Izinhlobo / izicubu ezithambile-i-sarcoma / isiguli / i-rhabdomyosarcoma-treatment-pdq

Ukwelashwa Kwe-Childhood Rhabdomyosarcoma (®) -Patient Version

Imininingwane ejwayelekile Mayelana neRhabdomyosarcoma Yezingane

I-rhabdomyosarcoma yobuntwana yisifo lapho amangqamuzana amabi (umdlavuza) akha izicubu zomzimba.

IRhabdomyosarcoma uhlobo lwesarcoma. I-Sarcoma umdlavuza wezicubu ezithambile (njengemisipha), izicubu ezixhuma (njengethoni noma uqwanga), noma ithambo. IRhabdomyosarcoma imvamisa iqala emisipheni enamathiselwe emathanjeni futhi esiza umzimba ukuba unyakaze. I-Rhabdomyosarcoma uhlobo oluvame kakhulu lwe-sarcoma yezicubu ezithambile ezinganeni. Ingaqala ezindaweni eziningi emzimbeni.

Kunezinhlobo ezintathu eziyinhloko ze-rhabdomyosarcoma:

• Embryonal: Lolu hlobo lwenzeka kakhulu ekhanda nasentanyeni noma ezithweni zangasese noma zomchamo, kepha kungenzeka noma kuphi emzimbeni. Uhlobo oluvame kakhulu lwe-rhabdomyosarcoma.

• I-Alveolar: Lolu hlobo lwenzeka kaningi ezingalweni noma emilenzeni, esifubeni, esiswini, ezithweni zangasese, noma endaweni yangemuva.

• I-Anaplastic: Lolu uhlobo olujwayelekile kakhulu lwe-rhabdomyosarcoma ezinganeni.

Bona izifinyezo ezilandelayo zokwelashwa kwe- ngolwazi mayelana nezinye izinhlobo ze-sarcoma yezicubu ezithambile:

• Izicubu Ezithambile Zengane Sarcoma

• Izicubu Zabantu Abadala Ezithambile Sarcoma

Izimo ezithile zofuzo zandisa ubungozi be-rhabdomyosarcoma yobuntwana.

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.

Izici ezinobungozi be-rhabdomyosarcoma zifaka ukuba nezifo ezilandelayo ezizuzwe njengefa:

• Isifo se-Li-Fraumeni.

• I-Pleuropulmonary blastoma.

• Uhlobo lwe-Neurofibromatosis 1 (NF1).

• I-Costello syndrome.

• Isifo se-Beckwith-Wiedemann.

• I-Noonan syndrome.

Izingane ezinesisindo esiphakeme sokuzalwa noma ezazinkulu kunokulindelekile lapho zizalwa zingaba nengozi eyengeziwe ye-rhabdomyosarcoma embryonal.

Ezimweni eziningi, imbangela ye-rhabdomyosarcoma ayaziwa.

Isibonakaliso se-rhabdomyosarcoma ebuntwaneni yisigaxa noma ukuvuvukala okuqhubeka kukhula.

Izimpawu nezimpawu zingabangelwa i-rhabdomyosarcoma yobuntwana noma ezinye izimo. Izimpawu nezimpawu ezenzekayo zincike lapho umdlavuza wakha khona. Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Isigaxa noma ukuvuvukala okuqhubeka nokukhula noma kungapheli. Kungaba buhlungu.

• Ukuqhuma kweso.

• Ubuhlungu bekhanda.

• Inkinga yokuchama noma ukunyakaza kwamathumbu.

• Igazi emchameni.

• Ukopha emakhaleni, umphimbo, isitho sangasese sowesifazane, noma i-rectum.

Ukuhlolwa kokuxilonga kanye ne-biopsy kusetshenziselwa ukuthola (ukuthola) nokuxilonga i-rhabdomyosarcoma yobuntwana.

Ukuhlolwa kokuxilongwa okwenziwa kuncike engxenyeni yokuthi umdlavuza wakha kuphi. 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.

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

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, njengesifuba, isisu, ukhalo, noma ama-lymph node, athathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.

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

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo zomzimba, njengogebhezi, ubuchopho nama-lymph node. 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-PET scan (i-positron emission tomography scan): Inqubo yokuthola amangqamuzana abulalayo omzimba emzimbeni. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni. Isithwebuli se-PET sizungeza umzimba futhi senze isithombe lapho i-glucose isetshenziswa khona emzimbeni. Amaseli amathumba amabi abonakala ekhanya esithombeni ngoba ayasebenza futhi athatha i-glucose eningi kunamaseli avamile.

Ukuskena kwePositron emission tomography (PET). Ingane ilele phezu kwetafula elishibilika ngesithwebuli se-PET. Ukuphumula kwekhanda nomucu omhlophe kusiza ingane ukuba ilele inganyakazi. Inani elincane le-glucose enemisebe (ushukela) lifakwa emthanjeni wengane, futhi isithwebuli senza isithombe sokuthi i-glucose isetshenziswa kuphi emzimbeni. Amaseli womdlavuza avela ngokugqamile esithombeni ngoba athatha i-glucose eningi kunamaseli avamile.

• 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.

• Isifiso somnkantsha we-Bone kanye ne-biopsy: Ukususwa komnkantsha wethambo, igazi, nocezu oluncane lwethambo ngokufaka inaliti engenalutho emvubeni. Amasampula asuswa kuwo womabili amathambo. Isazi sezifo sibheka umnkantsha, igazi, nethambo ngaphansi kwesibonakhulu ukuze kubhekwe izimpawu zomdlavuza.

Ukufiswa komnkantsha we-Bone kanye ne-biopsy. Ngemuva kokuthi indawo encane yesikhumba iboshwe, kufakwa inaliti yomnkantsha ethanjeni lesinqe sengane. Amasampula egazi, amathambo, nomnkantsha uyasuswa ukuze kuhlolwe ngaphansi kwesibonakhulu.

• Ukubhoboza i-Lumbar: Inqubo esetshenziselwa ukuqoqa i-cerebrospinal fluid (CSF) kusuka kukholamu lomgogodla. Lokhu kwenziwa ngokubeka inaliti phakathi kwamathambo amabili emgogodleni naku-CSF ezungeze umgogodla nokususa isampula loketshezi. Isampula le-CSF lihlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zamangqamuzana omdlavuza. Le nqubo ibizwa nangokuthi i-LP noma umpompi womgogodla.

Uma lezi zivivinyo zibonisa ukuthi kungenzeka kube ne-rhabdomyosarcoma, kwenziwa i-biopsy. I-biopsy ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Ngoba ukwelashwa kuncike ohlotsheni lwe-rhabdomyosarcoma, amasampula we-biopsy kufanele ahlolwe ngudokotela wezifo onolwazi lokuthola i-rhabdomyosarcoma.

Olunye lwezinhlobo ezilandelayo ze-biopsies lungasetshenziswa:

• I-Fine-needle aspiration (FNA) biopsy: Ukususwa kwezicubu noma uketshezi kusetshenziswa inaliti ezacile.

• I-Core needle biopsy: Ukususwa kwezicubu kusetshenziswa inaliti ebanzi. Le nqubo ingaqondiswa kusetshenziswa i-ultrasound, i-CT scan, noma i-MRI.

• I-biopsy evulekile: Ukususwa kwezicubu ngokusika (ukusika) okwenziwe esikhumbeni.

• I-Sentinel lymph node biopsy: Ukususwa kwe-sentinel lymph node ngesikhathi sokuhlinzwa. I-sentinel lymph node iyisakhi sokuqala se-lymph eqenjini lama-lymph node ukuthola i-lymphatic drainage evela ku-tumor yokuqala. Kuyi-lymph node yokuqala umdlavuza ongahle usabalale uye kusukela kusimila sokuqala. Kufakwa into enemisebe kanye / noma udayi oluhlaza okwesibhakabhaka eduze kwesimila. Into noma udayi ugeleza ngemigudu ye-lymph uye kuma-lymph node. I-lymph node yokuqala yokwamukela into noma udayi iyasuswa. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza. Uma amangqamuzana omdlavuza engatholakali, kungahle kungadingeki ukususa ama-lymph node amaningi. Kwesinye isikhathi, i-sentinel lymph node itholakala eqenjini elingaphezu kwelilodwa lama-node.

Ukuhlolwa okulandelayo kungenziwa kusampula lezicubu ezisusiwe:

• I-microscopy ekhanyayo: Isivivinyo selabhorethri lapho amaseli esampula yezicubu abukwa khona ngaphansi kwama-microscopes avamile futhi anamandla aphezulu ukubheka ushintsho oluthile kumaseli.

• I-Immunohistochemistry: Isivivinyo esisebenzisa amasosha omzimba ukubheka ama-antigen athile kusampula lezicubu. I-antibody ivame ukuxhunyaniswa nento enemisebe noma idayi ebangela ukuthi izicubu zikhanye ngaphansi kwesibonakhulu. Lolu hlobo lokuhlola lungasetshenziselwa ukutshela umehluko phakathi kwezinhlobo ezahlukahlukene zomdlavuza.

• I-FISH (i-fluorescence in situ hybridization): Ukuhlolwa kwaselebhu okusetshenziselwa ukubheka izakhi zofuzo noma ama-chromosomes kumaseli nezicubu. Izingcezu ze-DNA ezinodayi we-fluorescent zenziwa elabhoratri bese zengezwa kumaseli noma izicubu kusilayidi sengilazi. Lapho lezi zingcezu ze-DNA zinamathela kuzakhi zofuzo ezithile noma ezindaweni ezithile zama-chromosomes kwisilayidi, ziyakhanya lapho zibhekwa ngaphansi kwesibonakhulu esinokukhanya okukhethekile. Lolu hlobo lokuhlola lusetshenziselwa ukuthola izinguquko ezithile zofuzo.

• Reverse transcription – polymerase chain reaction (RT – PCR) test: Isivivinyo selabhorethri lapho kufundwa amaseli esampula yezicubu kusetshenziswa amakhemikhali ukubheka ushintsho oluthile esakhiweni noma ekusebenzeni kofuzo.

• Ukuhlaziywa kwe-cytogenetic: Ukuhlolwa kwelabhorethri lapho amaseli esampula yezicubu abukwa ngaphansi kwesibonakhulu ukubheka ushintsho oluthile kuma-chromosomes.

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

Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

• Iminyaka yesiguli.

• Lapho emzimbeni kuqale isimila.

• Ubukhulu be-tumor ngesikhathi sokuxilongwa.

• Ukuthi isimila sisuswe ngokuphelele yini ngokuhlinzwa.

• Uhlobo lwe-rhabdomyosarcoma (embryonal, alveolar, noma i-anaplastic).

• Ukuthi kunezinguquko ezithile yini kwizakhi zofuzo.

• Ukuthi isimila besisabalalele kwezinye izingxenye zomzimba ngesikhathi sokuxilongwa.

• Ukuthi isimila besiku-lymph node ngesikhathi sokuxilongwa.

• Ukuthi isimila siphendula i-chemotherapy kanye / noma i-radiation therapy.

Ezigulini ezinomdlavuza ophindaphindiwe, ukubikezela nokwelashwa nakho kuncike kokulandelayo:

• Lapho emzimbeni kuvele isimila (sabuya).

• Singakanani isikhathi esidlulile phakathi kokuphela kokwelashwa komdlavuza nalapho umdlavuza uphinde wabuya.

• Ukuthi isimila selashwa yini ngemithi yokwelashwa ngemisebe.

Izigaba zeRhabdomyosarcoma yobuntwana

AMAPHUZU ASEMQOKA

• Ngemuva kokutholakala kobuntwana i-rhabdomyosarcoma, ukwelashwa kusekelwe engxenyeni yesigaba somdlavuza futhi kwesinye isikhathi kusekelwe ekutheni ngabe wonke umdlavuza ususwe ngokuhlinzwa yini.

• Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

• Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

• Isiteji se-rhabdomyosarcoma ebuntwaneni senziwa ezingxenyeni ezintathu.

• Uhlelo lwesiteji lususelwe kubukhulu besimila, lapho busemzimbeni khona, nokuthi ngabe selusabalele nakwezinye izingxenye zomzimba:

• Isigaba 1

• Isigaba 2

• Isigaba 3

• Isigaba 4

• Uhlelo lokuqoqa lususelwa ekutheni umdlavuza ususakazekile nokuthi ngabe wonke umdlavuza ususwe ngokuhlinzwa:

• Iqembu I

• Iqembu II

• Iqembu III

• Iqembu IV

• Iqembu elinobungozi lisuselwe ohlelweni lokubeka esiteji nakuhlelo lokuqoqa.

• I-rhabdomyosarcoma yobuntwana obunobungozi obuphansi

• Ingozi ephakathi nendawo i-rhabdomyosarcoma yobuntwana

• Ingozi ephezulu yobuntwana i-rhabdomyosarcoma

Ngemuva kokutholakala kobuntwana i-rhabdomyosarcoma, ukwelashwa kusekelwe engxenyeni yesigaba somdlavuza futhi kwesinye isikhathi kusekelwe ekutheni ngabe wonke umdlavuza ususwe ngokuhlinzwa yini.

Inqubo esetshenziselwa ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwezicubu noma kwezinye izingxenye zomzimba ibizwa nge-staging. Kubalulekile ukwazi isigaba ukuze uhlele ukwelashwa. Udokotela uzosebenzisa imiphumela yezivivinyo zokuxilonga ukusiza ukuthola isigaba sesifo.

Ukwelashwa kwe-rhabdomyosarcoma ebuntwaneni kusekelwe ngokwengxenye esiteji futhi kwesinye isikhathi kunani lomdlavuza osala ngemuva kokuhlinzwa ukukhipha isimila. Udokotela wezifo uzosebenzisa imicroscope ukuhlola izicubu ezisusiwe ngesikhathi sokuhlinzwa, kufaka phakathi amasampula wezicubu emaphethelweni ezindawo lapho umdlavuza ukhishwe khona kanye nezindawo zamanzi. Lokhu kwenzelwa ukubona ukuthi ngabe wonke amangqamuzana omdlavuza akhishwe ngesikhathi sokuhlinzwa.

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 i-rhabdomyosarcoma isakazeka iye emaphashini, amangqamuzana omdlavuza asephashini empeleni angamaseli e-rhabdomyosarcoma. Lesi sifo siyi-metastatic rhabdomyosarcoma, hhayi umdlavuza wamaphaphu.

Isiteji se-rhabdomyosarcoma ebuntwaneni senziwa ezingxenyeni ezintathu.

I-rhabdomyosarcoma yobuntwana ihlelwe ngokusebenzisa izindlela ezintathu ezahlukene zokuchaza umdlavuza:

• Uhlelo lwesiteji.
• Uhlelo lokuqoqa.
• Iqembu eliyingozi.

Uhlelo lwesiteji lususelwe kubukhulu besimila, lapho busemzimbeni khona, nokuthi ngabe selusabalele nakwezinye izingxenye zomzimba:

Isigaba 1

Esigabeni 1, isimila sinanoma yisiphi isayizi, kungenzeka ukuthi sisakazekele kuma-lymph node, futhi sitholakala endaweni eyodwa kuphela kulezi ezilandelayo "ezithandekayo":

• Iso noma indawo ezungeze iso.

• Inhloko nentamo (kepha hhayi esikhunjeni esiseduze kobuchopho nomgogodla).

• I-gallbladder ne-bile ducts.

• Ama-Ureters noma i-urethra.

• Ukuhlolwa, isizalo, isitho sangasese sowesifazane, noma isibeletho.

IRhabdomyosarcoma eyakha kusayithi "elihle" inesibikezelo esingcono. Uma indawo lapho umdlavuza uvela khona akuyona enye yezindawo ezithandekayo ezibalwe ngenhla, kuthiwa yindawo "engathandeki".

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

Isigaba 2

Esigabeni sesi-2, umdlavuza utholakala endaweni "engathandeki" (noma iyiphi indawo eyodwa engachazwanga njenge "evumayo" esigabeni 1). Isimila asikho ngaphezu kwamasentimitha ama-5 futhi asisakazekanga kuma-lymph node.

Isigaba 3

Esigabeni sesi-3, umdlavuza utholakala endaweni "engathandeki" (noma iyiphi indawo eyodwa engachazwanga njenge "inhle" esigabeni 1) futhi okunye kwalokhu okulandelayo kuyiqiniso:

• Isimila asikho ngaphezu kwamasentimitha ama-5 kanti umdlavuza ususabalele kuma-lymph node aseduze.

• Isimila sikhulu kunamasentimitha ama-5 kanti umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.

Isigaba 4

Esigabeni sesi-4, isimila singaba bukhulu futhi umdlavuza kungenzeka usabalalele kuma-lymph node aseduze. Umdlavuza usabalalele ezingxenyeni ezikude zomzimba, njengephaphu, umnkantsha, noma ithambo.

Uhlelo lokuqoqa lususelwa ekutheni umdlavuza ususakazekile nokuthi ngabe wonke umdlavuza ususwe ngokuhlinzwa:

Iqembu I

Umdlavuza utholakale kuphela lapho uqale khona futhi wasuswa ngokuphelele ngokuhlinzwa. Izicubu zithathwe emaphethelweni lapho kukhishwe khona isimila. Izicubu zahlolwa ngaphansi kwesibonakhulu ngudokotela wezifo futhi awekho amaseli omdlavuza atholakele.

Iqembu II

Iqembu II lihlukaniswe ngamaqembu IIA, IIB, kanye ne-IIC.

• IIA: Umdlavuza wasuswa ngokuhlinzwa kepha amangqamuzana omdlavuza abonakala lapho izicubu, ezithathwe emaphethelweni lapho kukhishwe khona isimila, zabhekwa ngaphansi kwesibonakhulu ngudokotela wezifo.

• I-IIB: Umdlavuza wawusabalele kuma-lymph node aseduzane kanti umdlavuza nama-lymph node asuswa ngokuhlinzwa.

• IIC: I-Cancer yayisabalele kuma-lymph node aseduze, umdlavuza nama-lymph node asuswa ngokuhlinzwa, futhi okungenani okukodwa kokulandelayo kuyiqiniso:

• Izicubu ezithathwe emaphethelweni lapho kukhishwe khona isimila zahlolwa ngaphansi kwesibonakhulu ngudokotela wezifo kanye namaseli womdlavuza abonwa.

• I-lymph node eqhelelene kakhulu nesimila esasuswa yahlolwa ngaphansi kwesibonakhulu ngudokotela wezifo kanye namaseli womdlavuza abonwa.

Iqembu III

Umdlavuza ukhishwe kancane nge-biopsy noma ngokuhlinzwa kepha kusasele isimila esibonwayo ngeso.

Iqembu IV

• Umdlavuza ubusabalele ezingxenyeni ezikude zomzimba ngesikhathi kutholakala umdlavuza.

• Amaseli womdlavuza atholakala ngokuhlolwa kwe-imaging; noma

Kunamaseli womdlavuza kuluketshezi oluzungeze ubuchopho, umgogodla, noma amaphaphu, noma kuketshezi esiswini; noma izimila zitholakala kulezo zindawo.

Iqembu elinobungozi lisuselwe ohlelweni lokubeka esiteji nakuhlelo lokuqoqa.

Iqembu eliyingozi lichaza ithuba lokuthi i-rhabdomyosarcoma izophinda ibuye (ibuye). Yonke ingane elashelwa i-rhabdomyosarcoma kufanele ithole ukwelashwa ngamakhemikhali ukwehlisa umdlavuza wamathuba ozobuya. Uhlobo lwesidakamizwa se-anticancer, umthamo, kanye nenani lezindlela zokwelashwa ezinikeziwe kuncike ekutheni ingane inobungozi obuphansi, ingozi ephakathi, noma i-rhabdomyosarcoma enobungozi obukhulu.

Kusetshenziswa amaqembu ebungozi alandelayo:

I-rhabdomyosarcoma yobuntwana obunobungozi obuphansi

• I-rhabdomyosarcoma yobuntwana obunobungozi obuphansi ingenye yalezi ezilandelayo:

Isimila esiswini sombungu sanoma yisiphi isayizi esitholakala kusayithi "elihle". Kungase kube nesimila esisele ngemuva kokuhlinzwa okungabonakala nge-microscope noma ngaphandle kwaso. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze. Izindawo ezilandelayo zingamasayithi "amahle":

• Iso noma indawo ezungeze iso.

• Inhloko noma intamo (kepha hhayi esikhunjeni esiseduze nendlebe, ikhala, amasinusi, noma isisekelo sogebhezi).

• I-gallbladder ne-bile ducts.

• I-Ureter noma i-urethra.

• Ukuhlolwa, isizalo, isitho sangasese sowesifazane, noma isibeletho.

Isigaxa sombungu noma sosayizi esingatholakali kusayithi "elihle". Kungase kube nesimila esisele ngemuva kokuhlinzwa okungabonakala ngemicroscope kuphela. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.

Ingozi ephakathi nendawo i-rhabdomyosarcoma yobuntwana

I-rhabdomyosarcoma ebungozini obuphakathi nendawo ingenye yalokhu okulandelayo:

• Isimila esiswini sombungu sanoma yisiphi isayizi esingatholakali kwenye yezindawo "ezithandekayo" ezibalwe ngenhla. Kukhona isimila esisele ngemuva kokuhlinzwa, esingabonakala nge-microscope noma ngaphandle kwaso. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.

• Isigaxa se-alveolar sanoma yisiphi isayizi kusayithi "elihle" noma "elingalungile". Kungase kube nesimila esisele ngemuva kokuhlinzwa okungabonakala nge-microscope noma ngaphandle kwaso. Umdlavuza kungenzeka usabalalele kuma-lymph node aseduze.

Ingozi ephezulu yobuntwana i-rhabdomyosarcoma

I-rhabdomyosarcoma yengane enobungozi obukhulu ingaba uhlobo lwe-embryonal noma uhlobo lwe-alveolar. Kungenzeka ukuthi isakaze kuma-lymph node aseduze futhi isakaze kokukodwa noma ngaphezulu kokulandelayo:

• Ezinye izingxenye zomzimba ezingasondele lapho kwaqala khona isimila.

• Uketshezi oluzungeze ubuchopho noma umgogodla.

• Uketshezi emaphashini noma esiswini.

I-Rhabdomyosarcoma Yezingane Ephindaphindayo

I-rhabdomyosarcoma ebuntwaneni evamile ngumdlavuza obuye wabuya (ubuya) ngemuva kokuba welashwe. Umdlavuza ungabuya endaweni efanayo noma kwezinye izingxenye zomzimba, njengephaphu, ithambo, noma umnkantsha. Ngaphansi kokujwayelekile, i-rhabdomyosarcoma ingabuya ibele kwabesifazane abasebasha noma esibindini.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukene zokwelashwa kweziguli ezine-rhabdomyosarcoma yobuntwana.

• Izingane ezine-rhabdomyosarcoma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza ezinganeni.

• Ukwelashwa kwe-rhabdomyosarcoma ebuntwaneni kungadala imiphumela emibi.

• Izinhlobo ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa ngamakhemikhali

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• I-Immunotherapy

• 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 ezahlukene zokwelashwa kweziguli ezine-rhabdomyosarcoma yobuntwana.

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-rhabdomyosarcoma kufanele zihlelelwe ukwelashwa kwazo yiqembu labahlinzeki bezempilo abangongoti ekwelapheni umdlavuza ezinganeni.

Ngoba i-rhabdomyosarcoma ingakha ezingxenyeni eziningi zomzimba, izinhlobo eziningi zokwelashwa ziyasetshenziswa. Ukwelashwa kuzobhekwa ngudokotela wezingane oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. I-oncologist yezingane isebenza nabanye abahlinzeki bokunakekelwa kwezempilo abangochwepheshe ekwelapheni izingane ezine-rhabdomyosarcoma futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo:

• Udokotela wezingane.

• Udokotela ohlinzayo wezingane.

• I-radiation oncologist.

• I-hematologist yezingane.

• I-radiologist yezingane.

• Umhlengikazi ongumhlengikazi.

• Umeluleki wobungozi bezofuzo noma womdlavuza.

• Usonhlala kahle.

• Uchwepheshe wokuvuselelwa.

Ukwelashwa kwe-rhabdomyosarcoma 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 we-rhabdomyosarcoma 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 ezintathu zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Ukuhlinzwa (ukususa umdlavuza lapho usebenza) kusetshenziselwa ukwelapha i-rhabdomyosarcoma ebuntwaneni. Uhlobo lokuhlinzwa olubizwa ngokuthi ukusikwa kwendawo kabanzi kuvame ukwenziwa. Ukukhishwa okubanzi kwendawo ukususwa kwesimila nezinye izicubu ezisizungezile, kufaka phakathi ama-lymph node. Ukuhlinzwa kwesibili kungadingeka ukukhipha wonke umdlavuza. Ukuthi ukuhlinzwa kwenziwa nokuthi uhlobo lokuhlinzwa lwenziwe kuya ngalokhu okulandelayo:

• Lapho emzimbeni kuqale isimila.

• Umphumela ukuhlinzwa okuzoba nawo endleleni ingane ezobukeka ngayo.

• Umphumela ukuhlinzwa okuzoba nawo emisebenzini ebalulekile yomzimba yengane.

• Indlela isimila esiphendule ngayo ekwelashweni ngamakhemikhali noma ekwelashweni ngemisebe okungenzeka ukuthi kwanikezwa kuqala.

Ezinganeni eziningi ezine-rhabdomyosarcoma, akunakwenzeka ukususa sonke isimila ngokuhlinzwa.

I-Rhabdomyosarcoma ingakheka ezindaweni eziningi ezahlukene emzimbeni kanti ukuhlinzwa kuzohluka kwisiza ngasinye. Ukuhlinzwa ukwelashwa i-rhabdomyosarcoma yeso noma yezitho zobulili imvamisa kuyisifo se-biopsy. I-Chemotherapy, futhi kwesinye isikhathi ukwelashwa ngemisebe, kunganikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe izicubu ezinkulu.

Ngemuva kokuthi udokotela awususe wonke umdlavuza ongabonakala ngesikhathi sokuhlinzwa, iziguli zizonikezwa i-chemotherapy ngemuva kokuhlinzwa ukubulala noma yimaphi amangqamuzana omdlavuza asele. Ukwelashwa ngemisebe nakho kunganikezwa. Ukwelashwa okunikezwe ngemuva kokuhlinzwa, ukwehlisa ubungozi bokuthi umdlavuza uzobuya, kubizwa ngokuthi yi-adjuvant therapy.

Ukwelashwa ngemisebe

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

• Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni. Izindlela ezithile zokunikeza ukwelashwa ngemisebe kungasiza ukugcina imisebe ekulimaleni izicubu ezinempilo eziseduze. Lezi zinhlobo zokwelashwa ngemisebe yangaphandle zifaka okulandelayo:

• Ukwelashwa kwemisebe eguquguqukayo: Ukwelashwa kwemisebe eguquguqukayo kuwuhlobo lokwelashwa kwemisebe yangaphandle okusebenzisa ikhompyutha ukwenza isithombe esingu-3-dimensional (3-D) sesimila futhi kulolonge imishayo yemisebe ukuze ilingane nalesi sifo. Lokhu kuvumela umthamo omkhulu wemisebe ukuthi ufinyelele isimila futhi kubangele ukulimala okuncane ezicutshini eziseduze ezinempilo.

• Ukwelashwa kwemisebe ye-intension-modulated (IMRT): I-IMRT uhlobo lokwelashwa kwemisebe ka-3-dimensional (3-D) esebenzisa ikhompyutha ukwenza izithombe zosayizi nokuma kwesimila. Imishayo emincane yemisebe yamandla ahlukene (amandla) ihloselwe isimila ezinhlangothini eziningi.

• I-Volumetrical modulated arc therapy (VMAT): I-VMAT uhlobo lwezokwelashwa kwemisebe engu-3-D esebenzisa ikhompyutha ukwenza izithombe zosayizi nokuma kwesimila. Umshini wemisebe uhamba esiyingini esizungeze isiguli kanye ngesikhathi sokwelashwa bese uthumela imishayo emincane yemisebe yamandla ahlukahlukene (amandla) kulesimila. Ukwelashwa nge-VMAT kulethwa ngokushesha kunokwelashwa nge-IMRT.

• Ukwelashwa kwemisebe yomzimba we-stereotactic: Ukwelashwa kwemisebe yomzimba we-stereotactic uhlobo lwezokwelapha ngemisebe yangaphandle. Kusetshenziswa imishini ekhethekile ukubeka isiguli endaweni efanayo ekwelashweni kwemisebe ngayinye. Kanye ngosuku izinsuku eziningana, umshini wemisebe uhlose umthamo omkhulu kunokwejwayelekile wemisebe ngqo esihlahleni. Ngokuba nesiguli endaweni efanayo ekwelashweni ngakunye, kunomonakalo omncane ezicutshini eziseduze ezinempilo. Le nqubo ibizwa nangokuthi i-stereotactic external-beam radiation therapy kanye ne-stereotaxic radiation therapy.

• Ukwelashwa kwemisebe ye-Proton beam: Ukwelashwa kwe-Proton-beam uhlobo lwamandla amakhulu, ukwelashwa kwemisebe yangaphandle. Umshini wokwelapha ngemisebe uhlose imifudlana yama-proton (izinhlayiya ezincane, ezingabonakali, ezishajwa kahle) kumaseli womdlavuza ukuwabulala. Lolu hlobo lwezokwelapha lubangela ukulimala okuncane ezicutshini eziseduze ezinempilo.

• Ukwelashwa kwemisebe kwangaphakathi kusebenzisa into enemisebe eboshwe ngezinaliti, izimbewu, izintambo, noma ama-catheters abekwe ngqo noma eduze komdlavuza. Isetshenziselwa ukwelapha umdlavuza ezindaweni ezifana nesitho sangasese sowesifazane, isitho sangasese sangasese, isibeletho, isinye, iprostate, ikhanda noma intamo. Ukwelashwa kwemisebe kwangaphakathi kubizwa nangokuthi i-brachytherapy, imisebe yangaphakathi, ukufakwa kwemisebe, noma ukwelashwa kwemisebe yangaphakathi.

Uhlobo nenani lokwelashwa ngemisebe futhi uma kunikezwa kuncike eminyakeni yengane, uhlobo lwe-rhabdomyosarcoma, lapho emzimbeni kwaqala khona isimila, ukuthi kwahlala isimila esingakanani ngemuva kokuhlinzwa, nokuthi ngabe kukhona yini isimila kuma-lymph node aseduze .

Ukwelashwa kwemisebe yangaphandle kuvame ukusetshenziselwa ukwelapha i-rhabdomyosarcoma yobuntwana kepha ezimweni ezithile kusetshenziswa ukwelashwa ngemisebe yangaphakathi.

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).

I-Chemotherapy nayo inganikezwa ukunciphisa isimila ngaphambi kokuhlinzwa ukuze konge izicubu ezinempilo ngangokunokwenzeka. Lokhu kubizwa ngokuthi yi-neoadjuvant chemotherapy.

Yonke ingane elashelwa i-rhabdomyosarcoma kufanele ithole i-systemic chemotherapy ukunciphisa amathuba okuthi umdlavuza uphinde ubuye. Uhlobo lwesidakamizwa se-anticancer, umthamo, kanye nenani lezindlela zokwelashwa ezinikeziwe kuncike ekutheni ingane inobungozi obuphansi, ingozi ephakathi, noma i-rhabdomyosarcoma enobungozi obukhulu.

Bheka Izidakamizwa Ezamukelwe iRhabdomyosarcoma ukuthola eminye imininingwane.

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.

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 yi-biologic therapy noma i-biotherapy.

Kunezinhlobo ezahlukene ze-immunotherapy:

• Ukwelashwa ngokugoma ukwelashwa komdlavuza okusebenzisa into noma iqembu lezinto ukukhuthaza amasosha omzimba ukuthi athole isimila asibulale. Ukwelashwa ngokugoma kuyacutshungulwa ukwelapha i-rhabdomyosarcoma yemetastatic.

• Ukwelashwa kwe-immune checkpoint inhibitor isebenzisa amasosha omzimba ukubulala amangqamuzana omdlavuza. Izinhlobo ezimbili zama-immune checkpoint inhibitors ziyafundwa ekwelapheni i-rhabdomyosarcoma ebuntwaneni ebuyile ngemuva kokwelashwa:

• I-CTLA-4 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba womzimba zihloliwe. Lapho i-CTLA-4 inamathela kwenye iphrotheni ebizwa nge-B7 esitokisini somdlavuza, iyamisa i-T cell ekubulaleni iseli lomdlavuza. I-CTLA-4 inhibitors inamathela ku-CTLA-4 futhi ivumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. I-Ipilimumab uhlobo lwe-CTLA-4 inhibitor.

Isithiyo sokuhlola izivikeli mzimba. Amaprotheni e-Checkpoint, afana ne-B7-1 / B7-2 kumaseli we-antigen-presenting (APC) kanye ne-CTLA-4 kuma-T cell, asiza ukugcina izimpendulo zomzimba womzimba zibheke. Lapho i-T-cell receptor (TCR) ibophezela kuma-antigen kanye namaprotheni amakhulu we-histocompatibility complex (MHC) ku-APC naku-CD28 ibopha ku-B7-1 / B7-2 ku-APC, i-T cell ingasebenza. Kodwa-ke, ukubopha kwe-B7-1 / B7-2 kuya ku-CTLA-4 kugcina amaseli we-T esesimweni sokungasebenzi ngakho-ke awakwazi ukubulala amangqamuzana e-tumor emzimbeni (iphaneli langakwesobunxele). Ukuvimba ukubopha kwe-B7-1 / B7-2 kuya ku-CTLA-4 nge-immune checkpoint inhibitor (anti-CTLA-4 antibody) kuvumela ama-T cell ukuthi asebenze futhi abulale amangqamuzana wesimila (iphaneli lesokudla).

• I-PD-1 yiprotheni ebusweni bamaseli we-T asiza ukugcina izimpendulo zomzimba womzimba zihloliwe. Lapho i-PD-1 inamathela kwenye iprotheni ebizwa nge-PDL-1 kuseli lomdlavuza, iyeka i-T cell ekubulaleni iseli lomdlavuza. Ama-PD-1 inhibitors anamathisela ku-PDL-1 futhi avumela amaseli we-T ukuthi abulale amangqamuzana omdlavuza. INivolumab ne-pembrolizumab bangama-PD-1 inhibitors.

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

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana omdlavuza. Izindlela zokwelashwa ezihlosiwe zivame ukudala ukulimala okuncane kumaseli ajwayelekile kunokwenza ngamakhemikhali noma ngemisebe. Kunezinhlobo ezahlukene zokwelashwa okuqondisiwe:

• Ama-mTOR inhibitors amisa amaprotheni asiza amangqamuzana ahlukane futhi aphile. I-Sirolimus uhlobo lwe-mTOR therapy yokwelashwa olufundwayo ekwelapheni i-rhabdomyosarcoma ephindaphindwayo.

• Ama-Tyrosine kinase inhibitors yizidakamizwa ezincane ezinama-molecule angena kulwelwesi lweseli futhi asebenze ngaphakathi kwamangqamuzana omdlavuza ukuvimba amasiginali ukuthi amangqamuzana omdlavuza adinga ukukhula nokukhula. I-MK-1775 ne-cabozantinib-s-malate yi-tyrosine kinase inhibitors efundwa ekwelapheni i-rhabdomyosarcoma ephindaphindwayo.

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 zokwelashwa zeRhabdomyosarcoma yobuntwana

Kulesi Sigaba

• Phambilini I-Rhabdomyosarcoma Yezingane Engalashwa

• I-Rhabdomyosarcoma Yezingane Ephikisayo noma Ephindaphindayo

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

Phambilini I-Rhabdomyosarcoma Yezingane Engalashwa

Ukwelashwa kwe-rhabdomyosarcoma ebuntwaneni kuvame ukufaka ukuhlinzekwa, ukwelashwa ngemisebe kanye nokwelashwa ngamakhemikhali. Umyalo onikezwa ngalezi zindlela zokwelashwa uncike ekutheni umzimba waqala kuphi isimila, ubukhulu besimila, uhlobo lwesimila, nokuthi isimila sesinabele yini kuma-lymph node noma kwezinye izingxenye zomzimba. Bheka isigaba se-Treatment Option Overview salesi sifinyeto ukuthola eminye imininingwane ngokuhlinzwa, ukwelashwa ngemisebe, kanye ne-chemotherapy esetshenziselwa ukwelapha izingane ezine-rhabdomyosarcoma.

I-Rhabdomyosarcoma yobuchopho nekhanda nentamo

• Okwezimila zobuchopho: Ukwelashwa kungafaka ukuhlinzwa ukuze kususwe isimila, ukwelashwa ngemisebe nokwelashwa ngamakhemikhali.

• Ngezicubu zekhanda nentamo eziseduze noma eziseduze kweso: Ukwelashwa kungafaka i-chemotherapy kanye ne-radiation therapy. Uma isimila sihlala noma sibuya ngemuva kokwelashwa nge-chemotherapy kanye ne-radiation therapy, kungahlinzwa ukuhlinzwa ukuze kususwe iso futhi ezinye izicubu ezungeze iso.

• Ngezicubu zekhanda nentamo eziseduze nendlebe, impumulo, amasinusi, noma isisekelo sogebhezi kodwa hhayi esweni noma eduze: Ukwelashwa kungafaka ukwelashwa ngemisebe kanye ne-chemotherapy.

• Ngezicubu zekhanda nentamo ezingekho noma eziseduze kweso futhi ezingasondele endlebeni, ekhaleni, esonweni, noma esisekelweni sogebhezi: Ukwelashwa kungabandakanya i-chemotherapy, i-radiation therapy, kanye nokuhlinzwa ukususa isimila.

• Ngezicubu zekhanda nentamo ezingenakususwa ngokuhlinzwa: Ukwelashwa kungafaka i-chemotherapy kanye ne-radiation therapy kubandakanya ne-stereotactic radiation radiation therapy.

• Ngezicubu zomphimbo (ibhokisi lezwi): Ukwelashwa kungafaka i-chemotherapy kanye ne-radiation therapy. Ukuhlinzwa ukususa umphimbo ngokuvamile akwenziwa, ukuze izwi lingalimali.

I-Rhabdomyosarcoma yezingalo noma yemilenze

• I-Chemotherapy elandelwa ukuhlinzwa ukuze kususwe isimila. Uma isimila singasuswanga ngokuphelele, kungenziwa ukuhlinzwa kwesibili ukukhipha isimila. Ukwelashwa ngemisebe nakho kunganikezwa.

• Ngezicubu zesandla noma unyawo, i-radiation therapy kanye ne-chemotherapy kunganikezwa. Isimila kungenzeka singasuswa ngoba sizothinta ukusebenza kwesandla noma unyawo.

• Ukuhlukaniswa kwe-lymph node (i-lymph node eyodwa noma ngaphezulu iyasuswa futhi isampula lezicubu lihlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza).

• Okwezimila ezingalweni, ama-lymph node aseduze kwesimila nasendaweni yasemakhwapheni ayasuswa.

• Okwezimila emilenzeni, ama-lymph node aseduze kwesimila nasendaweni ye-groin ayasuswa.

I-Rhabdomyosarcoma yesifuba, isisu, noma i-pelvis

• Okwezimila esifubeni noma esiswini (kufaka phakathi udonga lwesifuba noma udonga lwesisu): Ukuhlinzwa (ukusikwa kwendawo okubanzi) kungenziwa. Uma isimila sikhulu, kunikezwa i-chemotherapy kanye ne-radiation therapy ukuze kuncishiswe isimila ngaphambi kokuhlinzwa.

• Kwamathumba wekhaba: Ukuhlinzwa (ukusikwa okubanzi kwendawo) kungenziwa. Uma isimila sikhulu, kunikezwa i-chemotherapy yokunciphisa isimila ngaphambi kokuhlinzwa. Ukwelashwa ngemisebe kunganikezwa ngemuva kokuhlinzwa.

• Okwezimila zesilonda: I-biopsy yesimila ilandelwa ukwelashwa ngamakhemikhali nokwelashwa ngemisebe ukunciphisa isimila. Ukuhlinzwa kungenziwa kamuva ukukhipha noma yimaphi amaseli omdlavuza asele.

• Ngezicubu ze-gallbladder noma i-bile ducts: I-biopsy yesimila ilandelwa ukwelashwa ngamakhemikhali nokwelashwa ngemisebe.

• Ngezicubu zemisipha noma izicubu ezungeze indunu noma phakathi kwesitho sangasese sangasese kanye ne-anus noma i-scrotum ne-anus.

I-Rhabdomyosarcoma yezinso

• Okwezimila zezinso: Ukuhlinzwa ukukhipha isimila ngangokunokwenzeka. I-Chemotherapy kanye nokwelashwa ngemisebe nakho kunganikezwa.

Rhabdomyosarcoma wesinye noma wendlala

• Kwezimila ezisezingeni eliphezulu kwesinye kuphela: Ukuhlinzwa (ukusikwa kwendawo okubanzi) kuyenziwa.

• Ngezicubu ze-prostate noma isinye (ngaphandle kwaphezulu kwesinye):

• Ukwelashwa ngamakhemikhali nokwelashwa ngemisebe kunikezwa kuqala ukunciphisa isimila. Uma amangqamuzana omdlavuza ahlala ngemuva kokwelashwa ngamakhemikhali nokwelashwa ngemisebe, isimila sisuswa ngokuhlinzwa. Ukuhlinzwa kungafaka ukususwa kwe-prostate, ingxenye yesinye, noma ukucasulwa kwezitho zangasese ngaphandle kokususwa kwe-rectum. (Lokhu kungafaka ukususwa kwekholoni nesinye esingezansi. Emantombazaneni, kungenzeka kususwe umlomo wesibeletho, isitho sangasese sowesifazane, ama-ovari nama-lymph node aseduze).

• I-Chemotherapy inikezwa kuqala ukunciphisa isimila. Ukuhlinzwa ukukhipha isimila, kodwa hhayi isinye noma indlala yesibeletho, kwenziwa. Ukwelashwa ngemisebe kwangaphakathi noma kwangaphandle kunganikezwa ngemuva kokuhlinzwa.

• Ukuhlinzwa ukukhipha isimila, kodwa hhayi isinye noma indlala yesinye. Ukwelashwa kwemisebe yangaphakathi kunikezwa ngemuva kokuhlinzwa.

IRhabdomyosarcoma yendawo eseduze namasende

• Ukuhlinzwa ukususa isende nentambo yesidoda. Ama-lymph node ngemuva kwesisu angahlolwa umdlavuza, ikakhulukazi uma ama-lymph node emakhulu noma ingane ineminyaka eyi-10 noma ngaphezulu.

• Ukwelashwa ngemisebe kunganikezwa uma isimila singeke sisuswe ngokuphelele ngokuhlinzwa.

I-Rhabdomyosarcoma yesitho sangasese sowesifazane, sangasese, isibeletho, umlomo wesibeletho, noma i-ovary

• Ngezicubu zesitho sangasese sowesifazane kanye nesitho sangasese sowesifazane: Ukwelashwa kungafaka i-chemotherapy elandelwa ukuhlinzwa ukuze kususwe isimila. Ukwelashwa ngemisebe kwangaphakathi noma kwangaphandle kunganikezwa ngemuva kokuhlinzwa.

• Okwezimila zesibeletho: Ukwelashwa kungafaka i-chemotherapy noma yokwelashwa ngemisebe noma ngaphandle kwayo. Kwesinye isikhathi kungadingeka ukuhlinzwa ukuze kususwe noma yimaphi amangqamuzana omdlavuza asele.

• Kwezimila zomlomo wesibeletho: Ukwelashwa kungafaka i-chemotherapy elandelwa ukuhlinzwa ukususa noma yisiphi isimila esisele.

• Ngezicubu ze-ovary: Ukwelashwa kungafaka i-chemotherapy elandelwa ukuhlinzwa ukususa noma yisiphi isimila esisele.

I-rhabdomyosarcoma yemetastatic

Ukwelashwa, okufana nokwelashwa ngamakhemikhali, ukwelashwa ngemisebe, noma ukuhlinzwa ukuze kususwe isimila, kunikezwa lapho kwaqala khona isimila. Uma umdlavuza ususabalele ebuchosheni, emgogodleni, noma emaphashini, ukwelashwa ngemisebe kunganikezwa nasezindaweni lapho umdlavuza usabalale khona.

Ukwelashwa okulandelayo kusacutshungulwa i-rhabdomyosarcoma yemetastatic:

• Isivivinyo somtholampilo se-immunotherapy (ukwelashwa kokugoma).

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-Rhabdomyosarcoma Yezingane Ephikisayo noma Ephindaphindayo

Izinketho zokwelashwa ze-rhabdomyosarcoma ebuntwaneni ephikisayo noma ephindaphindwayo isuselwa ezicini eziningi, kufaka phakathi ukuthi umdlavuza ubuyile emzimbeni, luhlobo luni lokwelashwa ingane ebenalo ngaphambili, nezidingo zengane.

Ukwelashwa kwe-rhabdomyosarcoma ephikisayo noma ephindaphindwayo kungafaka okukodwa noma okuningi kokulandelayo:

• Ukuhlinzwa.

• Ukwelashwa ngemisebe.

• Ukwelashwa ngamakhemikhali.

• Isivivinyo somtholampilo sokwelapha okubhekiswe kukho noma i-immunotherapy (sirolimus, ipilimumab, nivolumab, noma pembrolizumab).

• Isivivinyo somtholampilo sokwelapha okuhlosiwe nge-tyrosine kinase inhibitor (MK-1775 noma i-cabozantinib-s-malate) kanye ne-chemotherapy.

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

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-Rhabdomyosarcoma Yobuntwana

Ngemininingwane engaphezulu evela ku-National Cancer Institute mayelana ne-rhabdomyosarcoma yobuntwana, bheka okulandelayo:

• Ikhasi lasekhaya le-Soft Tissue Sarcoma

• I-Computed Tomography (CT) Iskena Nomdlavuza

• Izidakamizwa zivunyelwe iRhabdomyosarcoma

• Izindlela Zokwelapha Zomdlavuza

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