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Ukwelashwa kweWilms Tumor kanye nokunye Ukwelashwa Kwezinso Kwezinso (®) –Patient Version

Imininingwane ejwayelekile Mayelana neWilms Tumor kanye Nezinye Izicubu Zezinso Zengane

AMAPHUZU ASEMQOKA

  • Izicubu zezinso zezingane yizifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zezinso.
  • Kunezinhlobo eziningi zezimila zezinso zezingane.
  • UWilms Tumor
  • Umdlavuza We-Renal Cell (RCC)
  • I-Rhabdoid Tumor Yezinso
  • Sula i-Cell Sarcoma Yezinso
  • I-Mesoblastic Nephroma ezalwa nayo
  • I-Ewing Sarcoma Yezinso
  • I-Primary Renal Myoepithelial Carcinoma
  • ICystic Ihlukanise kancane iNephroblastoma
  • I-Multilocular Cystic Nephroma
  • I-Primary Renal Synovial Sarcoma
  • I-Anaplastic Sarcoma Yezinso
  • I-Nephroblastomatosis ayiwona umdlavuza kepha ingaba isimila seWilms.
  • Ukuba nama-syndromes athile wezakhi zofuzo noma ezinye izimo kungakhuphula ubungozi besimila seWilms.
  • Izivivinyo zisetshenziselwa ukuhlola isimila seWilms.
  • Ukuba nezimo ezithile kungakhuphula ubungozi besifo somdlavuza wamaseli.
  • Ukwelashwa kwesimila sikaWilms nezinye izicubu zezinso zezingane kungafaka ukwelulekwa ngezakhi zofuzo.
  • Izimpawu zesimila sikaWilms nezinye izicubu zezinso zezingane zifaka isigaxa esiswini negazi emchameni.
  • Ukuhlolwa okuhlola izinso negazi kusetshenziselwa ukuxilonga isimila sikaWilms nezinye izicubu zezinso zezingane.
  • Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Izicubu zezinso zezingane yizifo lapho amangqamuzana abulalayo (umdlavuza) akha izicubu zezinso.

Kunezinso ezimbili, eyodwa ohlangothini ngalunye lomgogodla, ngenhla kwesinqe. Amashubhu amancane ezinso ahlunga futhi ahlanze igazi. Bakhipha imfucuza benze umchamo. Umchamo udlula usuka ezinso ngalunye ngebhubhu ende ebizwa nge-ureter iye esinyeni. Isinye sigcina umchamo uze udlule kumchamo bese ushiya umzimba.

I-anatomy yesistimu yomchamo yabesifazane ekhombisa izinso, izindlala ze-adrenal, ureters, isinye, ne-urethra. Umchamo wenziwa kuma-tubules wezinso futhi uqoqwa ku-pelvis ye-renal yenso ngalinye. Umchamo ugeleza kusuka ezinso udabule ureters uye esinyeni. Umchamo ugcinwa esinyeni uze ushiye umzimba ngomchamo.

Kunezinhlobo eziningi zezimila zezinso zezingane.

UWilms Tumor

Esimeni seWilms, isimila esisodwa noma eziningi zingatholakala kuzinso eyodwa noma zombili. Isimila seWilms singasakazeka emaphashini, esibindini, emathanjeni, ebuchosheni noma kuma-lymph node aseduze. Ezinganeni nasebusheni abangaphansi kweminyaka eyi-15 ubudala, umdlavuza omningi wezinso yizicubu zikaWilms.

Umdlavuza We-Renal Cell (RCC)

Umdlavuza wesifo sezinso awuvamile ezinganeni nasebusheni abangaphansi kweminyaka eyi-15. Kuvame kakhulu kubantu abasha abaphakathi kweminyaka eyi-15 nengu-19 ubudala. Izingane kanye nentsha kunamathuba amaningi okuthi kutholakale ukuthi kunesigaxa esikhulu sezinso noma umdlavuza osusakazekile. Umdlavuza wamangqamuzana omzimba ungasakazeka emaphashini, esibindini noma kuma-lymph node. Umdlavuza we-renal cell ungabizwa nangokuthi i-renal cell carcinoma.

I-Rhabdoid Tumor Yezinso

Isigaxa seRhabdoid sezinso luhlobo lomdlavuza wezinso owenzeka kakhulu ezinganeni nasezinganeni ezisencane. Kuvame ukuthuthuka ngesikhathi sokuxilongwa. Isigaxa seRhabdoid sezinso sikhula futhi sisakazeke ngokushesha, imvamisa siye emaphashini noma ebuchosheni.

Izingane ezinoshintsho oluthile kuhlobo lwe-SMARCB1 zihlolwa njalo ukubona ukuthi isimila se-rhabdoid sesakhekile yini ezinso noma sesisabalele ebuchosheni:

  • Izingane ezingaphansi konyaka owodwa zine-ultrasound yesisu njalo ezinyangeni ezimbili kuya kwezintathu kanye ne-ultrasound yekhanda njalo ngenyanga.
  • Izingane ezinonyaka owodwa kuya kwemine ubudala zine-ultrasound yesisu kanye neMRI yobuchopho nomgogodla njalo ezinyangeni ezintathu.

Sula i-Cell Sarcoma Yezinso

Sula i-cell sarcoma yezinso uhlobo lwesimila sezinso esingasakazeka emaphashini, emathanjeni, ebuchosheni noma ezicutshini ezithambile. Ingaphinde ibuye (ibuye) kuze kube yiminyaka eyi-14 ngemuva kokwelashwa, futhi ivame ukubuyela ebuchosheni noma emaphashini.

I-Mesoblastic Nephroma ezalwa nayo

I-congenital mesoblastic nephroma iyisimila sezinso esivame ukutholakala ngonyaka wokuqala wokuphila. Ngokuvamile iyelapheka.

I-Ewing Sarcoma Yezinso

I-Ewing sarcoma (ebibizwa nge-neuroepithelial tumor) yezinso ayivamile futhi ivame ukwenzeka kubantu abadala abasebasha. Lezi zicubu zikhula futhi zisakazeke nakwezinye izingxenye zomzimba ngokushesha.

I-Primary Renal Myoepithelial Carcinoma

I-primary renal myoepithelial carcinoma wuhlobo lomdlavuza olungavamile oluvame ukuthinta izicubu ezithambile, kepha kwesinye isikhathi lakha ezithweni zangaphakathi (njengezinso). Lolu hlobo lomdlavuza luyakhula futhi lusakazeke ngokushesha.

ICystic Ihlukanise kancane iNephroblastoma

I-cyphic nephroblastoma ehlukaniswe kancane uhlobo olungajwayelekile kakhulu lwesimila seWilms esakhiwe ngama-cysts.

I-Multilocular Cystic Nephroma

Ama-multilocular cystic nephromas yizicubu ezinobungozi ezakhiwe ngama-cysts futhi zivame kakhulu ezinganeni, ezinganeni ezincane nakwabesifazane abadala. Lezi zicubu zingenzeka kuzinso eyodwa noma zombili.

Izingane ezinalolu hlobo lwesimila nazo zingaba ne-pleuropulmonary blastoma, ngakho-ke ukuhlolwa kwe-imaging okuhlola amaphaphu ama-cysts noma izicubu eziqinile kuyenziwa. Njengoba i-multilocular cystic nephroma ingaba yisimo esizuzwe njengefa, ukwelulekwa ngezakhi zofuzo nokuhlolwa kofuzo kungabhekwa. Bona isifinyezo se- mayelana ne-Childhood Pleuropulmonary Blastoma Treatment ukuthola eminye imininingwane.

I-Primary Renal Synovial Sarcoma

I-primary renal synovial sarcoma iyisigaxa esifana ne-cyst sezinso futhi ivame kakhulu kubantu abadala abasebasha. Lezi zicubu zikhula futhi zisakazeke ngokushesha.

I-Anaplastic Sarcoma Yezinso

I-Anaplastic sarcoma yezinso iyisimila esingavamile esivame kakhulu ezinganeni noma kwentsha engaphansi kweminyaka engu-15 ubudala. I-Anaplastic sarcoma yezinso ivame ukusabalala emaphashini, isibindi noma amathambo. Ukucabanga izivivinyo ezihlola amaphaphu ukuthola ama-cysts noma izicubu eziqinile kungenziwa. Njengoba i-anaplastic sarcoma kungaba yisimo esizuzwe njengefa, ukwelulekwa ngezakhi zofuzo nokuhlolwa kofuzo kungabhekwa.

I-Nephroblastomatosis ayiwona umdlavuza kepha ingaba isimila seWilms.

Kwesinye isikhathi, ngemuva kokuthi izinso zakheke embungwini, amaqembu angajwayelekile amaseli wezinso ahlala koyedwa noma zombili izinso. Ku-nephroblastomatosis (diffuse hyperplastic perilobar nephroblastomatosis), la maqembu angajwayelekile amaseli angakhula ezindaweni eziningi ngaphakathi kwezinso noma enze ungqimba olujiyile oluzungeze izinso. Lapho la maqembu amangqamuzana angajwayelekile etholakala ezinso ngemuva kokuba esuswe isimila kuWilms, ingane iba sengcupheni eyengeziwe yesimila sikaWilms kwesinye izinso. Ukuhlolwa okulandelwa njalo kubalulekile okungenani njalo ezinyangeni ezi-3, okungenani iminyaka engu-7 ingane selashwe.

Ukuba nama-syndromes athile wezakhi zofuzo noma ezinye izimo kungakhuphula ubungozi besimila seWilms.

Noma yini enyusa ingozi yokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wengane yakho uma ucabanga ukuthi ingane yakho ingaba sengcupheni.

Isimila seWilms singaba yingxenye yesifo sofuzo esithinta ukukhula noma ukukhula. I-genetic syndrome iqoqo lezimpawu nezimpawu noma izimo ezenzeka ndawonye futhi zidalwa yizinguquko ezithile ezakhiweni zofuzo. Izimo ezithile zingakhuphula nengozi yengane yokuthola isimila seWilms. Lawa namanye ama-syndromes nezimo zofuzo axhunyaniswe nesimila seWilms:

  • I-WAGR syndrome (isimila seWilms, i-aniridia, uhlelo olungajwayelekile lwe-genitourinary, kanye nokubambezeleka kwengqondo).
  • I-Denys-Drash syndrome (uhlelo olungavamile lwe-genitourinary).
  • I-Frasier syndrome (uhlelo olungavamile lwe-genitourinary).
  • I-Beckwith-Wiedemann syndrome (ukukhula okungavamile ngokungafani kolunye uhlangothi lomzimba noma ingxenye yomzimba, ulimi olukhulu, i-hernia ye-umbilical ngesikhathi sokuzalwa, kanye nohlelo olungavamile lwe-genitourinary)
  • Umlando womndeni wesimila seWilms.
  • I-Aniridia (iris, ingxenye enemibala yeso, ayikho).
  • I-hemihyperplasia ehlukanisiwe (ukukhula okungakajwayelekile kolunye uhlangothi lomzimba noma ingxenye yomzimba).
  • Izinkinga zomgudu we-Urinary njenge-cryptorchidism noma i-hypospadias.

Izivivinyo zisetshenziselwa ukuhlola isimila seWilms.

Ukuhlolwa kokuhlola kwenziwa ezinganeni ezinengozi eyengeziwe yesimila seWilms. Lezi zivivinyo zingasiza ekutholeni umdlavuza kusenesikhathi futhi zinciphise nethuba lokubulawa umdlavuza.

Ngokuvamile, izingane ezinengozi eyengeziwe yesimila seWilms kufanele zihlolwe isimila sikaWilms njalo ezinyangeni ezintathu zize zibe neminyaka okungenani engu-8 ubudala. Ukuhlolwa kwesisu kwe-ultrasound kuvame ukusetshenziselwa ukuhlolwa. Kungatholakala izicubu ezincane ze-Wilms futhi zisuswe ngaphambi kokuba kuvele izimpawu.

Izingane ezine-Beckwith-Wiedemann syndrome noma i-hemihyperplasia nazo zihlolwe izicubu zesibindi ne-adrenal ezixhunyaniswe nala ma-syndromes ezakhi zofuzo. Ukuhlolwa kokubheka izinga le-alpha-fetoprotein (AFP) egazini kanye ne-ultrasound yesisu kwenziwa kuze kube yilapho ingane ineminyaka engu-4 ubudala. I-ultrasound yezinso yenziwa phakathi kweminyaka engu-4 nengu-7 ubudala. Ukuhlolwa ngokomzimba ngochwepheshe (i-geneticist noma i-oncologist yezingane) kwenziwa kabili ngonyaka. Ezinganeni ezinezinguquko ezithile zofuzo, kungasetshenziswa uhlelo oluhlukile lwe-ultrasound yesisu.

Izingane ezine-aniridia nokushintsha okuthile kwezakhi zofuzo zihlolwe isimila seWilms njalo ezinyangeni ezintathu zize zibe neminyaka engu-8 ubudala. Ukuhlolwa kwesisu kwe-ultrasound kusetshenziselwa ukuhlolwa.

Ezinye izingane ziba nesimila kuWilms kuzo zombili izinso. Lokhu kuvame ukuvela lapho kutholakala kuqala isimila seWilms, kepha isimila seWilms singenzeka futhi ensozweni yesibili ngemuva kokuthi ingane yelashwe ngempumelelo isimila seWilms enso linye. Izingane ezinengozi eyengeziwe yesimila sesibili seWilms kwezinye izinso kufanele zihlolwe isimila sikaWilms njalo ezinyangeni ezintathu kuze kube yiminyaka eyisishiyagalombili. Ukuhlolwa kwesisu kwe-ultrasound kungasetshenziselwa ukuhlolwa.

Ukuba nezimo ezithile kungakhuphula ubungozi besifo somdlavuza wamaseli.

Umdlavuza wesifo sezinso ungahle uhlobane nalezi zimo ezilandelayo:

  • Isifo i-Von Hippel-Lindau (isimo esizuzwe njengefa esidala ukukhula okungajwayelekile kwemithambo yegazi). Izingane ezinesifo i-Von Hippel-Lindau kufanele zihlolwe minyaka yonke ngomdlavuza weseli we-renal nge-ultrasound yesisu noma nge-MRI (imaging resonance imaging) eqala eminyakeni eyi-8 kuye kwengu-11.
  • I-Tuberous sclerosis (isifo esizuzwe njengefa esikhonjiswe ngama-cyst angenamafutha ezinso).
  • Umdlavuza wesifo so-renal womndeni (isimo esizuzwe njengefa esenzeka lapho izinguquko ezithile ezakhiweni zofuzo ezidala umdlavuza wezinso zidluliselwa zisuka kumzali ziye enganeni).
  • Umdlavuza we-renal medullary (umdlavuza ongajwayelekile wezinso okhula futhi usabalale ngokushesha).
  • IHereditary leiomyomatosis (isifo esizuzwe njengefa esandisa ingozi yokuba nomdlavuza wezinso, isikhumba nesibeletho).

Ngaphambi kokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe yomdlavuza wezingane, njenge-neuroblastoma, izicubu ezithambile ze-sarcoma, i-leukemia, noma isimila seWilms nakho kungakhuphula ingozi yomdlavuza wamaseli wezinso. Bona isigaba somdlavuza wesibili kwisifinyezo se- mayelana nemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane.

Ukwelashwa kwesimila sikaWilms nezinye izicubu zezinso zezingane kungafaka ukwelulekwa ngezakhi zofuzo.

Ukwelulekwa ngofuzo (ingxoxo nochwepheshe oqeqeshiwe mayelana nezifo zofuzo nokuthi kudingeka ukuhlolwa kwezakhi zofuzo) kungadingeka uma ingane inesinye sezifo noma imibandela elandelayo:

  • Isifo sofuzo noma isimo esandisa ubungozi besimila seWilms.
  • Isimo esizuzwe njengefa esandisa ingozi yomdlavuza wamangqamuzana esinso.
  • Isigaxa seRhabdoid sezinso.
  • I-nephroma yama-cystic eminingi.

Izimpawu zesimila sikaWilms nezinye izicubu zezinso zezingane zifaka isigaxa esiswini negazi emchameni.

Kwesinye isikhathi izicubu zezinso zezingane azibangeli zimpawu futhi umzali uthola isisu esiswini ngengozi noma isisindo sitholakala ngesikhathi sokuhlolwa kwezempilo yengane enhle. Lezi kanye nezinye izimpawu nezimpawu zingabangelwa izicubu zezinso noma ezinye izimo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

  • Isigaxa, ukuvuvukala, noma ubuhlungu esiswini.
  • Igazi emchameni.
  • Umfutho wegazi ophezulu (ikhanda elibuhlungu, ukuzwa ukhathele kakhulu, ubuhlungu besifuba, noma ukungaboni kahle noma ukuphefumula).
  • I-Hypercalcemia (ukulahlekelwa isifiso sokudla, isicanucanu nokuhlanza, ukuba buthakathaka, noma ukuzizwa ukhathele kakhulu).
  • Umkhuhlane ngaphandle kwesizathu esaziwayo.
  • Ukuphelelwa isifiso sokudla.
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Isimila seWilms esisabalalele emaphashini noma esibindini singadala lezi zimpawu nezimpawu ezilandelayo:

  • Khwehlela.
  • Igazi esikhwehlelweni.
  • Ukuphefumula kanzima.
  • Ubuhlungu esiswini.

Ukuhlolwa okuhlola izinso negazi kusetshenziselwa ukuxilonga isimila sikaWilms nezinye izicubu zezinso zezingane.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

  • Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.
  • 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.
  • 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. Lokhu kuhlolwa kwenziwa ukubheka ukuthi isibindi nezinso zisebenza kahle kangakanani.
  • Ukuhlolwa komsebenzi we-renal: Inqubo lapho kuhlolwe khona amasampula egazi noma umchamo ukukala inani lezinto ezithile ezikhishwe egazini noma emchameni ngezinso. Inani eliphakeme noma elingaphansi kwenani elijwayelekile lezinto kungaba uphawu lokuthi izinso azisebenzi njengoba kufanele.
  • I-Urinalysis: Isivivinyo sokubheka umbala womchamo nokuqukethwe kuwo, njengoshukela, amaprotheni, igazi, namagciwane.
  • Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. I-ultrasound yesisu yenziwa ukuxilonga isimila sezinso.
I-ultrasound yesisu. I-ultrasound transducer exhunywe kwikhompyutha icindezelwa esikhunjeni sesisu. I-transducer igxilisa amaza omsindo ezithweni zangaphakathi nezicubu zayo ukuze yenze ama-echoes akha isithombe (sekhompyutha).
  • I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, ezifana nesifuba, isisu, nesikhumba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ifakwa 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 se-computed tomography (CT) sesisu. Ingane ilele etafuleni elishibilika ngesithwebuli se-CT, esithatha izithombe ze-x-ray zangaphakathi kwesisu.
  • I-MRI (imaging resonance imaging) ene-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengesisu. Into ebizwa ngokuthi i-gadolinium ijojowe emthanjeni. I-gadolinium iqoqa izungeze amangqamuzana omdlavuza ukuze akhanye ngokugqamile esithombeni. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).
I-Magnetic resonance imaging (MRI) yesisu. Ingane ilele etafuleni elingena kuskena seMRI, esithwebula izithombe zangaphakathi komzimba. Iphedi esiswini sengane isiza ukwenza izithombe zicace bha.
  • I-X-ray: I-x-ray uhlobo lomsebe wamandla ongangena emzimbeni ungene kwifilimu, wenze isithombe sezindawo ezingaphakathi komzimba, njengesifuba nesisu.
  • 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 emshinini ofanayo. Izithombe ezivela kuzo zombili izikena zihlanganisiwe ukwenza isithombe esinemininingwane eminingi kunalokho ukuhlolwa obekungakwenza ngokwakho. Ukuskena i-PET kuyinqubo yokuthola amangqamuzana amabi esigaxa 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-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Isinqumo sokuthi kwenziwe i-biopsy sisekelwe kokulandelayo:
  • Usayizi wesimila.
  • Isigaba somdlavuza.
  • Ukuthi umdlavuza ukuso yini noma zombili izinso.
  • Ukuthi ukuhlolwa kwe-imaging kukhombisa ngokusobala umdlavuza.
  • Ukuthi isimila singasuswa yini ngokuhlinzwa.
  • Ukuthi isiguli sisesivivinyweni somtholampilo yini.

I-biopsy ingenziwa ngaphambi kokuba kunikezwe noma iyiphi indlela yokwelashwa, ngemuva kwe-chemotherapy yokunciphisa isimila, noma ngemuva kokuhlinzwa ukuze kususwe isimila.

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

Izinketho zokubikezela nokwelashwa kwesimila seWilms zincike kokulandelayo:

  • Ahluke kanjani amangqamuzana ezimila kumaseli wezinso ajwayelekile lapho ebhekwa ngaphansi kwesibonakhulu.
  • Isigaba somdlavuza.
  • Uhlobo lwesimila.
  • Iminyaka yengane.
  • Ukuthi isimila singasuswa ngokuphelele ngokuhlinzwa.
  • Ukuthi kunezinguquko ezithile kuma-chromosomes noma izakhi zofuzo.
  • Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Isibikezelo somdlavuza wesifo so-renal sincike kulokhu okulandelayo:

  • Isigaba somdlavuza.
  • Ukuthi umdlavuza ususabalele kuma-lymph node.

Isibikezelo sesisu se-rhabdoid sezinso sincike kulokhu okulandelayo:

  • Iminyaka yengane ngesikhathi sokuxilongwa.
  • Isigaba somdlavuza.
  • Ukuthi umdlavuza ususabalele ebuchosheni noma emgogodleni.

Isibikezelo se-cell sarcoma esicacile sezinso sincike kulokhu okulandelayo:

  • Iminyaka yengane ngesikhathi sokuxilongwa.
  • Isigaba somdlavuza.

Izigaba zeWilms Tumor

AMAPHUZU ASEMQOKA

  • Izicubu ze-Wilms zihlelwa ngesikhathi sokuhlinzwa kanye nokuhlolwa kwe-imaging.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.
  • Ngaphezu kwezigaba, izicubu zeWilms zichazwa yi-histology yazo.
  • Lezi zigaba ezilandelayo zisetshenziselwa zombili i-histology evumayo kanye ne-anaplastic Wilms tumors:
  • Isiteji I
  • Isigaba II
  • Isigaba III
  • Isigaba IV
  • Isigaba V
  • Ukwelashwa kwezinye izicubu zezinso zezingane kuncike ohlotsheni lwesimila.
  • Kwesinye isikhathi isimila sikaWilms nezinye izicubu zezinso zobuntwana ziyabuya emuva kokwelashwa.

Izicubu ze-Wilms zihlelwa ngesikhathi sokuhlinzwa kanye nokuhlolwa kwe-imaging.

Inqubo esetshenzisiwe ukuthola ukuthi umdlavuza usabalale ngaphandle kwezinso kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imininingwane eqoqwe kusuka kusistimu yesiteji inquma isigaba sesifo. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa. Udokotela uzosebenzisa imiphumela yezivivinyo zokuxilonga nezibalo ukuze asize ukuthola isigaba sesifo.

Ukuhlolwa okulandelayo kungenziwa ukubona ukuthi umdlavuza ususabalele kwezinye izindawo emzimbeni:

  • I-lymph node biopsy: Ukususwa kwayo yonke noma ingxenye ye-lymph node esiswini. Isazi sezifo sibheka izicubu ze-lymph node ngaphansi kwesibonakhulu ukuhlola amaseli omdlavuza. Le nqubo ibizwa nangokuthi i-lymphadenectomy noma i-lymph node dissection.
  • Isivivinyo somsebenzi wesibindi : Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini yisibindi. Inani eliphakeme kunelejwayelekile lezinto kungaba uphawu lokuthi isibindi asisebenzi njengoba kufanele.
  • I-X-ray yesifuba namathambo: I-x-ray uhlobo lwensimbi yamandla engangena emzimbeni ifike kwifilimu, yenze isithombe sezindawo ezingaphakathi komzimba, njengesifuba.
  • I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, njengesisu, ukhalo, isifuba nobuchopho, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ifakwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computer ene-tomography, noma i-computer axial tomography.
  • 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 emshinini ofanayo. Izithombe ezivela kuzo zombili izikena zihlanganisiwe ukwenza isithombe esinemininingwane eminingi kunalokho ukuhlolwa obekungakwenza ngokwakho. Ukuskena i-PET kuyinqubo yokuthola amangqamuzana amabi esigaxa 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-MRI (imaging resonance imaging): Inqubo esebenzisa umazibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, njengesisu, ukhalo nobuchopho. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).
  • 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.
Ukuskena kwamathambo. Inani elincane lezinto ezikhipha imisebe lifakwa emthanjeni wengane futhi lihamba egazini. Izinto ezinemisebe eqoqa emathanjeni. Ngenkathi ingane ilele etafuleni elishibilika ngaphansi kwesithwebuli, kutholwa okokusebenza okukhipha imisebe bese kwenziwa izithombe esikrinini sekhompyutha.
  • Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. I-ultrasound yemithambo yenhliziyo emikhulu yenziwa ukulinganisa isimila seWilms.
  • I-cystoscopy: Inqubo yokubheka ngaphakathi kwesinye kanye nomchamo ukubheka izindawo ezingajwayelekile. I-cystoscope ifakwa nge-urethra iye esinyeni. I-cystoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa amasampula wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.

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 isimila sikaWilms sisakazeka siye emaphashini, amangqamuzana omdlavuza asephashini empeleni angamaseli wesimila sikaWilms. Lesi sifo yisimila se-Wilm metastatic, hhayi umdlavuza wamaphaphu.

Ngaphezu kwezigaba, izicubu zeWilms zichazwa yi-histology yazo.

I-histology (indlela amangqamuzana abukeka ngayo ngaphansi kwemicroscope) yesimila ithinta ukubikezela nokwelashwa kwesimila sikaWilms. I-histology ingahle ithandeke noma i-anaplastic (ingathandeki). Izimila ezine-histology evumayo zinokubikezela okungcono futhi ziphendula kangcono ekwelashweni ngamathumba kunama-aplastic tumor. Amangqamuzana ezigaxu aplastic ahlukana ngokushesha nangaphansi kwesibonakhulu awabukeki njengohlobo lwamaseli avela kuwo. Izicubu ze-Anaplastic kunzima ukuzelapha ngamakhemikhali kunamanye amathumba e-Wilms esigabeni esifanayo.

Lezi zigaba ezilandelayo zisetshenziselwa zombili i-histology evumayo kanye ne-anaplastic Wilms tumors:

Isiteji I

Esigabeni I, isimila sisuswe ngokuphelele ngokuhlinzwa futhi konke okulandelayo kuyiqiniso:

  • Umdlavuza utholakale kuphela ezinso futhi ubungasabalalisanga emithanjeni yegazi esonweni sezinso (ingxenye yezinso lapho ijoyina khona i-ureter) noma kuma-lymph node.
  • Ingqimba yangaphandle yezinso ayizange ivuleke.
  • Isimila asiqhamukanga.
  • I-biopsy ayenzwanga ngaphambi kokuba kususwe isimila.
  • Awekho amaseli omdlavuza atholakele emaphethelweni endawo lapho kususwe khona isimila.

Isigaba II

Esigabeni II, isimila sisuswe ngokuphelele ngokuhlinzwa futhi awekho amangqamuzana omdlavuza atholakele emaphethelweni endawo lapho kwasuswa khona umdlavuza. Umdlavuza awusabalalanga kuma-lymph node. Ngaphambi kokuba kususwe isimila, okunye kwalokhu kwakuliqiniso:

  • Umdlavuza ubusabalele esonweni sezinso (ingxenye yezinso lapho ijoyina khona i-ureter).
  • Umdlavuza ubusabalele emithanjeni yegazi engaphandle kwendawo yezinso lapho kwenziwa khona umchamo, njenge-renal sinus.

Isigaba III

Esigabeni III, umdlavuza uhlala esiswini ngemuva kokuhlinzwa kanti okunye kwalokhu okulandelayo kungaba yiqiniso:

  • Umdlavuza usabalalele kuma-lymph node esiswini noma okhalweni (ingxenye yomzimba phakathi kwezinqulu).
  • Umdlavuza usabalale waya noma ubuso be-peritoneum (ungqimba lwezicubu ezigcwala umgodi wesisu futhi lumboze izitho eziningi esiswini).
  • I-biopsy yalesi sifo yenziwa ngaphambi kokuba isuswe.
  • Isimila savuleka ngaphambi noma ngesikhathi sokuhlinzwa ukuze sisuswe.
  • Isigaxa sisuswe ezingxenyeni ezingaphezu kwesisodwa.
  • Amaseli womdlavuza atholakala emaphethelweni endawo lapho kukhishwe khona isimila.
  • Isimila sonke besingasuswa ngoba izitho ezibalulekile noma izicubu emzimbeni zizolimala.

Isigaba IV

Esigabeni IV, umdlavuza usabalale egazini waya ezingalweni ezinjengamaphaphu, isibindi, ithambo, noma ubuchopho, noma kuma-lymph node ngaphandle kwesisu nokhalo.

Isigaba V

Esigabeni V, amangqamuzana omdlavuza atholakala kuzo zombili izinso lapho umdlavuza utholakala okokuqala.

Ukwelashwa kwezinye izicubu zezinso zezingane kuncike ohlotsheni lwesimila.

Kwesinye isikhathi isimila sikaWilms nezinye izicubu zezinso zobuntwana ziyabuya emuva kokwelashwa.

Isimila se-Childhood Wilms singaphinde sibuye (sibuyele emuva) endaweni yokuqala, noma ephashini, esiswini, esibindini, noma kwezinye izindawo emzimbeni.

I-sarcoma yeselula ecacile yobuntwana yezinso ingahle ibuye endaweni yokuqala, noma ebuchosheni, emaphashini, noma kwezinye izindawo emzimbeni.

Ubuntwana bokuzalwa obungu-mesoblastic nephroma bungahle buvele ezinso noma kwezinye izindawo emzimbeni.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

  • Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezine-tumor yeWilms nezinye izicubu zezinso zezingane.
  • Izingane ezine-tumor ye-Wilms noma ezinye izicubu zezinso zezingane kufanele zihlelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni umdlavuza ezinganeni.
  • Ukwelashwa kwesimila seWilms nezinye izicubu zezinso zezingane kungadala imiphumela emibi.
  • Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:
  • Ukuhlinzwa
  • Ukwelashwa ngemisebe
  • Ukwelashwa ngamakhemikhali
  • I-Immunotherapy
  • I-chemotherapy ephezulu ene-stem cell Rescue
  • Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • Ukwelashwa okuhlosiwe
  • 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 ezine-tumor yeWilms nezinye izicubu zezinso zezingane.

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

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

Izingane ezine-tumor ye-Wilms noma ezinye izicubu zezinso zezingane kufanele zihlelwe ukwelashwa kwazo yiqembu labahlinzeki bezokunakekelwa kwempilo abangochwepheshe ekwelapheni umdlavuza ezinganeni.

Ukwelashwa kwengane yakho kuzobhekwa ngudokotela oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. I-oncologist yezingane isebenza nabanye abahlinzeki bezokunakekelwa kwempilo yezingane abangongoti ekwelapheni izingane ezinesigaxa seWilms noma ezinye izicubu zezinso zezingane futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

  • Udokotela wezingane.
  • Udokotela ohlinzayo wezingane noma i-urologist.
  • I-radiation oncologist.
  • Uchwepheshe wokuvuselelwa.
  • Umhlengikazi ongumhlengikazi.
  • Usonhlala kahle.

Ukwelashwa kwesimila seWilms nezinye izicubu zezinso zezingane kungadala imiphumela emibi.

Ngemininingwane ngemiphumela emibi eqala ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Imiphumela emibi yokwelashwa komdlavuza eqala ngemuva kokwelashwa futhi iqhubeke izinyanga noma iminyaka ibizwa ngemiphumela ephuzile. Imiphumela yamuva yokwelashwa komdlavuza ingafaka okulandelayo:

  • Izinkinga zomzimba, njengezinkinga zenhliziyo, izinkinga zezinso, noma izinkinga ngesikhathi sokukhulelwa.
  • Izinguquko zemizwa, imizwa, ukucabanga, ukufunda, noma inkumbulo.
  • Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza), njengomdlavuza womgudu wamathumbu noma umdlavuza webele.

Eminye imiphumela yesikhashana ingalashwa noma ilawulwe. Kubalulekile ukukhuluma nodokotela bengane yakho ngemiphumela yokwelashwa komdlavuza engaba nayo enganeni yakho. (Bheka isifinyezo se- mayelana nemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane).

Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe imithamo ephansi yokwelashwa ngamakhemikhali nemisebe ingasetshenziswa ukunciphisa imiphumela yokwelashwa emuva kwesikhathi ngaphandle kokushintsha ukuthi ukwelashwa kusebenza kahle kangakanani.

Izinhlobo ezinhlanu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Izinhlobo ezimbili zokuhlinzwa zisetshenziselwa ukwelapha izicubu zezinso:

  • I-Nephrectomy: Isimila seWilms nezinye izicubu zezinso zobuntwana zivame ukuphathwa nge-nephrectomy (ukuhlinzwa ukususa yonke inso). Ama-lymph node aseduze nawo angasuswa futhi ahlolwe izimpawu zomdlavuza. Kwesinye isikhathi ukufakelwa izinso (ukuhlinzwa ukuze kususwe izinso bese kufakwa izinso kumuntu onikelayo) kwenziwa lapho umdlavuza usezinsweni zombili futhi izinso zingasebenzi kahle.
  • I-nephrectomy engaphelele: Uma umdlavuza utholakala kuzo zombili izinso noma kungenzeka usabalalele kuzo zombili izinso, ukuhlinzwa kungafaka i-nephrectomy engaphelele (ukususwa komdlavuza ezinso nenani elincane lezicubu ezijwayelekile ezizungezile). I-nephrectomy engaphelele yenziwa ukugcina izinso eziningi zisebenza ngangokunokwenzeka. I-nephrectomy engaphelele ibizwa nangokuthi ukuhlinzwa kokuvikela izinso.

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. Kwesinye isikhathi, kwenziwa ukubukeka kwesibili ukuze kubonwe ukuthi umdlavuza uhlala ngemuva kwe-chemotherapy noma i-radiation 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 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 owelaswayo nokuthi ngabe kwenziwa i-biopsy ngaphambi kokuhlinzwa ukuze kususwe isimila. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha isimila sikaWilms nezinye izicubu zezinso zezingane.

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). Inhlanganisela yamakhemikhali ukwelashwa kusetshenziswa imishanguzo emibili noma ngaphezulu ye-anticancer.

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni nesigaba somdlavuza owelashwa. I-chemotherapy ejwayelekile isetshenziselwa ukwelapha isimila sikaWilms nezinye izicubu zezinso zezingane.

Kwesinye isikhathi isimila asikwazi ukususwa ngokuhlinzwa ngesinye sezizathu ezilandelayo:

  • Isimila sisondele kakhulu ezithweni ezibalulekile noma emithanjeni yegazi.
  • Isigaxa sikhulu kakhulu ukuthi singasuswa.
  • Umdlavuza usezinsweni zombili.
  • Kukhona ukujiya kwegazi ezitsheni eziseduze nesibindi.
  • Isiguli sinenkinga yokuphefumula ngoba umdlavuza ususabalele emaphashini.

Kulokhu, kwenziwa i-biopsy kuqala. Ngemuva kwalokho kunikezwa i-chemotherapy ukunciphisa ubukhulu besimila ngaphambi kokuhlinzwa, ukuze konge izicubu ezinempilo ngangokunokwenzeka futhi kunciphise izinkinga ngemuva kokuhlinzwa. Lokhu kubizwa ngokuthi yi-neoadjuvant chemotherapy. Ukwelashwa ngemisebe kunikezwa ngemuva kokuhlinzwa.

Bheka Izidakamizwa Ezivunyelwe i-Wilms Tumor kanye Neminye Umdlavuza Wezinso Wezingane ukuthola eminye imininingwane.

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.

I-Interferon ne-interleukin-2 (IL-2) yizinhlobo ze-immunotherapy ezisetshenziselwa ukwelapha umdlavuza wamangqamuzana ezingane. I-Interferon ithinta ukuhlukaniswa kwamangqamuzana omdlavuza futhi inganciphisa ukukhula kwesimila. I-IL-2 ikhulisa ukukhula nokusebenza kwamaseli amaningi omzimba, ikakhulukazi ama-lymphocyte (uhlobo lweseli elimhlophe). Ama-lymphocyte angahlasela futhi abulale amangqamuzana omdlavuza.

I-chemotherapy ephezulu ene-stem cell Rescue

Imithamo ephezulu yokwelashwa ngamakhemikhali inikezwa ukubulala amangqamuzana omdlavuza. Amaseli aphilile, kufaka phakathi amaseli akha igazi, nawo abhujiswa ukwelashwa komdlavuza. Ukutakulwa kwamaseli esiqu kuyindlela yokwelapha yokushintsha amaseli akha igazi. Ama-stem cells (amangqamuzana egazi angavuthiwe) ayasuswa egazini noma emnkantsheni wethambo lesiguli futhi afriziwe futhi agcinwe. Ngemuva kokuthi isiguli siqede i-chemotherapy, amangqamuzana eziqu agciniwe ancibilika abuyiselwa esigulini ngokumnika. Lawa maseli wesiqu abuyisiwe akhula abe (futhi abuyisele) amangqamuzana egazi omzimba.

I-chemotherapy ephezulu ene-stem cell Rescue ingasetshenziswa ukwelapha isimila esiphindayo sikaWilms.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe ukwelashwa okusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. Ukwelashwa okuhlosiwe okusetshenziselwa ukwelapha izicubu zezinso zezingane kungafaka okulandelayo:

  • Ama-Kinase inhibitors: Le ndlela yokwelashwa ebhekiswe kuyo ivimba izimpawu zokuthi amangqamuzana omdlavuza adinga ukukhula nokukhula. I-LOXO-101 ne-entrectinib ngama-kinase inhibitors afundelwa ukwelapha i-neobrastic nephroma ezalwe nayo. I-Tyrosine kinase inhibitors, efana ne-sunitinib noma i-cabozantinib, ingasetshenziswa ukwelapha i-renal cell carcinoma. I-Axitinib iyi-tyrosine kinase inhibitor efundelwa ukwelapha i-renal cell carcinoma engakhishwa ngokuhlinzwa noma isabalale kwezinye izingxenye zomzimba.
  • I-Histone methyltransferase inhibitors: Lokhu kwelashwa okuhlosiwe kubambezela ikhono leseli lomdlavuza lokukhula nokuhlukanisa. I-Tazemetostat iyi-histone methyltransferase inhibitor efundwayo ukwelapha isimila se-rhabdoid sezinso.
  • Ukwelashwa kwe-monoclonal antibody: Lokhu kwelashwa okubhekiswe kukho kusebenzisa ama-antibody enziwe elebhu, kusuka ohlotsheni olulodwa lwamaseli omzimba. La ma-antibody angakhomba izinto kumaseli womdlavuza noma ezintweni ezijwayelekile 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-Nivolumab i-anti-monoclonal antibody efundwayo ukwelapha i-renal cell carcinoma engakwazi ukususwa ngokuhlinzwa noma isabalale kwezinye izingxenye zomzimba.

Ukwelashwa okuhlosiwe kuyacutshungulwa ekwelapheni izicubu zezinso zezingane eziphinde zabuya (zabuya).

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

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

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sengane yakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho Zokwelapha i-Wilms Tumor

Kulesi Sigaba

  • Isigaba I Wilms Tumor
  • Isigaba II Wilms Tumor
  • Isigaba III Wilms Tumor
  • Isigaba IV Wilms Tumor
  • Isigaba V Wilms Tumor neziguli ezisengozini enkulu yokuthola isimila seWilms

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

Isigaba I Wilms Tumor

Ukwelashwa kwesimila sesigaba I Wilms nge-histology evumayo kungafaka:

  • I-Nephrectomy ngokususwa kwama-lymph node, kulandelwa inhlanganisela yamakhemikhali.
  • Isivivinyo somtholampilo se-nephrectomy kuphela.

Ukwelashwa kwesimila sesigaba se-Iaplastic Wilms kungafaka:

  • I-Nephrectomy ngokususwa kwama-lymph node kulandelwa inhlanganisela yokwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe endaweni eseceleni (kolunye uhlangothi lomzimba phakathi kwezimbambo ne-hipbone).

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 II Wilms Tumor

Ukwelashwa kwesigaxa sesigaba II seWilms nge-histology evumayo kungafaka:

  • I-Nephrectomy ngokususwa kwama-lymph node, kulandelwa inhlanganisela yamakhemikhali.

Ukwelashwa kwesimila sesigaba II se-anaplastic Wilms kungafaka:

  • I-Nephrectomy ngokususa ama-lymph node, ilandelwe ukwelashwa ngemisebe esiswini nokuhlanganiswa kwamakhemikhali.

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 Wilms Tumor

Ukwelashwa kwesimila sesigaba III seWilms nge-histology evumayo kungafaka:

  • I-Nephrectomy ngokususa ama-lymph node, ilandelwe ukwelashwa ngemisebe esiswini nokuhlanganiswa kwamakhemikhali.

Ukwelashwa kwesimila sesigaba III se-anaplastic Wilms kungafaka:

  • I-Nephrectomy ngokususa ama-lymph node, ilandelwe ukwelashwa ngemisebe esiswini nokuhlanganiswa kwamakhemikhali.
  • Inhlanganisela yamakhemikhali elandelwa i-nephrectomy nokususwa kwama-lymph node, kulandele ukwelashwa ngemisebe esiswini.

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 IV Wilms Tumor

Ukwelashwa kwesimila sesigaba IV seWilms nge-histology evumayo kungafaka:

  • I-Nephrectomy ngokususa ama-lymph node, ilandelwe ukwelashwa ngemisebe esiswini nokuhlanganiswa kwamakhemikhali. Uma umdlavuza ususabalele kwezinye izingxenye zomzimba, iziguli nazo zizothola ukwelashwa ngemisebe kulezo zindawo.

Ukwelashwa kwesimila sesigaba IV se-anaplastic Wilms kungafaka:

  • I-Nephrectomy ngokususa ama-lymph node, ilandelwe ukwelashwa ngemisebe esiswini nokuhlanganiswa kwamakhemikhali. Uma umdlavuza ususabalele kwezinye izingxenye zomzimba, iziguli nazo zizothola ukwelashwa ngemisebe kulezo zindawo.
  • Inhlanganisela yamakhemikhali enikezwa ngaphambi kwe-nephrectomy nokususwa kwama-lymph node, kulandele ukwelashwa ngemisebe esiswini. Uma umdlavuza ususabalele kwezinye izingxenye zomzimba, iziguli nazo zizothola ukwelashwa ngemisebe kulezo zindawo.

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 V Wilms Tumor neziguli ezisengozini enkulu yokuthola isimila seWilms

Ukwelashwa kwesigaxa sesigaba V Wilms kungahluka kwisiguli ngasinye futhi kungafaka:

  • Inhlanganisela ye-chemotherapy yokunciphisa isimila, kulandelwe ukucabanga okuphindiwe emavikini amane kuya kwayisishiyagalombili ukunquma ukwelashwa okuqhubekayo (i-nephrectomy eyingxenye, i-biopsy, i-chemotherapy eqhubekayo, kanye / noma i-radiation therapy).
  • I-biopsy yezinso ilandelwa i-chemotherapy ehlanganisiwe ukunciphisa isimila. Kuhlinzwa okwesibili ukukhipha umdlavuza omningi ngangokunokwenzeka. Lokhu kungalandelwa ukwelashwa ngamakhemikhali amaningi kanye / noma ukwelashwa ngemisebe uma umdlavuza uhlala ngemuva kokuhlinzwa.

Uma ukufakelwa izinso kuyadingeka ngenxa yezinkinga zezinso, kubambezeleka kuze kube unyaka ongu-1 kuya kwemibili ukwelashwa kuqediwe futhi azikho izimpawu zomdlavuza.

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 Ezinye Izicubu Zezinso Zengane

Kulesi Sigaba

  • Umdlavuza We-Renal Cell (RCC)
  • I-Rhabdoid Tumor Yezinso
  • Sula i-Cell Sarcoma Yezinso
  • I-Mesoblastic Nephroma ezalwa nayo
  • I-Ewing Sarcoma Yezinso
  • I-Primary Renal Myoepithelial Carcinoma
  • ICystic Ihlukanise kancane iNephroblastoma
  • I-Multilocular Cystic Nephroma
  • I-Primary Renal Synovial Sarcoma
  • I-Anaplastic Sarcoma Yezinso
  • I-Nephroblastomatosis (Isabalalisa i-Hyperplastic Perilobar Nephroblastomatosis)

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

Umdlavuza We-Renal Cell (RCC)

Ukwelashwa komdlavuza wamaseli wezinso kungafaka:

  • Ukuhlinzwa, okungahle kube:
  • i-nephrectomy ngokususwa kwama-lymph node; noma
  • i-nephrectomy engaphelele ngokususwa kwama-lymph node.
  • I-Immunotherapy (i-interferon ne-interleukin-2) yomdlavuza osakazekele kwezinye izingxenye zomzimba.
  • Ukwelashwa okuhlosiwe (i-tyrosine kinase inhibitors) yomdlavuza osakaze kwezinye izingxenye zomzimba.
  • Isivivinyo somtholampilo sokwelapha okuqondisiwe nge-tyrosine kinase inhibitor kanye / noma i-monoclonal antibody therapy yomdlavuza onoshintsho oluthile lwezakhi zofuzo futhi ongeke ususwe ngokuhlinzwa noma usabalele kwezinye izingxenye zomzimba.

Bona isifinyezo se- mayelana ne-Renal Cell Cancer Treatment ukuthola eminye imininingwane.

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.

I-Rhabdoid Tumor Yezinso

Akukho ukwelashwa okujwayelekile kwesimila se-rhabdoid sezinso. Ukwelashwa kungafaka:

  • Inhlanganisela yokuhlinzwa, i-chemotherapy, kanye / noma i-radiation therapy.
  • Isivivinyo somtholampilo sokwelapha okuhlosiwe (tazemetostat).

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.

Sula i-Cell Sarcoma Yezinso

Ukwelashwa kwe-clear cell sarcoma yezinso kungafaka:

  • I-Nephrectomy ngokususwa kwama-lymph node kulandelwa inhlanganisela yamakhemikhali nokwelashwa ngemisebe esiswini.
  • 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.

I-Mesoblastic Nephroma ezalwa nayo

Ukwelashwa kwezigaba I, II, kanye neziguli ezithile ezinesigaba III se-mesoblastic nephroma engazalwa kungafaka:

  • Ukuhlinzwa.

Ukwelashwa kweziguli ezithile ezinesigaba III se-mesoblastic nephroma kungabandakanya:

  • Ukuhlinzwa okungalandelwa ukwelashwa ngamakhemikhali.

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.

I-Ewing Sarcoma Yezinso

Akukho ukwelashwa okujwayelekile kwe-Ewing sarcoma yezinso. Ukwelashwa kungafaka:

  • Inhlanganisela yokuhlinzwa, i-chemotherapy, kanye nokwelashwa ngemisebe.

Kungaphathwa futhi ngendlela efanayo ne-Ewing sarcoma ephathwa ngayo. Bona isifinyezo se- mayelana ne-Ewing Sarcoma Treatment ukuthola eminye imininingwane.

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.

I-Primary Renal Myoepithelial Carcinoma

Akukho ukwelashwa okujwayelekile kwe-primary renal myoepithelial carcinoma. Ukwelashwa kungafaka:

  • Inhlanganisela yokuhlinzwa, i-chemotherapy, kanye nokwelashwa ngemisebe.

ICystic Ihlukanise kancane iNephroblastoma

Ukwelashwa kwe-nephroblastoma ehlukaniswe ngokwengxenye kungahlanganisa:

  • Ukuhlinzwa okungalandelwa ukwelashwa ngamakhemikhali.

I-Multilocular Cystic Nephroma

Ukwelashwa kwe-cystic nephroma yama-multilocular kuvame ukufaka:

  • Ukuhlinzwa.

I-Primary Renal Synovial Sarcoma

Ukwelashwa kwe-renal synovial sarcoma eyinhloko ngokuvamile kufaka phakathi:

  • Ukwelashwa ngamakhemikhali.

I-Anaplastic Sarcoma Yezinso

Akukho ukwelashwa okujwayelekile kwe-anaplastic sarcoma yezinso. Ukwelashwa imvamisa kuyindlela efanayo yokwelashwa okunikezwa isimila se-anaplastic Wilms.

I-Nephroblastomatosis (Isabalalisa i-Hyperplastic Perilobar Nephroblastomatosis)

Ukwelashwa kwe-nephroblastomatosis kuncike kulokhu okulandelayo:

  • Ukuthi ingane inamaqembu angajwayelekile amaseli koyedwa noma zombili izinso.
  • Ukuthi ingane inesimila sikaWilms kwesinye sezinso namaqembu amaseli angajwayelekile kwenye inso.

Ukwelashwa kwe-nephroblastomatosis kungafaka:

  • I-Chemotherapy elandelwa i-nephrectomy. Kwesinye isikhathi i-nephrectomy engaphelele ingenziwa ukugcina umsebenzi wezinso omningi ngangokunokwenzeka.

Ukwelashwa Kwezimila Ezivuselelayo Zezinso Zengane

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

Ukwelashwa kwesimila esiphindaphindayo seWilms kungafaka:

  • Inhlanganisela yamakhemikhali, ukuhlinzwa nokwelashwa ngemisebe.
  • Inhlanganisela yamakhemikhali, ukuhlinzwa nokwelashwa ngemisebe, kulandelwa ukutakulwa kwamaseli e-stem, kusetshenziswa amangqamuzana egazi engane uqobo.
  • Isivivinyo somtholampilo esihlola isampula lesimila sesiguli ukuthola izinguquko ezithile zofuzo. Uhlobo lokwelashwa okuqondisiwe oluzonikezwa isiguli kuncike ohlotsheni lokushintsha kofuzo.

Ukwelashwa kwesisu esijwayelekile se-rhabdoid sezinso kungafaka:

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

Ukwelashwa kwe-sarcoma yeseli ephindaphindiwe ecacile yezinso kungafaka:

  • Inhlanganisela yamakhemikhali, ukuhlinzwa ukususa isimila (uma kungenzeka), kanye / noma ukwelashwa ngemisebe.
  • Isivivinyo somtholampilo esihlola isampula lesimila sesiguli ukuthola izinguquko ezithile zofuzo. Uhlobo lokwelashwa okuqondisiwe oluzonikezwa isiguli kuncike ohlotsheni lokushintsha kofuzo.

Ukwelashwa kwe-neobrastic neobrastic nephroma engazalwa ingafaka:

  • Inhlanganisela yamakhemikhali, ukuhlinzwa nokwelashwa ngemisebe.
  • Isivivinyo somtholampilo esihlola isampula lesimila sesiguli ukuthola izinguquko ezithile zofuzo. Uhlobo lokwelashwa okuqondisiwe oluzonikezwa isiguli kuncike ohlotsheni lokushintsha kofuzo.
  • Isivivinyo somtholampilo sokwelapha okuqondisiwe (i-LOXO-101 noma i-entrectinib).

Ukwelashwa kwezinye izicubu zezinso zezingane eziphindaphindayo kuvame ukuba ngaphakathi kwesivivinyo somtholampilo.

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.

Ukufunda Okwengeziwe Nge-Wilms Tumor Nezinye Izicubu Zezinso Zengane

Ngeminye imininingwane evela ku-National Cancer Institute mayelana nesimila seWilms nezinye izicubu zezinso zezingane, bheka okulandelayo:

  • Ikhasi Lasekhaya Lomdlavuza Wezinso
  • I-Computed Tomography (CT) Iskena Nomdlavuza
  • Izidakamizwa Zivunyelwe i-Wilms Tumor kanye Neminye Umdlavuza Wezinso Wezingane
  • I-Immunotherapy Yokwelapha Umdlavuza
  • Ukuhlolwa Kofuzo Kwezifo Ezizuzwayo Zokuthola Umdlavuza

Ngemininingwane eminingi yomdlavuza wezingane nezinye izinsiza zomdlavuza ezijwayelekile, bheka okulandelayo:

  • Mayelana Nomdlavuza
  • Umdlavuza Wezingane
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