Kwararru daga Faxar Cancer na iya taimaka wa marasa lafiya wajen yin shawarwari kai tsaye tare da masana a manyan cibiyoyin proton don sanin dacewar marasa lafiya don maganin proton. A lokaci guda, za su iya taimaka wa marasa lafiya wajen tantance yanayin su da zabar wasu zaɓuɓɓukan jiyya kamar su tiyata, chemotherapy, immunotherapy, da ilimin ƙwayoyin cuta.
Farfesa Bachtiary, babban likita na RPTC ta Jamus (Munich Proton Center) ya taɓa jaddadawa a cikin tattaunawarmu cewa akwai nau'o'in ciwowi iri uku waɗanda ya kamata a ba fifiko ga proton radiotherapy. Na farko shine nasopharyngeal carcinoma. Na yi imanin cewa proton na iya cimma sakamako na warkarwa.
XKmed (tare da Kang Changrong) ya zaɓi lambobin likita da dama tare da ƙididdiga masu mahimmanci a cikin yawancin adadin cututtukan daji na nasopharyngeal da aka kula da su ta hanyar proton a ƙasashen waje, kuma an tsara su don marasa lafiya da ƙwararrun likitoci.
Yanayin asali:
Cutar: Ciwon daji na Nasopharyngeal (sake dawowa)
Jima'i: Jima'i
Shekaru: Shekaru 52
Lokacin saki: Mayu 2012
Wuri na farko: dama nasopharynx
Tumor ya yadu: bangon dama na bayan gida na nasopharyngeal, yana mamaye tsoka madaidaiciya, kan kwanyar kai, sinus mai rami
Tarihin likita da magani:
Shekaru biyu bayan kammala jinyar a shekarar 2014, kwatsam Mista H ya ji diplopia a idonsa na dama na sama da kuma kumbura a lebbansa na dama. An sake duba shi a asibitin yammacin kasar Sin na jami'ar Sichuan, kuma ya yi wani ingantaccen hoton MRI na hanci da wuyansa, inda ya nuna nasopharynx Ciwon daji na sake dawowa, ya shafi gindin kwanyar zuwa sama.
Saboda yawan yaduwar radiation da aka yi a baya da kuma shigar da kokon kai, yana da wahala magani na cikin gida ya yi tasiri kuma. Mista H. ya fara neman hanyoyin neman magani na duniya.
Ya gano wata ingantacciyar hanyar magance cutar kansa ta hanyar yanar gizo-proton therapy. Saboda haka, Mista H ya sami Chang Kang Evergreen, wata cibiyar likitancin kasashen waje da ta kware a fannin maganin cutar, kuma ya gudanar da bincike na farko game da cutar. Ya yi imanin cewa H ya dace sosai da maganin proton.
Ba da daɗewa ba aka fara maganin Proton a cikin watan Satumba na 2014, kuma yanzu raunin nasopharyngeal na Mr. H ya ragu, kuma binciken da aka biyo baya ya nuna kyakkyawan sakamako na magani.
Sakamakon ilimin lissafi:
Keungiyar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta ta nonkeratotic
Immunohistochemistry:
PCK (-), P63 (+), S-100 kusan 25% (+); a cikin yanayin haɓakawa: EBER nuclei (+)
Tarihin likita da magani:
18 ga Mayu, 2012-5 ga Yuli, 2012
33 sau na nasopharyngeal da wuyansa radiotherapy: 69.96Gy / 2.12Gy / 33F
Yankin shirin da ke da matukar hadari: 59.4Gy / 1.80Gy / 33F
Yankin shirin mai ƙananan haɗari: 56.10Gy
Chemotherapy na lokaci daya: kwasa-kwasan 2 na carboplatin 150mg, kwasa-kwasan 3 na cetuximab. An ba da Erbitux 600 MG, 400 MG, da kuma 400 MG a kan Mayu 23, Mayu 29, da Yuni 5, bi da bi.
23 ga Yuli, 2012-Yuli 27, 2012
Radioarin rediyo don ragowar ƙwayoyin lymph bayan sau 5 na pharynx: 10Gy / 5F
A farkon watan Yulin 2014, ya ji rashin jin daɗi a cikin hangen nesa na dama na dama, ƙarancin leɓensa na dama na dama, babu ciwon kai, kuma babu wuyan wuya. MRI ya inganta scanning, nasopharyngeal carcinoma ya sake dawowa, wanda ya hada da kwanyar kwanya sama, kuma ba a ga wani kara girman kwayar lymph a wuya ba.
Cibiyar Proton a Munich, Jamus:
Satumba 23, 2014 PET-CT
Hanyar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta ta sake dawowa, ƙwayar cutar ta shiga cikin ƙashi na lokaci da ƙwanƙwan kai, kuma ya ci gaba zuwa tsakiyar lobe a cikin kwakwalwa, yana taƙaita jijiyar carotid da jijiyoyin gani na dama, da kuma dacewar mastoid.
GTV: ƙarar ƙari bayan PET-CT chemotherapy
CTV: GTV1 + yaɗuwar farkon ƙari
PTV: CTV1 + 3mm nesa nesa
Oktoba 2-Oktoba 31, 2014
Proton radiotherapy kashi: PTV, 40 * 1.50Gy (RBE), sau biyu a kowace rana, awa 6 baya, jimla guda: 60.00Gy.
A lokaci guda, amfani da platinum-cis-chemotherapy a kowane mako.
Haƙuri yayin proton far:
Diplopia, rage ji a gefen dama, kuma rashin nutsuwa a leɓen dama na sama ya ta'azzara. 1 digiri radial erythema da radiation mucositis sun bayyana akan kuncin dama na sama, kuma osteonecrosis ya bayyana a gefen dama na murfin mai wuya. An yi juriya da maganin ƙwaƙwalwa guda ɗaya, kuma kawai wasu halayen hanji sun faru.
Bibiya da kwatancen sakamakon dubawa (hotuna) kafin da bayan jiyya:
Fabrairu 5, 2015: Mucositis da radiotherapy erythema an warware su gaba daya.
Binciken farko bayan maganin proton:
Idan aka kwatanta da binciken da aka inganta na MRI a ranar 28 ga Janairu, 2015 idan aka kwatanta da 1 ga Agusta, 2014, an rage ƙwanjin ƙari na bangon nasopharyngeal na dama, kuma babu wani canji mai mahimmanci a cikin sauran. Babu wata kwayar cutar lymphadenopathy tsakanin fascias na wuyansa, kafofin watsa labaru na otitis na dama, da sphenoid sinusitis.
Bincike na farko bayan maganin proton, Janairu 28, 2015 MRI ta inganta sikanin ya nuna: an ɗan rage girman nasopharyngeal carcinoma ƙari ba tare da ƙarin ci gaba ba ko metastasis
Labarin haƙuri:
Mista H likita ne a wani asibiti a Chengdu. A matsayinsa na malami na digiri, yana da kyakkyawar asalin ilimin ilimi, aikin nasara, da iyali mai farin ciki. Samfura ne mai son samun rayuwa mai dadi. Koyaya, abubuwa basu da tabbas. A watan Mayu 2012, kwatsam na ji ba ni da lafiya a gefen dama na hanci kuma na faɗaɗa ƙwayoyin lymph a cikin wuyan na sama. Na je asibitin marasa lafiya na Yammacin China na Jami'ar Sichuan don yin nasopharyngoscopy. Sakamako ya nuna cewa an fashe nama na madaidaicin pharyngeal crypt, an fadada jijiyoyin jini, kuma wasu pseudomembranes suna da sauƙin taɓa jini. An dauke shi azaman ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta. Rahoton cututtukan cututtukan halittu an tabbatar da cewa: (madaidaiciyar pharyngeal crypt) ba-keratotic squamous cell carcinoma. Hanyar rigakafi: PCK (-), P63 (+), S-100 kusan 25% (+); a cikin yanayin haɓakawa: EBER nuclei (+). MRI da jiki duka-Cet-CT an bincikar su azaman carcinoma nasopharyngeal tare da metastasis zuwa zurfin mahaifa mahaifa (T2N1M0).
Bayan shigarwa, an gudanar da maganin cutar ta hanyar iska mai ƙarfi wanda aka tsara 33, sannan kuma zagaye biyu na rediyo da kuma maganin ƙwaƙwalwa, da kuma zagaye uku na farfadowa. Daga baya, saboda tsananin halayen da ke tattare da muryar oropharyngeal da kuma rashin jin daɗin tsarin, an dakatar da aiki tare da magani da aka yi niyya. Bayan jiyya, an sake yin MRI na nasopharynx, kuma raunin ya ragu. Koyaya, akwai ragowar lymph nodes a cikin na baya pharynx da lymph nodes a cikin yankin wuyan dama IIb. An yanke shawarar bayar da maganin turawa na cikin gida na raunukan parapharyngeal a kashi 1000 cGy / 5f. Yi nazari akai-akai bayan fitarwa.
Shekaru biyu bayan ƙarshen jiyya, ba zato ba tsammani, Mr. H ya ji hangen nesa biyu a cikin idonsa na dama na dama kuma ya dushe a leɓensa na sama na dama. An sake duba shi a Asibitin Yammacin China na Jami'ar Sichuan. Ya gudanar da ingantaccen hoton MRI na nasopharynx da wuya, wanda ke nuna sakewar kansar nasopharyngeal, Ciki da kwanyar kansa zuwa sama.
Rahoton kulawa na Mr. H
Saboda yawan yaduwar radiation da aka yi a baya da kuma shigar da kokon kai, yana da wahala magani na cikin gida ya yi tasiri kuma. Mista H. ya fara neman hanyoyin neman magani na duniya.
Mista H sanannen malamin digiri ne, Tao Li Man Tianxia, kuma ɗalibansa suna taimakawa wajen nemo dabarun jiyya a duk faɗin duniya. Daya daga cikin daliban ya kasance a birnin Beijing, kuma ya gano wata babbar hanyar magance cutar kansa, wato proton therapy, ta hanyar Intanet. Saboda haka, Mista H ya sami Chang Kang Evergreen, wata cibiyar kiwon lafiya ta ketare da ta kware a fannin maganin proton, kuma ya gudanar da bincike na farko. Ya yi imani cewa H ya dace sosai don maganin proton.
Bayan kwatantawa da fahimta, Mista H ya yanke shawarar zaɓar RPTC Proton Center a Munich, Jamus tare da ingantaccen fasaha da haɓaka tsada don masu kulawa
t. Kafin tafiyata, Ina sadarwa tare da ma'aikatan da ke da alhakin kowace rana, gami da yawan fitilun, shawarwarin asibiti, da suttura, abinci, mahalli, da jigilar kaya bayan isa zuwa Jamus.
A watan Satumba na 2014, Mr. H ya isa Jamus. Tare da rakiyar ma’aikatan gida, ya fara sanin yanayin da ke kewaye da shi, yana cin kasuwa cikin farin ciki, yana jin daɗin abinci, ya kuma gudanar da gwajin jinya na farko. Hankalin fidda zuciya da fargabar Malam H sun lafa. Ya ce: "Ina jin ganin haske a cikin duhu." Bayan kwana uku na gwajin jiki, bayan mako guda, an kammala madaidaicin ƙayyadaddun mold kuma an fara tafiya ta proton na Mr. H.
Saboda sarkakiyar yanayin da Mr. H yake, wani sashi na kumburin ya lalata jijiyar ido na dama. Asibitin na Jamus ya tsara cikakken shirin yin allurar iska, jimillar yin amfani da iska sau 40, sau biyar a mako. Bayan karbar magunguna da yawa, likitoci a Cibiyar Proton ta Jamus sun ba da shawara idan za a iya haɗa su da cutar sankara don cimma sakamako mai kyau. Don haka Mista H ya shirya asibitin da ke ƙwarewa a fannin cutar sankara a Proton Center. Tare da kwararrun kayan aikin likitanci da kulawa ta kusa, Mista H ya sami kwanciyar hankali.
Bayan jinyar, Mista H da matarsa sun yi rangadi a kusa da Munich kuma sun yi liyafa tare da abokan Jamus. Bayan watanni biyu, Mr. H ya tashi daga Jamus ya dawo gida. Yanzu yana rayuwa cikin koshin lafiya da farin ciki.
