoma yisiphi isayizi futhi umdlavuza kungenzeka ukuthi usabalalele ezicutshini ezithambile ezungeze indlala yamathe noma esikhumbeni, emhlathini, emgodini wendlebe, kanye / noma emithanjeni yobuso. Umdlavuza usabalale:

• ku-lymph node eyodwa enkulu kunamasentimitha ayisithupha nomdlavuza awukakhuli ngaphandle kwe-lymph node; noma

• ku-lymph node eyodwa ohlangothini olufanayo lwekhanda noma kwentamo njengesimila; i-lymph node inkulu kunamasentimitha ama-3 kanti umdlavuza ukhule ngaphandle kwe-lymph node; noma

• kuma-lymph node angaphezu kweyodwa ohlangothini olufanayo lwekhanda noma kwentamo njengesimila, ohlangothini olubhekene nesimila sokuqala, noma ezinhlangothini zombili zekhanda noma kwentamo; umdlavuza usukhule ngaphandle kwanoma yimaphi ama-lymph node; noma

• ku-lymph node eyodwa yanoma iluphi usayizi ohlangothini lwekhanda noma kwentamo ebhekene nesimila sokuqala; umdlavuza ukhule ngaphandle kwe-lymph node;

noma

• Umdlavuza usabalalele phansi kogebhezi kanye / noma kuzungeza umthambo we-carotid. Umdlavuza kungenzeka usabalalele ku-lymph node eyodwa noma ngaphezulu yanoma iluphi usayizi ezinhlangothini zombili zekhanda noma entanyeni futhi kungenzeka ukuthi ikhule ngaphandle kwama-lymph node.

• Isiteji IVC:

• Umdlavuza ususabalele nakwezinye izingxenye zomzimba, njengamaphaphu.

Izindlala zamathe ezincane zihlelwe ngokwehlukile kunalezo ezibizwa ngokuthi yi-parotid, submandibular, kanye nezindlala ezincane.

Izindlala ezincane zamathe (izindlala ezincane zamathe ezingxenyeni zomlomo, zempumulo, nezomlomo) zomdlavuza zihlelwa ngokusho kwalapho zaqala khona ukwakheka, njenge-cavity yomlomo noma i-sinus.

Umdlavuza We-Salivary Gland Ophindaphindayo

Umdlavuza we-salivary gland ophindaphindiwe ngumdlavuza ophindile (wabuya) ngemuva kokuba welashwe. Umdlavuza we-salivary gland ophindaphindiwe ungabuya kwizindlala zamathe noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza wendlala yamathe.

• Iziguli ezinomdlavuza wendlala yamathe kufanele uhlelo lwazo luhlelwe yiqembu lodokotela abangochwepheshe ekwelapheni umdlavuza wekhanda nowentamo.

• Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ama-Radiosensitizers

• Ukwelashwa komdlavuza wendlala yamathe 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 wendlala yamathe.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezigulini ezinomdlavuza wendlala yamathe. 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.

Iziguli ezinomdlavuza wendlala yamathe kufanele uhlelo lwazo luhlelwe yiqembu lodokotela abangochwepheshe ekwelapheni umdlavuza wekhanda nowentamo.

Ukwelashwa kwakho kuzobhekwa ngudokotela oncologist, udokotela ogxile ekwelapheni abantu abanomdlavuza. Ngoba izindlala ezisizayo ziyasiza ekudleni nasekugayeni ukudla, iziguli zingadinga usizo olukhethekile lokuzivumelanisa nemiphumela emibi yomdlavuza nokwelashwa kwawo. Udokotela oncologist angakudlulisela kwabanye odokotela abanolwazi nobuchwepheshe ekwelapheni iziguli ezinomdlavuza wekhanda nentamo nabasebenza ezindaweni ezithile zemithi. Lokhu kufaka phakathi okulandelayo:

• Udokotela ohlinzayo wekhanda nentamo.

• I-radiation oncologist.

• Udokotela wamazinyo.

• Umelaphi wenkulumo.

• I-Dietitian.

• Isazi sokusebenza kwengqondo.

• Uchwepheshe wokuvuselelwa.

• Udokotela ohlinzayo wePlastiki.

Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa (ukususa umdlavuza lapho usebenza) kuyindlela ejwayelekile yokwelapha umdlavuza wendlala yamathe. Udokotela angawususa umdlavuza kanye nezinye izicubu ezinempilo ezungeze umdlavuza. Kwezinye izimo, kuzokwenziwa ne-lymphadenectomy (ukuhlinzwa lapho kukhishwa khona ama-lymph node).

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, ezinye iziguli zinganikezwa ukwelashwa ngemisebe ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa okunikezwe 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. 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.

Izinhlobo ezikhethekile zemisebe yangaphandle zingasetshenziswa ukwelapha ezinye izicubu zezindlala zamathe. Lokhu kufaka phakathi:

• Ukwelashwa kwemisebe ye-neutron esheshayo: Ukwelashwa kwemisebe ye-neutron esheshayo kuwuhlobo lokwelashwa kwemisebe yamandla aphezulu. Umshini wokwelapha ngemisebe uhlose ama-neutron (izinhlayiya ezincane, ezingabonakali) kumaseli womdlavuza ukuwabulala. Ukwelashwa kwemisebe ye-neutron esheshayo isebenzisa imisebe yamandla aphezulu kunohlobo lwe-x-ray lokwelashwa ngemisebe. Lokhu kuvumela ukuthi ukwelashwa ngemisebe kunikezwe ukwelashwa okumbalwa.

• Ukwelashwa kwemisebe ye-Photon-beam: Ukwelashwa kwemisebe ye-Photon-beam luhlobo lwezokwelapha ngemisebe yangaphandle efinyelela kwizicubu ezijulile ngamandla amakhulu e-x-ray enziwe ngomshini obizwa nge-accelerator eqondile. Lokhu kungalethwa njengokwelashwa kwemisebe ye-hyperfractionated, lapho umthamo ophelele wemisebe uhlukaniswe waba yimithamo emincane kanti ukwelashwa kunikezwa ngaphezu kwesisodwa ngosuku.

• 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 kusetshenziselwa ukwelapha umdlavuza wendlala yamathe, futhi kungasetshenziswa futhi njengokwelapha okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

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.

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

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.

Ama-Radiosensitizers

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

Ukwelashwa komdlavuza wendlala yamathe 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 Salivary Gland

• Umdlavuza Wesigaba Salivary Gland

• Isigaba III Salivary Gland Cancer

• Izigaba I-IVA, IVB, kanye ne-IVC Salivary Gland Cancer

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

Isigaba I Cancer Salivary Gland

Ukwelashwa komdlavuza wendlala yamathe yesiteji kuncike ekutheni umdlavuza uphansi (ukhula kancane) noma usezingeni eliphakeme (ukhula ngokushesha).

Uma umdlavuza uphansi, ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa noma ngaphandle kwemithi yokwelashwa ngemisebe.

• Ukwelashwa kwemisebe ye-neutron esheshayo.

Uma umdlavuza usezingeni eliphakeme, ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa noma ngaphandle kwemithi yokwelashwa ngemisebe.

• Isivivinyo somtholampilo se-chemotherapy.

• Isivivinyo somtholampilo sokwelapha okusha kwendawo.

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 Salivary Gland

Ukwelashwa komdlavuza wezindlala zesigaba II kuncike ekutheni umdlavuza uphansi (ukhula kancane) noma usezingeni eliphakeme (ukhula ngokushesha).

Uma umdlavuza uphansi, ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa noma ngaphandle kwemithi yokwelashwa ngemisebe.

• Ukwelashwa ngemisebe.

• Ukwelashwa ngamakhemikhali.

Uma umdlavuza usezingeni eliphakeme, ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa noma ngaphandle kwemithi yokwelashwa ngemisebe.

• Ukwelashwa kwemisebe ye-neutron esheshayo noma ye-photon-beam.

• Isivivinyo somtholampilo sokwelapha ngemisebe kanye / noma ama-radiosensitizers.

• Isivivinyo somtholampilo se-chemotherapy.

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.

Isigaba III Salivary Gland Cancer

Ukwelashwa komdlavuza wezindlala zesiteji sesithathu III kuncike ekutheni umdlavuza uphansi (ukhula kancane) noma usezingeni eliphakeme (ukhula ngokushesha).

Uma umdlavuza uphansi, ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa nge-lymphadenectomy noma ngaphandle kwayo. Ukwelashwa ngemisebe nakho kunganikezwa ngemuva kokuhlinzwa.

• Ukwelashwa ngemisebe.

• Ukwelashwa kwemisebe ye-neutron esheshayo kuma-lymph node anomdlavuza.

• Ukwelashwa ngamakhemikhali.

• Isivivinyo somtholampilo sokwelashwa ngemisebe ye-neutron esheshayo ku-tumor.

• Isivivinyo somtholampilo se-chemotherapy.

Uma umdlavuza usezingeni eliphakeme, ukwelashwa kungafaka okulandelayo:

• Ukuhlinzwa nge-lymphadenectomy noma ngaphandle kwayo. Ukwelashwa ngemisebe nakho kunganikezwa ngemuva kokuhlinzwa.

• Ukwelashwa kwemisebe ye-neutron esheshayo.

• Ukwelashwa ngemisebe njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

• Isivivinyo somtholampilo sokwelapha ngemisebe kanye / noma ama-radiosensitizers.

• Isivivinyo somtholampilo se-chemotherapy.

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.

Izigaba I-IVA, IVB, kanye ne-IVC Salivary Gland Cancer

Ukwelashwa kwesigaba se-IVA, isigaba IVB, kanye nomdlavuza wesigcawu se-salivary gland kungafaka okulandelayo:

• Ukwelashwa kwemisebe ye-neutron esheshayo noma ye-photon-beam.

• Isivivinyo somtholampilo se-chemotherapy noma ngaphandle kwemithi yokwelashwa 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 zokwelashwa zomdlavuza we-Salivary Gland oqhubekayo

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

Ukwelashwa komdlavuza wezindlala ophindaphindiwe kungafaka okulandelayo:

• Ukwelashwa ngemisebe.

• 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 mayelana nomdlavuza we-Salivary Gland

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana nomdlavuza wamathe wendlala, bona okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza Wekhanda Nentamo

• Izidakamizwa zivunyelwe i-Head and Neck Cancer

• Izinkinga zomlomo zeChemotherapy kanye neNhloko / Intamo Yemisebe

• 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