Kansarka naasaha
With the advancement of breast cancer diagnosis and treatment, the survival time of breast cancer patients has prolonged significantly, but the incidence of breast cancer brain metastases (BCBM) has gradually increased. This article reviews recent clinical studies related to the survival prognosis and treatment of breast metastases from breast cancer. It is generally believed that factors such as age, KPS score, receptor status, number of brain metastases, and control of extracranial lesions affect patient prognosis. Surgery, whole brain radiotherapy (WBRT), and stereotactic radiosurgergy (SRS) are currently the first-line treatments for brain metastases. With the development of comprehensive kansarka naasaha treatment, the application of chemotherapy and molecular targeted therapy in breast metastasis has received more and more attention.
Maskaxda maskaxda ee kansarka naasaha
Sanadihii la soo dhaafay, iyadoo si joogto ah loo sii wanaajinayo ogaanshaha cudurka iyo daaweynta, waqtiga badbaadada ee bukaanku si aad ah ayey u dheereeyeen, iyo dhacdooyinka metastases-ka maskaxda (metastasis maskaxda, BM) ayaa sidoo kale si aad ah u kordhay. Qiyaastii 30% bukaannada ayaa aakhirka horumarin doona metastases maskaxda, iyo waqtiga badbaadada ka dib metastases maskaxda waa 2 ~ 14 bilood. Kansarka naasuhu wuxuu leeyahay dhacdooyin sare oo ah metastasis maskaxeed iyo saadaal xumo. Waxay noqotay qodob muhiim ah oo saameeya tayada nolosha iyo badbaadada. Saadaalinta iyo daaweynta BM marwalba waxay ahayd diiradda iyo dhibaatada wareegyada tacliinta. Waa muhiim in la falanqeeyo astaamaheeda caafimaad iyo in la helo daaweyn wax ku ool ah. Iyo hawl deg deg ah. Maqaalkani wuxuu dib u eegis ku sameynayaa saadaalinta daaweynta iyo daaweynta BCBM.
Waxyaabaha saadaalinta ee metastases maskaxda ka kansarka naasaha
Daraasadaha qaarkood waxay muujiyeen in saadaasha BCBM ay la xiriirto arrimo ay ka mid yihiin da'da, kala soocidda molikaliska, metastasis ka baxsan, tirada dhaawacyada BM, aagga ugu badan ee dhaawaca, iyo dhibcaha KPS. Cilmi-baarayaashu waxay aasaaseen moodallo qiimeyn saadaal oo kala duwan oo ku saleysan arrimaha kor ku xusan, iyagoo isku dayaya inay si wax ku ool ah u kala soocaan bukaanada leh metastases-ka maskaxda ee kala duwan si ay u caawiyaan xulashada istiraatiijiyadda caafimaad.
Daaweynta kansarka naasaha maskaxda ku dhaca
Daaweynta metastases-ka maskaxda ee kansarka naasaha waa in si buuxda loo qiimeeyaa iyadoo lagu saleynayo arrimo ay ka mid yihiin xaaladda guud ee bukaanka, meesha nabarku ku yaal, iyo xakamaynta ka-baxsan ka hor inta aan la go'aansan qorshaha daaweynta. Waqtigan xaadirka ah, qalliinka, WBRT, iyo SRS wali waa daaweynta ugu horeysa ee BCBM. Horumar ayaa sidoo kale laga sameeyay daaweynta kemotherabi iyo daaweynta molekuleelada bartilmaameedka ah.
Daaweynta hormoonka ee kansarka naasaha ee naasaha
Daawada sida caadiga ah loo isticmaalo waa dexamethasone, daawaynta hoormoonkana loogama baahna bukaanada qaba cudurka asymptomatic metastases maskaxda. Dexamethasone waxay yaraynaysaa calaamadaha bararku muddo gaaban gudaheed iyadoo dib u soo celinaysa dabacsanaanta xididdada dhiigga ee halbowlaha ah waxayna yaraynaysaa qulqulka xididada. Qiyaasta bilowga lagu taliyey ee dexamethasone waa 4 ~ 8mg / d; Marka metastases-ka maskaxdu ay sare u kacdo bararka maskaxda ee daran iyo cadaadiska gudaha intracranial oo sarreeya, waxaa lagu talinayaa in la isticmaalo dexamethasone qiyaasta 16mg / d ama ka weyn, taas oo ah in si tartiib tartiib ah loo yareeyo marka la joojiyo. qadarka.
Daaweynta qalliinka ee kansarka naasaha ee naasaha
Waxay inta badan ku habboon tahay bukaanjiifka hal tallaal iyo KPS> 70. Caafimaad ahaan, 20% -30% bukaannada ayaa ku habboon daaweynta qalliinka. Faa'iidooyinkeeda ayaa ah inay si dhakhso leh u yareyn karto calaamadaha, ay u heli karto tijaabooyinka cudurada, iyo hagaajinta heerka xakamaynta maxalliga ah Xaaladda qalliinka ee metastases-ka maskaxda badan ayaa wali ka maqan xogta ku habboon iyo gabagabada.
Daaweynta shucaaca maskaxda oo dhan
Bukaannada qaba dhaawacyada intracranial> 3, wadarta guud ee wax ku ool ah ee shucaaca maskaxda oo dhan kaliya waxay ahayd 60 ilaa 80%. Qiyaastii 70% bukaannada ayaa lahaa calaamado soo roonaaday waxayna dheereeyeen celceliska wakhtiga badbaadada ee 3 ilaa 6 bilood. Qalliinka Raadiyaha Stereotactic (SRS) Waxaa guud ahaan la rumeysan yahay in SRS ay inta badan ku habboon tahay bukaannada qaba 3 ama ka yar nabarrada, dhexroorka <3.0 cm, iyo saameyn yar oo meel bannaan ah, gaar ahaan burooyinka aan si fudud loo heli karin xilliga qalliinka oo ku yaal meel muhiim ah. meelaha shaqaynta. Laakin SRS ayaa aad iyo aad u badan baa loo daraaseeyay dhowr qaybood oo maskaxda ah, waxayna u muuqataa mid macquul ah.
Chemotherapy ee kansarka naasaha ee metastatic
Waxtarka kemotherabi ee BCBM waa xaddidan yahay sababtoo ah dawadu waxay ku adagtahay inay ka gudubto xannibaadda dhiigga-maskaxda. Daraasadaha qaar ee sanadihii ugu dambeeyay ayaa muujiyay in isku darka kemotherabi iyo daaweynta shucaaca ay hagaajin karaan waxtarka. Sababtoo ah daawaynta shucaaca ayaa furaysa xannibaadda dhiigga-maskaxda, daawadu waxay geli karaan madaxa si ay u sameeyaan saameyn lid ku ah buro. Inkasta oo dawooyinka kiimikaad ay adagtahay in la gaaro saameyn cad oo antitumor ah oo ku jirta madaxa, xakamaynta wax ku oolka ah ee dhaawacyada ka baxsan waxay hagaajin kartaa tayada nolosha waxayna sii dheereyn kartaa wakhtiga badbaadada bukaanka.
Daaweynta loogu talagalay daaweynta kansarka naasaha
With the continuous understanding of the mechanism of buro formation and metastasis, molecular targeted therapy has become a routine treatment strategy for malignant tumors. Bevacizumab combined with radiotherapy is mainly used for the treatment of gliomas, and there are few studies in brain metastases such as breast cancer and lung cancer, and further research is still needed.
Daaweynta Endocrine ee kansarka naasaha ee naasaha
Waxaa jira xog cilmi baaris oo aad u yar oo ku saabsan daaweynta endocrine ee daaweynta BCBM. Sababtoo ah daawaynta endocrine ayaa si tartiib tartiib ah u bilaabeysa ficilka, iyo bukaanada qaba BM badankood waxay leeyihiin saadaal xumo waxayna u baahan yihiin in la xakameeyo calaamadaha maxalliga ah sida ugu dhakhsaha badan, daweynta endocrine laguma talinayo daaweynta safka hore ee BCBM. Marka la soo koobo. Dhacdooyinka sare iyo saadaalinta liidata ee metastases-ka maskaxda ee kansarka naasaha ayaa noqday dhibaatooyin caafimaad ahaan adag. Waxaa guud ahaan la rumeysan yahay in arrimo ay ka mid yihiin da'da, dhibcaha KPS, heerka soo dhaweynta, tirada metastases maskaxda, iyo xasilloonida dhaawacyada ka baxsan maskaxda ay saameeyaan saadaasha bukaanka, laakiin qaabka qiimeynta saadaasha ee hadda jira ayaa leh awood xaddidan oo saadaalin ah wuxuuna u baahan yahay in la sii wanaajiyo oo la wanaajiyo. . Marka la eego daaweynta, qalliinka iyo daaweynta shucaaca ayaa weli ah hababka daawaynta ugu weyn, iyo heerka daaweynta kemotherabi iyo daawooyinka molecular ayaa si tartiib tartiib ah u kordhay.
