Daaweynta kansarka beerka, qorshaha daaweynta kansarka beerka, habka daaweynta kansarka beerka, habka daaweynta kansarka beerka, daawo loogu talagalay daaweynta kansarka beerka.
Kansarka beerka koowaad
Kansarka aasaasiga ah ee kansarka waa mid ka mid ah sababaha ugu badan ee sababa burooyinka halista ah iyo dhimashada burooyinka ee dalalka soo koraya, kuwaas oo si ba'an u khatar geliya nolosha dadka iyo caafimaadka. Jaangoynta baaritaanka iyo daaweynta kansarka beerka ayaa aad muhiim ugu ah hagaajinta ogaanshaha iyo daaweynta bukaannada kansarka beerka iyo hagaajinta tayada nolosha bukaannada.
There are many treatment options for kansarka beerka, including surgery, radiotherapy, radiofrequency ablation, venous embolization, and drug treatment. Among them, the chemotherapy effect of liver cancer is not good, because most liver cancer cells are not sensitive to chemotherapeutic drugs, even if the benefit of using chemotherapeutic drugs may be smaller than the side effects. Therefore, the proportion of patients with liver cancer treated with chemotherapy is not large.
Laga soo bilaabo 2007, soo bixitaankii sorafenib, oo ah dawadii ugu horaysay ee lala bartilmaameedsado kansarka beerka, waxay jabisay xaalada ah inaan daawo loo helin kansarka beerka, laakiin waxay sii waday in kabadan 10 sano. Kaliya sorafenib ayaa loo isticmaali karaa sidii daaweynta-safka-koowaad ee kansarka beerka ee aan la-daweyn karin. Ka dib iska caabinta daroogada, ma garanaysid sida loo doorto?
However, through unremitting efforts, scientists broke through obstacles. In 2018, the second targeted drug that could replace sorafenib was successfully launched, that is, lovatinib! Both sorafenib and lovatinib It is a targeted drug used for first-line treatment of liver cancer. Later, a variety of second-line treatment drugs have also come out one after another!
Since 2017, many new high-level evidences in line with the principles of evidence-based medicine have emerged in the diagnosis, staging and treatment of liver cancer at home and abroad, especially research results adapted to China’s national conditions. This article focuses on the drug treatment plan and sequence in the latest edition of the “Specifications for the Diagnosis and Treatment of Primary Liver Cancer (2019 Edition)”, giving a clear guide for liver cancer friends.
Tilmaamaha daaweynta kansarka beerka ee FDA
saaxiibada kansarka beerka
| taariikhda | FDA waxay ansaxineysaa daroogada bartilmaameedka kansarka beerka | Muujin | Oggolaanshaha guryaha |
| 2007-11 | Sorafenib (Sorafenib, Nexavar) | Daaweynta kansarka cagaarshowga hepatocellular ama kansarka beerka | Gudaha ka qoran kuna daboolan caymiska caafimaadka |
| 2018-8 | Lenvatinib (Levatinib, Lenvima) | Daaweynta-koowaad ee daaweynta kansarka cagaarshowga hepatocellular | Liiska guryaha |
| 2017-4 | Regorafenib (Sigvarga) | Daaweynta safka labaad ee kansarka beerka ee sorafenib u adkaysta | Suuqa gudaha |
| 2017-9 | Nivolumab (navumab, Opdivo) | Daaweynta safka labaad ee kansarka beerka ee sorafenib u adkaysta | Suuqa gudaha |
Xulashada daaweynta safka hore ee kansarka beerka
(1) Sorafenib
Tiro cilmi-baaris caafimaad ah ayaa muujisay in Sorafenib ay leedahay faa'iidooyin badbaado oo gaar ah oo loogu talagalay bukaannada qaba kansarka beerka sare ee dalal kala duwan iyo asal ahaan cudurrada beerka ee kala duwan (heerka caddaynta 1).
Isticmaalka caadiga ah ee lagu taliyay waa 400 mg afka, laba jeer maalintii. Waxaa loo isticmaali karaa bukaanjiifka Class-Pugh Class A ama B ee leh shaqada beerka. Marka loo barbardhigo shaqada beerka ee Child-Pugh B, Child-Pugh A Faa'iidada badbaadada bukaanka ayaa aad u muuqata.
Waxaad ubaahantahay inaad fiiro gaar ah u yeelato saameynta HBV iyo shaqada beerka, iyo kor u qaadida maaraynta cudurka aasaasiga ah ee beerka inta lagu gudajiro howsha. Dareen-celinta xun ee ugu caansan waa shuban, miisaanka oo yaraada, cilladda gacanta iyo cagaha, firiiric, myocardial ischemia, iyo dhiig-kar, oo badanaa ku dhaca 2 ilaa 6 toddobaad ka dib bilowga daaweynta.
(2) Lemvatinib
Lenvatinib wuxuu ku habboon yahay bukaanjiifka aan lakala furi karin ee leh heerka IIb, IIIa, IIIb, shaqada beerka ee Child-Pugh A kansarka beerka, iyo daaweyntiisa safka koowaad ma liito sorafenib. Kansarka beerka ee la xiriira HBV wuxuu leeyahay faa iidooyin Badbaadada [185] (heerka caddaynta 1).
Lenvatinib ayaa loo oggolaaday in loo isticmaalo bukaan-socodka kansarka beerka ee loo yaqaan 'Child-Pugh A' oo qaba kansarka beerka ee horumarsan. Isticmaalka: 12mg, afka, hal mar maalintii culeyska jirka ≥60kg; 8mg, afka, hal mar maalintii culeyska jirka <60kg. Dareen-celinta xun ee caadiga ah waa dhiig-kar, shuban, rabitaanka cuntada oo yaraada, daal, cilladda gacanta, cilladda borotiinka, lallabbada, iyo hypothyroidism.
(3) Dawaynta kimikalka
FOLFOX4 (fluorouracil, calcium folinate, oxaliplatin) borotokoolka ayaa lagu ansixiyay Shiinaha oo loogu talagalay daawaynta beerka hore u maray iyo metastatic kansar aan ku habboonayn dib-u-soo-celinta qalliinka ama daaweynta maxalliga ah (heerka caddaynta 1).
Daraasado badan oo wajiga II ah ayaa soo sheegay in daaweynta kemotherabi ee nidaamsan ee leh oxaliplatin oo ay weheliso sorafenib ay hagaajin karto heerarka jawaabta ujeeddada, kordhinta badbaadada horumarka lahayn iyo guud ahaan badbaadada, iyo inay bixiso nabadgelyo wanaagsan (heerka caddaynta 3).
Bukaannada qaba shaqo wanaagsan oo beerka ah iyo xaalad jireed, daaweyntan isku dhafan ayaa la tixgelin karaa, laakiin daraasadaha la kala soocay ee kiliinikada ayaa wali loo baahan yahay si loo bixiyo caddayn caafimaad oo caddayn heer sare ah. Intaa waxaa sii dheer, arsenic trioxide waxay leedahay saameyn daaweyn gaar ah oo ku saabsan kansarka beerka ee horumarsan (heerka caddaynta 3). Codsiga bukaan socodka, taxaddar waa in la sameeyaa si loola socdo oo looga hortago sumowga beerka iyo kelyaha.
Daaweynta-labaad ee kansarka beerka
(1) Regofin
Regorafenib waxaa loo oggol yahay in loo isticmaalo bukaanada qaba heerka IIb, IIIa, iyo IIIb kansarka beerka CNLC ee horay loogu daaweeyay sorafenib (heerka caddaynta 1). Isticmaalku waa 160mg hal mar maalintii muddo 3 toddobaad ah waana la joojiyey 1 toddobaad.
Shiinaha, qiyaasta ugu horreysa waxay noqon kartaa 80mg ama 120mg hal mar, hal mar maalintii, waxayna tartiib tartiib u kordheysaa iyadoo loo eegayo dulqaadka bukaanka. Dhacdooyinka xun ee caadiga ah waa dhiig-kar, falcelinta maqaarka lugta lugta, daal, iyo shuban.
(2) Navumab iyo Paimumab
FDA waxay ogolaatay isticmaalka Navulinu monoclonal antibodies (Nivolumab) iyo Pabrolizumab monoclonal antibodies (Pembrolizumab) ee bukaanada qaba kansarka beerka kuwaas oo horumaray ama aan u dulqaadan karin sorafenib ka dib daaweyn hore oo sorafenib ah (heerka caddaynta 2).
Waqtigan xaadirka ah, horjoogayaasha isbaarada difaaca ee ay si madaxbanaan u soo saareen shirkadaha Shiinaha, sida Carellidizum monoclonal antibodies, difaaca jirka ee Treplepril monoclonal, iyo Xindili monoclonal antibodies, ayaa ku socda cilmi baaris caafimaad. Isku darka immunotherapy and targeted drugs, chemotherapeutic drugs, and topical treatments is also constantly being explored.
Immunomodulators kale (sida interferon α, thymosin α1, iwm.), immunotherapy unugyada (sida. Chimeric antigen receptor T cell therapy, CAR-T, iyo cytokine-ku-daawaynta unugyada dilaaga ah, CIK) dhamaantood waxay leeyihiin saamayn antitumor gaar ah. Si kastaba ha ahaatee, weli laguma xaqiijin daraasado caafimaad oo baaxad leh.
