Malangizo ndi Kugonjetsa
Kuchita opaleshoni sikuchitika kawirikawiri kwa khansara yaing'ono ya m'mapapo ya m'mapapo monga khansa yaing'ono yopanda mapapo, ndipo anthu ambiri amadabwa chifukwa chake. Tiye tikambirane za nthawi yomwe zingatheke, ndipo zifukwa zomwe mankhwala a chemotherapy ndi ma radiation ndizobwino nthawi zambiri amachiritsira.
Kodi Zingatheke?
M'mbuyomu, opaleshoni ya khansa yaing'ono yamapapo ya m'mapapo siyinali yoganiziridwa.
Kawirikawiri, pamene khansa yaing'ono ya m'mapapo ya mitsempha imapezeka, yayamba kufalikira kumadera opitirira mapapo (omwe amafa) kapena amakhala m'mapapo awiri onse. M'makonzedwe amenewo, mankhwala a chemotherapy ndi ma radiation ndiwo njira zabwino zothandizira.
Koma madokotala akuyang'ananso kachigawo kakang'ono ka anthu omwe angapindule, ndikukhala kwa nthawi yayitali, akutsata opaleshoni yabwino ya khansa yaing'ono yamapapo ya m'kati.
Pamene Opaleshoni Siperekedwa
Ndalama za khansa ya m'mapapo ya maselo pafupifupi 15 peresenti ya khansa ya m'mapapo. Ikuphwasulidwa mu magawo awiri: sitepe yochepa ndi siteji yambiri. Ngati wina ali ndi siteji yambiri ya khansa ya m'mapapo ya m'mapapo (yomwe ilipo pafupifupi 70 peresenti ya anthu panthawi ya matenda), opaleshoni siimapangitsa kuti munthu akhale ndi moyo. Ndi khansa yaing'ono ya mapapu ya m'mapapo, mankhwala omwe amaphatikizapo mankhwala ndi mankhwala omwe amawathandiza kumathandiza kwambiri, makamaka poyamba. Ngati opaleshoni iyenera kuchitidwa sizingakhale zophweka koma zingasokoneze mankhwala omwe amathandiza.
Pamene Opaleshoni Ingakhale Yabwino
Kuchita opaleshoni kungapangitse mwayi wa kupulumuka kwa nthawi yaitali mwa anthu ena omwe ali ndi khansa yaing'ono ya m'mapapo ya m'mapapo .
- Khansa ilipo m'mapapu amodzi okha.
- Khansara samaphatikizapo mitsempha ya mitsempha kapena ilipo m'mayendedwe a pafupi. (Mwa kuyankhula kwina, opaleshoni si njira yabwino kwa anthu omwe ali ndi nthenda pa matenda a kansa yamapapo a TNM , omwe amatanthawuza maselo a khansa omwe ali ndi khansara pakati pa mapapo.
- Kuchita opaleshoni kumakhala kovuta ngati khansara ili kumbali ya mapapo.
Mitundu Yopaleshoni
Pali mitundu ikuluikulu ya opaleshoni yomwe imapangidwa ku khansara yamapapo:
- Pneumonectomy. Pneumonectomy ndi opaleshoni yomwe imachotsa kuchotsa mapapo onse. Anthu ena amadabwa kuti opaleshoniyi ndi yotheka, koma anthu omwe ali ndi ntchito zina zabwino, anthu ambiri alekerera njirayi bwino.
- Lobectomy. Lobectomy ndi njira imene kuchotsa mapapo kumachotsedwa. Mapapu abwino ali ndi malabe 3 ndipo mapapu akumanzere ali ndi 2.
- Kuthetsa resection kapena segmentectomy. Mpheta resection ndi opaleshoni imene chiphuphu chophatikizapo chigawo cha minofu yozungulira chikuchotsedwa. Izi zimapangitsa kuti minofu yaing'ono iwonongeke kusiyana ndi lobectomy, koma ingakhale ndi chiopsezo chachikulu cha kubwereza.
- Kutsatsa kwa manja.
Mwa izi, lobectomy ikuwoneka kuti ili ndi zotsatira zabwino kwambiri kwa anthu omwe ali ndi khansa yaing'ono ya m'mapapo.
Asanachitike Opaleshoni
Ngati opaleshoni ikuwongosoledwa, kufufuza mosamala kwambiri kuyenera kuchitidwa, kuphatikizapo mediastinoscopy (njira yomwe imayang'ana khansa m'madera pakati pa mapapo), kuonetsetsa kuti khansa sinafalikire ku maselo am'mimba m'madera awa (nlifu ya n2 mfundo). PET / CT ikhoza kukhala njira yotsutsana ndi mediastinoscopy kwa anthu ena.
Mayesero a pulmonary amayenera kuchitidwa kuti atsimikizire kuti munthu amalekerera opaleshoniyo ndi kukhala ndi mapulogalamu okwanira pambuyo pa opaleshoniyo.
Popeza kupulumuka kwa opaleshoni ya khansa yaing'onoting'ono yamapapu ikuoneka kuti ili bwino ku malo opatsirana khansa omwe amachititsa opaleshoni yambiri, ndikofunikira kufufuza khansara yanu musanayambe opaleshoni yanu ndikuganiza kuti mutenge kachilombo ka kansa .
Pambuyo pa Opaleshoni
Ngati opaleshoni yachitidwa, nkofunika kuti mankhwala a chemotherapy komanso mankhwala omwe amawotchedwa ma ARV ambiri apitirire opaleshoni, chifukwa izi zimapangitsa kuti apulumuke.
Pulolactic cranial irradiation (PCI) , mtundu wa ma radiation wokonzedwa kuti ateteze kufala kwa khansa ku ubongo, ingagwiritsenso ntchito kuchepetsa chiopsezo cha khansa kufalikira ku ubongo pambuyo pa opaleshoni.
Kuopsa kwa ubongo wa ubongo kumachitika patatha zaka zitatu opaleshoni ikuwonjezeka ndi sitepe ya chifuwacho, ndipo kafukufuku wina adapeza kuti chiopsezochi chidzakhala 9.7 peresenti pa gawo 1, 18.5 peresenti ya gawo 2, ndi 35.4 peresenti ya katatu.
Kuthamangitsani
Kafukufuku amasonyeza kuti anthu omwe ali ndi zaka zochepa (khansa yaing'ono) ya khansa ya m'magazi (T1 kapena T2), opaleshoni imapangitsa kuti pakhale moyo. Powonongeka kwakukulu, kunapezeka kuti kupulumuka kwa anthu omwe ali ndi matenda a m'deralo ndi m'deralo kunakula bwino ndi opaleshoni.
Kwa anthu omwe ali ndi matenda omwe akukhala nawo omwe ali ndi lobectomy, kuchulukitsa kwapakati kwa miyezi 65 ndipo chiwerengero cha zaka zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu. Ziwerengerozi zingamveke zoopsa kufikira mutakuyerekezera ndi chiwerengero cha anthu omwe alibe opaleshoni yomwe ili ndi miyoyo 25 ya miyezi 25 ndipo peresenti ya 31,8 peresenti yapulumuka.
Zindikirani kuti chithandizo cha ubongo metastases chifukwa cha khansa ya m'mapapo ikusintha, ndipo nthawi zina anthu omwe ali ndi masastases angapo ("oligometastases") amatha kuchiritsidwa ndi cholinga chochizira ndi thupi la stereotactic radiotherapy (SBRT) kapena mankhwala a proton beam .
Pansi
M'mbuyomu, opaleshoni sikunkachitidwa ngati njira yothandizira khansa yaing'ono ya m'mapapo. Izi zikuwoneka kuti zikusintha ngati maphunziro atsopano apeza mwayi wopulumuka kwa anthu ena omwe ali ndi matendawa. Makamaka, anthu omwe ali ndi khansa ya m'mapapo yocheperapo yapamwamba ali ndi zaka zisanu ndi zisanu zowonjezereka zowonjezereka ndi opaleshoni kusiyana ndi mankhwala a chemotherapy ndi mankhwala omwe amawathandiza. Mwa njira zosiyanasiyana zomwe zilipo, lobectomy ili ndi zotsatira zabwino kwambiri.
Ndikofunika kukumbukira kuti aliyense ali wosiyana. Gawo lina laling'ono (khansa lochepa) maselo ang'onoang'ono a khansa amatha kukhala ovuta kapena osatheka kuchiza ndi opaleshoni chifukwa cha malo otupa. Kupezeka kwa matenda ena kungachititse opaleshoni yaikulu kuposa opaleshoni.
Ngati mukukhala ndi khansa ya m'mapapo ndikofunika kukhala wothandizira pawekha. Njira zothandizira khansa ya m'mapapo ya m'mapapo ikukula ndipo mankhwala atsopano akuyang'aniridwa mu mayesero a zamankhwala. Zina mwa mankhwalawa, monga omwe amagwiritsira ntchito mankhwala atsopano ogwiritsira ntchito ma immunotherapy amapereka lonjezo la zotsatira zabwino kwambiri m'tsogolomu. Ngakhale anthu ambiri akuopa mayesero, ndibwino kukumbukira kuti mankhwala alionse omwe tili nawo tsopano anali mbali ya mayesero a zachipatala.
> Zotsatira:
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> Koletsis, E., Prokakis, C., Karanikolas, M., Apostolakis, E., ndi D. Dougenis. Udindo wamakono wochitidwa opaleshoni ndi khungu kakang'ono khungu la carcinoma. Journal of Surgery Cardiothoracic . 2009. 4:30.
> National Cancer Institute. Mankhwala Ochepetsa Kachilombo ka Cell Cell (PDQ) - Odwala Matenda. Kusinthidwa 11/09/17.
> Schreiber, D., Rineer, J., Weedon, J. et al. Zotsatira za kupulumuka ndi kugwiritsa ntchito opaleshoni mu kansa yaling'ono ya khansa yamapapo ya m'mapapo: kodi mbali yake iyenera kuyambiranso? Khansa . 116 (5): 1350-7.
> Zhu, J., Bi. Y., Han A. et al. Zotsatira zoopsa za metastases za ubongo zimatulutsa khansa yaing'ono ya m'mapapo ya khansa: kufufuza mobwerezabwereza kuti adziwe odwala omwe angapindule ndi prophylactic iraniation. Mafilimu a Oncology . 2014. 9: 216.