Kodi Chatsopano Chithandizo cha Khansa ya Prostate N'chiyani?

Chithandizo cha kansa ya prostate yosavomerezeka yotetezeka

Zinthu zambiri zasintha pakuchiza kansa ya prostate zaka zingapo zapitazo. Izi ndizofunika makamaka pakuchiza kansa ya prostate yosakanikirana (mCRPC). Iyi ndi kansa ya prostate yomwe yalephera kuchiza matenda (opaleshoni, ma radiation ndi zina zotero) ndipo yayamba kusamalidwa mankhwala (androgen blockade kapena castration).

Izi zikugwiranso ntchito kwa odwala omwe ali ndi matenda oopsa komanso alephera kuchipatala. Asanayambe kugwiritsidwa ntchito kwa chemotherapy kwa odwala awa pafupifupi nthawi ya moyo inali pafupi miyezi 8. Chemotherapy imapindulitsa pa izi koma sizowononga.

Kuchokera mu 2010 mankhwala ambiri atsopano akhala akupezeka kwa odwala omwe ali ndi mCRPC. Zotsatirazi ndizofotokoza mwachidule za mankhwala atsopano.

1. Abiraterone Acetate (Zytiga) - Zytiga imalepheretsa opanga testosterone kupanga ndi kuchepetsa ma testosterone. Kaŵirikaŵiri amaperekedwa ndi prednisone. Zytiga poyamba anawonetsedwa kwa odwala omwe analephera docetaxel (chemotherapy) koma kafukufuku waposachedwapa wasonyeza phindu kwa wodwala asanakhalepo. Kafukufuku wina adawonetsa kuti kupuma kwaufulu kwapadera (rPFS) kunali miyezi yoposa 16 mu Abiraterone ndi gulu la prednisone ndi miyezi isanu ndi umodzi mu gulu lolamulira.
2. Enzalutamide (Xtandi) - Yemwe amadziwika kuti MDV3100 mankhwala awa ndi kachiwiri kachiwiri komansorogen-receptor blocker. Zimagwirira ntchito kunja ndi mkati mwa selo. Poyamba amasonyeza odwala mankhwala a mCRPC pambuyo pake koma kafukufuku wasonyeza phindu kwa wodwalayo. Kufufuza koyambirira kunawonetsa kuti pafupipafupi, enzalutamide inachedwetsa kufunika kwa chemotherapy ndi miyezi 17 (28 vs 11). Anasonyezanso kuti kugwiritsa ntchito mankhwalawa kwacheperachepera 81%.

1. Radium 223 Dichloride (Xofigo) - Ngakhale izi ndi jekeseni kwenikweni ndi mtundu wa ma radiation wotchedwa alpha radiation. Mankhwalawa amatanthauza kulumikiza maselo a khansa ya prostate m'mapfupa. Mitsempha ya kansa ya prostate imatenga kwambiri Xofigo. Radium ndiye imatulutsa ma radiation, omwe ndi ochepa kwambiri. Lingaliro ndi kupha maselo a khansa yogwira ntchito ndi kuwonongeka kochepa ku fupa labwino. Izi ziyenera kukhala zovuta kwambiri kuposa strontium-89, zomwe zakhala zikugwiritsidwa ntchito kale. Kafukufuku wasonyeza kuwonjezeka kwapulumuka kwa odwala omwe ali ndi mCRPC ndi mitsempha ya mafupa.

1. Sipuleucel-T (Zopatsa) - Sipuleucel-T ndi katemera wa khansa ya kansa ya prostate. Zimapangidwira odwala omwe ali ndi mCRPC. Ndilipadera kwa wodwala aliyense ndipo amafuna kupereka magazi. Mwazi umatsegulidwa pa labu ndipo kenaka umalowetsedwanso kamodzi sabata. Mankhwalawa amaperekedwa katatu pa nthawi ya mwezi. Ndilo FDA yoyamba yathandizira katemera wodwala khansa (mosiyana ndi katemera woteteza). Kupulumuka kwathunthu kunayambika ndi kugwiritsiridwa ntchito kwa Zopereka mwa odwala omwe ali ndi matenda kapena ochepa omwe ali ndi mCRPC.

Mafunso omwe mukuyembekeza kuwunikira mtsogolomu ndi momwe mungatsatire bwino mankhwala atsopanowa? Pamene wodwalayo ataya mahomoni, ndi mankhwala ati omwe ayenera kugwiritsidwa ntchito kapena ayenera kuyambitsa chemo? Ndi mankhwala ati omwe amapereka zabwino kwambiri? Kodi mankhwalawa ayenera kugwiritsidwa ntchito paokha kapena kuphatikiza? Ngakhale pali mafunso ochuluka omwe akuwonjezeredwa posachedwapa ku kansa ya prostate armamentarium ndithudi amapindula odwala ambiri.

_Zotsatira

_{Rathkopf DE, Smith MR, De Bono JS, ndi al. Kusinthidwa kafukufuku wamkati (IA) wa COU-AA-302, kafukufuku wapadera wachitatu wa abiraterone acetate (AA) mwa odwala (pts) omwe ali ndi kansa ya prostate yosagonjetsedwa (mCRPC) yopanda mankhwala. J Clin Oncol. 2013; 31 (suppl 6, osambira 5).}

_{Beer TM et. al. Enzalutamide mwa amuna omwe ali ndi khansa ya chemotherapy-naive metastatic prostate (mCRPC): Zotsatira za gawo III KUYAMBIRA kuphunzira. J Clin Oncol 32, 2014 (suppl 4; abstr LBA1 ^).}

_{Parker C et al. Mbalame yotchedwa Alpha Emitter Radium-223 ndi Survival mu Canast Metastatic Cancer. N Engl J Med. 2013; 369: 213.}

_{Longo DL (July 2010). "Mankhwala atsopano a kansa ya prostate yosagonjetsedwa". N. Engl. J. Med. 363 (5): 479-81.}