TNM yekuratidzira system
Chimwe chishandiso vanachiremba vanoshandisa kurondedzera cancer cancer is the TNM system. Vanachiremba vanoshandisa mhedzisiro yekuongororwa bvunzo uye scans kupindura inotevera mibvunzo:
Tumor (T): Iko bundu rinokura pamadziro ekoloni kana rectum? Mangani masara anotyorwa?
• Lymph nodes (N): Has the tumarara spread to the lymph nodes? If so, where and how much?
Metastasis (M): Kenza yakapararira kune dzimwe nhengo dzomuviri here? Kana hongu, kupi uye zvakadii?
Sanganisa mhedzisiro iri pamusoro kuti uone danho rekenza remunhu wega wega.
Pane zvikamu zvishanu: nhanho 0 (zero) uye nhanho I kusvika IV (1 kusvika 4). Iyi danho inopa nzira yakajairika yekutsanangura gomarara, saka vanachiremba vanokwanisa kushanda pamwechete kuronga kurapwa kwakanyanya.
Izvi zvinotevera zvimwe zvechikamu chega chega cheTNM system ye kenza yakajeka :
Bundu (T)
Uchishandisa iyo TNM system, shandisa "T" pamwe netsamba kana nhamba (0 kusvika 4) kutsanangura kuti bundu rekutanga rinopinda sei muura. Dzimwe nhanho dzakakamurwa zvakare mumapoka madiki, ayo anogona kutsanangura mamota mune zvakadzama. Rakananga bundu ruzivo rwunotevera.
TX: Bundu rekutanga harigone kuongororwa.
T0: Iko hakuna humbowo hwecancer mukoloni kana rectum.
Tis: refers to carcinoma in situ (also called carcinoma in situ). Cancer cells are only found in the epithelium or primary layer, they are the top layer arranged inside the colon or rectum.
T1: Bundu rakura kusvika ku submucosa.
T2: Bundu racho razova muswe musumbu, mukobvu uye mukobvu mutsipa, uyo unopinda mutsandanyama.
T3: Bundu rinokura kuburikidza nemhasuru uye rinopinda serosa. Icho chidimbu chakatetepa chemukati wekubatana pasi pechikamu chekunze chemamwe matumbu, kana chakura kuita mhasuru dzakakomberedza colon kana rectum.
T4a: Bundu rakura kusvika pamusoro peiyo visceral peritoneum, zvinoreva kuti yakapinda mativi ese ekoloni kuti ikure.
T4b: Bundu rakura kana kubatanidzwa kune dzimwe nhengo kana zvivakwa.
Node node (N)
"N" muTNM system inomiririra lymph node. MaLymph node idiki nhengo dzakaumbwa sebhinzi dziri mukati memuviri wese, izvo zvinobatsira muviri kurwisa hutachiona sechikamu chedziviriro. Iwo maLymph node padyo nekoloni uye rectum anonzi emunharaunda ma lymph node. Dzimwe dzese dziri kure lymph node dzinowanikwa mune dzimwe nhengo dzemuviri.
NX: Nharaunda node node haigone kuongororwa.
N0 (N kuwedzera zero): Hapana kupararira kumatunhu enode node.
N1a: Kune maseru emarara mune 1 nzvimbo yema lymph node.
N1b: Kune mamota maseru mune maviri kusvika matatu ematunhu lymph node.
N1c: Tumor maseru nodules anowanikwa muzvivakwa padyo nekoloni haaratidzike kunge ma lymph node, asi maqhumu.
N2a: Kune maseru emota mune 4 kusvika ku6 enharaunda node node.
N2b: Kune mamota maseru mune manomwe kana anopfuura emunharaunda ma lymph node.
Kutamisa (M)
"M" iri muNNM system inotsanangura gomarara rakapararira kune dzimwe nhengo dzemuviri, senge chiropa kana mapapu. Uku kunodaidzwa kuchinjisa kure.
MX: Kutamisa kure kure hakugone kuongororwa.
M0: Chirwere hachina kupararira kure nemuviri.
M1a: Kenza yapararira kune dzimwe nhengo dzemuviri kunze kwekoloni kana rectum.
M1b: Kenza yakapararira kune inopfuura chikamu chimwe chemuviri kunze kwekoloni kana rectum.
Chikamu (G)
Vanachiremba vakatsanangurawo rudzi urwu rwegomarara nekukora (G), iyo inotsanangura kufanana kwemasero egomarara nemaseru ane hutano kana ichitariswa pasi pe microscope
Chiremba anofananidza kenza matinji nehutano hwakanaka. Nyama ine hutano inowanzo kuve nemhando dzakasiyana dzemasero akabatanidzwa pamwechete. Kana gomarara richiita serakafanana nethishu ine hutano uye iine akasiyana maseru emapoka, inonzi yakakamurwa kana yakaderera-giredhi bundu. Kana gomarara rinenge rakatarisika rakasiyana nemanyowa ane hutano, rinodaidzwa kuti bundu rakasiyana kana bundu repamusoro. Chikamu chekenza chinogona kubatsira vanachiremba kufanotaura mwero wekukura kwegomarara. Pakati pese, iyo yakaderera iyo gomarara giredhi, zvirinani kufungidzira.
GX: Haigone kuona gomarara giredhi.
G1: Masero acho akafanana nemasero ane hutano (anonzi musiyano wakanaka).
G2: Masero acho akafanana nemasero ane hutano (anonzi kusiyanisa zvine mwero).
G3: Masero haatariki semasero ane hutano (anonzi asina kusiyaniswa).
G4: Masero anenge asina kufanana nemasero ane hutano (anonzi asina kusarudzika).
Colorectal kenza staging
Chiremba anopa nhanho dzekenza nekubatanidza T, N, uye M kusarudzwa.
Stage 0: Iyi inonzi carcinoma in situ. Iwo maseru ekenza ari chete mune mucous membrane kana lining yekoloni kana rectum.
Stage I: Kenza yakura kuburikidza neiyo mucosa uye yakapinda muscularis yekoloni kana rectum. Izvo hazvina kupararira kumatunhu ari padyo kana lymph node (T1 kana T2, N0, M0).
Stage I Kenza yakajeka
Stage IIA: Iyo kenza yakura kuburikidza nekoloni kana rectal madziro uye haina kupararira kumatunhu ari pedyo kana pedyo node node (T3, N0, M0).
Chikamu IIB: Kenza yakura kuburikidza nemhasuru yakatetepa kusvika padumbu remudumbu, inonzi visceral peritoneum. Iyo haina kupararira kune lymph node dzepedyo kana dzimwe nzvimbo (T4a, N0, M0).
Chikamu IIC: Bundu rakapararira kuburikidza nemadziro ekoloni kana rectum uye rakakura kuita zvivakwa zviri padyo. Iyo haina kupararira kune lymph node dzepedyo kana dzimwe nzvimbo (T4b, N0, M0).
Stage IIIA: Iyo kenza yakura kuburikidza neyemhasuru yekumukati mekutenderera kana ura, uye yakapararira kumatishu akakomberedza colon kana rectum. 1-3 lymph node kana bundu mamota anoonekwa akatenderedza colorectum, asi hapana kusawedzera kune zvimwe zvikamu zvemuviri (T1 kana T2, N1 kana N1c, M0; kana T1, N2a, M0).
Stage IIIB: Iyo kenza yakura kuburikidza nematumbo madziro kana nhengo dzakatenderedza, uye yakura ikaita 1 kusvika 3 lymph node kana bundu mamota mumatumbu akakomberedza colon kana rectum. Iyo haina kupararira kune zvimwe zvikamu zvemuviri (T3 kana T4a, N1 kana N1c, M0; T2 kana T3, N2a, M0; kana T1 kana T2, N2b, M0).
Chikamu IIIC: Kenza yeColon, no matter how deep it grows, has spread to 4 or more lymph nodes, but has not spread to other distant parts of the body (T4a, N2a,
M0; T3 kana T4a, N2b, M0; kana T4b, N1, N2, M0).
Chikamu IVA: Iyo kenza yakapararira kune chimwe chikamu chiri kure chemuviri, senge chiropa kana mapapu (chero T, chero N, M1a).
Chikamu IVB: Kenza yakapararira kune chinopfuura chikamu chemuviri (chero T, chero N, M1b).
Gomarara rinowanzoitika: Gomarara rinowanzoitika igomarara rinodzokazve mushure mekurapwa. Chirwere ichi chinogona kuwanikwa mukoloni, rectum, kana chimwe chikamu chemuviri. Kana gomarara rikadzokororazve, pachave nekumwe kutenderera kwekuongororwa kuti unzwisise kukura kwekudzokazve. Iyi bvunzo uye zviyero zvinowanzo fanika nezvakaitwa panguva yekutanga kuongororwa.
Colorectal cancer: nzira dzekurapa
Kurapa Kuongorora
Mukenza kuongororwa uye kurapwa, vanachiremba vemhando dzakasiyana vanowanzoshanda pamwechete kugadzira chirongwa chekurapa chinowanzo sanganisira kana kusanganisa varwere vane mhando dzakasiyana dzekurapa. Izvi zvinonzi timu yemhando dzakasiyana siyana. Kune kenza yakajeka, izvi zvinowanzo sanganisira vanovhiya, oncologists, radiation oncologists, uye gastroenterologists. Gastroenterologists vanachiremba vanoita hunyanzvi hwemudumbu uye kusagadzikana. Chikwata chekuchengetedza gomarara chinosanganisirawo vamwe vakasiyana vezvehutano, vanosanganisira vanachiremba, vanamukoti ve oncology, vashandi vezvemagariro, vemishonga, vanopa mazano, vezvehutano, nezvimwe.
Iyi inotevera rondedzero yesarudzo yakajairika yekurapa gomarara, inoteverwa nerondedzero pfupi yesarudzo dzekurapa dzakanyorwa nedanho. Masarudzo ekurapa uye kurudziro zvinoenderana nezvinhu zvinoverengeka, zvinosanganisira mhando uye danho rekenza, zvinokanganisa mhedzisiro, uye zvinodiwa nevarwere uye hutano hwakakwana. Urongwa hwako hwekuchengetedza hunogona zvakare kusanganisira kurapwa kwezviratidzo uye mhedzisiro, inova chikamu chakakosha checancer care. Tora nguva yekunzwisisa zvese zvaunogona pakurapa uye taura nachiremba wako nezve zvinangwa zvekurapwa kwega kwega uye nezvaungatarisira kana uchirapwa.
Zvidzidzo zvakaratidza kuti akasiyana marapirwo anopa akafanana mabhenefiti kuvarwere zvisinei nezera ravo. Nekudaro, varwere vakwegura vanogona kuve neakasarudzika matambudziko ekurapa Kuti ubate murwere wega wega, sarudzo dzese dzekurapa dzinofanira kufunga zvinotevera zvinhu:
• Kurwara kwemurwere
• Hutano hwese hwemurwere
• Zvinogona kuitika mhedzisiro yehurongwa hwekurapa
• Mimwe mishonga yatorwa nemurwere
Mamiriro ehutano hwevarwere uye rutsigiro rwemagariro
Kuvhiya kwakajeka
Kuvhiya ndiko kubviswa kwemamota uye mamwe akakomberedza matissue ane hutano panguva yekuvhiyiwa. Iyi ndiyo inonyanya kurapa kenza yakajeka uye inowanzozivikanwa sekuvhiya resection. Chikamu chekoloni ine hutano kana rectum uye ma lymph node ari padyo achabviswa. Chiremba wekenza chiremba ane hunyanzvi hwekurapa gomarara nekuvhiya. Chiremba anovhiya akasiyana-siyana inyanzvi iyo yakadzidziswa kurapa zvirwere zvecolon, rectum uye anus.
Pamusoro pekuvhiya resection, mamwe maseru ekuvhiya kenza anosanganisira:
Laparoscopic kuvhiyiwa kwekenza yakajeka
Vamwe varwere vanogona kuita laparoscopic colorectal cancer kuvhiyiwa. Nemaitiro aya, iyo incision idiki uye iyo yekudzoreredza inowanzo ipfupi pane yakajairwa colon kuvhiya. Laparoscopic kuvhiya inoshanda seyakajairika colon kuvhiya kubvisa cancer. Vanachiremba vanovhiya laparoscopic kuvhiyiwa vakanyatsodzidziswa muhunyanzvi uhu.
Rectal kenza colostomy
Chikamu chidiki chevarwere vane rectal cancer vangada colostomy. Iyi inzira yekuvhiya inobatanidza colon nedumbu kupa nzira yekuti tsvina ibude mumuviri. Tsvina iyi inounganidzwa muhomwe inopfekwa nemurwere. Dzimwe nguva, colostomy inongova yenguva pfupi kubatsira ronda rectal kupora, asi rinogonawo kuva rekusingaperi. Uchishandisa nzira dzemazuva ano dzekuvhiya, uchishandisa radiation therapy uye chemotherapy vasati vavhiyiwa, vanhu vazhinji vari kurapwa rectal cancer havadi zvachose colostomy.
Radio frequency ablation (RFA) kana cryoablation
Vamwe varwere vanogona kukwanisa kuita radiofrequency ablation pachiropa kana mapapu kubvisa mabundu anenge apararira kunhengo idzi. Dzimwe nzira dzinosanganisira kushandiswa kwesimba rekudziisa nenzira yemasaisai eredhiyo inonzi RFA, kana kuti cryoablation. Haasi ese mamota echiropa kana emumapapu anogona kurapwa nenzira idzi. RFA inogona kuitwa kuburikidza neganda kana kuvhiyiwa.
Zvimwe zvinokanganisa zvekuvhiya kwakanaka
Kurukura nachiremba wako pachine nguva mberi nezve zvingangoitika mhedzisiro yechimwe chiitiko uye bvunza kuti ungadzivirira kana kudzikamisa sei. Muzhinji, mhedzisiro yekuvhiya inosanganisira kurwadziwa uye unyoro munzvimbo yekuvhiya. Kuvhiya kunogona kukonzeresa kupatirwa kana manyoka, ayo anowanzo kutsakatika. Vanhu vane colostomy vanogona kushatirwa vakakomberedza stoma. Kana iwe uchida kuve necolostomy, chiremba kana mukoti anova nyanzvi mune colostomy manejimendi anogona kukudzidzisa iwe nzira yekuchenesa nzvimbo uye kudzivirira hutachiona.
Vanhu vazhinji vanofanirwa kuita ura zvakare mushure mekuvhiya, izvo zvinogona kutora nguva uye kubatsira. Kana iwe usingakwanise kuwanazve hutano hwakanaka hwekugadzirisa, unofanira kutaura nachiremba wako.
Radiation kurapwa mukenza yakajeka
Radiation therapy inoshandisa simba guru x-rays kuparadza masero ekenza. Inowanzo shandiswa kurapa rectal cancer, nekuti bundu iri rinowanzo dzoka panzvimbo yarakatanga. Vanachiremba vane hunyanzvi hwekurapa neradiation yegomarara vanonzi radiation oncologists. Zvirongwa zvekurapa kwemwaranzi (zvirongwa) zvinowanzopihwa nenhamba chaiyo yekurapa uye inoshandiswazve nekufamba kwenguva.
• Kurapa kwekunze kwemwaranzi. Radiotherapy yekunze inoshandisa muchina kuburitsa maX-ray kune iriko kenza. Radiation kurapwa inowanzo kutora mazuva mashanu pavhiki kwevhiki dzinoverengeka.
• Stereotactic radiotherapy. Stereotactic radiotherapy is an exogenous radiation therapy that can be used if the tumor has spread to the liver or lungs. This type of radiation therapy can provide a large, precise dose of radiation to a small area of focus. This technique can avoid normal liver and lung tissue that may be removed during surgery. However, not all cancers that spread to the liver or lungs can be treated in this way.
• Dzimwe mhando dzeradiotherapy kurapwa.
Kune vamwe vanhu, hunyanzvi hwekurapa radiotherapy, senge intraoperative radiotherapy kana brachytherapy, inogona kubatsira kubvisa chikamu chiduku chekenza isingagoni kubviswa panguva yekuvhiyiwa.
• Intraoperative radiation kurapwa.
Intraoperative radiotherapy inoshandisa imwe-yepamusoro-dhiyo radiotherapy panguva yekuvhiya.
Brachytherapy mukenza yakajeka
Brachytherapy inoshandisa radioactive "mbeu" yakaiswa mumuviri. Mune brachytherapy, chigadzirwa chinonzi SIR-Spheres, chidiki che radioactive zvinhu zvinodaidzwa kuti yttrium-90 inojowa muchiropa kurapa gomarara rakakura rakapararira kuchiropa nekuti kuvhiya hakuchina kukodzera, uye zvimwe zvidzidzo zvakaratidza kuti yttrium -90 inogona kubatsira kudzora kukura kwekenza maseru.
Neoadjuvant radiotherapy yekenza rectal
Nezve gomarara reruvara, radiation radiation inonzi neoadjuvant therapy inogona kushandiswa usati wavhiyiwa kudzikisa bundu, zvichiita kuti zvive nyore kubvisa bundu. Inogona zvakare kushandiswa kuparadza chero akasara cancer maseru mushure mekuvhiyiwa. Dzese nzira dzinoshanda pakurapa chirwere ichi. Chemotherapy inowanzo shandiswa panguva imwe chete neye radiation radiation, iyo inonzi yakasanganiswa radiochemotherapy yekuvandudza t
iye kugona kwe radiation kurapwa. Chemotherapy uye radiotherapy inowanzo shandiswa kenza rectal usati wavhiyiwa kudzivirira colostomy kana kudzikisira mukana wekenza kudzoka. Imwe ongororo yakawana kuti radiation radiation pamwe nekemotherapy kurapwa kusati kwavhiyiwa kwaive nemhedzisiro uye kuve nemhedzisiro mishoma pane postoperative radiation kurapwa uye chemotherapy. Iwo mabhenefiti akakosha anosanganisira yakaderera mwero yekenza kudzoka uye kushomeka kwematumbo kupora ne radiation radiation.
Zvikanganiso zve radiation kurapwa
Zvimwe zvinokanganisa kurapwa nemwaranzi zvinogona kusanganisira kuneta, kuita kudiki kweganda, kushushikana mudumbu, uye kunetsekana kuita tsvina. Inogona zvakare kukonzera zvituru zveropa kuburikidza nekudzoka kweropa kana kuvharika kwematumbo. Mushure mekurapwa, mhedzisiro yakawanda inonyangarika.
Chemotherapy mukenza yakajeka
Chemotherapy inoshandisa zvinodhaka kuparadza gomarara maseru, kazhinji nekudzivirira maseru ekenza kubva mukukura nekukamurwa. Chemotherapy inowanzo kupihwa nachiremba oncologist, chiremba uyo ane hunyanzvi hwekurapa kenza nemishonga.
Systemic chemotherapy mishonga inopinda muropa uye inosvika maseru ekenza mumuviri wese. Maitiro akajairika ekurapa chemotherapy anosanganisira intravenous management kana kumedza (muromo) mapiritsi kana macapsule.
Chemotherapy regimen inowanzo kuve nenhamba yakatarwa yemarapirwo anopiwa mukati menguva yakati yenguva. Varwere vanogona kugamuchira 1 mushonga kana musanganiswa wemishonga yakasiyana panguva imwe chete.
Chemotherapy inogona kupihwa mushure mekuvhiya kubvisa chero masero egomarara asara. Kune vamwe varwere vane gomarara reruzivo, vanachiremba vanoita chemotherapy uye radiation radiation vasati vavhiyiwa kuti vadzikise saizi yemota inodzora uye vadzikise mukana wekenza yemukenza.
Mhando dzekenza yakajeka kenza chemotherapy zvinodhaka
Parizvino, iyo US Chikafu neDrug Administration (FDA) yakabvumidza yakati wandei mishonga yekurapa kenza yakajeka. Chiremba wako anogona kukurudzira kirasi 1 kana akati wandei zvinodhaka panguva dzakasiyana panguva yekurapa. Dzimwe nguva mishonga iyi inoshandiswa pamwe chete nemishonga yakanangwa yekurapa (ona "Targeted Therapy" pazasi).
• Xeloda
• Fluorouracil (5-FU, Adrucil)
• Irinotecan (Camposar)
• Eloxatin
• Trifluorouridine / Tiracilidine (TAS-102, Lonsurf)
Dzimwe sarudzo dzekurapa dzekushandisa iyi mishonga dzinosanganisira:
• 5-FU
• 5-FU uye Wellcovorin (Wellcovorin), mavitamini anowedzera kushanda kwe5-FU
• Capecitabine, fomu yemuromo ye5-FU
• 5-FU ine leucovorin uye oxaliplatin (inonzi FOLFOX)
• 5-FU ine leucovorin uye irinotecan (inonzi FOLFIRI)
• Irinotecan inoshandiswa yoga
• Capecitabine uye irinotecan (inonzi XELIRI kana CAPIRI) kana oxaliplatin (inonzi XELOX kana CAPEOX)
• Chero ipi zvayo yemishonga iri pamusoro yakasanganiswa nemishonga yakananga inotevera (ona pazasi): cetuximab, bevacizumab kana panitumumab
FOLFIRI inosanganiswa nemishonga yakanangwa (ona pazasi): ziv-aflibercept kana lamucirumab
Chemotherapy mhedzisiro
Chemotherapy inogona kukonzera kurutsa, kuda kurutsa, manyoka, neuropathy, kana aphthous ulcers. Nekudaro, mishonga inodzivirira iyi mhedzisiro inogona kushandiswa. Nekuda kwekushandurwa kwenzira dzehutongi, izvi zvinokanganisa muvarwere vazhinji hazvisi zvakanyanya senge zvakapfuura. Uye zvakare, varwere vanogona kunge vakaneta zvakanyanya uye njodzi yehutachiona inowedzera. Mimwe mishonga inogona kukonzeresa chirwere cheuropathy, kurira kana kudzimbirwa netsoka kana maoko nemakumbo. Bvudzi kurasikirwa ndere lisingawanzo mhedzisiro mhedzisiro yemishonga inoshandiswa kurapa kenza yakajeka.
Kana iyo mhedzisiro yakanyanya kukomba, muyero wemushonga unogona kudzikiswa kana kurapwa kunogona kunonoka. Kana iwe uri kugamuchira chemotherapy, iwe unofanirwa kutaurirana nechikwata chako chekurapa kuti unzwisise nguva yekurega chiremba wako arape mhedzisiro. Kamwe kurapwa kwapera, iyo mhedzisiro yemakemotherapy ichanyangarika.
Inotarisirwa mishonga yekurapa mukenza yakajeka
Targeted Therapis kurapwa kwecancer-yakanangana nemajini, mapuroteni, kana materu enharaunda anobatsira mukukura kwegomarara uye kupona. Mushonga uyu unodzivirira kukura uye kupararira kwemasero ekenza uchidzikisa kukuvara kwemasero ane hutano.
Ongororo dzichangobva kuitika dzakaratidza kuti haazi ese mamota ane tarisiro yakafanana. Kuti uwane kurapwa kwakanyanyisa, chiremba wako anogona kuita magene ekuongorora kuti aone magene, mapuroteni, uye zvimwe zvinhu zviri mumota. Izvi zvinobatsira vanachiremba zvirinani kuenzanisa murwere mumwe nemumwe nemushonga unoshanda kwazvo. Pamusoro pezvo, ongororo zhinji dzave kuitika kuti dzidze zvakawanda nezve chaiwo mamorekuru zvinangwa uye marapirwo matsva anotungamirwa kwavari. Iyi mishonga iri kuramba ichikosha pakurapa kenza yakajeka.
Zvidzidzo zvakaratidza kuti varwere vakura vanogona kubatsirwa kubva pakurapa kwakanangwa kwakafanana nevarwere vadiki. Uye zvakare, mhedzisiro inotarisirwa mhedzisiro inodzora muvarwere vakwegura nevarwere vadiki.
Kuenzanisa kweakanangwa kurapwa
Nezve kenza yakajeka, zvinotevera zvinotarisirwa kurapwa zviripo.
Anti-angiogenesis kurapwa mukenza yakajeka
Anti-angiogenesis kurapa kwakanangwa kurapwa. Inotarisa pakudzivirira angiogenesis, inova nzira iyo mamota anogadzira matsva eropa matsva. Sezvo bundu rinoda angiogenesis uye richipa zvinovaka muviri, chinangwa chekurwisa-angiogenesis kurapa ndiko "kuziya nenzara" bundu.
• Bevacizumab (Avastin)
Kana bevacizumab ikasanganiswa nekemotherapy, ichawedzera nguva yekurarama kwevarwere vane gomarara repamberi. Muna 2004, iyo FDA yakabvumidza bevacizumab inosanganiswa nekemotherapy senge yekutanga sarudzo kana yekutanga-kurapwa kurapwa kwekenza yepamusoro kenza. Ongororo ichangobva kuitika inoratidza kuti inoshandawo sekurapa-mutsara wechipiri.
• Sikarga (Stivarga)
Mushonga uyu wakabvumidzwa muna2012 kuvarwere vane metastatic colorectal cancer avo vakagamuchira mamwe marudzi ekemotherapy uye mamwe marapirwo anotarisirwa.
Ziv-aflibercept (Zaltrap) uye lamucirumab (Cyramza)
Chero ipi yemishonga iyi inogona kushandiswa musanganiswa neFOLFIRI chemotherapy seyechipiri-mutsara kurapwa kwemasastatic colorectal cancer.
Epidermal growth factor receptor (EGFR) inhibitor.
EGFR inhibitor chirwere chakanangwa. Vatsvagiri vakaona kuti mishonga inovhara EGFR inogona kudzivirira kana kudzora kukura kwekenza yakajeka.
• Cetuximab (Erbitux). Cetuximab antibody inogadzirwa kubva kumagonzo maseru, ayo achine mamwe mameseji egonzo.
• Panitumumab (Vectibix). Panitumumab inogadzirwa zvizere nemapuroteni emunhu uye haikonzere kusagadzikana kwecetuximab.
Zvidzidzo zvenguva pfupi zvakaratidza kuti cetuximab uye panitumumab hazvina zvazvinoita pamamota neRAS geni shanduko kana shanduko. ASCO inokurudzira kuti vese varwere vane metastatic colorectal cancer vanogona kuwana anti-EFGR kurapwa, senge cetuximab uye panitumumab, vanogona kuona RAS gene shanduko. Kana bundu remurwere rachinja muRAS geni, ASCO inokurudzira kurwisa nemishonga inorwisa-EFGR.
Bundu rako rinogonawo kuongororwa mamwe mamolecular marker, anosanganisira BRAF, HER2 overexpression, microsatellite instability, etc. Aya mamarker haasati atenderwa neFDA kuti arapwe kwakanangwa, asi panogona kuve nemikana yekurapa mumiedzo yekiriniki inodzidza shanduko yemamolecular idzi. .
Zvimwe zvinokanganisa zvechiremba kurapwa
Mhedzisiro yemhedzisiro yekurapa inogona kusanganisira kuputika kweganda kumeso nemuviri wepamusoro, uyo unogona kudzivirirwa kana kudzikiswa nemarapirwo akasiyana siyana.
Kurapa kwekenza zviratidzo uye mhedzisiro
Kenza uye kurapwa kwayo kunowanzo kukonzera mhedzisiro. Kunze kwekudzora kukura kwegomarara kana kubvisa gomarara, chikamu chakakosha pakurapwa kwegomarara kubvisa zviratidzo zvemunhu pamwe nemhedzisiro. Iyi nzira inonzi yekurapa kana yekutsigira kurapwa, uye inosanganisira kutsigira zvinodiwa nemurwere panyama, pamoyo, uye nemagariro.
Kurapa kwekurapa inzira yekurapa yakanangana nekuderedza zviratidzo, kugadzirisa hupenyu, nekusimbisa varwere nemhuri dzavo. Chero ani, zvisinei nezera, mhando uye nhanho yekenza, anoda kurapwa kwekurapa. Palliative t
kudzoreredza kunotangwa nekukurumidza sezvinobvira panguva yekenza kurapwa, mhedzisiro iri nani. Vanhu vanowanzo gamuchira kurapwa kwegomarara uye kurapwa kuti vabvise mhedzisiro panguva imwe chete. Muchokwadi, varwere vanogamuchira aya marapirwo maviri vanowanzo kuve nezviratidzo zvakadzikama uye nehupenyu huri nani, uye vanotaura kuti vanogutsikana nemushonga.
Kuchengetedza kwekurapa kunosiyana zvakanyanya uye kazhinji kunosanganisira mishonga, shanduko yezvekudya, maitiro ekuzorora, kutsigirwa kwemanzwiro uye mamwe marapirwo Iwe unogona zvakare kugamuchira sarudzo dzekurapa dzakafanana nekubvisa cancer, senge chemotherapy, kuvhiyiwa, kana radiation radiation.
Sarudzo dzakasiyana dzekurapa kenza
Kazhinji, zvikamu 0, I, II, uye III zvinowanzorapika nekuvhiya. Nekudaro, varwere vazhinji vane chikamu chechitatu checancer corsa uye chikamu chechipiri varwere vanowana chemotherapy mushure mekuvhiyiwa kuwedzera mukana wekuporesa chirwere. Varwere vane danho II uye danho III gomarara remakwara vakagamuchira radiotherapy uye chemotherapy pamberi kana mushure mekuvhiyiwa. Stage IV haigone kurapwa, asi inorapika uye inogona kudzora kukura kwekenza uye zviratidzo zvechirwere. Kutora chikamu mumakiriniki miedzo zvakare inzira yekurapa kune mumwe nemumwe akarongwa.
Chikamu 0 kenza yakajeka
Iyo yakajairwa kurapwa ndeye polypectomy kana polyp kubviswa panguva yekolonoscopy. Kunze kwekunge polyps isingakwanise kubviswa zvachose, hapana kumwe kuvhiya kunodiwa.
Chikamu I kenza yakajeka
Kuvhiya kubviswa kwemamota uye lymph node kazhinji ndiyo nzira yekurapa.
Stage II kenza yakajeka
Kuvhiya ndiko kazhinji kurapwa kwekutanga. Varwere vane cancer II yecolorectal cancer vanofanirwa kutaura navanachiremba pamusoro pekuti vangade here kurapwa mushure mekuvhiyiwa, nekuti vamwe varwere vanogamuchira adjuvant chemotherapy. Adjuvant chemotherapy ndeye post-oparesheni kurapwa yakagadzirirwa kuparadza chero asara egomarara maseru. Nekudaro, iyo yekurapa mwero wekuvhiyiwa wega wakanaka chaizvo, uye kune varwere vane iri danho rekenza yakajeka, kubatsirwa kwekuwedzera kurapwa kudiki kwazvo. Kune varwere vane kenza yechipiri rectal cancer, radiation radiation inowanzo kuve yakabatana nekemotherapy pamberi kana mushure mekuvhiyiwa. Kuwedzera chemotherapy kunogona kupihwa mushure mekuvhiya.
Stage III kenza yakajeka
Kurapa kunowanzo sanganisira kubviswa kwekuvhiya kwebundu kunoteverwa neadjuvant chemotherapy. Kliniki miedzo inowanikwawo. Kune varwere vane kenza rectal, radiation radiation inogona kuitwa pamberi uye mushure mekuvhiyiwa.
Metastatic (nhanho IV) kenza yakajeka
Kana gomarara rikapararira kubva panzvimbo yaro yekutanga kuenda kune chimwe chikamu chemuviri, vanachiremba vanoridaidza kuti kenza yemastastatic. Colorectal cancer inogona kutapukira kunhengo dziri kure, senge chiropa, mapapu, uye peritoneum, ndiko kuti, dumbu kana vakadzi ovaries. Kana izvi zvikaitika, vanachiremba vanogona kuve nemaonero akasiyana pane akanyanya akarongeka marapirwo chirongwa. Uye zvakare, kutora chikamu mumakiriniki miedzo inogona kunge iri sarudzo.
Chirongwa chako chekurapa chingasanganisira musanganiswa wekuvhiya, radiation radiation uye chemotherapy, iyo inogona kushandiswa kudzikisira kukura kwechirwere uye kazhinji kudzikisira bundu. Kuchengetedza kwepamoyo kwakakoshawo kubatsira kubvisa zviratidzo uye mhedzisiro.
Panguva ino, kushandiswa kwekuvhiya kubvisa chikamu chekoloni uko gomarara kunoitika kazhinji hakurape kenza, asi kunogona kubatsira kubvisa kuvharika kwekoloni kana mamwe matambudziko ane chekuita nekenza. Izvo zvakare zvinokwanisika kushandisa kuvhiya kubvisa zvikamu zveimwe mitezo ine cancer, inonzi resection. Kana huwandu hwakaganhurirwa hwegomarara hukapararira kunhengo imwe, senge chiropa kana mapapu, vamwe vanhu vanogona kurapwa.
Mukenza yakajeka, kana gomarara rapararira kuchiropa, kana kuvhiya kuchikwanisika (pamberi kana shure kwekemotherapy), pane mukana wekurapa kwakakwana. Kunyangwe zvisingakwanise kurapa cancer, kuvhiya kunogona kuwedzera kupona kwemwedzi kana kunyange makore. Kusarudza kuti ndevapi varwere vanogona kubatsirwa nekuvhiyiwa kwekenza yakaendeswa kuchiropa kazhinji kuita kwakaomarara kunosanganisira nyanzvi dzinoverengeka dzichishandira kuronga chirongwa chakanakisa chekurapa.
Mikana yekuregererwa nekenza uye kudzokazve
Cancer kuregererwa ndipo kana muviri usingakwanise kuona cancer uye isina zviratidzo. Izvi zvinogona zvakare kunzi "hapana humbowo hwechirwere" kana NED.
Ruyamuro runogona kuve rwechinguvana kana rwechigarire. Kusaziva uku kwakonzera kuti vanhu vazhinji vanetseke kuti gomarara richadzoka. Kunyangwe kuregererwa kwakawanda kuri kwekusingaperi, zvakakosha kuti utaure nachiremba wako nezve mukana wekenza yekudzokazve. Kunzwisisa kudzokerazve panjodzi uye nzira dzekurapa dzinogona kukubatsira kugadzirira kudzoka kwekenza zvakanyanya.
Kana gomarara rikadzokazve mushure mekurapwa, rinonzi gomarara rinodzokororwa. Inogona kudzoka munzvimbo imwechete (inonzi yekudzokorora kwenzvimbo), padyo (kudzoreredza kwedunhu) kana kune imwe nzvimbo (kudzokedzana kure).
Kana izvi zvikaitika, kutenderera kutenderera kunotanga zvakare kuti unzwisise zvakanyanya sezvinobvira nezve kudzokazve. Mushure mekuongorora kwapera, chirongwa chekurapa chinowanzo sanganisira nzira dzekurapa dziri pamusoro, dzakadai sekuvhiya, chemotherapy uye radiation, asi inogona kushandiswa mukubatanidzwa kwakasiyana kana kupihwa pamitengo yakasiyana. Chiremba wako anogona zvakare kukurudzira kutora chikamu mumuedzo wekiriniki uri kudzidza kurapwa kweiyi gomarara inowanzoitika. Muzhinji, sarudzo dzekurapa kenza inowanzoitika yakafanana neiya yekenza yemastastatic (ona pamusoro), kusanganisira kuvhiya, radiation radiation, uye chemotherapy. Hazvina mhosva kuti ndedzipi chirongwa chekurapa chaunosarudza, kurapwa kwekurapa kuchave kwakakosha kubvisa zviratidzo uye mhedzisiro.
