Proton far don ciwon hanta, tsawon rayuwar marasa lafiya tare da maganin ciwon hanta na hepatocellular carcinoma proton therapy
Ciwon daji na hanta shine nau'in ciwon hanta da aka fi sani, tare da mutuwar fiye da 700,000 a duk duniya a kowace shekara, kuma abin da ya faru yana karuwa. Hanyoyin magani don ciwon hanta sun haɗa da dashen hanta, aikin tiyata, hanyoyin ablative da radiotherapy (photon radiotherapy ko proton far). Daga cikin su, tiyata har yanzu magani ne da aka fi so, amma tushen hanta wanda za'a iya amfani dashi don dasawa sun yi karanci kuma yawancin marasa lafiya ba zasu iya karɓar aikin tiyata ba saboda cutar hanta da sauran dalilai.
Maganin Proton na iya faɗaɗa rayuwar mai haƙuri gabaɗaya
Babban Asibitin Massachusetts Nina Sanford, MD da ƙungiya a hankali sun gwada tasirin warkar da marasa lafiya 133 tare da cutar hanta wanda ba zai iya aiki ba wanda ya sami aikin gargajiyar photon na gargajiya ko proton far a Babban Asibitin Massachusetts tsakanin 2008 da 2017, wanda shari'oi 49 (37%) daga cikinsu suka karɓi maganin proton. Wannan shine farkon binciken kwatancen proton far da photon radiotherapy don ciwon daji na hepatocellular.
Matsakaicin biyan karatun tsakani na tsawon watanni 14 ne, yawan sanyawa a iska shine 45 Gy / 15 ko 30 Gy / 5 ~ 6, kuma shekarun tsakiyar marasa lafiya shekaru 68 ne. Nazarin ya nuna cewa yawan rayuwar marasa lafiya a cikin rukunin farfajiyar ta fi kyau fiye da na rukunin rediyo na photon, tare da tsaka-tsakin rayuwa na watanni 31 da watanni 14, bi da bi, da kuma yawan rayuwar watanni 24 na 59.1% da 28.6% , bi da bi. A lokaci guda, maganin proton na iya rage faruwar cutar hanta mai saurin yaduwa (RILD) idan aka kwatanta da radiotonrapy na photon. Daga cikin marasa lafiya 21 da ba RILD ba na zamani, 4 sun sami maganin proton kuma 17 sun sami rediyon rediyo; kuma bayan magani Abinda ya faru na RILD a cikin watanni 3 ya dace da rayuwa gabaɗaya. Controlididdigar kulawa ta gida na ƙungiyar maganin proton da rukunin rediyo na photon sun kasance 93% da 90%, bi da bi, kuma babu wani bambanci mai mahimmanci tsakanin ƙungiyoyin biyu.
The article indicates that the longer overall survival of patients in the proton therapy group may be due to the lower incidence of decompensated liver function after treatment. Dr. Sanford said that in the United States, patients with hepatocellular carcinoma are often accompanied by other liver diseases, making these patients unable to undergo surgery and making radiotherapy more difficult. The proton therapy has a lower radiation dose to normal tissues around the tumo, so for patients with hepatocellular carcinoma, the non-target liver tissue receives less radiation dose. “We think this will reduce the incidence of liver injury. Because the cause of many hepatocellular carcinoma patients is other liver diseases, the lower liver injury rate in the proton therapy group can translate into better patient survival.”
Gano masu hango nesa game da ciwon hanta bayan maganin proton
Radiotherapy don cutar sankarar hanta har yanzu ana takaddama saboda yawan sanyaya ƙwayoyin cuta na haifar da wasu cututtukan hanta (RILD). MD Anderson Cancer Center da radiation oncologist Cheng-En Hsieh, MD na asibitin Chang Gung Memorial Hospital a Taiwan tare da tawagarsa sun gano masu hangen nesa na RILD bayan maganin proton.
Liverarfin hanta mara nauyi / daidaitaccen ƙimar hanta (ULV / SLV) histogram mai girma-sakamako
Wannan binciken na cibiyoyin da yawa ya hada da marasa lafiya 136 da ke fama da cutar sankarar hanta wacce ba ta ci gaba zuwa cututtukan ciki ba bayan maganin proton. An rarraba maganin proton zuwa 2 GyE. Analysisididdigar rikice-rikice da yawa ya nuna cewa ƙarancin hanta wanda ba shi da manufa / daidaiton ƙimar hanta (ULV / SLV), ƙarar makircin ƙari, da kuma rabe-raben yara-Pugh sun kasance masu hangen nesa na RILD, kuma matsakaicin ciwon hanta da maƙasudin isar da sakon ba su da alaƙa RILD Jima'i. Masu binciken sunyi imanin cewa ƙimar ULV / SLV ita ce mahimmin hangen nesa na RILD; bayyanar da ≥1 GyE na iya haifar da rikicewar hanta. Sabili da haka, don rigakafi da maganin cututtukan hanta, ƙarancin hanta mara manufa shine mafi mahimmanci fiye da matsakaicin ƙimar hanta.
"Bayananmu sun nuna cewa idan ana iya kare isassun hanta, maganin proton yana da lafiya sosai kuma ana iya rage haɗarin RILD," in ji Dokta Hsieh. “Kamar reshen hanta ne, wanda ke riƙe isasshen hanta Ana iya cire babban adadin hanta cikin aminci tare da nama. "
Mahimmancin zaɓin haƙuri da magani na musamman
Laura Dawson, MD, zababben shugaban ASTRO, ya bayyana cewa bayyana abubuwan hangen nesa da ke tattare da babban haɗarin ciwon hanta zai iya taimaka wa masu ilimin kanzarala su daidaita fa'idodi da haɗarin magani da haɓaka dabarun magani na musamman.
Both studies have emphasized the need for individualized radiotherapy for liver cancer,” Dr. Dawson said. “Although there are currently suitable patient types for proton therapy, there is still insufficient clinical evidence to treat proton therapy as the liver prior to photon radiotherapy. The preferred treatment for cell cancer. We still need randomized trials (such as NRG-GI003) to guide clinical practice and make it clearer which patients can benefit from proton therapy. “
Dokta Sanford ya ce: “A halin yanzu, maganin proton har yanzu magani ne mai tsada kuma yana da karancin kayan aiki. Saboda haka, muna buƙatar ci gaba da gudanar da bincike don inganta zaɓi na marasa lafiyar marasa lafiya dangane da dalilai na asibiti ko masu sayar da ƙwayar cuta. ”
