Preventing recurrence of lung cancer, preventing recurrence after lung cancer surgery, how to prevent recurrence of lung cancer, how to prevent recurrence of lung cancer.
Kanker paru-paru mangrupikeun panyabab utama maotna anu aya hubunganana sareng kanker di dunya. Pikeun penderita awal (tahap I sareng II) kanker paru sél non-leutik (NSCLC) sareng sababaraha pasien anu cocog sareng kanker paru-paru sél non-sél maju lokal (tahap IIIA), reseksi bedah lengkep tina lesi tumor mangrupikeun metode perawatan anu pangsaéna. Sanaos kamajuan parantos dilakukeun dina diagnosis awal sareng perawatan sareng parantos ningkatkeun tingkat kasalametan sacara efektif, kambuh postoperative tetep janten masalah anu penting.
After surgical resection, 30% -75% of kanker paru patients will relapse, including about 15% of patients with stage I lung cancer. Most recurrent tumors occur in distant lesions, and more than 80% of recurrent lung cancers occur within the first two years after resection.
Kambuh mangrupa alesan penting pikeun gagalna loba penderita kanker paru ngalawan kanker. Kumaha ngahindarkeun kambuh saatos operasi mangrupikeun topik anu perhatian pikeun unggal pasien sareng kulawarga.
Naon kanker kambuh?
Kambuh kanker diartikeun salaku kambuh deui kanker dina pasien kanker dirawat saatos periode remisi atanapi henteu aya tanda-tanda kanker. Kangker nu kapanggih dina tilu bulan ti diagnosis aslina umumna dianggap progression kanker. Métastasis kanker nujul kana fénoména yén jaringan kanker metastasis tina lesi primér dina bayah ka organ séjén, sarta tumuwuh sarta proliferasi dina organ.
Kambuh bisa dibagi kana tilu kasus nurutkeun lokasi béda tina kambuh:
1. Kambuh lokal-lési masih aya dina bayah, gigireun lesi aslina;
2. Regional recurrence-when the lesion recurs in the lymph nodes near the original tumor;
3. Distal recurrence-when a lung cancer relapses in the bones, brain, adrenal glands or liver.
Naon anu jadi sabab kambuh kanker paru?
Kasempetan kanker paru-paru kambuh gumantung kana sababaraha faktor, kalebet jinis kanker paru-paru, tahap kanker paru-paru nalika didiagnosis, sareng pengobatan kanker asli.
After the diagnosis of lung cancer, the first treatments play an important role, such as surgery and radiotherapy, which are considered local treatments, which can treat cancers that exist around the original tumor site. Sometimes the cells in the original tumor spread farther through the bloodstream or lymphatic channels, but these cells are too small to be detected by imaging. Chemotherapy is a systemic treatment that mainly treats cancer cells that may be present throughout the body. Unfortunately, chemotherapy has large side effects and is prone to drug resistance. Even with chemotherapy, cancer cells may survive and continue to grow in the future.
Naon gejala kambuh kanker paru?
Gejala kambuh kanker paru gumantung kana dimana kanker kambuh. Mun éta kambuh lokal, atawa dina titik limfa deukeut tumor aslina, gejala bisa ngawengku batuk, hemoptysis, shortness tina napas, wheezing, atawa pneumonia. Kambuh deui otak tiasa nyababkeun pusing, panurunan visi atanapi visi ganda, kalemahan atanapi leungitna koordinasi dina hiji sisi awak. Kambuh dina ati bisa ngabalukarkeun nyeri beuteung, jaundice (konéng kulit jadi konéng), itching atawa bingung. Kambuh tulang paling umum sareng nyeri jero dina dada, tonggong, taktak, atanapi anggota awak. Gejala anu langkung umum sapertos kacapean sareng leungitna beurat anu teu kaduga ogé tiasa ngaduga kambuh kanker.
Kumaha carana nyegah kambuh deui kanker paru?
Tinjauan périodik
Kusabab kanker paru-paru teu gaduh sinyal anu tiasa dipercaya sareng diprediksi awal pikeun kambuh sareng metastasis, pikeun ngadeteksi kambuh atanapi metastasis dini, panjagaan caket sareng panjagaan panyakit diperyogikeun.
Sacara umum, taun kahiji sanggeus operasi ieu reviewed unggal tilu bulan; taun kadua, operasi diulang unggal genep bulan, sarta ujian cyclical dituluykeun.
Strictly follow the doctor’s advice and review regularly and on time. When the patient has symptoms, a corresponding chest and abdomen CT, craniocerebral CT or MRI, bone scan, fiberoptic bronchoscopy, etc. should be performed.
Sanggeus perlakuan, penderita kanker paru bisa ngamekarkeun komplikasi atawa gejala séjén alatan kaayaan sorangan jeung alesan séjén. Ku alatan éta, review biasa teu matak dipaliré sarta kudu dibayar perhatian hébat.
Deteksi biomarker
An important tool for predicting the risk of recurrence is the use of molecular biology techniques. Lung cancer is a highly invasive tumor. Pathological classification (histological differentiation, vascular infiltration, lymphatic infiltration, and pleural infiltration), tumor TNM stage, and genotyping are all closely related to prognosis. Genetic testing and immunohistochemistry can be combined to use genetic mutations, such as KRAS status, and CEA and Ki-67 expression levels to predict risk of recurrence.
Nguatkeun gizi sareng nyegah pilek
Pikeun penderita kanker paru, gizi kudu dijamin pikeun nyegah colds, sarta perhatian husus kudu dibayar ka diet. Pilihan dahareun kudu euyeub tur variatif, kalawan bungbuahan sarta sayuran seger. Pikeun penderita sepuh, tuang langkung bubur sareng tuangeun sup bakal langkung saé dicerna. Dina waktos anu sami, urang kedah nengetan jaminan gizi sareng asupan protéin anu berkualitas tinggi.
Pasién kanker paru-paru kedah nengetan tetep haneut, nyegah pilek sareng ngahindarkeun inféksi. Naha éta inféksi virus atanapi baktéri, éta bakal nyababkeun kekebalan awak turun, sareng sél kanker gampang proliferasi sareng kambuh.
Ningkatkeun gaya hirup anjeun sareng tetep bagja
Quit alcohol, quit alcohol, quit alcohol, important things are said three times, you must quit alcohol. In addition, don’t smoke, don’t overwork, pay attention to emotional regulation, and maintain a happy mood.
Latihan anu pas, 2-3 bulan saatos dioperasi, anjeun tiasa ngalakukeun latihan anu lembut, sapertos leumpang, sareng laun-laun ningkat tina 15 menit dugi ka 40 menit; Anjeun ogé tiasa latihan qigong, Tai Chi, latihan radio sareng latihan hipu anu sanés.
Perhatian khusus kedah diperhatoskeun dina diét, tong tuang kadaharan kapang, barbecue, bacon, tahu sareng tuangeun sanés anu ngandung nitrit, sareng henteu tuang ubar tradisional Cina sareng produk kaséhatan.
Perawatan kanker paru
operasi
Cara anu pangsaéna pikeun ngubaran kanker paru-paru nyaéta ngaleungitkeun lesi anu ngulang pikeun ngahontal tujuan penyembuhan radikal. Upami kritéria bedah kacumponan, sadaya tumor tiasa dipiceun sacara bedah.
Upami aya sababaraha lesi, daérah invasi relatif ageung, atanapi metastasis jauh, reseksi tumor tiasa dipilih numutkeun kaayaan. Dina kasus yén kauntungan bedah henteu dijamin, padika pangobatan anu sanés tiasa dipilih.
Terapi proton pikeun pengobatan kanker paru-paru
Radiotherapy is an adjuvant treatment for many patients with postoperative lung cancer. However, in traditional radiotherapy, X-rays or photon beams are inevitably transmitted to the tumor site and the surrounding healthy tissues. This can damage nearby healthy tissue and can cause serious side effects. Proton terapi sampurna tiasa nyingkahan efek samping ieu.
In contrast, proton therapy uses proton beam irradiation and can stop at the tumor site without leaving a radiation dose behind the tumor, so it is unlikely to damage nearby healthy tissue. Some experts believe that proton therapy is safer than traditional radiation therapy.
Pasién kanker ngagaduhan kakebalan anu rendah, paparan radiasi inténsitas tinggi tiasa nyababkeun karusakan organ normal, nyababkeun réaksi ngarugikeun anu serius, sareng nyababkeun beban anu serius pikeun awak anu parantos lemah. Husus pikeun kanker paru-paru, lesi tumor aya di gigireun seueur organ penting, sapertos ati, jantung, esophagus, sareng sajabana, ogé metastase otak anu umum pikeun kanker paru-paru. Milih terapi proton sacara efektif tiasa ngahindarkeun karusakan kana jaringan séhat di sakurilingna sareng ngahontal pangaruh pembunuhan anu sami sareng radioterapi tradisional.
Pangobatan Narkoba Kanker Lung
Terapi anu disasarkan
With the continuous advancement of precision medicine and the continuous advent of various targeted drugs, the front-line treatment of kanker paru sél non-leutik (NSCLC) has changed from chemotherapy to the preferred targeted treatment.
These six key driver gene mutations in non-small cell lung cancer targeted drugs: EGFR (exon 19/21), ALK, BRAF V600E, ROS1, RET, and NTRK are important for patients with lung cancer because they already have Very effective targeted drugs can be used for treatment, replacing traditional chemotherapy.
Kanker paru mutasi-positip EGFR:
Pilihan pangobatan lini kahiji: gefitinib, erlotinib, afatinib, dacotinib, ositinib, sareng ectinib (ubar domestik).
Pilihan perlakuan susulan: Oxitinib.
Kanker paru-paru positif susunan ulang ALK:
Pilihan pengobatan lini kahiji: crizotinib, ceritinib, aletinib, sareng bugatinib.
Perawatan susulan: Aletinib, Bugatinib, Ceritinib, Lauratinib.
Kanker paru-paru positif susunan ulang ROS1:
Pilihan obat lini kahiji: ceritinib, crizotinib, emtricinib.
BRAF V600E kanker paru mutasi-positip:
Pilihan perlakuan lini kahiji: Dalafenib + Trametinib
Perawatan susulan: Dalafenib + Trametinib
NTRK fusi gén kanker paru positif:
Pilihan perlakuan lini kahiji: Larotinib, Emtricinib.
Perawatan susulan: Larotinib, Emtricinib.
Naha aya seueur target mutasi anu tiasa dideteksi kanker paru-paru? Nya kantenan henteu. Salaku tambahan, aya sababaraha mutasi target anu muncul sapertos MET, RET, HER2, jsb. TMB ogé janten spidol prediktif pikeun immunotherapy. Upami mutasi target anu muncul ieu dideteksi, anjeun tiasa milih terapi obat anu dituju (tingali tabel di handap) ).
Target gén anu muncul sareng ubar anu ditargetkeun pikeun kanker paru sél non-leutik
| Sasaran mutasi | Sadia ubar sasaran |
| MET amplifikasi atanapi mutasi exon 14 | Crizotinib (NCCN); Capmatinib, Tepotinib (ASCO) |
| susunan ulang RET | Cabozantinib, Vandetanib (NCCN); LOXO292, BLU667 (ASCO) |
| mutasi HER2 (ERBB2). | Trastuzumab-Metasin conjugate (NCCN) |
| TMB (mutasi tumor) | Nivolumab + Ipilimumab, Nivolumab (NCCN)
|
Pilihan ubar pikeun kanker paru nalika teu aya mutasi genetik
For patients with non-small cell lung cancer without genetic mutations, an important biomarker still needs to be detected, that is PD-L1. PD-L1 is up-regulated in many tumor cells. 1 combination, can inhibit the proliferation and activation of T cells, make T cells in an inactive state, and finally induce immune escape, tumorigenesis and development.
Metode diagnostik pendamping PD-L1 anu disatujuan FDA tiasa ngabimbing paimumab dina pengobatan pasien NSCLC, dumasar kana skor proporsi tumor (TPS). TPS nyaeta persentase sél tumor giat némbongkeun parsial atawa pinuh mémbran staining dina inténsitas nanaon.
Kanker paru sél non-leutik kalayan ekspresi PD-L1 tina TPS ≥1%
Pilihan perlakuan lini kahiji:
Monoterapi paimumab
2. Karsinoma sél non-squamous: (carboplatin / cisplatin) + pemetrexed + paimumab
3. Non-squamous cell carcinoma: carboplatin + paclitaxel + bevacizumab + atejuzumab
4. Karsinoma sél skuamosa: (carboplatin / cisplatin) + (paclitaxel / albumin paclitaxel) + paimumab
Upami duanana mutasi gen dideteksi sareng ekspresi PD-L1 ningkat, terapi obat anu ditargetkeun langkung dipikaresep.
Pilihan obat lini kahiji pikeun kanker paru sél skuamosa non-leutik (teu aya mutasi genetik, teu aya kontraindikasi imun, skor PD 0-1)
| PD-L1 TPS (skor rasio tumor) | Pilihan pangobatan garis kahiji | Tingkat bukti | Dianjurkeun kakuatan |
| ≥50% | K ubar tunggal ubar | luhur | kuat |
| ≥50% | Ubar K + carboplatin + paclitaxel atanapi albumin paclitaxel | in | kuat |
| ≥50% | Taya bukti séjén tina sambetan checkpoint imun digabungkeun jeung kémoterapi lini kahiji | luhur | kuat |
| 0,1-49% | Ubar K + carboplatin + paclitaxel atanapi albumin paclitaxel | in | kuat |
| 0,1-49% | contraindications imun, perlakuan nu ngandung platinum mungkin | luhur | kuat |
| 0,1-49% | Kontraindikasi imun, henteu cocog pikeun terapi platinum, kémoterapi dua-agén non-platinum tiasa dipilih | in | leuleus |
| 0,1-49% | Nolak K ubar gabungan kémoterapi, tapi K ubar tunggal ubar | saeutik | leuleus |
Catetan: ubar K nyaéta paimumab, ubar T nyaéta atezumab, duanana ubar geus dipasarkan di Cina
Pilihan ubar garis kahiji pikeun n non-squamous
kanker paru sél leutik (euweuh mutasi genetik, euweuh kontraindikasi imun, skor PD 0-1)
| PD-L1 TPS (skor rasio tumor) | Pilihan pangobatan garis kahiji | Tingkat bukti | Dianjurkeun kakuatan |
| ≥50% | K ubar tunggal ubar | luhur | kuat |
| ≥50% | K ubar + carboplatin + pemetrexed | luhur | kuat |
| ≥50% | K ubar + carboplatin + paclitaxel + bevacizumab | in | in |
| ≥50% | Ubar T + carboplatin + albumin paclitaxel | saeutik | leuleus |
| ≥50% | Taya bukti séjén tina sambetan checkpoint imun digabungkeun jeung kémoterapi lini kahiji | luhur | kuat |
| 0,1-49% | K ubar + carboplatin + pemetrexed | luhur | kuat |
| 0,1-49% | T ka + carboplatin + paclitaxel + bevacizumab | in | in |
| 0,1-49% | Ubar K + carboplatin + albumin paclitaxel | in | in |
| 0,1-49% | Nolak immunotherapy, kémoterapi dua-ubar anu ngandung platinum | luhur | kuat |
| 0,1-49% | contraindications imun, teu cocog pikeun perlakuan nu ngandung platinum, non-platinum dual-ubar kémoterapi mangrupa pilihan. | in | leuleus |
| 0,1-49% | Nolak K ubar gabungan kémoterapi, tapi K ubar tunggal ubar | saeutik | leuleus |
Catetan: ubar K nyaéta paimumab, ubar T nyaéta atezumab, duanana ubar geus dipasarkan di India.
Vaksin kanker paru-paru
Taun 2008, Cimavax-EGF, vaksin protéin-péptida munggaran di dunya pikeun pengobatan kanker paru tahap III jeung IV, hasil dimekarkeun; taun 2012, Kuba successfully developed the second lung cancer vaccine, Vaxira.
Vaksin péptida protéin munggaran dipasarkan di dunya-Cimavax-EGF
Indikasi: IIIB, IV kanker paru non-sél leutik.
Waktos ka pasar: 2011 (didaptarkeun dina Kuba)
Saatos 25 taun panilitian, Cuban Panaliti parantos suksés nyiapkeun vaksin anu tiasa ngeureunkeun kamajuan kanker paru-paru.
Data Tés:
CIMAvax-EGF di penderita NSCLC canggih (Fase III percobaan klinis) ngabuktikeun yén vaksin aman tur éféktif dina penderita NSCLC canggih.
Dina sidang fase III, laju survival 5 taun subjék divaksinasi éta 14.4%, dibandingkeun kalawan ngan 7.9% dina grup kontrol, ampir dua kali!
Cocog pikeun penderita:
bayah vaksin kanker are not effective in all patients. The most suitable population is: only for patients with advanced non-small cell lung cancer lung cancer, lung cancer patients with stable disease after first-line chemoradiation and no brain metastases If the patient is in advanced disease, the vaccine is not suitable.
Panaliti yakin yén hiji tina lima pasien ieu bakal suksés. Seuseueurna tumor ngaleungit, sareng sababaraha pasien ngaleungit lengkep! 23% pasien salamet langkung ti 5 taun. Sanaos aranjeunna kanker paru-paru maju, saatos nampi perawatan vaksin, aranjeunna tiasa damel sareng hirup normal, sareng kualitas hirupna luhur pisan, sacara efektif ngalambatkeun kamajuan panyakit.
Note, however, that CimaVax EGF cannot stop the development of cancer, let alone cure it. Instead, a mechanism was initiated, through which the uncontrolled growth and division of cancer cells was more restricted, thereby transforming advanced invasive lung cancer into a chronic disease. At present, the Cuban lung cancer vaccine has been approved in more than 80 countries around the world, and domestic patients can also apply to purchase the vaccine for treatment from Kuba ku nelepon di + 91 96 1588 1588.
