Kuchiza kwa Matenda a Metastatic Stan IV Imapereka Chiyembekezo
Interleukin-2 ya melanoma ya metastatic ndi imodzi mwa njira ziwiri zomwe mungathandizire matendawa. Matenda a melanoma omwe afalikira kunja kwa khungu kupita ku ziwalo zakutali amatchedwa "metastatic" (kapena stage IV ) ya melanoma. Ngakhale kuti njira zothandizira pakalipano sizingatheke, anthu ena amapulumuka pachigawo chachikulu kwambiri cha matendawa. Pali zofukufuku zambiri zomwe zikuchitika mderali, koma pakadali pano, zithandizo ziwiri zokha zatsimikiziridwa: interferon-alfa2b komanso chitetezo cha m'thupi choteteza interleukin-2 (IL-2).
Ngati a oncologist akulimbikitsani IL-2, kufotokoza mwachiduleku kukuthandizani ndi mfundo zofunikira zomwe mukufuna kudziwa momwe zimagwirira ntchito, zotsatira zake ndi zotsatira zake.
Interleukin-2
Komanso Proleukin ndi aldesleukin, IL-2 inavomerezedwa ndi Food and Drug Administration (FDA) pofuna kuchiza khansa ya m'magazi mu 1998. (Mwatsoka, palibe mankhwala ena a melanoma avomerezedwa kuyambira.)
IL-2 ndi yosiyana ndi mankhwala a chemotherapy - kwenikweni ndi gawo lachilengedwe la chitetezo cha thupi lanu. Ndi mtundu wa nthumwi ya nthumwi yomwe imatchedwa "cytokine" yomwe imadziwika kuchokera ku maselo ena kuti izindikire maselo ena odzaza ndi matenda opatsirana. Mitundu 15 ya interleukins yapezeka m'zaka za m'ma 1970: IL-2 imadziwika kuti ikukula ndi kusasitsa mitundu iwiri ya maselo oyera, omwe amatchedwa "T and B lymphocytes". IL-2 yomwe imagwiritsidwa ntchito pochizira khansa ya m'magazi siimachokera ku thupi koma imakhala yopangidwa ndi misala, pogwiritsira ntchito njira zamagetsi.
Zili ndi zofanana zomwe zimafanana ndi chilengedwe, koma liri ndi dzina losiyana, aldesleukin.
Umboni Wothandiza wa Interleukin-2
Phunziro lomwe linapangitsa kuti livomerezedwe, 6 peresenti ya odwala omwe adasankhidwa (omwe ali ndi thanzi labwino ndi matenda) ndi ma melanoma a metastatic adayankha kwambiri IL-2 ya dozi yapamwamba, ndipo 10 peresenti anali ndi yankho lapadera.
Kuyankha kwathunthu kumatanthauzidwa kuti ndizokhalitsa (zaka 10+ ndi kuwerengera) kuthetsa matendawa, ngakhale kuti sizowona "mankhwala". Mosasamala kanthu za mawu omveka, ndi mankhwala okhawo amene ali ndi mwayi wokhala wotsimikiza komanso wotalika kwambiri. Mayankho anawonedwa kwa odwala okhala ndi mitundu yosiyanasiyana ya metastases, kuphatikizapo m'mapapo, chiwindi, mafupa a mitsempha, minofu yofewa, mazira a adrenal ndi zigawo zakuya za khungu. IL-2, komabe, sichivomerezedwa kwa odwala omwe ali ndi metastases ya ubongo.
Mayesero ambiri a chipatala akhala akuchitidwa (ndipo akuchitidwabe) pofuna kuyesa kuchuluka kwa mayankho a IL-2 mwa kuphatikiza ndi mankhwala ena. Mwachitsanzo, kafukufuku anawonetsa mitengo yapamwamba yopambana pamene IL-2 inaperekedwa pamodzi ndi katemera (22 peresenti) poyerekezera ndi IL-2 yekha (13 peresenti). Mwamwayi, ambiri amayesetsa kugwirizanitsa IL-2 ndi mankhwala osiyanasiyana a chemotherapy (cisplatin, vinblastine, dacarbazine ndi ena) - njira yomwe imatchedwa "biochemotherapy" - komanso mankhwala ena ( interferon-alfa2b , etc.). palibe kusintha kwakukulu kwa chiwerengero chomwe chili chofunika kwambiri: nthawi yopulumuka.
Kugwiritsira ntchito Interleukin-2
IL-2 imaperekedwa ndi mphindi khumi ndi zinayi (IV) kulowetsedwa kwa maola asanu ndi atatu (8) masiku asanu ndi limodzi.
Njira iliyonse yothandizira imakhala ndi miyezi iwiri ya masiku ochizira mankhwala osiyana ndi nthawi ya mpumulo wa masiku 9, ndipo maphunziro angapo ndi ozolowereka. Momwemonso mumaganizira za mwezi umodzi mutatha chithandizo chanu choyamba. Ngati mukuyankha, mwinamwake mupatsidwa kalasi yachiwiri ya mankhwala kwa masabata 6 mpaka 12 mutatha maphunziro oyambirira. Kuti muyenerere kulandira mankhwala a IL-2, muyenera kukhala ndi thupi labwino, ndi mtima wabwino, mapapo, chiwindi, ndi impso.
Zochitika Zowopsa
IL-2 imakhala kawirikawiri, nthawi zambiri yoopsa ndipo nthawi zina imayambitsa mavuto. Iyenera kuperekedwa kuchipatala motsogoleredwa ndi dokotala woyenerera amene amagwiritsidwa ntchito pogwiritsira ntchito mankhwala osokoneza bongo.
Malo osungirako odwala komanso akatswiri odziwa bwino mankhwala okhudzidwa ndi matenda odwala kwambiri ayenera kukhalapo. Mliri wa imfa zokhudzana ndi mankhwala m'zovuta zamakono za odwala matenda a melanoma omwe analandira IL-2 anali 2%.
Zotsatira zake zambiri zimachokera ku "capillary leak," zomwe zimayambira nthawi yomweyo chithandizo chitayambika. Kutupa kwa kapilisi kumayambitsa kuphulika kwa mapuloteni kunja kwa magazi omwe amachititsa kuchepa kwa magazi. Zotsatira zofala kwambiri ndi izi:
- kunyoza, kusanza, kutsekula m'mimba, kusowa kwa njala
- kufooka ndi kutopa
- zizindikiro zofanana ndi matenda a chimfine (malungo, kuzizira, kupweteka mutu ndi minofu ya aches)
- kuthamanga kwa magazi
- ululu waukulu, kupweteka pachifuwa (angina)
- Kupuma mavuto chifukwa cha madzi m'mapapo
- phindu lolemera, kusungirako madzi
- malingaliro (kupweteka, kupotoza, kusowa tulo)
- kuyabwa, kupukuta khungu
- kuperewera kwa magazi m'thupi
- chiwerengero chochepa cha mapiritsi (kuonjezera chiopsezo chokhala ndi magazi)
- kuchuluka kwa maselo oyera a magazi
- kupweteka kwa impso
- zilonda zam'kamwa
Zotsatirapozi ndizochepa koma zafotokozedwa mwa anthu ena kutenga IL-2:
- mtima wosayenerera, mtima
- kupuma kwa kupuma
- matenda aakulu
- m'mimba mwazi
- mavuto a chithokomiro
- Matenda a chiwindi
- chizungulire chachikulu, kutaya
Chenjezo / Kuyanjana
IL-2 ingapangitse zotsatira zoyipa za mankhwala ena ndi matenda ambiri, choncho auzeni dokotala ngati muli:
- mavuto a impso
- matenda a mtima
- matenda a chiwindi
- matenda a m'mapapo
- matenda osokoneza bongo
- matenda a chithokomiro
- matenda
- chifuwa chilichonse
- matenda aliwonse a chitetezo cha mthupi
Muuzeni dokotala wanu kuti adziwe za mankhwala kapena mankhwala omwe mumagwiritsa ntchito, makamaka corticosteroids, indomethacin, mankhwala osokoneza bongo, anti-depressants, mankhwala osokoneza bongo kapena mankhwala ena oyamwitsa. Musayambe kapena kusiya mankhwala aliwonse popanda dokotala.
Zindikirani: Zomwezi sizingapange zothandizira, kuyanjana kapena zotsatira za mankhwalawa. Ngati muli ndi mafunso okhudza mankhwala alionse omwe mukuwutenga, onetsetsani kuti muyang'ane ndi dokotala wanu wa zamankhwala.
Zotsatira:
"Melanoma." National Comprehensive Cancer Network. V.1.2009. 27 January 2009.
"Proleukin Kulongosola Information." Novartis Pharmaceuticals Corp. 27 January 2009.
Smith FO, Downey SG, Klapper JA, et al. Kuchiza kwa melanoma ya metastatic pogwiritsa ntchito interleukin-2 yokha kapena kuphatikizapo katemera. Clin Cancer Res 2008 14: 5610-5618. 27 January 2009.