Waa maxay 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 buro formed by cancellous bone, cartilage, fat, muscle, blood vessels, and tissue.
Three of these factors make the treatment of sarcoma very challenging. Therefore, it is very important for sarcoma patients to be treated by an experienced multidisciplinary team. The team needs to include surgeons, pathologists, radiologists, oncologists, specialist nurses, physical therapists and pharmacists. .
Ciladda cudurka sarcoma
Si loo xaqiijiyo ogaanshaha, ka-qaadis ayaa loo baahan yahay si loo xaqiijiyo joogitaanka iyo nooca hoose ee sarcoma. Sababtoo ah burooyinkani waa kuwo naadir ah oo isku dhafan, waxaa muhiim ah in dhakhtar khibrad leh uu baaro shaybaarka biopsy. Tijaabooyinkii hore ee shucaaca ee lagu ogaanayo waxa ka mid ahaa CT scans iyo MRI-ga si loo go'aamiyo meesha iyo nooca sarcoma.
Daaweynta sarcoma
Daaweynta caadiga ah ee sarcoma gudaha ah waxaa ka mid ah qalliin dhamaystiran oo lagu daray daaweynta shucaaca ama shucaac la'aan. Baahida loo qabo dhakhtar khibrad leh si uu u sameeyo qalliinka waa mid aad muhiim u ah, sababtoo ah hirgelinta qalliinka aan habooneyn ayaa saameyn ku yeelan kara natiijada daaweynta.
Tiro badan oo tijaabooyin caafimaad oo la kala soocay ayaa xaqiijiyay in daaweynta shucaaca ka hor ama qalliinka kadib ay faa'iidooyin muuqda u leedahay sarcoma ee gacmaha iyo cagaha iyo sarcoma darbiga laabta. Tijaabo caafimaad oo caalami ah oo dhowaan la kala soocay ayaa lagu qiimeeyay doorka daaweynta shucaaca ka hor ee daaweynta sarcoma retroperitoneal.
In specific sarcoma subtype weeks, multi-agent chemotherapy is an important part of treatment management; these subtypes include Cudurka Ewing, 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.
Saadaalinta sarcoma
Nasiib darrose, in kasta oo loo isticmaalo daaweynta ugu habboon ee qalliinka dhammaystiran, qiyaastii 50% bukaanada qaba sarcoma dhexdhexaad ah / sare waxay yeeshaan burooyin soo noqnoqday / metastatic. Metastasis sida caadiga ah wuxuu ku faafaa xididdada dhiigga, sambabbuna waa meesha ugu badan ee cudurka metastatic.
Natiijooyinka saadaalinta bukaanka qaba sarcoma metastatic guud ahaan waa liiteen waagii hore, waxaana jira xulashooyin daaweyn oo yar. Si kastaba ha noqotee, xogta dhowaan waxay muujineysaa in guud ahaan badbaadada guud ee bukaanka qaba unugyada jilicsan ee sarcoma ay ka kordheen qiyaastii 12 bilood illaa iyo hadda 18 bilood. Hadda waxaa jira fursado badan oo daaweyn nidaamsan oo la heli karo oo loogu talagalay bukaanada qaba sarcoma metastatic.
Bukaannada leh nooc-hoosaadyada histological-ka ee tartiib-tartiib u koraya, la socodka nabarada yar-yar/asymptomatic metastatic waa ikhtiyaar. Dib-u-soo-celinta qalliinka waxaa la tixgeliyaa marka bukaanku leeyahay nabar gaar ah oo metastatic ah, gaar ahaan marka nabarku ku jiro sambabada. Xeeladaha kale ee daaweynta maxaliga ah ayaa sidoo kale laga yaabaa in la tixgeliyo oo ay ku jiraan daaweynta shucaaca, soo noqnoqoshada shucaaca iyo embolization.
Go'aanka lagu daaweynayo dhaawacyada metastatic waxay noqon karaan kuwo aad u dhib badan, waxaanan mar labaad ku nuuxnuuxsanaynaa inay tani u baahan tahay koox khibrad badan oo khibrad leh leh. Bukaannada badankood ee qaba sarcoma metastatic, daaweynta ugu weyn waxay kuxirantahay daaweynta nidaamka, badanaa daaweynta kiimikada.
Daaweynta bartilmaameedka ah ee sarcoma
Targeted therapy drugs have been introduced in the subtype of soft tissue sarcoma called buro caloosha ku dhacda (GIST), which has become an example of targeted therapy for solid tumors. Most burooyinka stromal caloosha iyo mindhicirka (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.
Intaa waxaa dheer, imatinib waxaa loo ansixiyay inuu daaweyn ka bixiyo burooyinka halista sare leh kadib qaliinka. Imatinib ayaa sidoo kale si guul leh loogu isticmaalay daaweynta noocyada kale ee sarcoma (oo loo yaqaan 'promacional dermatofibrosarcoma (DFSP)).
Doxorubicin ayaa loo isticmaali karaa kaligiis ama marka lagu daro ifosfamide weli waa heerka ugu horeeya ee daaweynta ugu horeysa ee loo yaqaan 'metastatic tissue sarcoma'. Dhowrkii sano ee la soo dhaafay, natiijooyinka seddex tijaabo oo caalami ah oo heer caalami ah ayaa la daabacay ama la daabacay.
Tijaabadii ugu horreysay ee bukaan socod eegtada ah ayaa si aan kala sooc lahayn loogu xushay bukaanada inay helaan doxorubicin ama doxorubicin iyo ifosfamide Tijaabadani bukaan socod eegtada ah ma soo sheegin wax farqi ah oo ku saabsan heerarka badbaadada guud ee labada gacmood, laakiin bukaanada ku jira daaweynta isku dhafan waxay si aad ah u sii dheeraadeen badbaado la'aan iyo heerar jawaab celin aad u sarreeya.
Tijaabadii labaad ee caafimaad ayaa si aan kala sooc lahayn loogu xushay bukaanada inay helaan doxorubicin iyo ifosfamide analogs (palifosfamide) ama doxorubicin oo lagu daray placebo. Tijaabadan caafimaad waxay muujisay in natiijooyinka baaritaanka ee labada gacmood aysan si weyn uga duwaneyn. Tijaabinta seddexaad ee tijaabada caafimaad ee bukaanka ayaa loo kala saaray si loo helo hal qadar oo ah dawada loo yaqaan 'doxorubicin' ama 'gemcitabine / docetaxel'. Wax farqi ah oo udhaxeeya natiijooyinka laguma arag labadan gacmood.
Intaa waxaa dheer, tijaabo caafimaad oo la kala soocay ayaa la barbar dhigay gemcitabine / docetaxel iyo gemcitabine monotherapy si loo sameeyo jadwal samatabbixin wax ku ool ah gaar ahaan daaweynta leiomyosarcoma iyo polymorphic sarcoma aan kala sooc lahayn.
In 2007, trabectedin-ka-soo-saarka badda ayaa loo oggolaaday in loo isticmaalo Midowga Yurub. Ansixinta waxay ku saleysneyd natiijooyinka laba jadwal oo kala duwan oo loogu talagalay daroogada marxalad kala sooc ah oo tijaabo caafimaad ah. Intaa kadib, wajiga III tijaabada caafimaad ayaa muujisay in bukaanada qaba liposarcoma sare / metastatic iyo leiomyosarcoma loo kala saaray si loo helo trabectedin ama diazolid (bukaanada waxay heleen Huihuan antitumor drugs and one other antitumor treatment before enrollment).
Tijaabadan caafimaad waxay muujisay in bukaanada helay trabectedin ay muujiyeen badbaado aad u dheer oo horumar la'aan ah marka loo eego kuwa helay diazolid. Tani waxay horseeday oggolaanshaha adeegsiga trabectedin ee Maamulka Cuntada iyo Dawooyinka ee Mareykanka bishii Nofeembar 2015.
The pazotinib pazotinib ee afka laga qaato ee tyrosine kinase ayaa la ansixiyay iyadoo lagu saleynayo natiijooyinka tijaabada caafimaad ee la kala soocay ee bukaannada qaba sarcoma unugyada jilicsan ee qaata pazotinib ama placebo. Tijaabada caafimaadku waxay muujisay in kooxda pazotinib ay horumar weyn ka sameeyeen badbaadada aan horumarka lahayn, laakiin ma jirin farqi weyn oo u dhexeeya badbaadada guud.
Sannadkii 2016-kii, soo-saarista 'microtubule inhibitor eribulin' ee badda ayaa waxaa oggolaaday Maamulka Cuntada iyo Dawooyinka ee Mareykanka si loogu daaweeyo liposarcoma heer sare ah. Ansixinta waxay ku saleysan tahay tijaabinta bukaan socodka ee la kala soocay ee bukaanka qaba liposarcoma heerka III sare / metastatic iyo leiomyosarcoma ee qaata eribulin ama dacrabzine. Tijaabadan caafimaad waxay muujisay in gacanta eribulin ay si guud uga sii dheer tahay waqtiga badbaadada marka loo eego cududda dacarbzaine.
Ugu Dambeyn
Gabagabadii, sarcomas waa koox kansarro dhif ah leh walxo isku dhafan, waxayna la kulmaan caqabado waaweyn xagga daaweynta iyo horumarinta daroogada. Soo bandhigida kinasiyada 'tyrosine kinases' ee daaweynta burooyinka caloosha ku dhaca ee caloosha ku dhaca (GIST) waxay horeyba tusaale ugu tahay daaweynta bartilmaameedka burooyinka adag.
Intaa waxaa dheer, dhowrkii sano ee la soo dhaafay, qaar ka mid ah wakiilada daaweynta nidaamka cusub ayaa lagu daray xulashooyinka la heli karo ee loogu talagalay daaweynta sarcoma sare, oo ay ku jiraan pazopanib, trabectedin, iyo eribulin. Wadashaqeynta caalamiga ah ee udhaxeysa cilmi baarayaal kala duwan iyo saynisyahano aasaasi ah ayaa si isdaba joog ah kor ugu qaaday horumarka hababka daaweynta kansarka isku dhafan ee maaddooyinkaan.
