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Menene mafi kyau ga medulloblastoma - Raɗaɗɗiyar rediyo ta gargajiya ko farfaganda?

Menene mafi kyau ga medulloblastoma - Raɗaɗɗiyar gargajiya ko maganin wutsiya? Proton far don maganin medulloblastoma. Kudin maganin proton a cikin maganin medulloblastoma.

Share Wannan Wallafa

Myeloblastoma is one of the most common childhood tumors. Among children under 10 years of age, the incidence rate is about 20% to 30% of all tumors. The peak age of onset is 5 years, and men are slightly more than women. The tumo is located in the posterior cervical fovea, near the cerebellar vermis and the fourth ventricle midline, and advanced tumors spread in the cerebrospinal fluid. Typical clinical manifestations are mainly related to the increased intracranial pressure caused by tumor occupying the posterior cranial fossa and blocking the fourth ventricle or midbrain aqueduct: headache, nausea, vomiting, blurred vision, and balance function caused by tumor compression on the cerebellum Obstacles, such as walking instability, ataxia, etc.

At present, the treatment of medulloblastoma should be based on the clinical stage and risk stage of the child, and comprehensive treatment methods: a reasonable combination of three treatment methods: surgery, radiation therapy and chemotherapy, to improve the cure rate of the tumor and reduce the damage to normal tissues. Growth and development, intellectual effects.
Tunda yawancin medulloblastomas suna faruwa a cikin yara kuma sun fi kula da radiation, farmakin radiation yana ɗaya daga cikin hanyoyin da ba za a iya yin maganin medulloblastomas ba. Yara suna cikin matakin haɓakawa da haɓakawa, maganin radiation ba makawa yana haifar da lalacewar ci gaban yara, endocrine da hankali. A halin yanzu, hanyoyin radiotherapy masu girma uku ko ƙaramin ƙarfi-modulated radiotherapy galibi ana amfani da su don rage ƙimar ƙwayar ƙwayar ƙwayar cuta, kunnen ciki, lobe na ɗan lokaci, yankin hypothalamus-pituitary, da glandar thyroid, da faransa faransa faransa faranti na sieve ƙaddara don samun isasshen kashi. Irradiation. An kunna wutan lantarki tare da kwakwalwar gaba ɗaya, duka kashin baya da burbushin cranial na baya.
Matsakaicin maganin rediyo na gargajiya: duka kwakwalwa da kashin baya bisa ga rukunin haɗarin, adadin rigakafin rigakafin shine 1.8Gy / lokaci, jimlar adadin shine 30-36Gy, rukunin haɗarin haɗari shine 36Gy, kuma fossa na cranial na baya shine ya canza zuwa +55.8%. Lokacin da akwai babban metastasis zuwa nama na kwakwalwa da / ko kashin baya, ana buƙatar ƙarin allurai. Dukan kwakwalwar gabaɗayan fasaha na fasaha na kashin baya shine fasahar rediyo tare da babban kewayon sakawa, wanda ke buƙatar isocenters da yawa da filayen da yawa, kuma yana buƙatar babban daidaito a cikin matsayi, tsarawa, da matsayi. Tsarin tsarin gabaɗaya yana amfani da 6MV Harkokin X. Saboda dogon wurin da aka yi niyya, tsarin ƙira gabaɗaya yana buƙatar cibiyoyi guda uku daidai: kwakwalwa da cibiyoyin kwakwalwa, cibiyoyin mahaifa da thoracic, da cibiyoyin thoracic da na ciki. Koyaya, maganin rediyo na gargajiya ba zai iya sarrafa duk ƙwayoyin kansa yadda ya kamata ba. Babban dalili shi ne cewa wurin ciwon daji ya yi zurfi sosai, matsakaicin zurfin radiation zuwa ciwon daji bai wuce cm 3 kawai ba, ƙwayoyin tumor suna da matukar juriya ga maganin rediyo na gargajiya, kuma ciwon daji yana kula da radiation na gargajiya. Nama yana kewaye da ƙari kuma ba za a iya sarrafa ƙwayar cuta yadda ya kamata ba.
Protons ana cajin barbashi. Girman ions, mafi girman tasirin ilimin halitta. Yawansu ya kai ninki 1836 na adadin electrons. Canja wurin makamashinsu ya yi daidai da murabba'in saurin motsi na proton. Asarar makamashi yana kusa da ƙarshen kewayon. Anan ga kololuwar Bragg (mai suna bayan wanda ya gano ta, wanda ya lashe kyautar Nobel ta Jamus William Henry Prague), adadin da aka yi bayan kololuwar Bragg ba shi da komai, kuma an sanya raunin a cikin kololuwar yanki yayin jiyya, wanda zai iya samun babban rabo na warkewa. .
Na farko, proton far wani nau'in radiation ne na waje ta amfani da ionizing radiation. A lokacin jiyya, mahaukaciyar hanzarin tana fitar da kumburin tare da katako na protons. Waɗannan ƙwayoyin da aka caje suna haifar da raguwa a cikin DNA, suna lalata DNA na ƙwayoyin tumor, kuma a ƙarshe suna haifar da ƙwayoyin cutar kansa su mutu ko tsoma baki tare da ikon haihuwa. Yawan rabe -raben sel masu cutar kansa da raguwar ikon gyara DNA da ya lalace yana sa DNArsu ta kasance mai sauƙin kai hari.
Abu na biyu, abubuwan da aka samo asali na proton:
1) penetarfin kutsawa mai ƙarfi: Ana iya daidaita ƙarfin Proton daidai da wuri da zurfin rauni, don haka katakon katangar ya isa kowane zurfin jikin ɗan adam;
2) Lalacewar nama na yau da kullun karami ne: kashi a gaban raunin ya yi ƙanƙanci, kashi a baya baya sifili, kuma an rage ƙwanjin al'ada;
3) Babban kashi a cikin yankin da aka nufa: Ana samun yaduwar karfin tsiya (SOBP) ta hanyar fadada Bragg, saboda haka raunin yana cikin yankin SOBP, don haka samun babban kashi a yankin da ake niyyar
4) teringananan tarwatsewa: Saboda yawan taro na proton, akwai ƙaramar watsewa a cikin kayan, don haka an rage yawan kumburin iska na kayan adon al'ada a kusa da shi.
Na uku, haɓakar ƙarfin wutar lantarki
Don magance marurai masu zurfin gaske, dole ne mai hanzarin gaggawa ya samar da katangar katako na ƙarfin kuzari, kuma don ciwace-ciwace na sama ana amfani da katako mai ƙarfi na ƙarfi. Masu haɓaka hanyoyin kwantar da hankulan Proton yawanci suna samar da katako tare da kuzari tsakanin 70 da 250 megaelectron volts (MeV). Ta hanyar daidaita ƙarfin proton yayin jiyya, katako na proton na iya kara lalacewar ƙwayoyin tumo. Nama kusa da saman jiki fiye da ƙari yana karɓar ƙananan allurai don haka rashin lalacewa. Da kyar sassan jikin mutum ya bayyana.
4. Haɓakawar haɓakar ƙwayar cuta

Proton wuka far

Proaramar rediyo mai amfani da wutan zamani ta haɗu da 3D-CRT da fasaha ta IMRT don cimma daidaitaccen haɓakar radiotherapy. Proton ƙarfin da aka tsara rediyotherapy (IMPT) yana haɗakar da cikakkiyar hoto na 3D-CRT da fasaha na IMRT, yin proton radiotherapy don cimma daidaito mafi girma na ɓarkewar ƙwayar cuta har zuwa yau, kuma yawan ƙwayar jikin da ke kewaye da ƙari yana ragu sosai.

Don haka, idan aka kwatanta da aikin rediyo na yau da kullun, maganin wuka na proton yana da ingantattun halaye na jiki da na halitta, kuma yana da isasshen kashi na radiation don isa ga ciwace -ciwacen a cikin zurfin sassan jiki. Ions masu nauyi da protons na iya isa ga kyallen takarda mai zurfin 30 cm ƙarƙashin fata, wanda yana inganta haɓaka ikon sarrafa ƙari. idan aka kwatanta da hanyoyin gargajiya na gargajiya, ana iya ƙara ƙarfin kuzarin da ke isa ga wurin ƙari (ƙarar proton da kashi 20%), wanda hakan ke rage raguwar kumburin. Lalacewa da illa na kyallen takarda na al'ada; rage yawan guba na kyallen takarda na al'ada tare da aikace -aikacen radiotherapy da chemotherapy lokaci guda; rage taƙaitaccen tafarkin magani ta hanyar ƙara yawan adadin hasken rana; rage faruwar ciwon kansa na biyu na farko.

 

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1) Maganin ciwon daji a kasashen waje?
2) CAR T-Cell far
3) rigakafin cutar daji
4) Shawarar bidiyo ta kan layi
5) Maganin Proton