Ciwon daji na nono
With the advancement of breast cancer diagnosis and treatment, the survival time of breast cancer patients has prolonged significantly, but the incidence of breast cancer brain metastases (BCBM) has gradually increased. This article reviews recent clinical studies related to the survival prognosis and treatment of breast metastases from breast cancer. It is generally believed that factors such as age, KPS score, receptor status, number of brain metastases, and control of extracranial lesions affect patient prognosis. Surgery, whole brain radiotherapy (WBRT), and stereotactic radiosurgergy (SRS) are currently the first-line treatments for brain metastases. With the development of comprehensive ciwon nono treatment, the application of chemotherapy and molecular targeted therapy in breast metastasis has received more and more attention.
Metwayar ƙwayar ƙwayar nono
A cikin 'yan shekarun nan, tare da ci gaba da ci gaba da ganewar asali da magani, lokacin rayuwar marasa lafiya ya tsawaita sosai, kuma abin da ya haifar da metastases na kwakwalwa (metastasis kwakwalwa, BM) ya kuma ƙaru sosai. Kimanin kashi 30% na marasa lafiya daga ƙarshe za su haɓaka metastases na kwakwalwa, kuma lokacin rayuwa bayan ƙwaƙwalwar kwakwalwa shine watanni 2 ~ 14. Ciwon nono yana da babban haɗarin ƙwayar metastasis da rashin hangen nesa mara kyau. Ya zama muhimmin mahimmanci da ke shafar ingancin rayuwa da rayuwa. Hannun hangen nesa da magani na BM koyaushe shine mai da hankali da wahalar da'irar ilimi. Yana da mahimmanci a bincika halayen asibiti kuma a sami ingantattun magunguna. Kuma aiki mai gaggawa. Wannan labarin yana nazarin hangen nesa na asibiti da magani na BCBM.
Abubuwan da za a iya ganowa don ƙaddarar kwakwalwa daga ciwon nono
Wasu nazarin sun nuna cewa hangen nesa na BCBM yana da alaƙa da dalilai kamar shekaru, ƙayyadaddun ƙwayoyin cuta, ƙarancin ƙwayar cuta, adadin raunin BM, matsakaicin yanki na rauni, da ƙimar KPS. Masu bincike sun kafa nau'ikan kimantawa na hangen nesa dangane da abubuwan da ke tasiri a sama, suna kokarin bambance marasa lafiya yadda ya kamata tare da wasu kwakwalwa na zamani don taimakawa wajen zabar dabarun asibiti.
Jiyya na ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta
Dole ne a kimanta maganin metastases na kwakwalwa daga kansar nono gabaɗaya gwargwadon dalilai kamar yanayin lafiyar mai haƙuri, wurin cutar, da kulawar ƙetare kafin yanke shawarar shirin maganin. A halin yanzu, tiyata, WBRT, da SRS har yanzu sune farkon layin BCBM. Har ila yau, an sami ci gaba a cikin ilimin kimiya da magungunan ƙwayoyin cuta.
Hormone far don ƙwayar ƙwayar nono
Maganin da aka saba amfani da shi shine dexamethasone, kuma ba a buƙatar maganin hormone ga majiyyata da ke fama da ciwon kwakwalwar asymptomatic. Dexamethasone na iya kawar da alamun bayyanar da edema ke haifarwa a cikin ɗan gajeren lokaci ta hanyar maido da elasticity na jijiya jini da kuma rage permeability na capillaries. Matsakaicin farawa na dexamethasone shine 4 ~ 8mg / d; Lokacin da metastases na kwakwalwa ya kasance na biyu zuwa matsanancin edema na cerebral da matsanancin matsa lamba na ciki, ana ba da shawarar yin amfani da dexamethasone a kashi na 16mg / d ko mafi girma, wanda ya kamata a rage a hankali lokacin da aka daina. adadin.
M jiyya na metastatic nono
Ya fi dacewa da marasa lafiya tare da harbi guda da KPS> 70. A asibiti, kashi 20% -30% na marasa lafiya sun dace da maganin tiyata. Fa'idodinsa shine cewa zai iya sauƙaƙe bayyanar cututtuka da sauri, samo samfuran ƙwayoyin cuta, da haɓaka ƙimar sarrafa gida. Matsayin tiyata a cikin ƙananan ƙananan kwakwalwa har yanzu ba shi da cikakkun bayanai da ƙarshe.
Dukkanin rediyo na kwakwalwa
Ga marasa lafiya tare da raunuka na intracranial> 3, jimillar tasiri na aikin rediyo na kwakwalwa gaba ɗaya shine 60 zuwa 80%. Kimanin kashi 70% na marasa lafiya sun inganta alamun bayyanar cututtuka kuma sun tsawaita matsakaicin lokacin rayuwa na watanni 3 zuwa 6. Stereotactic Radiosurgery (SRS) An yi imani da cewa SRS ya fi dacewa da marasa lafiya da 3 ko žasa da raunuka, diamita na <3.0 cm, da ƙananan tasirin sararin samaniya, musamman ga ciwace-ciwacen da ba su da sauƙi a lokacin tiyata kuma suna cikin mahimmanci. yankunan aiki. Amma an ƙara nazarin SRS a cikin ƙwayoyin cuta masu yawa, kuma da alama mai yiwuwa ne.
Chemotherapy don ciwon nono na ƙwayar cuta
Amfanin chemotherapy akan BCBM yana iyakance saboda maganin yana da wahalar ketare shingen kwakwalwar jini. Wasu nazarin a cikin 'yan shekarun nan sun nuna cewa haɗin chemotherapy da radiotherapy na iya inganta tasiri. Saboda maganin radiation yana buɗe shingen jini-kwakwalwa, kwayoyi na iya shiga cikin kwanyar don yin tasirin maganin ƙwayar cuta. Kodayake magungunan chemotherapeutic suna da wuya a cimma wani sakamako mai mahimmanci na antitumor a cikin kwanyar, kulawa mai kyau na cututtuka na extracranial zai iya inganta yanayin rayuwa da kuma tsawaita lokacin rayuwa na marasa lafiya.
Tsarin da aka yi niyya don cutar kansar nono
With the continuous understanding of the mechanism of tumo formation and metastasis, molecular targeted therapy has become a routine treatment strategy for malignant tumors. Bevacizumab combined with radiotherapy is mainly used for the treatment of gliomas, and there are few studies in brain metastases such as breast cancer and lung cancer, and further research is still needed.
Endocrine far don ƙwayar ƙwayar nono
Akwai ƙananan bayanan bincike akan maganin endocrin a cikin jiyya na BCBM. Saboda maganin endocrin yana da sannu a hankali fara aiki, kuma yawancin marasa lafiya tare da BM suna da rashin fahimta kuma suna buƙatar sarrafa alamun gida da wuri-wuri, ba a ba da shawarar maganin endocrin azaman magani na farko na BCBM ba. A takaice. Babban abin da ya faru da rashin hangen nesa na metastases na kwakwalwa a cikin ciwon nono ya zama matsaloli masu wuyar asibiti. An yi imani da cewa abubuwa kamar shekaru, ƙimar KPS, matsayi mai karɓa, adadin ƙwayoyin kwakwalwa, da kuma kwanciyar hankali na cututtuka na extracranial suna shafar hangen nesa na marasa lafiya, amma samfurin kima na yanzu yana da iyakacin tsinkaya kuma yana buƙatar ƙarin haɓakawa da ingantawa. . Dangane da jiyya, tiyata da radiation far har yanzu sune manyan hanyoyin jiyya, kuma matsayin maganin chemotherapy da magungunan ƙwayoyin cuta ya karu a hankali.
