Pafupifupi 1 peresenti ya miliri yonse imakhala ndi chithokomiro, ndipo khansa ya chithokomiro imakhala yofala katatu kwa amayi. M'mayiko a Kumadzulo ali ndi mavitamini okwanira okwanira mu zakudya zowonjezera, ambiri mwa khansawa ndi mawonekedwe a khansara yotchedwa papillary thyroid carcinoma . Mwamwayi, anthu akuluakulu omwe ali ndi katemera wa chithokomiro cha papillary, metastases yayitali kwambiri
Komabe, kutalika kwa metastases-komwe kumayendetsa kayendetsedwe ka kayendedwe ka magazi (kufalikira kwa magazi) ndi kumangoyenda m'matomic malo monga mapapo ndi fupa-ndizofala kwambiri ndi khansa ya mtundu wina wotchedwa follicular thyroid carcinoma . Chowopsya, metastases yoteroyo ikhoza kukhala chizindikiro chopereka! Mwamwayi, ena mwa anthuwa omwe ali ndi chithokomiro cha follicular sagwirizana ndi radiotherapy (radioiodine) atachotsedwa chithokomiro. Kwa odwala otero omwe ali ndi khansara, amasiyanitsa khansara, mankhwala a lenvatinib (Lenvima) angathandize. Zindikirani, lenvatinib imabwera mu mawonekedwe a capsule.
Zambiri Zokhudzana ndi Khansa ya Chithokomiro Yosiyana
Matenda onse a chithokomiro ndi mapuloteni amatha kupangidwa kuchokera ku maselo a epulosiyake omwe amatha kupweteka. Iwo amapezeka ndi zosiyana ndi zomangamanga. Matenda makumi asanu ndi anayi mphambu asanu ndi atatu a khansa ya chithokomiro amakhala osasinthasintha ndipo palibe cholowa cha banja chomwe chimadziwika.
Mazira akunja ndi omwe amatsimikizira kuti ndi kanseri ya kanseri komanso khansa yosiyana-siyana ya kansa-makamaka makamaka papillary kanseri ya khansa, komabe, ayodini wochulukirapo kapena kusowa kwa mankhwala amatha kukhala ndi gawo.
Ndi khansa ya chithokomiro, mitsempha ya chithokomiro kapena "ziphuphu" ndiwo chizindikiro chofala kwambiri . Chifukwa chakuti minofu imeneyi imakhala "yozizira" pajambuzi ya chithokomiro, zabwino zokhudzana ndi singano (mtundu wa biopsy) ndi njira yabwino yodziwira zotupazi.
Kusiyana kwa khansa ya chithokomiro kumayamba kuchitidwa opaleshoni, kukula kwake komwe kumakhala kovuta kapena kosasinthika-kumatsutsana ndipo kumadalira kukhudza kwa chithokomiro ndi zam'mimba. Panthawi ya khansa ya follicular yomwe imakhala yovuta kwambiri (chithokomiro chakutali), chithokomiro chonse chiyenera kuchotsedwa kuti radioiodine itenge.
Zindikirani, khansara yowonongeka yafala kwambiri mwa anthu omwe ali ndi zaka za m'ma 50 ndi 60, ndipo kamodzi kokha kamene kamasokoneza, zaka 10 zomwe zimakhalapo ndi 10 peresenti. (Pafupifupi, mu 2014, anthu 1,890 ku United States anafa ndi khansa ya chithokomiro yonse.) Komanso, mankhwala a chemotherapy sayenera kutsimikiziridwa ogwira ntchito mwa iwo omwe ali ndi khatekomiya yosiyana.
Zambiri Zokhudza Lenvatinib
Popanda kumveketsa bwino, lenvatinib ndi tyrosine kinase inhibitor yambirimbiri yomwe imalepheretsa njira zamagazi kukula ndi kukonza. Mwa kuyankhula kwina, lenvatinib imaletsa kukula kwa maselo otupa kutali ndi chithokomiro chomwe chasokoneza mankhwala ndi ayodini ya radioactive.
Mu February 2015 pambuyo pofufuza zotsatira kuchokera ku mayesero a chipatala cha Phase 3, a FDA amavomereza lenvatinib. Ochita kafukufuku anafufuza anthu 392 omwe ali ndi khansa yosiyana ya chithokomiro yomwe imatsutsana ndi radioiodine. Kwenikweni, lenvatinib inkaperekedwa kwa anthu 261 pamene ophunzira 131 analandira placebo.
Chofunika kwambiri, phunziroli linapangidwa ndi mtanda umene unathandiza anthu omwe ali ndi matenda kuti apite kuchokera ku placebo kupita ku lenvatinib. Chifukwa cha crossover yotere, ofufuza sankatha kufotokoza ngati lenvatinib yowonjezera nthawi yonse yopulumuka.
Komabe, ochita kafukufuku anatha kutsimikizira kuti kupulumuka kwapakatipakati kwa miyezi 18.3 mu gulu loyesera kapena omwe amalandira lenvatinib ndi miyezi 3.6 kwa iwo omwe ali mu gulu lolamulira omwe analandira placebo.
Anthu 40 pa 100 aliwonse omwe amatenga lenvatinib anakumana ndi zotsatira zovuta zomwe nthawi zambiri zinkasinthidwa ndi kusintha kwa mankhwala.
Komabe, 14.2 peresenti ya anthu omwe akutenga lenvatinib adachoka pamaphunziro, ndipo imfa 6 mwa 20 yomwe inachitikira pa nthawi ya miyezi 14 yophunziridwa inkayengedwa chifukwa cha mankhwalawa.
Mwachidziwitso, apa pali zina mwa zotsatira zoipa za lenvatinib:
- matenda oopsa (67,8 peresenti ya ophunzira)
- Kutsekula m'mimba (59.4 peresenti ya ophunzira)
- kutopa (59 peresenti ya ophunzira)
- kuchepetsa chilakolako (50.2 peresenti ya ophunzira)
- kuchepa kwao (46.4 peresenti ya ophunzira)
- kunyoza (41.0 peresenti ya ophunzira)
Zonsezi, zotsatira za mayeserowa zimasonyeza kuti mwa iwo omwe ali ndi khansa yowonongeka yomwe imakhala yosiyana ndi radiotherapy, lenvatinib ingalepheretse kufala kwa khansa. Ngati inu kapena wokondedwa wanu mukudwala matenda oopsa ngati amenewa, zotsatira za phunziroli zikulimbikitsa. Komabe, kafufuzidwe kafukufuku amafunika kuchitidwa kuti apeze ndondomeko yomwe akufunikira mankhwalawa, ndiyeso iti yomwe ili yothandiza kwambiri, komanso ngati kuleka kupita patsogolo kumabweretsa moyo wabwino. Ndipotu ngakhale mankhwala opindulitsa kwambiri amatanthauza pang'ono ngati moyo wanu uli woopsa.
Zotsatira:
Chaputala cha mutu wakuti "Kusiyanitsa chithokomiro cha carcinoma" ndi O. Gimm ndi H. Dralle kuchokera ku Chithandizo cha Opaleshoni: Umboni Wowonongeka ndi Wovuta-Unayambira mu 2001.
Nkhani yotchedwa "Lenvatinib imapulumuka ku khansara yowonongeka" ndi S Mayer kuchokera ku The Lancet yofalitsidwa mu 2015.
Nkhani yotchedwa "Opaleshoni Yambiri Yopangitsira Khansa ya Chithokomiro Yosiyana: Buku Loperekedwa" lolembedwa ndi GA Rahman wochokera ku Oman Medical Journal lofalitsidwa mu 2011.
Nkhani yotchedwa "Lenvatinib ndi Placebo mu Radioiodine Refractory Thyroid Khansa" ya M Shlumberger ndi alembi ena ochokera ku NEJM inafalitsidwa mu 2015.