Ubwino ndi Kuipa kwa Mgwirizano wa Chemotherapy
Kodi ndi mankhwala otani omwe amagwiritsidwa ntchito, pamene amagwiritsidwa ntchito, ndipo ndi ubwino wanji ndi njira zabwino za njira imeneyi?
Mwachidule
Chemotherapy kuphatikizapo kugwiritsira ntchito mankhwala osaphatikizapo mankhwala amodzi panthaŵi yake kuchiza khansa. M'mbuyomu, khansa nthawi zambiri inkachizidwa ndi mankhwala osakaniza, koma mankhwala omwe amapezeka masiku ambiri a khansa amagwiritsa ntchito mankhwala awiri kapena osiyana nthawi imodzi.
Mbiri Yophatikiza Chemotherapy
Kugwiritsiridwa ntchito kwa mankhwala othandizira khansa kunapangidwa muzaka za 1960 pamene asayansi anadzifunsa ngati njira yothetsera chifuwa chachikulu - pogwiritsira ntchito mankhwala ochepetsa tizilombo toyambitsa matenda - ingagwiritsenso ntchito kuchiza khansa. Pogwiritsa ntchito njirayi, khansa yomwe kale inali yoopsa kwambiri monga khansa ya m'magazi ndi Hodgkin's lymphoma inayamba kuchira. Kuchokera nthawi imeneyo, kuphatikizapo chemotherapy yakhala ikuvomerezedwa kuti ichitire mankhwala ena khansa ambiri.
M'ma 1970, kuphatikiza mankhwala a chemotherapy anapezeka kuti ndi othandiza kwa anthu omwe ali ndi khansara yamapapu, komanso ogwira ntchito kwambiri kuposa "mankhwala omwe amagwiritsidwa ntchito mophatikizapo mankhwala" kapena kugwiritsa ntchito chemotherapy mankhwala nthawi imodzi motsatira, osati nthawi yomweyo.
Phindu
Pali ubwino wambiri wogwiritsa ntchito mankhwala osokoneza bongo osati mankhwala okhaokha.
Ena mwa awa ndi awa:
- Kuchepetsa mwayi kuti chotupa chikhale chosagwirizana ndi chithandizo. Monga momwe mankhwala osakanikirana angagwiritsidwe ntchito ngati mabakiteriya ena ali osagwirizana ndi imodzi mwa mankhwala, kugwiritsa ntchito mankhwala awiri kapena kuposa omwe amachititsa mankhwalawa kumachepetsa chiopsezo kuti chotupa chikhale chosagonjetsedwa ndi chithandizo.
- Kuwathandiza kuti apereke mankhwala onse mwamsanga mwamsanga.
- Kukhoza kuthana ndi zolinga zingapo mu kansa pa nthawi yomweyo. Khansara ndi matenda ovuta omwe amachititsa masitepe ambiri. Kugwiritsiridwa ntchito kwa mankhwala a chemotherapy omwe amagwira ntchito zosiyana ndi maselo a khungu, kapena akuti mu njira ya khansa, ayenera, mwa kulingalira, kuwonjezera mwayi wochotsa khansa.
- Kutulutsa "kusagwirizana" - Asayansi amagwiritsa ntchito mawu akuti tumor heterogeneity pofotokoza mmene maselo a khansa m'matumbo amasiyana. Ngakhale maselo oyambirira ali ndi khansara ndi "macones" - m'mawu ena ofanana - magawano otsatizana amachititsa kusintha m'maselo. Zina mwa maselo omwe amachititsa chiwombankhanga angayankhe ku mankhwala ena pamene ena angakhale omvera kwambiri ku mankhwala ena.
- Posachedwapa kafukufuku akuyang'aniranso njira zomwe amagwiritsira ntchito mankhwala othandizira mankhwala omwe angagwiritsidwe ntchito kuti athe kugwiritsa ntchito mankhwala osokoneza bongo kuti agwiritse ntchito mankhwala ena pazitsulo zochepa, motero kuchepetsa mwayi wa poizoni.
Mwachizoloŵezi, kugwiritsa ntchito mankhwala othandizira ena ndi khansa zambiri zakhala zikupezeka kuti zipititse patsogolo kupulumuka, kapena kuti pakhale yankho labwinoko la mankhwala.
Kuipa
Zina zowonongeka za kuphatikiza ndi:
- Kuwonjezeka kwa mankhwala a chemotherapy zotsatira zake -.Siti popanda kunena kuti nthawi iliyonse mankhwala ena amagwiritsidwa ntchito ndizowonjezera kuti zotsatira zake zidzachitika.
- Kuvuta kudziŵa mankhwala omwe amachititsa mbali inayake - Ngati wodwala amakhala ndi zotsatira zoyipa pamene mankhwala ambiri amagwiritsidwa ntchito, zingakhale zovuta kudziŵa kuti ndi mankhwala ati omwe ali ndi udindo.
- Kugwiritsa ntchito mankhwala osokoneza bongo - Nthawi zina zotsatira zowopsa sizichitika chifukwa cha mankhwala enaake, koma chifukwa cha kusintha kwa mankhwala.
- Zotsatira za zotsatirazi - Mwachitsanzo, ngati mumagwiritsa ntchito mankhwala awiri omwe amachititsa kuti maselo oyera a m'magazi aang'ono azitha kuwerengeka, chiopsezo chotchedwa neutropenia (chochepa cha maselo oyera omwe amadziwika kuti neutrophils) chikuwonjezeka.
Zitsanzo
Pali mankhwala ambiri omwe amagwiritsidwa ntchito pa mitundu yosiyanasiyana ya khansa. Chitsanzo ndi khansara yamapapu ikugwiritsidwa ntchito kuphatikizapo Platinol (cisplatin) ndi Navelbine (vinorelbine) kuti athetse kansa yaing'ono ya m'mapapo.
Nthawi zina mawu amodzi amagwiritsidwa ntchito pofotokozera mankhwala othandizira mankhwala. Chitsanzo chimodzi ndi ABVD ya matenda a Hodgkin omwe amaimira mankhwala a chemotherapy Adriamycin (doxorubicin), Blenoxane (bleomycin), Oncovin (vinblastine) ndi DTIC-Dome (dacarbazine).
Kulimbana
Dziwani zambiri za mankhwala omwe amagwiritsidwa ntchito pafupipafupi komanso zotsatira za nthawi yaitali za chemotherapy , koma kumbukirani kuti njira zothetsera zizindikirozi zakula bwino kwambiri m'zaka zaposachedwapa. Mwachitsanzo, anthu ambiri salinso achisoni komanso kusanza ngakhale mankhwala omwe amatha kuchititsa zizindikirozi.
Kuti ndikupangire masiku ena pa chemo kupita patsogolo pang'ono, onetsetsani mndandanda wa zofunika zomwe munganyamule pa mankhwala a chemotherapy .
Zotsatira:
Delbaldo, C., Michiels, S., Syz, N. et al. Ubwino Wowonjezera Mankhwala Kwa Wothandizira Mmodzi Kapena Wachiwiri-Wothandizira Chemotherapy Zomwe Zimayambitsa Khansa Yopangika Kwambiri Yopanda Pang'onopang'ono. JAMA . 2004. 292 (4): 470-484.
DeVita, V. ndi E. Chua. Mbiri ya Khansa Chemotherapy. Kafukufuku wa Khansa . 2008. 68: 8643.
Hu, M., Huang, P, Wang, Y., Su, Y., Zhou, L., Zhu, X., ndi D. Yan. Synergistic Combination Chemotherapy ya Camptothecin ndi Floxuridine kupyolera mwa Self-Assembly of Amphiphilic Drug-Drug Conjugate. Bioconjugate Chemistry . 2015. 26 (12): 2497-506.
Zimmermann, G. et al. Zovuta zambiri zothandizira: pamene lonse ndi lalikulu kuposa kuchuluka kwa ziwalozo. Kupeza Mankhwala Masiku Ano . 2007. 12 (1-2): 34-42.