R-CHOP ndi dzina lophatikizana la mankhwala omwe amagwiritsidwa ntchito kwambiri ngati mankhwala a chemotherapy a khansa zina, monga amphwimisi omwe sali a Hodgkin, kapena NHLs . Kalata iliyonse mu R-CHOP imayimira mankhwala osiyana, koma zizindikirozo zingakhale zosokoneza kuti mankhwala amodzi nthawi zambiri amakhala ndi dzina limodzi.
R = Chiwerengero
C = Cyclophosphamide
H = Doxorubicin Hydrochloride (Hydroxydaunomycin)
O = Vincristine Sulfate (Oncovin)
P = Prednone
Rituximab ndi antibody yomwe imatsutsana ndi CD20 antigen, mapuloteni omwe ali pa ma Bymphocytes a B-Pre and B okhwima. Rituximab imayambitsa chitetezo cha mthupi kuchokera kwa wodwala motsutsana ndi maselo ophwanya CD20.
Cyclophosphamide amadziwika ngati wothandizira komanso amatsutsana ndi khansa komanso anti-immune activity. M'chiwindi, cyclophosphamide imasandulika kukhala metabolites yomwe imamangiriza DNA, kupangitsa maselo kusokoneza kupanga mapepala a DNA, ndi kuyambitsa selo kufa.
Hydroxydaunomycin ndi mawonekedwe a doxorubicin, omwe amadziwika ngati antithrotic anthracycline, ndipo ali ndi ntchito yotsutsa khansa.
Oncovin kapena vincristine imamanga zing'onozing'ono m'maselo otchedwa microtubules ndipo imalepheretsa kuti maselo athe kugawa.
Prednisone ndi wothandizira steroid ndi anti-yotupa katundu, ndipo ali ndi ntchito zosiyanasiyana zamankhwala. Mu mitundu ina ya khansa yowopsya, prednisone ikhoza kuyambitsa selo yopangidwa ndi program.
R-CHOP imagwiritsidwa ntchito kwambiri mu non-Hodgkin lymphoma. Zitha kugwiritsidwa ntchito payekha, kapena zingagwiritsidwe ntchito limodzi ndi mankhwala ena kapena mankhwala, kapena kuchiza mitundu ina ya khansa kupatula lymphoma. Mofananamo, mamembala a R-CHOP, monga rituximab, akhoza kugwiritsidwa ntchito payekha m'maganizo ena ndi odwala ena, kuti athetse matenda.
Zambiri pa R-CHOP
Pozindikira mitundu yosiyanasiyana ya maimphine ikufalikira, asayansi akuphunzira kuti mitundu yosiyanasiyana ya lymphoma ingayankhe mosiyana ndi regimen yopatsidwa. Zilonda zam'chipatala zikuyang'ana kugwiritsiridwa ntchito kwa othandizira ena, kuphatikizapo R-CHOP, chifukwa cha zolakwika zosiyanasiyana.
R-CHOP amaonedwa kuti ndi mankhwala ochiritsira amodzi mwa mitundu yofala kwambiri ya NHL, yofala kwambiri B-cell lymphoma, kapena DLBCL . Mukayang'ana pa NHL yonse, DLBCL imakhala ndi zaka 25 mpaka 35 peresenti ya matenda atsopano padziko lonse chaka chilichonse. R-CHOP ingagwiritsidwenso ntchito pazochitika zina za follicular lymphoma, malinga ndi malangizo a 2016 ochokera ku National Comprehensive Cancer Network.
Kodi Ndalama Zonse Zimaperekedwa Motani?
Zomwe zili mu regimen yonse, kuphatikizapo ndi nthawi zingapo zomwe mankhwala amapatsidwa, pa nthawi yambiri, ndi momwe zimakhalira, zimasiyana malinga ndi malungo, yankho la wodwalayo, ndi madokotala kapena mabungwe omwe akukhudzidwa.
- Njira imodzi ya mankhwala imatchulidwa ngati kuzungulira, kotero mukhoza kumamva madotolo akulankhula za "R-CHOP" angapangidwe kangati, mwachitsanzo.
- Pulogalamu imodzi imaphatikizapo kayendetsedwe ka rituximab monga kulowetsedwa kwa maola angapo pa tsiku loyamba la mankhwala, pomwe mankhwala a CHOP akhoza kukhazikitsidwa tsiku lotsatira. Maphunziro onsewo akhoza kubwerezedwa milungu itatu iliyonse kwazaka 6-8. Komabe, masiku ano madokotala amalankhulanso za "zizindikiro zofanana ndi za CHOP," komanso, pali madongosolo osiyanasiyana osiyana omwe madokotala angatsatire kuti agwiritse ntchito mankhwalawa.
Chitsanzo cha zina mwa kusintha kwa R-CHOP, chomwe chimatchedwa "R - mini-CHOP" chikufufuzidwa. The Groupe d'Etude des Lymphomes de l'Adulte (GELA) - gulu lofufuzira lomwe lili ndi dzina lachifalansa kwambiri - linayesa funso lochepetsera poizoni kwa anthu omwe ali ndi zaka 80 mpaka 95 za DLBCL. Iwo amayenera kufufuza momwe ntchito ndi chitetezo cha kuchepa mlingo wa CHOP (doxorubicin, cyclophosphamide, vincristine, ndi prednisone) chemotherapy ndi mlingo wodalirika wa rituximab - maselo oyang'anitsitsa a antioclonal antibody omwe ali ndi CD20 'tag' - odwala achikulire omwe ali ndi DLBCL.
Pakalipano, patatha zaka ziwiri, zotsatira zakhala zikulimbikitsa; Kuwonetseranso kufunika kwa zifukwa za m "modzi zaumphawi m'gulu lino.
Pamene mankhwala opatsirana amadzimadzi apansi, kapena R-"minichOP", amagwiritsidwa ntchito, mphamvu zowoneka ngati zowoneka ngati zaka 2 mpaka mlingo woyenera, koma ndifupipafupi zomwe zimaphatikizapo kuchipatala kuchipatala.
Zotsatira Zogwirizana
Onse a rituximab ndi a CHOP ali ndi zotsatira zoyipa, ndipo mndandanda wonse wa zotsatira zake ndizopitirira momwe zilili m'nkhani ino. Nazi ochepa, sankhani zotsatira zowopsa, komabe:
- Nthawi zambiri mumataya tsitsi lonse pamutu mwanu. Tsitsi mu nsidze ndi madera ena zingakhalenso zoonda kapena zowonongeka. Kawirikawiri tsitsi limayamba pambuyo poyamba mankhwala kapena mankhwala achiwiri, ndipo nthawi zambiri nthawi yayitali imakhala kuti tsitsi limakula pambuyo poti chemotherapy imatha.
- Nthenda ndi kusanza kapena kumva wodwala ndi wamba ndipo zingabwere kuchokera kuchipatala patapita masiku atatu chithandizo.
- Kugonjera kungabwere chifukwa cha vincristine komanso mankhwala ena omwe angaperekedwe chifukwa cha kunyowa ndi kupweteka.
- Zilonda za m'mphuno zikhoza kuwonekera pakapita nthawi pambuyo pa chithandizo, ndipo izi zingakupangitseni kuti mukhale ndi matenda m'kamwa mwanu, kotero kuti kusamalira mkamwa n'kofunika.
- R-CHOP ingakhudze momwe mungathe kutenga pakati kapena abambo mwana.
- Mukhoza kukhala odwala matenda opatsirana pa CHOP, choncho yesetsani kupewa kukhudzana ndi anthu omwe ali ndi chimfine kapena chimfine komanso kusamba m'manja nthawi zambiri kuti muthetse kachilombo ka HIV kapena matenda.
- R-CHOP ikhoza kuchepetsa chiwerengero cha mapiritsi omwe amathandiza magazi kuti aphimbe, choncho onetsetsani kuti muwauze dokotala ngati muli ndi vuto lililonse kapena magazi omwe simungathe kufotokoza.
- Prednisone ndi steroid ndipo imakhala ndi zotsatira zambiri, kuphatikizapo kusinthasintha, kulemera, ndi kutupa.
> Zotsatira:
> Kupereka F, Samoilova O, Osmanov E, et al. Pambuyo pake rituximab, cyclophosphamide, doxorubicin, ndi prednisone ndi bortezomib (VR-CAP) kapena vincristine (R-CHOP) osati a GCB DLBCL. Magazi . 2015; 126 (16): 1893-1901.
> Eyre TA, Clifford R, Roberts C, ndi al. Dzanja limodzi la NCRI gawo lachiwiri lofufuza za CHOP kuphatikizapo Ofatumumab mu kudulidwa ndi kusamalira kwa odwala omwe ali ndi matenda a Richter atsopano. BMC Khansa. 2015; 15: 52.
> Bibas M, Castillo JJ. Kudziwa zamakono za Plasmablastic Lymphoma yogwirizana ndi HIV. Mediterr J Hematol Wopanda Dis. 2014; 6 (1): e2014064.