SBRT ya khansa ya pulayimale yoyamba ndi oligometastases
SBRT (thupi la stereotactic radiotherapy) ndi njira yatsopano yothandizira khansa ya m'mapapo yomwe imagwiritsira ntchito mlingo wa ma radiation woperekedwa kwachindunji. Pogwiritsira ntchito malo apadera ndi zizindikiro zoikidwa m'thupi, akatswiri a radiologists amatha kupereka mankhwala opatsirana kwambiri kuposa khansa, poyerekeza ndi minofu yathanzi.
Ntchito kwa Anthu Amene Ali ndi Khansa Yam'mimba
Pa nthawiyi, pali zifukwa zitatu zoyambirira zomwe zimapangitsa kuti SBRT isagwiritsidwe ntchito ndi khansa yamapapo.
- Ndi khansa yamapapu, SBRT imagwiritsidwa ntchito nthawi yoyambirira, khansa yaing'ono yamapapu (khansa yaing'ono ya m'mapapo ya khansa) omwe sangathe kuchitidwa opaleshoni pazifukwa zina. Kansa ya m'mapapo ingawonedwe ngati khansa yamapapu yopanda matenda chifukwa cha malo otupa, kapena matenda ena omwe angapangitse opaleshoni ya khansa yamapapo yowopsa.
- Odwala okalamba amene angayembekezere kuchita opaleshoni bwino kapena kukhala ndi matenda omwe angabweretse mavuto opaleshoni.
- Pa malo amodzi kapena owerengeka a kufalitsa khansara yamapapo kapena metastasis (oligometastase.)
Ndondomeko
Thupi la radiotherapy lamtundu winawake limagwiritsira ntchito mlingo waukulu wa ma radiation woperekedwa ku dera labwino kwambiri la minofu. Izi ndi zosiyana ndi mankhwala ochizira omwe amapanga khansa ya m'mapapo yomwe imagwiritsa ntchito mlingo wazing'ono kwambiri wa miyezi yoperekedwa kwa nthawi yaitali.
Akatswiri a zamaphunziro amawunikira mapulaneti ozungulira maulendo 4 kuti afotokoze molondola dera limene akuyenera kulandira.
SBRT ya kansa ya pulayimale yaikulu
SBRT nthawi zina imatha kugwira ntchito mogwira mtima ngati opaleshoni kwa anthu ena omwe ali ndi tizilombo tating'onoting'ono ta maselo omwe sagwiritsidwa ntchito, kapena odwala omwe ali ndi matenda omwe angachititse opaleshoni owopsa.
SBRT yachititsa kuti matendawa aziwoneka ngati opaleshoni, ndipo anthu akhala akusankha nthawi yaitali kuti apulumuke. Ziphuphu ziyenera kukhala zazing'ono, nthawi zambiri zosachepera masentimita awiri (2 cm), komanso osakhala pafupi kwambiri ndi mpweya kapena mtima.
SBRT ya Oligometastases
M'mbuyomu, kukhalapo kwa metastases kumakhala njira zochepetsera mankhwala, komanso kupulumuka kusakwana chaka chinali ulamuliro. Kwa anthu omwe ali ndi malo amodzi kapena owerengeka chabe a khansa yamapapu (spreads) ntchito ya SBRT yasintha kwambiri. Zapezeka kuti anthu omwe ali ndi oligometastase (oligo amatanthauza kuti "ochepa") akuchiza metastases ndi SBRT yawonjezera kuchuluka kwa chiwerengero cha kupulumuka kwapakatikati ndipo pakhala pali anthu omwe apulumuka nthawi yaitali chifukwa cha mankhwalawa.
Khansa ya m'magazi imafalikira ku ubongo, mafupa, chiwindi, ndi zilonda za adrenal, ndi SBRT amagwiritsidwa ntchito nthawi zambiri kwa anthu okhala ndi chiwindi ndi metastases chifukwa cha khansara yamapapo. Chifukwa cha kupita patsogolo pochiza oligometastase - monga SBRT - zakhala zotheka kwa anthu ena omwe ali ndi kansa ya m'mapapo kuti athe kukhala ndi moyo wathanzi nthawi yaitali komanso moyo wabwino kuposa momwe zingakhalire.
Zovuta Zilipo
Pali mavuto ambiri a SBRT a khansa ya m'mapapo, yofanana ndi zotsatira za mankhwala ochizira omwe amawoneka ngati kutopa komanso pneumonitis . Zambiri mwazovuta za SBRT zomwe zimagwiritsidwa ntchito pa khansa ya m'mapapo ndi:
- Kuwopsa kwa chiphuphu - Mvula imatha kuwononga mitsempha m'dera lotchedwa brachial plexus . Izi zingapangitse ululu mdzanja kapena pamapewa, ndifooka ndiyeno kufooka kwa dzanja ndi mkono.
- Kupweteka kwa khoma la mchifu kapena kutayika - Ngati chotupa chiri pafupi ndi khoma la chifuwa, minofu yambiri imayambitsa kupweteka ndi kulepheretsa.
Tsogolo
Zotsatira zoyambirira zikuwonetsa zotsatira ndi SBRT yofanana ndi opaleshoni ya khansa ya m'mapapo imalimbikitsa chiyembekezo kuti, kwa anthu ena, SBRT ingagwiritsidwe ntchito ngati njira yowonjezera yovuta kwa opaleshoni ya khansa ya m'mapapo m'tsogolomu.
N'kuthekanso kuti, ndi mankhwala abwino a khansara yamapapo tsopano akuvomerezedwa komanso m'mayesero a chipatala, ndipo ndi zotsatira zoyamba zopezeka ndi metastases, kuti SBRT ingagwiritsenso ntchito kuchotsa malo a chifuwa chachikulu.
Amadziwika monga: stereotactic radiotherapy, stereotactic radiosurgery, mankhwala osokoneza bongo
Zotsatira:
Ashworth, A., Rodriques, G., Boldt, G., ndi D. Palma. Kodi pali chiwerengero cha oligometastatic mu kansa ya m'mapapo yopanda mapapo? Kupenda moyenera kwa mabukuwa. Khansa Yam'mimba . 2013. 82 (2): 197-203.
Ashword, A., Senan, S., Palma, R. et al. Dokotala wodwala deta metaanalysis wa zotsatira ndi zizindikiro zowonetsera pambuyo pa mankhwala a kansa ya oligometastatic yomwe si yaing'ono ya m'mapapo. Khansara Yam'mimba Yamakono . 2014. 15 (5): 346-55.
Griffoen, G., Toquri, D., Dahele, M. et al. Mankhwala amphamvu a synchronous oligometastatic omwe si ang'onoang'ono sepapola carcinoma (NSCLC): zotsatira za odwala komanso zizindikiro. Khansa Yam'mimba . 2013. 82 (1): 95-102.
Guerrero, E., ndi M. Ahmed. Udindo wa stereotactic ablative radiotherapy (SBRT) mu kayendetsedwe ka kansa ya oligometastatic yopanda khungu yochepa ya maselo. Khansa Yam'mimba . 2015. (Epub 2015 Dec 2).
Ricardi, U., Badellino, S., ndi A. Filipi. Kachilombo kotchedwa radiotherapy thupi la khansa ya m'mapapo oyambirira: Ntchito yambiri ndi yosinthidwa. Khansa Yam'mimba . 2015. 90 (3): 388-96.
Salama, J., ndi S. Schild. Mankhwala othandiza mazira kwa khungu la oligometastatic osati laling'ono la khansa. Kanema Metastasis Review . 2015. 34 (2): 183-93.