Njira Zatsopano Zopereka Chithandizo Chamankhwala Mwachangu Mwachangu
Mankhwalawa ndi ofunika pochiza mitundu yosiyanasiyana ya khansa. Mitundu yosiyanasiyana ya ma radiation imagwiritsidwa ntchito kuyesa maselo owonongeka ndi tizirombo. Kawirikawiri, photons (x-ray) amagwiritsidwa ntchito mu njira yotchedwa radiation radiation, kapena EBRT.
Palinso njira zamakono zothandizira ma ARV, ndipo ena awonetsa lonjezo pofuna kuthana ndi mitsempha yambiri ya khansa pamene akuyang'ana zida zowonjezera.
Njira Zatsopano Zophatikizapo Zitsulo za Proton ndi Kuyimira 4D
- PBT imatanthawuzira mankhwala othandizira pulotoni.
- EBRT yogwirizana ndi 3D imatanthawuza kuwonetseratu kusanthula kwa mafano okupanga kujambula kukonzekera kwa chiwerengero cha ma radiation molondola.
- IMRT imapanga mphamvu yowonongeka ya ma radiation, ndipo iyi ndi njira ina yowononga minofu ya khansa koma sungani minofu yozungulira.
- IGRT imakhala ndi mankhwala othandizira mazira, ndipo imaphatikizapo kugwiritsira ntchito zithunzi zojambula panthawi ya chithandizo cha ma radiation, kutsogolera miyezi yowonongeka yomwe imagwiritsidwa ntchito panthawi yopanga chithandizo cha mankhwala.
- RMM imatanthawuza njira zowonetsera kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka maulendo a radiotherapies omwe amawerengera kayendetsedwe ka khoma la mthunzi, minofu ya mitsempha, ndi zinthu zina zomwe zimayenda panthawi yopuma kuti dzuwa lifike pamalo oyenera ngakhale kuti dera lomwelo likuyenda.
- 4D CT zojambula zimagwiritsanso ntchito chimodzimodzi monga RMM mujambulidwa kuti wodwalayo amapuma, ndipo mulingo womwe umagwiritsidwa ntchito umaganizira zochitika zonse za chotupa panthawi yophunzira zojambula, patapita nthawi.
Kodi Proton Beam Therapy N'chiyani?
Malo ena a khansa ayamba kugwiritsa ntchito makina a radiation omwe amapereka mapuloteni a proton mmalo mwa photons, kapena x-ray.
Mapiritsi a Proton ndi mchere wa magawo omwe amapereka mphamvu mkati mwapafupi. Malingaliro, mapulotoni akhoza kufika ku zotupa mkati mwa thupi mopanda kuvulaza kwa makoswe oyandikira.
Mabungwe monga National Comprehensive Cancer Network, kapena NCCN, ayamba kugwiritsa ntchito mankhwala a proton, kapena PBT, mu malangizo ndi ndondomeko. Mwachitsanzo, ponena za matendawo ena a T-cell lymphomas, NCCN radiotherapy compendium ikuphatikizapo kutchulidwa kwa protoni ndi njira zina zatsopano kuti "... pitirizani [a] kufalitsa kwa mlingo wofunikira kwambiri kwa odwala ochizira omwe ali ndi chiyembekezo chokhala ndi moyo wautali. " Mwa kuyankhula kwina, pali kuyembekezera kuti kutulutsa ma radiation kupita kumalo ovomerezeka kwambiri ndi kuteteza minofu yowonongeka kudzabweretsa zotsatira zabwino ndi zochepetsetsa za nthawi yaitali za mankhwalawa.
Kodi Zopindulitsa Zotani Zochiritsira Zimatha Kuperekedwa PBT?
Pakadali pano, kugwiritsa ntchito PBT nthawi zonse sikuthandizidwa pakuchiza lymphoma. Komabe, kwa odwala omwe ali ndi lymphoma, njira ina monga mankhwala a proton tsiku lina iyenera kukhala yotchulidwa nthawi zina ndi zifukwa zosiyanasiyana. Ngakhale kuti chemotherapy yogwiritsidwa ntchito popanga ma lymphomas ikhoza kukhala ndi poizoni kwa mtima ndi m'mapapo.
Pamene ma radiation amawonjezeredwa ku chemotherapy, ziwopsezo ku ziwalo zathanzi zingawonjezereke, chifukwa minofu yomwe ili pangozi imazindikira zotsatira za chemotherapy ndi radiation.
Kawirikawiri mankhwala a chemotherapy ndi ma radiation amakonzedwa palimodzi, koma amaperekedwa mosiyana, ndipo nthawi zambiri, wina amatsata mzake pochiza lymphoma. Thandizo la Proton limapangidwa kuti lichepetse kutsekula kwa tizilombo tomwe timayambitsa matendawa. Odwala ambiri omwe ali ndi lymphoma ali aang'ono ngati amapezeka ndi kukhala ndi moyo wautali atalandira chithandizo, choncho ali pangozi yowonjezereka, zotsatira za nthawi yaitali zogwirizana ndi mankhwala ochiritsira.
Malingana ndi zomwe zimadziwika ponena za mankhwala a proton, ambiri amakhulupirira kuti zotsatira zake zidzachepetsedwa poyerekeza ndi mankhwala ochiritsira. Madokotala ndi ochita kafukufuku akugwiritsanso ntchito mankhwala a chemotherapy, akufufuza momwe amagwiritsira ntchito atsopano omwe ali ndi zotsatira zochepa, akuyang'anitsitsa zotsatira za zotsatira za nthawi yaitali ndi zotsatira zochedwa.
Odwala omwe ali ndi Hodgkin lymphoma , makamaka ali ndi mankhwala ambiri, koma amakhalanso ndi zotsatira zochiza matenda kuchokera ku chemotherapy ndi radiation. Ndipotu, opulumuka ana a Hodgkin lymphoma ndi amodzi mwa magulu omwe ali pangozi yowopsa kwambiri kapena yoopsa ya moyo, monga khansa yachiwiri kapena matenda a mtima . Zowonjezereka zachulukidzirozi zimakhulupirira chifukwa chakuti mbali imodzi mwa zotsatira za zotsatira za chemotherapy ndi radiotherapy.
Chifukwa chakuti mankhwala a proton apangidwa kuti azikhala olondola kwambiri popereka ma radiation, chiyembekezo ndi chakuti matenda ochepa a mtima ndi ochepa khansa yachiwiri adzakhalapo. Pakalipano, pakufufuza kwina, chiŵerengero cha khansa yachiwiri pakati pa anthu omwe amachiritsidwa ndi proton versus photon radiation chinawoneka chimodzimodzi, koma deta ndi yochepa ndipo kufufuza kwakukulu kumafunika.
Mawu Ochokera
Othandiza anthu omwe amagwiritsa ntchito mankhwala a proton kwa Hodgkin lymphoma adalongosola ntchito yolimbitsa thupi yomwe imachitika, pakati pa kubwezeretsedwa chifukwa cha kuchepa kwa mankhwala omwe amachititsa kuti mankhwalawa asakhalenso otha msanga.
Ena amanena kuti ngati mwawonjezera mankhwala a chemotherapy kuti musakhale ndi mankhwala opatsirana pogwiritsa ntchito mankhwala, simungapindulitse phindu lililonse. Kuonjezera apo, akulangiza kuti ufulu wotsatira kachilombo ka lymphoma ndizofunika kwambiri kuti ukhalebe ndi zotsatira, monga momwe ochita kafukufuku amayesera kuthetsa mavuto ndi mapindu a njira zatsopano.
Malinga ndi kafukufuku wochedwa Hoppe ndi anzake, mankhwala a proton amapereka mankhwala ochepa omwe amawaika pamtima, mapapo, mafupa, malo ena, ndi ziwalo zina kwa ophunzira ambiri omwe ali ndi Hodgkin lymphoma. Nthawi yokhayo idzauza ngati chithandizo cha proton chikhala chizoloŵezi chochuluka.
> Zotsatira:
> Chung CS, Yock TI, Nelson K, Xu Y, Keating NL, Tarbell NJ. Zotsatira za zizindikiro zachiwiri pakati pa odwala zimagwiritsidwa ntchito ndi proton versus photon radiation. Int J Radiat Oncol Biol Phys. 2013; 87 (1): 46-52.
> Hoppe BS, Flampouri S, Su Z, ndi al. Kuchepetsa kuchepetsa mlingo kwa miyoyo ya thupi pogwiritsira ntchito mapulotoni poyerekezera ndi 3DCRT ndi IMRT mu Hodgkin lymphoma yapakatikati. Int J Radiat Oncol Biol Phys 2012; 84: 449-455.
> NCCN Radiation Therapy Compendium. 2017.