Menene sarcoma?
Sarcoma is a rare connective tissue tumor, so sarcoma can invade any part of our body. These tumors include liposarcoma, neurosarcoma, osteosarcoma, tendon sarcoma, muscle and skin sarcoma. They account for approximately 1% of all adult cancers and approximately 15% of childhood tumors. In addition to the widespread existence of potentially major sites and rare locations, there are more than 80 tumors with very mixed components with different histological subtypes. Sarcoma is a type of cancer. Sarcoma—Malignant tumo formed by cancellous bone, cartilage, fat, muscle, blood vessels, and tissue.
Uku daga cikin waɗannan dalilai suna sa maganin sarcoma ya zama ƙalubale. Sabili da haka, yana da mahimmanci ga marasa lafiyar sarcoma da za a kula da su ta hanyar ƙwararrun ƙungiya mai yawa. Needsungiyar tana buƙatar haɗawa da likitocin tiyata, masu ilimin cututtuka, masu ilimin rediyo, masu ilimin kanko, ƙwararrun likitocin, masu ilimin motsa jiki da masu harhaɗa magunguna. .
Ganewar asali na sarcoma
In order to confirm the diagnosis, biopsy is needed to confirm the presence and specific subtype of sarcoma. Because these tumors are very rare and mixed, it is vital that an experienced pathologist examine biopsy samples. The initial diagnostic radiation tests included CT scans and MRI scans to determine the location and type of sarcoma.
Jiyya na sarcoma
The mainstream treatment for localized sarcoma includes complete surgery combined with radiotherapy or no radiotherapy. The need for an experienced surgeon to perform the operation is very important, because the implementation of improper surgery may have an impact on the treatment outcome.
A large number of randomized clinical trials have confirmed that preoperative or postoperative radiotherapy has obvious benefits for sarcoma of the hand and foot and chest wall sarcoma. A recent international randomized clinical trial evaluated the role of preoperative radiotherapy in the treatment of retroperitoneal sarcoma.
In specific sarcoma subtype weeks, multi-agent chemotherapy is an important part of treatment management; these subtypes include Ewing’s sarcoma, osteosarcoma, and rhabdomyosarcoma. The introduction of these subtypes of multi-agent chemotherapy and limb salvage surgery has become a great success in the field of cancer treatment in the past 40 years.
Hasashen sarcoma
Abin baƙin cikin shine, duk da yin amfani da ingantaccen magani don cikakken aikin tiyata, kimanin kashi 50% na marasa lafiya tare da matsakaiciyar / sarcoma mai ci gaba na ci gaba da ɓarna / cututtukan ƙwayoyin cuta. Metastasis yawanci yana yaduwa ta cikin jijiyoyin jini, kuma huhu sune mafi yawan wurare don cututtukan ƙwayar cuta.
Sakamakon bincike na marasa lafiya tare da sarcoma mai lalacewa gabaɗaya talakawa ne a da, kuma akwai ƙananan zaɓuɓɓukan magani. Koyaya, bayanan kwanan nan sun nuna cewa yawancin rayuwar marasa lafiya tare da sarcoma mai laushi ya karu daga kimanin watanni 12 zuwa watanni 18 na yanzu. Yanzu akwai ƙarin zaɓuɓɓukan tsarin tsarin don marasa lafiya da sarcoma mai kama da cuta.
For patients with slow-growing histological subtypes, the monitoring of small / asymptomatic metastatic lesions is an option. Surgical resection is considered when the patient has a separate metastatic lesion, especially when the lesion is in the lungs. Other local treatment strategies may also be considered including radiotherapy, radiofrequency ablation and embolization.
Shawarwarin magance cututtukan metastatic na iya zama mai rikitarwa, kuma muna sake sake jaddada cewa wannan yana buƙatar ƙwararrun ƙungiya da yawa. Ga yawancin marasa lafiya da ke fama da cutar sarcoma, babban magani ya dogara da tsarin tsari, akasarin cutar sankara.
Neman da aka yi niyya a cikin sarcoma
Targeted therapy drugs have been introduced in the subtype of soft tissue sarcoma called ciwon ciki na stromal (GIST), which has become an example of targeted therapy for solid tumors. Most ciwon ciki na stromal (GIST) have KIT and PDGFRA gene mutation characteristics. Due to the introduction of these tyrosine kinase inhibitors, the prognosis of patients with metastatic gastrointestinal stromal tumors (GIST) has been greatly improved.
Bugu da ƙari, an yarda da imatinib a matsayin magani ga ciwace-ciwacen da ke da haɗari bayan sakewa. Imatinib kuma anyi nasarar amfani dashi wajen magance wasu ƙananan nau'in sarcoma (wanda ake kira dermatofibrosarcoma protuberances (DFSP)).
Ana iya amfani da Doxorubicin shi kaɗai ko a hade tare da ifosfamide har yanzu shine daidaitaccen layin farko na layin sarcoma mai laushi. A cikin 'yan shekarun da suka gabata, an buga ko buga sakamakon sakamakon gwaji na asibiti na zamani na uku na duniya.
Gwajin gwaji na farko da aka zaba marasa lafiya da bazuwar karɓar doxorubicin ko doxorubicin da ifosfamide. Wannan gwajin na asibiti ba da rahoton wani bambanci a cikin yawan rayuwar rayuwa ga duka hannayen biyu, amma marasa lafiya a kan haɗin haɗin gwiwa suna da ƙarancin ci gaba ba tare da ci gaba ba kuma mafi girman ƙimar amsawa.
Gwaji na biyu na gwaji da aka zaba marasa lafiya ba tare da kaɗan ba don karɓar doxorubicin da analogs na ifosfamide (palifosfamide) ko doxorubicin da placebo. Wannan gwajin na asibiti ya nuna cewa sakamakon gwajin hannayen biyu ba shi da bambanci sosai. Gwaji na uku na gwaji ya bazu marasa lafiya don karɓar kashi ɗaya na doxorubicin ko gemcitabine / docetaxel. Babu wani bambanci mai mahimmanci a sakamakon da aka lura tsakanin waɗannan hannayen biyu.
Bugu da ƙari, gwajin asibiti da bazuwar idan aka kwatanta da gemcitabine / docetaxel da gemcitabine monotherapy don kafa ingantaccen jadawalin ceto musamman don kula da leiomyosarcoma da sarmoma polymorphic da ba a rarrabe ba.
A cikin 2007, an yarda da trabectedin da aka samo daga ruwa don amfani da Tarayyar Turai. Yarda ya dogara ne akan sakamakon jadawalin lokuta daban-daban guda biyu don miyagun ƙwayoyi a cikin bazuwar lokacin II gwaji na asibiti. Bayan haka, gwajin gwaji na lokaci na III ya nuna cewa marasa lafiya da ke fama da cutar liposarcoma mai ci gaba da haɓaka da kuma leiomyosarcoma an bazu su don karɓar trabectedin ko diazolid (marasa lafiya sun karɓi magunguna na Huihuan antitumor da wani maganin rigakafin kafin yin rajista)
Wannan gwajin na asibiti ya nuna cewa marasa lafiyar da suka sami trabectedin sun nuna mahimmancin rayuwa ba ci gaba fiye da waɗanda suka karɓi diazolid. Wannan ya haifar da amincewa da amfani da trabectedin ta Hukumar Abinci da Magunguna ta Amurka a cikin Nuwamba Nuwamba 2015.
The oral tyrosine kinase inhibitor pazotinib has been approved based on the results of a randomized clinical trial of patients with soft tissue sarcoma receiving pazotinib or placebo. This clinical trial showed that the pazotinib group had a significant improvement in progression-free survival, but there was no significant difference in overall survival.
A cikin 2016, Cibiyar Abinci da Magunguna ta Amurka ta amince da kwayar cutar eribulin mai fitar da microtubule don maganin ci gaban liposarcoma. Yarda ya dogara ne akan gwajin gwaji na marasa lafiya tare da matakin III mai ci gaba / metastatic liposarcoma da leiomyosarcoma masu karɓar eribulin ko dacrabzine. Wannan gwajin na asibiti ya nuna cewa hannun eribulin yana da tsawon lokacin rayuwa gaba daya fiye da hannun dacarbzaine.
Kammalawa
A ƙarshe, sarcomas rukuni ne na ƙananan cututtukan daji tare da cakuda abubuwan haɗi, kuma suna fuskantar babbar ƙalubale wajen magani da haɓaka ƙwayoyi. Gabatarwar cutar ta tyrosine kinases a cikin maganin cututtukan ciki na ciki (GIST) ya riga ya zama misali a cikin maƙasudin maganin ciwace ciwace.
Bugu da ƙari, a cikin 'yan shekarun da suka gabata, an ƙara wasu sabbin magungunan warkewa na tsari zuwa zaɓuɓɓukan da ake da su don maganin sarcoma na gaba, gami da pazopanib, trabectedin, da eribulin. Hadin gwiwar kasa da kasa tsakanin masu fadi-tashin masu binciken asibiti da masana kimiya na ci gaba da bunkasa ci gaban hanyoyin hada kansar kansar wadannan sinadarai.
