Izinhlobo / isibindi / isiguli / ingane-ukwelashwa kwesibindi-pdq

Ukwelashwa Komdlavuza Wesibindi Ebuntwaneni

Imininingwane Ejwayelekile Mayelana Nomdlavuza Wesibindi Ebuntwaneni

AMAPHUZU ASEMQOKA

• Umdlavuza wesibindi wengane yisifo lapho amangqamuzana amabi (umdlavuza) akha izicubu zesibindi.

• Kunezinhlobo ezahlukahlukene zomdlavuza wesibindi ebuntwaneni.

• Izifo nezimo ezithile zingakhuphula ingozi yokuba nomdlavuza wesibindi ebuntwaneni.

• Izimpawu nezimpawu zomdlavuza wesibindi ebuntwaneni zifaka phakathi iqhubu noma ubuhlungu esiswini.

• Izivivinyo ezihlola isibindi negazi zisetshenziselwa ukuthola (ukuthola) nokuhlonza umdlavuza wesibindi sezingane nokuthola ukuthi umdlavuza ususabalele yini.

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

Umdlavuza wesibindi wengane yisifo lapho amangqamuzana amabi (umdlavuza) akha izicubu zesibindi.

Isibindi singesinye sezitho ezinkulu kakhulu emzimbeni. Inama-lobes amabili futhi igcwalisa ohlangothini olungaphezulu kwesokudla sesisu ngaphakathi kwezimbambo. Imisebenzi emithathu kweminingi ebalulekile yesibindi yile:

• Ukuhlunga izinto eziyingozi egazini ukuze zidluliswe zisuka emzimbeni ngendle nomchamo.

• Ukwenza i-bile ukusiza ukugaya amafutha ekudleni.

• Ukugcina i-glycogen (ushukela), umzimba oyisebenzisela amandla.

I-anatomy yesibindi. Isibindi sisesiswini esingenhla eduze kwesisu, amathumbu, i-gallbladder, ne-pancreas. Isibindi sine-lobe yangakwesokudla ne-lobe yesobunxele. I-lobe ngayinye ihlukaniswe izigaba ezimbili (ezingakhonjisiwe).

Umdlavuza wesibindi awuvamile ezinganeni nasebusheni.

Kunezinhlobo ezahlukahlukene zomdlavuza wesibindi ebuntwaneni.

Kunezinhlobo ezimbili eziyinhloko zomdlavuza wesibindi ebuntwaneni:

• I-Hepatoblastoma: I-Hepatoblastoma uhlobo oluvame kakhulu lomdlavuza wesibindi ebuntwaneni. Imvamisa kuthinta izingane ezingaphansi kweminyaka emithathu ubudala.

Ku-hepatoblastoma, i-histology (indlela amangqamuzana omdlavuza abukeka ngayo ngaphansi kwesibonakhulu) ithinta indlela umdlavuza ophathwa ngayo. I-histology ye-hepatoblastoma ingaba kokulandelayo:

• I-histology ehlukaniswe kahle ye-fetal (pure fetal).

• Iseli elincane elingenakuqhathaniswa.

• I-histology ye-fetus engahlukanisiwe kahle, i-histology engafani neseli engeyona encane.

• I-Hepatocellular carcinoma: I-Hepatocellular carcinoma ivame ukuthinta izingane ezindala nentsha. Kuvame kakhulu ezindaweni zase-Asia ezinamazinga aphezulu okutheleleka nge-hepatitis B kunase-US

Ezinye izinhlobo ezingajwayelekile zomdlavuza wesibindi ebuntwaneni zifaka okulandelayo:

• I-embarconal sarcoma yesibindi: Lolu hlobo lomdlavuza wesibindi luvame ukwenzeka ezinganeni ezineminyaka ephakathi kwemihlanu nengu-10 ubudala. Imvamisa isakazeka sonke isibindi kanye / noma amaphaphu.

• I-Infantile choriocarcinoma yesibindi: Lesi isimila esingavamile kakhulu esiqala ku-placenta bese sisakazeka embungwini. Isimila ngokuvamile sitholakala ezinyangeni ezimbalwa zokuqala zokuphila. Futhi, umama wengane angatholwa ukuthi une-choriocarcinoma. I-Choriocarcinoma uhlobo lwesifo se-gestational trophoblastic disease. Bona isifinyezo se- ku-Gestational Trophoblastic Disease Treatment ukuthola eminye imininingwane yokwelashwa kwe-choriocarcinoma komama wengane.

• Izicubu zesibindi semisipha: Lezi zicubu zenzeka esibindini kusuka kumaseli enza imithambo yegazi noma imithambo ye-lymph. Izicubu zesibindi semithambo kungenzeka zibe nobungozi (hhayi umdlavuza) noma zibe yingozi (umdlavuza). Bona isifinyezo se- ku-Childhood Vascular Tumors Treatment ukuthola eminye imininingwane ngamathumba wesibindi semithambo.

Lesi sifinyezo simayelana nokwelashwa komdlavuza oyinhloko wesibindi (umdlavuza oqala esibindini). Ukwelashwa komdlavuza wesibindi we-metastatic, okuwumdlavuza oqala kwezinye izingxenye zomzimba bese usakazekela esibindi, akuxoxwa ngakho kulesi sifinyeto.

Umdlavuza wesibindi oyinhloko ungavela kubantu abadala kanye nasezinganeni. Kodwa-ke, ukwelashwa kwezingane kuhlukile kunokwelashwa kwabantu abadala. Bona isifinyezo se- ekwelashweni komdlavuza wesibindi sabantu abadala ukuze uthole imininingwane eminingi ngokwelashwa kwabantu abadala.

Izifo nezimo ezithile zingakhuphula ingozi yokuba nomdlavuza wesibindi ebuntwaneni.

Noma yini eyandisa amathuba akho okuthola 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.

Izici zobungozi be-hepatoblastoma zifaka ama-syndromes noma imibandela elandelayo:

• I-Aicardi syndrome.

• Isifo se-Beckwith-Wiedemann.

• Hemihyperplasia.

• I-adenomatous polyposis (FAP) ejwayelekile.

• Isifo sokugcina i-Glycogen.

• Isisindo esiphansi kakhulu lapho kuzalwa.

• ISimpson-Golabi-Behmel syndrome.

• Izinguquko ezithile zofuzo, njengeTrisomy 18.

Izingane ezisengozini ye-hepatoblastoma zingase zihlolwe ukuhlolwa komdlavuza ngaphambi kokuba kuvele noma yiziphi izimpawu. Njalo ezinyangeni ezintathu kuze kube yilapho ingane ineminyaka engu-4 ubudala, kwenziwa ukuhlolwa kwesisu kwe-ultrasound futhi kuhlolwa izinga le-alpha-fetoprotein egazini.

Izici zobungozi ze-hepatocellular carcinoma zifaka ama-syndromes noma imibandela elandelayo:

• I-Alagille syndrome.

• Isifo sokugcina i-Glycogen.

• Ukutheleleka ngegciwane le-Hepatitis B okwadluliselwa kusuka kumama kuya enganeni lapho izalwa.

• Isifo esiqhubekayo somndeni we-intrahepatic.

• I-Tyrosinemia.

Ezinye iziguli ezine-tyrosinemia zizofakelwa isibindi ukwelapha lesi sifo ngaphambi kokuba kube nezimpawu noma izimpawu zomdlavuza.

Izimpawu nezimpawu zomdlavuza wesibindi ebuntwaneni zifaka phakathi iqhubu noma ubuhlungu esiswini.

Izimpawu nezimpawu zivame kakhulu ngemuva kokuthi isimila sikhule. Ezinye izimo zingadala izimpawu nezimpawu ezifanayo. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Isigaxa esiswini esingaba buhlungu.

• Ukuvuvukala esiswini.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukuphelelwa isifiso sokudla.

• Isicanucanu nokuhlanza.

Izivivinyo ezihlola isibindi negazi zisetshenziselwa ukuthola (ukuthola) nokuhlonza umdlavuza wesibindi sezingane nokuthola ukuthi umdlavuza ususabalele yini.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Isivivinyo somaka weSerum tumor: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho, izicubu, noma amaseli wesimila emzimbeni. Izinto ezithile zixhunyaniswe nezinhlobo ezithile zomdlavuza lapho zitholakala emazingeni akhuphukile egazini. Lokhu kubizwa ngokuthi yizimpawu zesimila. Igazi lezingane ezinomdlavuza wesibindi kungenzeka likhuphuke inani le-hormone ebizwa nge-beta-human chorionic gonadotropin (beta-hCG) noma iprotheni ebizwa nge-alpha-fetoprotein (AFP). Eminye imidlavuza, izicubu zesibindi ezinobungozi, nezimo ezithile ezingezona umdlavuza, kufaka phakathi i-cirrhosis ne-hepatitis, nazo zingakhuphula amazinga e-AFP.

• 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 kokusebenza kwesibindi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini yisibindi. Inani eliphakeme kunelijwayelekile lezinto kungaba uphawu lokulimala kwesibindi noma umdlavuza.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-bilirubin noma i-lactate dehydrogenase (LDH), ekhishwe egazini izitho nezicubu emzimbeni. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• Ukuhlolwa kwegciwane le-Epstein-Barr (EBV): Ukuhlolwa kwegazi ukuhlola amasosha omzimba ku-EBV nakuma-DNA markers e-EBV. Lezi zitholakala egazini leziguli ezitheleleke nge-EBV.

Ukuhlolwa kwe-hepatitis: Inqubo lapho kuhlolwe khona isampula segazi ukuthola izingcezu zegciwane le-hepatitis.

• I-MRI (imaging resonance imaging) ene-gadolinium: Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi kwesibindi. 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-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. Emdlavuzeni wesibindi ebuntwaneni, i-CT scan yesifuba nesisu ivame ukwenziwa.

Iskena se-computed tomography (CT) sesisu. Ingane ilele etafuleni elishibilika ngesithwebuli se-CT, esithatha izithombe ze-x-ray zangaphakathi kwesisu.

• 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. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi. Ebuntwaneni umdlavuza wesibindi, ukuhlolwa kwe-ultrasound kwesisu ukuhlola imithambo yegazi emikhulu kuvame ukwenziwa.

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-x-ray yesisu: I-x-ray yezitho esiswini. I-x-ray wuhlobo lwe-beam yamandla engangena emzimbeni ifilimu, yenze isithombe sezindawo ezingaphakathi komzimba.

• I-Biopsy: Ukususwa kwesampula lamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ukuhlola izimpawu zomdlavuza. Isampula ingathathwa ngesikhathi sokuhlinzwa ukususa noma ukubuka isimila. Isazi sezifo sibheka isampula ngaphansi kwesibonakhulu ukuthola uhlobo lomdlavuza wesibindi.

Ukuhlolwa okulandelayo kungenziwa kusampula lezicubu ezisusiwe:

• I-Immunohistochemistry: Isivivinyo selabhorethri esisebenzisa amasosha omzimba ukubheka ama-antigen (amakaki) athile kusampula yezicubu zesiguli. Amasosha omzimba avamise ukuhlanganiswa ne-enzyme noma udayi we-fluorescent. Ngemuva kokuthi ama-antibody abophele kwi-antigen ethile kusampula yezicubu, i-enzyme noma idayi iyasebenza, bese kuthi i-antigen ibonakale ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lusetshenziselwa ukubheka ukuguquka kwezakhi ezithile zofuzo, ukusiza ukuthola umdlavuza, nokusiza ukutshela uhlobo olulodwa lomdlavuza kolunye uhlobo lomdlavuza.

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

Isibikezelo (ithuba lokululama) kanye nezinketho zokwelashwa kwe-hepatoblastoma kuncike kulokhu okulandelayo:

• Iqembu le-PRETEXT.

• Usayizi wesimila.

• Ukuthi uhlobo lwe-hepatoblastoma luyi-fetal ehlukaniswe kahle (i-pure fetal) noma i-histology encane engahlukanisiwe yeseli.

• Ukuthi umdlavuza ususabalele nakwezinye izindawo emzimbeni, njengesifafazi, amaphaphu, noma imithambo ethile yegazi emikhulu.

• Noma ngabe kukhona isimila esingaphezu kwesisodwa esibindini.

• Ukuthi ikhava engaphandle ezungeze isimila ivulekile yini.

• Indlela umdlavuza ophendula ngayo ekhemotherapy.

• Ukuthi umdlavuza ungasuswa ngokuphelele ngokuhlinzwa.

• Ukuthi isiguli singakwazi yini ukufakelwa isibindi.

• Ukuthi amazinga egazi e-AFP ayehla yini ngemuva kokwelashwa.

• Iminyaka yengane.

• Ukuthi umdlavuza usanda kutholakala noma usuphindile.

Isibikezelo (ithuba lokululama) kanye nezinketho zokwelashwa kwe-hepatocellular carcinoma kuncike kulokhu okulandelayo:

• Iqembu le-PRETEXT.

• Ukuthi umdlavuza ususabalele nakwezinye izindawo emzimbeni, njengamaphaphu.

• Ukuthi umdlavuza ungasuswa ngokuphelele ngokuhlinzwa.

• Indlela umdlavuza ophendula ngayo ekhemotherapy.

• Ukuthi ingane inesifo se-hepatitis B yini.

• Ukuthi umdlavuza usanda kutholakala noma usuphindile.

Ngomdlavuza wesibindi wobuntwana ophindayo (ubuya emuva) ngemuva kokwelashwa kokuqala, ukubikezela kanye nezindlela zokwelashwa zincike ku:

• Lapho emzimbeni isimila saphinda sabuya.

• Uhlobo lokwelashwa olusetshenziselwa ukwelapha umdlavuza wokuqala.

Umdlavuza wesibindi wezingane ungalapheka uma isimila sincane futhi singasuswa ngokuphelele ngokuhlinzwa. Ukususwa okuphelele kungenzeka kaningi kakhulu ku-hepatoblastoma kune-hepatocellular carcinoma.

Izigaba Zomdlavuza Wesibindi Ebuntwaneni

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala komdlavuza wesibindi ebuntwaneni, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile yini esibindi noma kwezinye izingxenye zomzimba.

• Kunezinhlelo ezimbili zokuqoqa umdlavuza wesibindi sezingane.

• Kunamaqembu amane we-PRETEXT ne-POSTTEXT:

• I-PRETEXT ne-POSTTEXT Group I

• I-PRETEXT ne-POSTTEXT Group II

• I-PRETEXT ne-POSTTEXT Group III

• I-PRETEXT ne-POSTTEXT Group IV

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Ngemuva kokutholakala komdlavuza wesibindi ebuntwaneni, kwenziwa ukuhlolwa ukuthola ukuthi amangqamuzana omdlavuza asakazekile yini esibindi noma kwezinye izingxenye zomzimba.

Inqubo esetshenziselwe ukuthola ukuthi umdlavuza ususakazekile ngaphakathi kwesibindi, kuya ezicutshini eziseduze noma ezithweni, noma kwezinye izingxenye zomzimba ibizwa nge-staging. Esikhathini somdlavuza wesibindi ebuntwaneni, kusetshenziswa amaqembu e-PRETEXT ne-POSTTEXT esikhundleni sesiteji ukuhlela ukwelashwa. Imiphumela yokuhlolwa nezinqubo ezenziwe ukuthola, ukuxilonga, nokuthola ukuthi umdlavuza ususabalalisiwe yini kusetshenziselwa ukucacisa amaqembu e-PRETEXT ne-POSTTEXT.

Kunezinhlelo ezimbili zokuqoqa umdlavuza wesibindi sezingane.

Izinhlelo ezimbili zokuqoqa zisetshenziselwa umdlavuza wesibindi wezingane ukunquma ukuthi ngabe isimila singasuswa ngokuhlinzwa:

• Iqembu le-PRETEXT lichaza isimila ngaphambi kokuba isiguli sithole ukwelashwa.

• Iqembu le-POSTTEXT lichaza isimila ngemuva kokuthi isiguli sithole ukwelashwa okufana neoadjuvant chemotherapy.

Kunamaqembu amane we-PRETEXT ne-POSTTEXT:

Isibindi sihlukaniswe izigaba ezine. Amaqembu e-PRETEXT ne-POSTTEXT ancike ekutheni iziphi izingxenye zesibindi ezinomdlavuza.

I-PRETEXT ne-POSTTEXT Group I

Isibindi PRETEXT I. Umdlavuza utholakala engxenyeni eyodwa yesibindi. Izingxenye ezintathu zesibindi eziseduze komunye nomunye azinawo umdlavuza kuzo.

Eqenjini I, umdlavuza utholakala engxenyeni eyodwa yesibindi. Izingxenye ezintathu zesibindi eziseduze komunye nomunye azinawo umdlavuza kuzo.

I-PRETEXT ne-POSTTEXT Group II

Isibindi PRETEXT II. Umdlavuza utholakala engxenyeni eyodwa noma ezimbili zesibindi. Izingxenye ezimbili zesibindi eziseduze komunye nomunye azinawo umdlavuza kuzo.

Eqenjini lesibili, umdlavuza utholakala engxenyeni eyodwa noma ezimbili zesibindi. Izingxenye ezimbili zesibindi eziseduze komunye nomunye azinawo umdlavuza kuzo.

I-PRETEXT ne-POSTTEXT Group III

Isibindi PRETEXT III. Umdlavuza utholakala ezingxenyeni ezintathu zesibindi kanti ingxenye eyodwa awunawo umdlavuza, noma umdlavuza utholakala ezingxenyeni ezimbili zesibindi kanti izingxenye ezimbili ezingasondelani azinawo umdlavuza kuzo.

Eqenjini lesithathu, okukodwa kokulandelayo kuyiqiniso:

• Umdlavuza utholakala ezingxenyeni ezintathu zesibindi kanti isigaba esisodwa asinawo umdlavuza.

• Umdlavuza utholakala ezingxenyeni ezimbili zesibindi kanti izingxenye ezimbili ezingasondelani azinawo umdlavuza.

I-PRETEXT ne-POSTTEXT Group IV

Isibindi PRETEXT IV. Umdlavuza utholakala kuzo zozine izingxenye zesibindi.

Eqenjini IV, umdlavuza utholakala kuzo zozine izingxenye zesibindi.

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

Umdlavuza Wesibindi Ophindaphindayo

Umdlavuza wesibindi owenzeka njalo ebuntwaneni ngumdlavuza obuye wabuya (ubuye) ngemuva kokuba welashwe. Umdlavuza ungabuya esibindini noma kwezinye izingxenye zomzimba. Umdlavuza okhulayo noma okhulayo ngesikhathi sokwelashwa yisifo esiqhubekayo.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinomdlavuza wesibindi sobuntwana.

• Izingane ezinomdlavuza wesibindi kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni lo mdlavuza ongavamile wezingane.

• Ukwelashwa komdlavuza wesibindi ebuntwaneni kungadala imiphumela emibi.

• Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukulinda okulindile

• Ukwelashwa ngamakhemikhali

• Ukwelashwa ngemisebe

• Ukwelashwa kwe-Ablation

• Imithi elwa namagciwane

• 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 ezinomdlavuza wesibindi sobuntwana.

Izinhlobo ezahlukene zokwelashwa ziyatholakala ezinganeni ezinomdlavuza wesibindi. 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.

Ukubamba iqhaza esivivinyweni somtholampilo kufanele kubhekelwe kuzo zonke izingane ezinomdlavuza wesibindi. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izingane ezinomdlavuza wesibindi kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni lo mdlavuza ongavamile wezingane.

Ukwelashwa kuzobhekwa ngudokotela wezingane oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. I-oncologist yezingane isebenza nabanye abahlinzeki bezempilo abangongoti ekwelapheni izingane ezinomdlavuza wesibindi futhi abagxile ezindaweni ezithile zemithi. Kubaluleke kakhulu ukuba nodokotela ohlinzayo wezingane onolwazi lokuhlinzwa kwesibindi ongathumela iziguli ohlelweni lokufakelwa kwesibindi uma kudingeka. Abanye ongoti bangafaka okulandelayo:

• Udokotela wezingane.

• I-radiation oncologist.

• Umhlengikazi ongumhlengikazi.

• Uchwepheshe wokuvuselelwa.

• Isazi sokusebenza kwengqondo.

• Usonhlala kahle.

Ukwelashwa komdlavuza wesibindi ebuntwaneni 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:

• Izinkinga zomzimba.

• Izinguquko zemizwa, imizwa, ukucabanga, ukufunda, noma inkumbulo.

• Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza).

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

Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Uma kungenzeka, umdlavuza ususwa ngokuhlinzwa.

• I-hepatectomy engaphelele: Ukususwa kwengxenye yesibindi lapho kutholakala umdlavuza. Ingxenye esusiwe kungenzeka ibe yinhlanganisela yezicubu, i-lobe ephelele, noma ingxenye enkulu yesibindi, kanye nenani elincane lezicubu ezijwayelekile ezizungezile.

• Ukufakelwa kwesibindi ngokuphelele: Ukususwa kwesibindi sonke kulandelwe ukufakelwa kwesibindi esinempilo kumnikeli. Ukufakelwa kwesibindi kungenzeka lapho umdlavuza ungazange usabalale ngale kwesibindi futhi kutholakala isibindi esinikelwe. Uma isiguli kufanele silinde isibindi esinikelwe, okunye ukwelashwa kunikezwa lapho kudingeka.

• Ukutholakala kabusha kwe-metastases: Ukuhlinzwa ukususa umdlavuza osabalale ngaphandle kwesibindi, njengezicubu eziseduze, amaphaphu, noma ubuchopho.

Uhlobo lokuhlinzwa olungenziwa luxhomeke kokulandelayo:

• Iqembu le-PRETEXT neqembu le-POSTTEXT.

• Usayizi wesimila sokuqala.

• Noma ngabe kukhona isimila esingaphezu kwesisodwa esibindini.

• Ukuthi umdlavuza ususabalele emithanjeni yegazi emikhulu eseduze.

• Izinga le-alpha-fetoprotein (AFP) egazini.

• Ukuthi isimila singancishiswa yini ngamakhemikhali ukuze sisuswe ngokuhlinzwa.

• Ukuthi ukufakelwa kwesibindi kuyadingeka yini.

I-Chemotherapy kwesinye isikhathi inikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe isimila futhi kube lula ukusikhipha. Lokhu kubizwa ngokuthi ukwelashwa kwe-neoadjuvant.

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.

Ukulinda okulindile

Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu. Ku-hepatoblastoma, lokhu kwelashwa kusetshenziselwa kuphela izicubu ezincane ezisuswe ngokuphelele ngokuhlinzwa.

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). Ukwelashwa usebenzisa imishanguzo engaphezu kweyodwa ye-anticancer kubizwa ngokuthi inhlanganisela yamakhemikhali.

I-Chemoembolization yomthambo we-hepatic (umthambo omkhulu onikeza igazi esibindini) wuhlobo lwe-chemotherapy yesifunda esetshenziselwa ukwelapha umdlavuza wesibindi wezingane ongasuswa ngokuhlinzwa. Isidakamizwa se-anticancer sijojelwa emthanjeni we-hepatic nge-catheter (ithubhu elincanyana). Isidakamizwa sixutshwe nento evimba umthambo, inqamula ukugeleza kwegazi kuya kulesimila. Iningi lomuthi olwa nomdlavuza ubhajwe eduze kwesimila futhi inani elincane kuphela lomuthi lifinyelela kwezinye izingxenye zomzimba. Ukuvinjelwa kungaba okwesikhashana noma unomphela, kuya ngento esetshenzisiwe ukuvimba umthambo. Isimila sivinjelwe ekutholeni umoya-mpilo nezakhamzimba esidinga ukuthi sikhule. Isibindi siyaqhubeka sithola igazi kusuka emthanjeni wesibindi we-hepatic, ophethe igazi kusuka esiswini nasemathunjini uye esibindini.

Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni lomdlavuza owelashwayo kanye neqembu le-PRETEXT noma le-POSTTEXT.

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.

I-Radioembolization yomthambo we-hepatic (umthambo omkhulu onikeza igazi esibindini) wuhlobo lokwelashwa kwemisebe yangaphakathi okusetshenziselwa ukwelapha i-hepatocellular carcinoma. Inani elincanyana kakhulu lezinto ezinemisebe enamathiselwe lifakwa kobuhlalu obuncane obufakwa emthanjeni we-hepatic ngokusebenzisa ipayipi (ithubhu elincanyana). Ubuhlalu buxutshwe nento evimba umthambo, inqamula ukugeleza kwegazi kuya esihlahleni. Imisebe eminingi ibhajwe eduze kwesimila ukubulala amangqamuzana omdlavuza. Lokhu kwenziwa ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo yezingane ezine-hepatocellular carcinoma.

Indlela okunikezwa ngayo ukwelashwa ngemisebe kuncike ohlotsheni lomdlavuza owelashwayo kanye neqembu le-PRETEXT noma le-POSTTEXT. Ukwelashwa kwemisebe yangaphandle kusetshenziselwa ukwelapha i-hepatoblastoma engenakususwa ngokuhlinzwa noma isabalale kwezinye izingxenye zomzimba.

Ukwelashwa kwe-Ablation

Ukwelashwa kwe-Ablation kususa noma kubhubhise izicubu. Izinhlobo ezahlukene zokwelashwa kwe-ablation zisetshenziselwa umdlavuza wesibindi:

• Ukuchithwa kwe-Radiofrequency: Ukusetshenziswa kwezinaliti ezikhethekile ezifakwa ngqo esikhunjeni noma ngokusebenzisa imbobo esiswini ukufinyelela esiswini. Amagagasi omsakazo anamandla amakhulu ashisa izinaliti nesimila esibulala amangqamuzana omdlavuza. Ukukhishwa kwe-Radiofrequency kusetshenziselwa ukwelapha i-hepatoblastoma ephindaphindiwe.

• Umjovo we-ethanol onamandla: Inaliti encane isetshenziselwa ukujova i-ethanol (i-alcohol engaxutshwe nalutho) ngqo ku-tumor ukubulala amangqamuzana omdlavuza. Ukwelashwa kungadinga imijovo eminingana. Umjovo we-ethanol onamandla usetshenziselwa ukwelapha i-hepatoblastoma ephindaphindwayo.

Imithi elwa namagciwane

I-hepatocellular carcinoma exhumene negciwane le-hepatitis B ingalashwa ngemithi elwa namagciwane.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Lesi sigaba esifingqiwe sichaza izindlela zokwelashwa ezicwaningwa ekuhlolweni kwemitholampilo. Kungenzeka kungasho yonke imishanguzo emisha efundwayo. Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana omdlavuza athile. Ukwelashwa kweTyrosine kinase inhibitor (TKI) uhlobo lwezokwelapha ezihlosiwe. Amasiginali we-TKIs adingekayo ukuze izicubu zikhule. I-Sorafenib ne-pazopanib ngama-TKI afundelwa ukwelashwa kwe-hepatocellular carcinoma ebuyile kanye ne-embryonal sarcoma yesibindi esanda kutholakala.

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 ukuthi iqembu lokwelashwa lingahle liphindwe. 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 Umdlavuza Wesibindi Ebuntwaneni

Kulesi Sigaba

• I-hepatoblastoma

• I-Hepatocellular Carcinoma

• I-Embryonal Sarcoma Engafaniyo Yesibindi

• I-Infantile Choriocarcinoma yesibindi

• Izimila Zesibindi Semithambo

• Umdlavuza Wesibindi Ophindaphindayo

• Izinketho zokwelashwa ezivivinyweni zomtholampilo

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

I-hepatoblastoma

Izinketho zokwelashwa kwe-hepatoblastoma ezingasuswa ngokuhlinzwa ngesikhathi sokuxilongwa zingafaka okulandelayo:

• Ukuhlinzwa kususwe isimila, kulandelwe inhlanganisela yokwelashwa ngamakhemikhali ye-hepatoblastoma engahlukanisi kahle nge-fetology histology. Nge-hepatoblastoma eneseli elincane elingenasici, kunikezwa i-chemotherapy enobudlova.

• Ukuhlinzwa kususwe isimila, kulandelwe ukulinda okulindile noma i-chemotherapy, ye-hepatoblastoma ene-fetology histology ehlukaniswe kahle.

Izinketho zokwelashwa kwe-hepatoblastoma ezingenakususwa ngokuhlinzwa noma zingasuswa ngesikhathi sokuxilongwa zingafaka okulandelayo:

• Inhlanganisela yokwelashwa ngamakhemikhali ukunciphisa isimila, kulandelwe ukuhlinzwa ukuze kususwe isimila.

• Inhlanganisela yamakhemikhali, ilandelwa ukufakelwa kwesibindi.

• I-Chemoembolization yomthambo wesibindi wokunciphisa isimila, kulandelwe ukuhlinzwa ukuze kususwe isimila.

• Uma isimila esisesibindi singasuswa ngokuhlinzwa kepha azikho izimpawu zomdlavuza kwezinye izingxenye zomzimba, ukwelashwa kungaba ukufakelwa kwesibindi.

Kwi-hepatoblastoma eye yasakazekela kwezinye izingxenye zomzimba ngesikhathi sokuxilongwa, inhlanganisela yokwelashwa ngamakhemikhali inikezwa ukunciphisa izicubu esibindini kanye nomdlavuza osakazekele kwezinye izingxenye zomzimba. Ngemuva kwamakhemikhali, ukuhlolwa kwe-imaging kuyenziwa ukuhlola ukuthi izicubu zingasuswa yini ngokuhlinzwa.

Izinketho zokwelashwa zingafaka okulandelayo:

• Uma isimila esisesibindi nezinye izingxenye zomzimba (imvamisa amaqhuqhuva ephashini) singasuswa, kuzokwenziwa ukuhlinzwa ukuze kususwe izicubu ezilandelwa yi-chemotherapy ukubulala noma yimaphi amangqamuzana omdlavuza angahlala.

• Uma isimila kwezinye izingxenye zomzimba singeke sisuswe noma ukufakelwa isibindi kungenzeki, i-chemotherapy, i-chemoembolization yomthambo we-hepatic, noma ukwelashwa ngemisebe kunganikezwa.

• Uma isimila kwezinye izingxenye zomzimba singeke sisuswe noma isiguli singafuni ukuhlinzwa, kunganikezwa ukuqedwa kwe-radiofrequency.

Izinketho zokwelashwa ezivivinyweni zokwelashwa kwe-hepatoblastoma esanda kutholakala zifaka:

• Isivivinyo somtholampilo se-chemotherapy nokuhlinzwa.

I-Hepatocellular Carcinoma

Izinketho zokwelashwa kwe-hepatocellular carcinoma ezingasuswa ngokuhlinzwa ngesikhathi sokuxilongwa zingafaka okulandelayo:

• Ukuhlinzwa wedwa ukususa isimila.

• Ukuhlinzwa kususwe isimila, kulandelwe ukwelashwa ngamakhemikhali.

• Inhlanganisela yamakhemikhali, ilandelwa ukuhlinzwa ukuze kususwe isimila.

Izinketho zokwelashwa kwe-hepatocellular carcinoma ezingenakususwa ngokuhlinzwa futhi zingakasakazeki kwezinye izingxenye zomzimba ngesikhathi sokuxilongwa zingafaka okulandelayo:

• I-Chemotherapy yokunciphisa isimila, kulandele ukuhlinzwa ukuze kususwe ngokuphelele isimila.

• I-Chemotherapy yokunciphisa isimila. Uma ukuhlinzwa ukukhipha ngokuphelele isimila kungenzeki, ukwelashwa okuqhubekayo kungafaka okulandelayo:

• Ukufakelwa kwesibindi.

• I-Chemoembolization yomthambo wesibindi wokunciphisa isimila, kulandelwe ukuhlinzwa ukususa isimila noma ukufakelwa kwesibindi.

• I-Chemoembolization ye-artery hepatic iyodwa.

• I-Chemoembolization elandelwa ukufakelwa kwesibindi.

• I-Radioembolization yomthambo we-hepatic njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

Ukwelashwa kwe-hepatocellular carcinoma okusakazekele kwezinye izingxenye zomzimba ngesikhathi sokuxilongwa kungafaka:

• Inhlanganisela yokwelashwa ngamakhemikhali ukunciphisa isimila, kulandelwe ukuhlinzwa ukuze kususwe isimila esiningi ngangokunokwenzeka esibindini nakwezinye izindawo lapho umdlavuza usabalale khona. Ucwaningo alukhombisanga ukuthi le ndlela yokwelashwa isebenza kahle kepha ezinye iziguli zingathola inzuzo ethile.

Izinketho zokwelashwa kwe-hepatocellular carcinoma ehlobene nokutheleleka ngegciwane le-hepatitis B (HBV) zifaka:

• Ukuhlinzwa ukukhipha isimila.

• Imithi elwa namagciwane elapha ukutheleleka okubangelwa igciwane le-hepatitis B.

Izinketho zokwelashwa ezivivinyweni zokwelashwa ze-hepatocellular carcinoma esanda kutholakala zifaka:

• Isivivinyo somtholampilo se-chemotherapy nokuhlinzwa.

I-Embryonal Sarcoma Engafaniyo Yesibindi

Izinketho zokwelashwa ze-embarconal sarcoma yesibindi zingafaka okulandelayo:

• Inhlanganisela yokwelashwa ngamakhemikhali ukunciphisa isimila, kulandelwe ukuhlinzwa ukuze kususwe isimila esiningi ngangokunokwenzeka. I-Chemotherapy nayo inganikezwa ngemuva kokuhlinzwa ukukhipha isimila.

• Ukuhlinzwa kususwe isimila, kulandelwe ukwelashwa ngamakhemikhali. Ukuhlinzwa kwesibili kungenziwa ukususa isimila esisele, kulandelwe ukwelashwa ngamakhemikhali okuningi.

• Ukufakelwa kwesibindi uma ukuhlinzwa kukhipha isimila akunakwenzeka.

• Isivivinyo somtholampilo sohlobo olusha lokwelashwa olungafaka phakathi ukwelashwa okuhlosiwe (pazopanib), i-chemotherapy kanye / noma i-radiation therapy ngaphambi kokuhlinzwa.

I-Infantile Choriocarcinoma yesibindi

Izinketho zokwelashwa ze-choriocarcinoma yesibindi ezinganeni zingabandakanya okulandelayo:

• Inhlanganisela yokwelashwa ngamakhemikhali ukunciphisa isimila, kulandelwe ukuhlinzwa ukuze kususwe isimila.

• Ukuhlinzwa ukukhipha isimila.

Izimila Zesibindi Semithambo

Bona isifinyezo se- ekwelashweni kwe-Childhood Vascular Tumors Treatment ukuthola imininingwane yokwelashwa kwezimila zesibindi semithambo.

Umdlavuza Wesibindi Ophindaphindayo

Ukwelashwa kwe-hepatoblastoma eqhubekayo noma ephindaphindayo kungafaka okulandelayo:

• Ukuhlinzwa ukuze kususwe izicubu zemithambo ezihlukanisiwe (ezingashadile nezihlukile) ezine-chemotherapy noma ezingenayo.

• Ukukhishwa kwe-Radiofrequency.

• Inhlanganisela chemotherapy.

• Ukufakelwa kwesibindi.

• Ukwelashwa kwe-Ablation (i-radiofrequency ablation noma umjovo we-ethanol onqenqemeni) njengokwelashwa okunciphisayo ukukhulula izimpawu nokuthuthukisa ikhwalithi yempilo.

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

Ukwelashwa kwe-carcinoma eqhubekayo noma ephindaphindekayo kungafaka okulandelayo:

• I-Chemoembolization yomthambo we-hepatic wokunciphisa isimila ngaphambi kokufakelwa kwesibindi.

• Ukufakelwa kwesibindi.

• Isivivinyo somtholampilo sokwelapha okuqondisiwe (i-sorafenib).

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

Ukwelashwa kwe-embryonal sarcoma yesibindi engabandakanyi kungafaka okulandelayo:

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

Ukwelashwa kwe-choriocarcinoma ephindaphindwayo yesibindi ezinganeni kungabandakanya okulandelayo:

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

Izinketho zokwelashwa ezivivinyweni zomtholampilo

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 Wesibindi Wengane

Ngemininingwane engaphezulu evela kuNational Cancer Institute mayelana nomdlavuza wesibindi ebuntwaneni, bheka okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza Wesibindi Nebhali

• I-Computed Tomography (CT) Iskena Nomdlavuza

• I-MyPART - Inethiwekhi Yami Yezingane ne-Adult Rare Tumor Network

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

• Mayelana Nomdlavuza

• Umdlavuza Wezingane

• I-CureSearch ye-Cancer YezinganePhuma Ukuzikhulula

• Imiphumela Emuva Yokwelapha Yomdlavuza Wezingane

• Intsha kanye nabantu abadala abancane abaneCancer

• Izingane Ezinomdlavuza: Umhlahlandlela Wabazali

• Umdlavuza Ezinganeni Nasebusheni

• Isiteji

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli