Tsayar da sake dawowa kansar huhu

Hana sake kamuwa da cutar kansar huhu, hana sake dawowa bayan tiyatar ciwon huhu, yadda za a hana sake kamuwa da cutar kansar huhu, yadda za a hana sake kamuwa da cutar kansar huhu.

Cutar sankarar sankara ita ce kan gaba wajen haifar da mace-macen da ke da nasaba da cutar kansa a duniya. Ga marasa lafiya da ke da wuri (matakin I da na II) wadanda ba ƙananan ƙwayoyin huhu na huhu (NSCLC) da wasu marasa lafiya masu dacewa tare da ci gaban cikin gida (mataki IIIA) ƙananan ƙananan ƙwayoyin cutar huhu, cikakken aikin tiyata na cututtukan ƙwayar cuta shine mafi kyawun hanyar magani. Kodayake an sami ci gaba a farkon ganewar asali da magani kuma sun inganta ƙimar rayuwa yadda ya kamata, sake dawowa bayan aiki ya kasance muhimmiyar matsala.

After surgical resection, 30% -75% of kwayar cutar huhu patients will relapse, including about 15% of patients with stage I lung cancer. Most recurrent tumors occur in distant lesions, and more than 80% of recurrent lung cancers occur within the first two years after resection.

Sake dawowa wani muhimmin dalili ne na gazawar yawancin masu fama da cutar sankarar huhu don yaƙi da cutar kansa. Yadda za a guji sake dawowa bayan tiyata shine batun damuwa ga kowane mai haƙuri da iyali.

Menene cutar sankara?

An bayyana sake kamuwa da cutar kansa a matsayin sake kamuwa da cutar kansa a cikin mai cutar kansa da aka kula da shi bayan wani lokaci na gafara ko babu alamun cutar kansa. Cutar daji da aka samo a cikin watanni uku na asalin asali ana ɗaukarsu ci gaba da cutar kansa. Cancer metastasis yana nufin abin da ke haifar da cututtukan da ke cutar kansa daga ƙananan raunuka a cikin huhu zuwa wasu gabobin, kuma suna girma da haɓaka a cikin gabobin.

Za a iya sake dawowa zuwa yanayi uku bisa ga wurare daban-daban na sake dawowa:

1. Sake dawowa na cikin gida-raunin har yanzu yana cikin huhu, kusa da asalin rauni;

2. Regional recurrence-when the lesion recurs in the lymph nodes near the original tumo;

3. Distal recurrence-when a lung cancer relapses in the bones, brain, adrenal glands or liver.

Menene musababbin sake kamuwa da cutar sankarar huhu?

Damar damar cutar sankarar huhu ta sake dawowa ya dogara da dalilai da yawa, gami da nau'in ciwon huhu na huhu, matakin kansar huhu lokacin da aka gano shi, da kuma maganin kansar na asali.

Bayan gano ciwon huhu na huhu, jiyya na farko suna taka muhimmiyar rawa, irin su tiyata da radiotherapy, waɗanda ake la'akari da jiyya na gida, wanda zai iya magance ciwon daji da ke kusa da asalin asalin ciwon daji. Wani lokaci ƙwayoyin da ke cikin ƙwayar cuta ta asali suna bazuwa ta hanyar jini ko tashoshi na lymphatic, amma waɗannan ƙwayoyin suna da ƙanƙanta don gano su ta hanyar hoto. Chemotherapy magani ne na tsari wanda galibi yana magance ƙwayoyin cutar kansa waɗanda ke iya kasancewa a cikin jiki. Abin baƙin ciki, chemotherapy yana da babban sakamako masu illa kuma yana da sauƙi ga juriya na miyagun ƙwayoyi. Ko da chemotherapy, ƙwayoyin kansa na iya rayuwa kuma su ci gaba da girma a nan gaba.

Menene alamun kamuwa da ciwon sankara na huhu?

Alamomin kamuwa da cutar sankarar huhu sun dogara da inda kansar ta sake komawa. Idan sake komawa gida ne, ko kuma a cikin kumburin lymph kusa da asalin tumo, alamun cutar na iya haɗawa da tari, hemoptysis, gajeren numfashi, numfashi, ko ciwon huhu. Sake dawowa daga kwakwalwa na iya haifar da jiri, rage hangen nesa ko hangen nesa biyu, rauni ko rashin daidaito a bangare daya na jiki. Sake dawowa a cikin hanta na iya haifar da ciwon ciki, jaundice (launin fata zuwa launin rawaya), kaikayi ko rikicewa. Sake dawo da kasusuwa galibi yana da ciwo mai zafi a kirji, baya, kafadu, ko wata gabar jiki. Symptomsarin bayyanar cututtuka na yau da kullun irin su gajiya da asarar nauyi wanda ba zato ba tsammani na iya zama tsinkayar sake faruwar cutar kansa.

Yaya za a hana sake dawowa kansar huhu?

Binciken lokaci-lokaci

Tun da yake cutar sankarar huhu ba ta da amintattun alamun da aka hango da wuri don sake dawowa da kuma saurin kamuwa da cutar, domin gano sake dawowa ko saurin yaduwa da wuri, ana bukatar sa ido sosai da bin diddigin cutar.

Gabaɗaya magana, ana duba shekara ta farko bayan aikin kowane wata uku; a shekara ta biyu, ana maimaita aikin kowane watanni shida, kuma ana ci gaba da gwajin kewaya.

A bi shawarar likita da bita akai-akai kuma akan lokaci. Lokacin da mai haƙuri yana da alamun bayyanar cututtuka, ya kamata a yi daidai kirji da ciki CT, craniocerebral CT ko MRI, duban kashi, fiberoptic bronchoscopy, da dai sauransu.

Bayan jiyya, marasa lafiya da ke fama da cutar sankarar huhu na iya haifar da rikice-rikice ko wasu alamomin saboda yanayin su da sauran dalilai. Sabili da haka, bita na yau da kullun bai kamata a yi watsi da shi ba kuma ya kamata a mai da hankali sosai.

Binciken biomarker

Wani muhimmin kayan aiki don tsinkayar haɗarin sake dawowa shine amfani da dabarun ilimin kwayoyin halitta. Ciwon daji na huhu wani ƙari ne mai haɗari sosai. Rarrabewar cututtuka (bambancin tarihin tarihi, ƙwanƙwasa jini, ƙwayar lymphatic, da ƙwayar ƙwayar cuta), matakin TNM ƙari, da genotyping duk suna da alaƙa da tsinkaye. Ana iya haɗa gwajin kwayoyin halitta da immunohistochemistry don amfani da maye gurbin kwayoyin halitta, kamar matsayin KRAS, da CEA da matakan maganganun Ki-67 don hasashen haɗarin sake dawowa.

Nutritionarfafa abinci mai gina jiki da hana mura

Ga marasa lafiya da ke fama da cutar sankarar huhu, ya kamata a tabbatar da abinci mai gina jiki don guje wa mura, kuma ya kamata a ba da kulawa ta musamman ga abincin. Zaɓin abinci ya zama mai wadatarwa da bambance bambancen, tare da 'ya'yan itace da sabbin kayan lambu. Ga tsofaffin majiyyata, cin abinci mai yawa da kayan miya zai fi narkewa sosai. A lokaci guda, dole ne mu kula da garantin abinci mai gina jiki da ingantaccen haɓakar protein.

Marasa lafiya da ke fama da cutar sankarar huhu dole ne su kula da dumi, hana mura da guje wa kamuwa da cuta. Kodai kwayar cuta ta kwayar cuta ko kwayar cuta, hakan zai haifar da kariyar jiki ta ragu, kuma yana da sauki ga kwayoyin cutar kansa su yadu da sake dawowa.

Inganta rayuwar ku da kasancewa cikin farin ciki

Bar barasa, bar barasa, bar barasa, an faɗi abubuwa masu mahimmanci sau uku, dole ne ku daina barasa. Bugu da ƙari, kada ku sha taba, kada ku yi aiki da yawa, ku kula da ƙa'idodin motsin rai, kuma ku kula da yanayi na farin ciki.

motsa jiki da ya dace, watanni 2-3 bayan tiyata, za ku iya yin motsa jiki mai laushi, kamar tafiya, kuma a hankali ƙara daga minti 15 zuwa minti 40; Hakanan zaka iya motsa jiki na qigong, Tai Chi, motsa jiki na rediyo da sauran motsa jiki masu laushi.

Ya kamata a ba da kulawa ta musamman ga abincin, kada ku ci abinci mai laushi, barbecue, naman alade, tofu da sauran abinci masu dauke da sinadarin nitrite, kuma kada ku ci magungunan gargajiya na kasar Sin da kayayyakin kiwon lafiya.

Maganin kansar huhu

Surgery

Hanya mafi kyawu don magance kansar huhu ita ce cire raunin da ke maimaituwa don cimma burin warkarwa mai faɗi. Idan ka'idojin tiyata suka cika, duk ciwace ciwace ana iya cire su ta hanyar tiyata.

Idan akwai raunuka da yawa, yankin mamayewa yana da girma babba, ko kuma metastases mai nisa, ana iya zaɓar raunin tumo bisa ga yanayin. Idan ba a tabbatar da fa'idar tiyata ba, za a iya zaɓar wasu hanyoyin magani.

Proton far don maganin ciwon daji na huhu

Radiotherapy is an adjuvant treatment for many patients with postoperative lung cancer. However, in traditional radiotherapy, X-rays or photon beams are inevitably transmitted to the tumor site and the surrounding healthy tissues. This can damage nearby healthy tissue and can cause serious side effects. Proton farfadowa zai iya guje wa waɗannan tasirin.

Sabanin haka, maganin proton yana amfani da hasken wuta na proton kuma yana iya tsayawa a wurin ciwon daji ba tare da barin kashi na radiation a bayan ciwon ba, don haka da wuya ya lalata nama mai lafiya kusa. Wasu masana sun yi imanin cewa maganin proton ya fi aminci fiye da maganin radiation na gargajiya.

Marasa lafiya masu fama da cutar kansa suna da ƙananan rigakafi, tasirin haskakawar iska mai sauƙi na iya haifar da lahani ga gabobi na al'ada, haifar da mummunan sakamako, da kuma kawo nauyi mai nauyi ga jikin da yake da rauni. Musamman ga kansar huhu, cututtukan tumo suna kusa da yawancin gabobin da yawa, kamar hanta, zuciya, esophagus, da sauransu, da kuma metastases na kwakwalwa waɗanda suka saba da cutar kansa ta huhu. Zaɓin maganin proton na iya kauce wa lalacewa da kewaya kyallen takarda mai ƙoshin lafiya da kuma cimma sakamako na kisan kai kamar rediyon gargajiya.

Magungunan Magungunan Canji

Farfesa da aka tsara

With the continuous advancement of precision medicine and the continuous advent of various targeted drugs, the front-line treatment of cututtukan daji na kansa marasa kansar (NSCLC) has changed from chemotherapy to the preferred targeted treatment.

Wadannan manyan maye gurbi guda shida masu mahimmanci a cikin ƙwayoyin cutar kansar huhu waɗanda ba ƙananan ƙwayoyin cuta ba: EGFR (exon 19/21), ALK, BRAF V600E, ROS1, RET, da NTRK suna da mahimmanci ga marasa lafiya da ciwon huhu saboda sun riga sun sami magunguna masu tasiri sosai. za a iya amfani da shi don magani, maye gurbin maganin chemotherapy na gargajiya.

EGFR maye gurbi-tabbataccen ciwon huhu:

Zaɓin magungunan magani na farko: gefitinib, erlotinib, afatinib, dacotinib, ositinib, da ectinib (magungunan gida).

Zaɓuɓɓukan maganin biyo baya: Oxitinib.

ALK sake sake fasalin-tabbataccen ciwon huhu:

Zaɓuɓɓukan maganin layi na farko: crizotinib, ceritinib, aletinib, da bugatinib.

Kulawa mai zuwa: Aletinib, Bugatinib, Ceritinib, Lauratinib.

ROS1 sake sake fasalin-tabbataccen ciwon huhu:

Zaɓin magunguna na farko: ceritinib, crizotinib, emtricinib.

BRAF V600E maye gurbi-tabbataccen ciwon huhu:

Zaɓuɓɓukan maganin layin farko: Dalafenib + Trametinib

Kulawa mai zuwa: Dalafenib + Trametinib

NTRK jigilar kwayar cutar kwayar cutar huhu mai kyau:

Zaɓuɓɓukan maganin layi na farko: Larotinib, Emtricinib.

Kulawa mai zuwa: Larotinib, Emtricinib.

Akwai makasudin maye gurbi da yawa wanda kansar huhu ke iya ganowa? Ko shakka babu. Bugu da kari, akwai wasu maye gurbi masu tasowa kamar MET, RET, HER2, da sauransu TMB shima yana zama alamar hasashe immunotherapy. Idan an gano waɗannan maye gurbi masu tasowa, zaku iya zaɓar madaidaicin maganin da aka yi niyya (duba teburin da ke ƙasa)).

Abubuwan da ke haifar da ƙwayoyin cuta da ƙwayoyi masu mahimmanci don ƙananan ƙwayoyin cuta na huhu

Zaɓin zaɓi don ciwon daji na huhu lokacin da babu canjin kwayar halitta

Ga marasa lafiya masu ciwon huhu marasa ƙananan ƙwayoyin cuta ba tare da maye gurbin kwayoyin halitta ba, har yanzu ana buƙatar gano wani muhimmin alamar halitta, wato PD-L1. PD-L1 an inganta shi a yawancin ƙwayoyin ƙari. Haɗin 1, zai iya hana haɓakawa da kunna ƙwayoyin T, yin ƙwayoyin T a cikin yanayin rashin aiki, kuma a ƙarshe ya haifar da tserewa na rigakafi, tumorigenesis da ci gaba.

Hanyar bincikar PD-L1 ta FDA wacce aka yarda da ita zata iya jagorantar paimumab wajen kula da marasa lafiyar NSCLC, gwargwadon yawan ƙwayar ƙari (TPS). TPS shine yawan ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin cuta waɗanda ke nuna lalata ko cikakken membrane a kowane ƙarfi.

Cancerananan ƙananan ƙwayar cutar huhu tare da bayanin PD-L1 na TPS ≥1%

Zaɓuɓɓukan magani na farko:

Monimum monotherapy

2. cinwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta: (karboplatin / cisplatin) + an gyara shi + paimumab

3. Non-squamous cell carcinoma: carboplatin + paclitaxel + bevacizumab + atejuzumab

4.Cacamoma cell carcinoma: (carboplatin / cisplatin) + (paclitaxel / albumin paclitaxel) + paimumab

Idan an gano maye gurbi duka kuma an daukaka PD-L1 magana, an fi son maganin ƙwayoyi masu niyya.

Zaɓin magungunan farko na layin ƙwayoyin cuta na ƙananan ƙwayoyin cuta (ba maye gurbi ba, babu musanyawar rigakafi, PD ci 0-1)

Jawabinsa: K magani ne paimumab, magungunan T shine atezumab, an sayar da magungunan biyu a ƙasar China

Zaɓin magungunan farko na layi don rashin n-squamous n
kan-karamin kwayar cutar sankara (ba maye gurbi na kwayar halitta ba, babu wasu rikice-rikice na rigakafi, PD ci 0-1)

Jawabinsa: K magani ne paimumab, magungunan T shine atezumab, an sayar da magungunan biyu a Indiya.

Alurar rigakafin cutar huhu

A cikin 2008, Cimavax-EGF, allurar rigakafin peptide ta farko a duniya don maganin mataki na III da na huhu na huhu, an sami nasarar haɓaka; a cikin 2012, Cuba an yi nasarar samar da maganin cutar kansar huhu na biyu, Vaxira.

Kasuwancin furotin na peptide na farko da aka tallata a duniya-Cimavax-EGF

Nuni: IIIB, IV ƙananan ƙwayoyin cuta na huhu.

Lokaci zuwa kasuwa: 2011 (da aka jera a ciki Cuba)

Bayan shekaru 25 na bincike, Cuban masu bincike sun yi nasarar shirya allurar rigakafin da za ta iya dakatar da ci gaban cutar kansa ta huhu.

Bayanan Gwaji:

CIMAvax-EGF a cikin marasa lafiya tare da NSCLC na ci gaba (gwaji na asibiti na Phase III) ya tabbatar da cewa allurar rigakafi ce kuma tana da inganci a cikin marasa lafiya masu cutar NSCLC.

A cikin gwajin lokaci na III, ƙimar rayuwa ta shekaru 5 na batutuwa masu allurar rigakafi ya kasance 14.4%, idan aka kwatanta da kawai 7.9% a cikin rukunin sarrafawa, kusan ninki biyu!

Dace da marasa lafiya:

huhu maganin ciwon daji are not effective in all patients. The most suitable population is: only for patients with advanced non-small cell lung cancer lung cancer, lung cancer patients with stable disease after first-line chemoradiation and no brain metastases If the patient is in advanced disease, the vaccine is not suitable.

Masu bincike suna da tabbaci cewa ɗayan cikin biyar na waɗannan marasa lafiya zai yi nasara. Yawancin ƙari sun ɓace, kuma wasu marasa lafiya sun ɓace! 23% na marasa lafiya sun rayu fiye da shekaru 5. Kodayake sun ci gaba da cutar kansa ta huhu, bayan sun sami maganin alurar riga kafi, za su iya aiki da rayuwa daidai, kuma ingancin rayuwarsu yana da matukar yawa, yana kawo jinkirin ci gaban cutar.

Lura, duk da haka, CimaVax EGF ba zai iya dakatar da ci gaban ciwon daji ba, balle a warkar da shi. Maimakon haka, an ƙaddamar da wata hanya, ta hanyar da ba a sarrafa girma da rarraba kwayoyin cutar kansa ya fi ƙuntatawa, ta yadda za a canza ciwon huhu na huhu zuwa wata cuta mai tsanani. A halin yanzu, an amince da rigakafin cutar kansar huhu na Cuba a cikin kasashe sama da 80 na duniya, kuma majinyata na cikin gida za su iya neman siyan maganin cutar kansa daga Cuba ta hanyar kira a + 91 96 1588 1588.