Chipangizo cha SAVI Chothandizira Kuchepetsa Khansa ya M'thupi

Mapulogalamu ndi Machitidwe a SAVI Brachytherapy Device kwa APBI

Ngati ma radiation oncologist adalimbikitsa chipangizo cha SAVI breast brachytherapy pa kansa ya m'mawere , mwina muli ndi mafunso ambiri. Mazira otsekemera a m'mawere (APBI) ndi njira imodzi ngati muli ndi lumpectomy kwa khansa ya m'mawere. Kodi muyenera kudziwa chiyani za chipangizochi ndi chiyani chomwe mungayembekezere kuchipatala? Kodi njirayi ndi yogwira mtima motani poyerekeza ndi mitundu yambiri ya mankhwala a ma radiation? Tiyeni tiyankhule za momwe chipangizo cha SAVI brachytherapy chimagwirira ntchito, ndipo phindu ndi zovuta zomwe mungaganizire pakupanga chisankho chanu.

Cholinga cha mankhwala opatsirana pogwiritsa ntchito mankhwalawa ndi kuteteza kupewa kansara ya m'mawere. Ndiko kubwereza kwa khansa ya m'mawere yomwe imayambitsa imfa zambiri. Kuchita opaleshoni yamtenda monga lumpectomy sizowonongeka kwambiri kusiyana ndi mastectomy ndipo imakhala ndi moyo pokhapokha ngati ikutsatiridwa ndi mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala ophera khansa. Mbali yoipa ya izi, komabe, mankhwalawa amatha kuwononga minofu yachibadwa. Matenda opatsirana pogwiritsa ntchito mankhwala, kapena mankhwala omwe amatulutsa mkati mwake, ndi njira yomwe ingapangitse minofu yathanzi poyendetsa minofu pamtunda.

Kulimbana ndi khansa ya m'mimba kuchokera mkati

Mankhwala opatsirana pogwiritsa ntchito kansa ya m'mawere angaperekedwe ndi miyendo ya kunja kapena yapakati.

Mazira a kunja, omwe amatchedwanso mazira onse a mawere (WBI), amachititsa chifuwa chonse kuchokera kunja, poyang'ana kwambiri ma-x-ray pa chifuwa chanu.

Matenda a ubongo , omwe amatchedwanso interstitial brachytherapy, ndi mawonekedwe a ma radiation omwe amagwiritsira ntchito catheters (tiyi ting'onoting'ono tomwe timapanga) kuti tithe kutulutsa mpweya wochokera m'mimba mwathu ku chifuwa chanu ndi zochepa zazingwe.

Kuthamanga kwapadera kwapakati pa mimba (APBI)

Tidzakhala tikuyankhula za chipangizo cha SAVI kuti chidziwitso cha m'mawere chidziwike mwamsanga (APBI), koma ndifunikira kuzindikira kuti APBI ikhoza kuchitidwa ngati mawonekedwe a ma radiation akunja, kapena ngati mawonekedwe a ma radiation mkati kapena a brachytherapy monga ndi chipangizo cha SAVI.

Nthawi zina mazira amtundu wa kunja amachitidwa, ngakhale makamaka pa malo opatsirana khansa omwe amachitiranso brachytherapy APBI. Poyerekeza ndi chifuwa chonse cha mankhwala osokoneza bongo, mafukufuku oyambirira adapeza kuti kunja kwa APBI kumagwirizanitsidwa ndi chiopsezo chachikulu cha kubwerera kwawo komweko komanso chiopsezo chachikulu cha khansa yatsopano yoyamba yomwe imakhala pamtanda womwewo monga khansa yapachiyambi.

Zokhudzana ndi mankhwala onse a mazira a m'mawere, kunja kwa APBI kumawoneka kuti ikugwirizana ndi zotsatira zosauka zodzikongoletsera koma ndi poizoni wochepa wa khungu. Mu maphunziro, kunja kwa APBI kunkagwiritsidwa ntchito kawirikawiri kwa amayi omwe ali ndi zotupa zazing'ono zomwe zinali zosayenera, zotchedwa estrogen receptor zabwino, ndi HER2 zoipa.

Mwachidziwitso, APBI ikhoza kuchitidwa nthawi yochepa kwambiri, yophunzitsa kuti kutopa ndi khalidwe labwino.

Ngakhale kugwiritsidwa ntchito kwa kunja kwa APBI pakalipano kukuzunguliridwa ndi kutsutsana, malo ena akuluakulu a khansa akuphunzira njira zowonetsera kayendedwe ka zowonongeka ndi mtundu uwu wa ma radiation.

Tiyeni tsopano tiwone mkati (brachytherapy) APBI ndi chipangizo cha SAVI.

SAVI ™ Yothamanga Pakati Pazitsamba (APBI)

The SAVI, yomwe idali FDA kuvomerezedwa mu 2006, ndi chifuwa ma radiation chipangizo chomwe chingakhale mwambo-oyenera wanu lumpectomy cavity, mosasamala mtundu kapena kukula kwake.

Chipangizo ichi ndi mtolo wa makina ochepa kwambiri. Madzi a SAVI amalowetsedwa kudzera mu kanyumba kakang'ono, ndipo mtolo wa catheter umafalikira mofananamo, koma mawonekedwe ake apadera amalola kuti atsegulidwe mwanjira yomwe ikugwirizana kwenikweni ndi kukula ndi mawonekedwe a chotupa chanu.

Mankhwala a radiation amatha kudziwidwa mwachindunji kupyolera mu catheter iliyonse, zomwe zimapangitsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tiwone bwinobwino. Chipangizochi chimakhala chosinthika kwambiri kuposa chipangizo cha catheter chachikhalidwe kotero amayi omwe ali ndi mabere aang'ono akhoza kulandira mankhwalawa.

Zimene Mungayembekezere Kuchokera Pulogalamu ya SAVI

Dokotala wanu angathe kuika opaleshoni ya SAVI pa nthawi ya lumpectomy yanu, kapena akhoza kuikidwa pa opaleshoni yosiyana. Kutengeka kochepa kokha ndikofunikira, kuti mulole kuti kachipatala kameneka kaikidwe mkati mwanu. Malo osungirako mankhwalawa adzasungidwa ndi kuvala, ndipo gawo la mzere uliwonse wa catheter udzatambasula kunja kwa bere lanu mpaka mankhwala anu atsirizidwa.

Catheters ndi osinthasintha komanso ofewa, choncho ayenera kukhala omasuka kwa masiku asanu ndi awiri mpaka asanu ndi awiri. Zovala zanu zidzasinthidwa kawiri patsiku panthawi ya mankhwala, ndipo ziyenera kukhala zouma. Pofuna kuteteza matenda, mukhoza kupatsidwa mankhwala opha tizilombo.

M'kati mwa chipangizochi muli mbewu zazing'ono za brachytherapy (mapuloteni a radioactive omwe ali pafupi kukula kwa njere ya mpunga).

Kusokoneza Kwambiri Pa Nthawi Yopereka Chithandizo

Mudzafotokozera malo anu opangira mafilimu a radiation kawiri pa tsiku kwa masiku 5 mpaka 7, kuti mukhale ndi mankhwala. Konzani pa kukhala pafupi mphindi 30 pa ulendo uliwonse; Pafupifupi mphindi zisanu ndi zisanu ndi zisanu (5-10 minutes) za kusankhidwa kwanu zidzagwiritsidwa ntchito pa nthawi ya chithandizo cha mankhwala. Gulu lanu lamagetsi opanga mafilimu limapangitsa kuti mukhale omasuka, ndipo gwirizanitsani SAVI yanu yoyenera ku chitsimikizo cha ma radiation.

Pa chithandizo chilichonse, chitsime cha radiation chimatumizidwa kathethala imodzi pamodzi. Mafuta ena osiyanasiyana adzaperekedwa pazithunzi zosiyanasiyana pambali ya catheter iliyonse. Izi zimakupatsani mlingo wabwino kwambiri wa minofu yokhudzidwa, komanso chitetezo cha minofu yathanzi.

Kumaliza Mazira ndi Kuchotsa SAVI Applicator Yanu

Pambuyo pa chithandizo chanu chotsirizira cha ma radiation, ma radiation anu oncologist akhoza kuchotsa chipangizo cha SAVI. Iyenera kutenga pafupi mphindi ziwiri kuchotsa chipangizocho, kuyeretsa malo osungira malo, ndi kutseka khungu ndi zikhomo. Bandage kapena kuvala kuikidwa pamwamba, ndipo mudzakhala omasuka kupita. Onetsetsani kuti mupite ku maulendo anu otsogolera, kotero dokotala wanu aone kuti mankhwala anu akuchiritsa bwino.

Mphamvu

Popeza chifuwa cha m'mawere chodziwika bwino (brachytherapy kapena APBI) chinalandiridwa koyamba mu 2002, madokotala apeza kuti mankhwalawa amachititsa kuti anthu omwe ali ndi kansa ya m'mawere oyambirira ayambe kudwala matenda otupa, komanso omwe ali woyenera kugwiritsa ntchito.

Poyerekeza ndi kuyamwa kwa m'mawere komwe kumapangitsa kuti peresenti 2 peresenti ikhale yofunika kwambiri, APBI inachititsa kuti chiwerengero cha 4 peresenti chiwonongeke. Chipangizo cha SAVI brachytherapy chikuwoneka bwino kwambiri poyerekeza ndi zipangizo zina zomwe zilipo pakalipano.

Ubongo wa Brachytherapy Ubwino

Posankha mtundu wa mankhwala ochizira ma ARV, zingakhale zothandiza kulemba ubwino ndi kuipa kwa chithandizo chilichonse. Zoonadi, ubwino ndi chiopsezo sizomwe zimakhala zofanana, ndipo mukhoza kutha kusankha mankhwala omwe ali ndi chidziwitso choposa. Zina mwa ubwino wa mawere a brachytherapy ndi awa:

• Kuwonongeka kwa minofu yathanzi. Dothi lonse la mazira (ma radiation kunja) limakhudza minofu yathanzi komanso maselo a khansa ndipo ikhoza kuwononga zotsatirapo za minofu yathanzi. Chifuwa cha bere chimapangidwa kuti chiwonongeke minofu yathanzi.
• Chiwerengero cha mankhwala. Zonse zochiritsira mazira zamtambo zimaperekedwa tsiku lolemba Lachisanu mpaka Lachisanu kwa masabata pafupifupi 6. Ndi mawere a bere, mankhwala amatha kumaliza masiku 5 mpaka 7. Matenda a ubongo amakhudza kuchuluka kwa minofu ya m'mawere ndipo amapereka mlingo woyenerera wa miyendo yanu ku malo anu ochepetsetsa.
• Nthawi yobwezeretsa. Nthawi yobwezeretsa nthawi zambiri imakhala yothamanga kwambiri ndi mawere a bere kusiyana ndi mazira onse.
• Zotsatira zoyipa. Kawirikawiri, zotsatira zoyipa monga kutopa ndizochepa ndi mawere a bere.

Mavuto a Breastytherapy

Monga momwe pali ubwino wa m'mawere a brachytherapy, pangakhale phindu. Izi ziphatikizapo:

• Kuopsa kwa kubwerera kwa khansa ya m'mawere. Monga momwe tawonera mogwira mtima, chiopsezo cha kubwereka kwa khansa ya m'mawere n'chapamwamba kwambiri ndi bere la brachytherapy. Izi zati, pakalipano palibe umboni wosonyeza kuti kuchuluka kwake kwa kubwereza kuli ndi zotsatirapo pa zotsatira.
• Kuopsa kwa matenda. Chifukwa cha mavitamini omwe akulowa pakhungu lanu, chiwopsezo chotenga kachilomboka ndi chokwanira kuposa ma radiation kunja, ngakhale kuti ndi ochepa.
• Kutonthoza. Anthu ena amapeza kuti chipangizochi n'chosavuta.
• Zotsatira zakanthawi. Zodzoladzola za nthawi yaitali zikhoza kukhala zapamwamba kwambiri ndi bere la brachytherapy, ngakhale zikuwoneka kuti ndizochepa poizoni wa khungu (mwayi wochepa wofiira ndi mphukira).
• Kupezeka. Thandizo la ma radiation kunja limapezeka kwambiri kuposa chifuwa cha bere.

Kodi SAVI Ikundipeza?

SAVI breast brachytherapy imapezeka ku America konse, koma sikupezeka pa malo onse a khansa. Idzagwira ntchito kwa mawere akuluakulu kapena ang'onoang'ono, koma zifukwa zina zingapangitse kuti zisakwaniritsidwe kwa anthu ena. Yang'anirani ndi dokotala wanu za njira yowonjezereka yowonjezera mazira a m'mawere.

Mawu Ochokera pa Savi Brachytherapy kwa khansa ya m'mawere

Zosankha zambiri zatsopano zakhala zikupezeka pochiza khansa ya m'mawere m'zaka zaposachedwapa. Ngakhale izi ndizodabwitsa, zimatanthauzanso zosankha zambiri. Ndikofunika kwambiri kusiyana ndi kale lonse kwa anthu omwe ali ndi khansa kuphunzira za matenda awo ndikuchita nawo mbali mu gulu lawo la chisamaliro cha khansa.

Thandizo lirilonse liri ndi phindu ndi phindu, ndipo chomwe chiri choyenera kuti munthu mmodzi sangakhale cha wina. Khalani woyimira nokha pa chisamaliro chanu cha khansa ndipo musankhe mankhwala omwe amamverera bwino kwa inu nokha osati wina. Kudzipangira nokha zokhudzana ndi chithandizo cha khansa ya m'mawere ndi njira imodzi yodzilemekezera kudzera kuchipatala ndi kupitirira.

> Zotsatira:

> Gabani, P., Cyr, A., Zoberi, J. et al. Zotsatira Zakale za APBI kudzera mu Multicatheter Interstitial HDR Brachytherapy: Zotsatira za Zolembera Zomwe Momwe Mungakhalire Osungira Malamulo. Brachytherapy . 2017 Oct 28. (Epub patsogolo pa kusindikiza).

> Hepel, J., Arthur, J., Shaitelman, S. et al. American Brachytherapy Society Lipoti lovomerezeka la Kuwonjezereka kwapadera kwa Chifuwa Kugwiritsa ntchito Mitsempha ya Mutagatheter Brachytherapy. Brachytherapy . 2017. 16 (5): 919-928.

> Hikkey, B., Lehman, M., Francis, D., ndi A. Onani. Mazira Amtundu Wachiberekero Kwa Khansa Yoyamba Yamatenda. Dongosolo la Cochrane la Zosintha Zogwirizana . 2016. 7: CD007077.pub3.

> Polgar, C., Ott, O., Hildebrandt, G. et al. Zotsatira Zotsalira Zotsatira Zomwe Zidzakhala Zosakaniza Zambiri Zomwe Zidzasintha Pakati pa Chifuwa Chokhazikika Ndi Mitsempha Yophatikizapo Kulimbana ndi Chifuwa Chakumapeto Kwa Breast-Conserving Surgery kwa Opaleshoni Yosauka Kwambiri ndi In-Situ Carcinoma ya Chifuwa. Lancet Oncology . 2017. 18 (2): 259-268.

> Rana, Z., Nasr, N., Ji, H. et al. Zomwe Zimagwirizanitsa Zomwe Zimagwiritsidwa Ntchito Pogwiritsa Ntchito Kuthamanga Kwambiri kwa Matenda a Chiberekero Pamtundu Wambiri wa Catheter. Mafilimu a Oncology . 2015. 10: 160.