Ciwon nono & magani
Daga cikin cututtukan daji da yawa, ciwon nono yana yiwuwa ya fi wuya a yanke shawarar ko za a sha chemotherapy bayan tiyata. Hakazalika da sauran cututtuka, abubuwan da ke ƙayyade chemotherapy na nono sune (shekaru, girman ƙwayar cuta, metastasis na nodes na lymph da sauran gabobin (wanda ake kira TNM, staging), ER, PR, CerbB-2, Ki-67, P53, da dai sauransu. .). Idan sakamakon binciken ya kasance a fili a gefe, yana da sauƙi don yanke shawara game da ko za a gudanar da ilimin chemotherapy. Amma a yawancin lokuta, sakamakon binciken ya kasance daidai a tsakiyar "yankin launin toka" (Ba na yin karin gishiri, akwai misalai da yawa na yankin tsakiya), wanda zai haifar da halin da ake ciki na rashin tabbas. Sau da yawa muna cewa: Ra'ayi na biyu (saurari ra'ayoyin likitoci da yawa), amma kun taɓa yin tunani akai, ko da kun tambayi likitoci 10, amsar da za ku iya samu ita ce: 5 ce chemotherapy, 5 ce a'a ( Har yanzu biyu ra'ayi), ba abin ban haushi ba ne.
Bayan kana da ciwon nono, it’s important to make a decision about whether to get chemotherapy. If patients who do not need chemotherapy receive unnecessary chemotherapy, it will not only waste time and money, but also endure the various side effects of chemotherapy (nausea, vomiting, hair loss, bone marrow suppression, infection, bleeding, etc.). Patients who originally needed chemotherapy miss the chance of chemotherapy, which increases the risk of recurrence.
Me zaiyi?
ASaya daga cikin gwajin an ba da shawarar ta ASCO ta Amurka (American Clinical Oncology Association). An kira shi samfurin DX. Wannan gwajin yana amfani da hanya mai sauki ta nazarin halittu don nazarin abubuwan da muka ambata a sama kan sashen cututtukan sankarar mama na mara lafiya, sannan kuma ya ba da “Sakamakon Maimaitawa” (RS). Marasa lafiya tare da babban RS suna buƙatar chemotherapy, kuma waɗanda ke da ƙananan RS ba sa bukatar chemotherapy. RS a tsakiya yana buƙatar ƙarin bincike (kodayake yawancin marasa lafiya tare da RS a yankin na tsakiya ba sa amfanuwa da yawa daga chemotherapy).
A Amurka, wannan gwajin ya zama ruwan dare gama gari don maganin cutar sankarar mama, saboda yanke shawara ko a buƙatar chemotherapy yana da alaƙa kai tsaye da tasirin maganinku. An kiyasta cewa sabbin cututtukan 225,000 da ke faruwa a kowace shekara a cikin Amurka, kuma 94,500 suna karɓar isrogen masu kyau kuma ana ɗaukarsu ‘yan takara don maganin cutar sankara. Kudin chemotherapy ga kowane mai haƙuri kusan $ 15,000, kuma farashin kwayar cutar DX guda ɗaya shine $ 4,000. Sabili da haka, idan duk marasa lafiya da ƙananan ƙarancin haɗari ba su karɓi maganin ƙwaƙwalwar ba, Amurka za ta adana miliyan 300 kowace shekara $ 30.8 miliyan.
Dr. Joseph Ragaz of the University of British Columbia in Vancouver and colleagues analyzed tumo samples from 196,967 estrogen receptor-positive breast cancer patients from the database of Genomic Health, the parent company that developed the test, and found that oncotype DX The proportion of patients with positive axillary lymph nodes (59%) with a 10-year recurrence risk score below 18 was greater than that of patients with negative lymph nodes (54%).
Waɗannan bayanan sun nuna cewa ya kamata a yi gwajin oncotype DX akan duk masu karɓar isrogen mai karɓar ciwon nono, a cikin ɗabi'a da tattalin arziƙi, ba tare da la'akari da matsayin kumburin kumburin axillary ba. Koyaya, ana iya amfani da wannan gwajin don gwaji kawai a asibitoci a Amurka, Japan da sauran yankuna. Don cikakkun bayanai, da fatan za a ziyarci Cibiyar Sadarwar Oncologist ta Duniya.
NCCN tana ba da shawarar gwajin kwayar cutar kansar mama: ncotype DX
An gudanar da taron shekara-shekara na kasa da kasa karo na 20 (NCCN) na shekara-shekara daga 12 zuwa 14 ga Maris, 2015 a Hollywood, Florida, Amurka. A cewar labaran da aka fitar a taron, NCCN kawai ta sanya hannu kan gwajin kwayoyin halittar kansar nono da wuri. Yimaitong ya ruwaito wannan.
Amy Cyr na Cibiyar Cancer ta Siteman a Jami'ar Washington, a lokacin da take jawabi a wurin taron, ta ce oncotype DX, wanda Genomic Health ta haɓaka, ya sami wannan girmamawar.
Wannan gwajin yana da ayyuka biyu. Baya ga samar da bayanan hangen nesa, gwajin kuma yana da sakamako na tsinkaye akan sakamakon magani; yana iya ainihin hango ko hasashen amsar marasa lafiya game da cutar sankara.
A takaice dai, Oncotype DX kayan aiki ne guda biyu don hango nesa da hango ko hasashe.
Amy Cyr ya ce ikonsa na hango hangen nesan maganin shi ne "wani abu ne ya sanya shi fice har yanzu." Ta kara da cewa sauran gwaje-gwajen kwayoyin cutar kansar nono, da suka hada da MammaPrint, Prosigna, EndoPredict, da Cancer Index, ba su nuna shaidar dukkan karfin ba.
o ncotype DX ya dace da mai karɓar hormone tabbatacce mata masu fama da cutar sankarar mama (kuma ya dace da HER2 korau, pT1, PT2, ko pT3 da pN0 ko pN1).
Dokta Cyr ya ce kasuwar gwaji na kara fadada yayin da aka gano karin mata da cutar sankarar mama ta farko, abin nuni ga samfurin, ta hanyar binciken nono.
Dokta Cyr ya ce bayanin bayyana kwayoyin shi ne “daya daga cikin nasarorin da aka samu” a fannin ilimin likitanci, kuma gwaje-gwaje masu yawa na cutar sankarar mama sun kawo karin bayanai.
"Gwajin oncotype DX kayan aiki ne mai matukar amfani," in ji Michael Stone a Glealey Clinic a Jami'ar Colorado a taron, wanda ya yi hasashen hadarin sake dawowa gida ko metastatic. "Da yawa daga cikin majiyyata suna farin ciki wataƙila ba sa buƙatar maganin ƙwaƙwalwa."
Dokta Stone ya bayyana cewa ba a ba da shawarar ba da magani ga marasa lafiya tare da ƙananan maimaita rauni, amma ana ba da shawarar ga marasa lafiya da yawan ci gaba. Koyaya, sake dawowa shine yanki mai launin toka. Ya ce yana ba da shawarar chemotherapy wanda ya dogara ne da shekarun mai haƙuri da lafiyarsa. Chemotherapy ana ba da shawarar gabaɗaya ga ƙarami, lafiyayyun marasa lafiya bayan angogin maza da mata tare da matsakaiciyar sake dawowa. Dokta Cyr ya yarda cewa yana da wahala a san ko matan da ke da matsakaiciyar koma baya ya kamata su karɓi magani.
Cyr ya jaddada cewa kodayake DX na oncotype kawai ya dace da marasa lafiyar lymph node, amma kuma yana da amfani ga marasa lafiyar lymph node.
Ta ambaci binciken na TransATAC, wanda ya shafi matan da ke fama da cutar sankarar mama da aka bi da anastrozole ko tamoxifen (J Clin Oncol. 2010; 28: 1829-1834). Oncotype DX anyi amfani dashi don nazarin ƙwayar ƙwayar ƙwayar marasa lafiya, kuma an sake lissafin abubuwan da suka faru na lymph node marasa kyau da ƙwararrun ƙwayoyin lymph node daidai.
Dr. Cyr ya ce "za a iya amfani da ci gaba a matsayin mai hangen nesa game da sakamako mai tsawo a cikin rukunin marasa lafiya biyu." Ya kamata a lura cewa yana da ƙimar tsinkaya ɗaya ga marasa lafiya da ke da ƙananan ƙarancin ƙwayar ƙwayar ƙwayar cuta 3 da ƙananan ƙwayoyin cuta 4 ko fiye.
