Isigaxa sobuchopho

Yini isimila ebuchosheni?

A brain tumor is a mass or growth of abnormal cells in your brain. Many different types of brain tumors exist. Some brain tumors are noncancerous (benign), and some brain tumors are cancerous (malignant). Brain izicubu can begin in your brain (primary brain tumors), or cancer can begin in other parts of your body and spread to your brain (secondary, or metastatic, brain tumors).

Ukuthi isimila ebuchosheni sikhula ngokushesha kangakanani kungahluka kakhulu. Izinga lokukhula kanye nendawo yesimila ebuchosheni inquma ukuthi izowuthinta kanjani umsebenzi wesimiso sakho sezinzwa.

Izinketho zokwelapha isimila ebuchosheni zincike ohlotsheni lwesimila ebuchosheni onaso, kanye nobukhulu baso nendawo.

Izinhlobo Zezimila Zobuchopho

Isimila ebuchosheni, esaziwa ngokuthi i-intracranial tumor, inqwaba yethishu engavamile lapho amaseli akhula futhi aziphindaphindeka ngokungalawuleki, okubonakala sengathi akulawulwa yizinqubo ezilawula amaseli avamile. Zingaphezu kwe-150 izimila zobuchopho ezibhaliwe, kepha amaqembu amabili amakhulu amathumba obuchopho abizwa okuyisisekelo futhi i-metastatic.

Izimila zobuchopho eziyinhloko zihlanganisa izimila ezisuka ezicutshini zobuchopho noma endaweni eseduze yobuchopho. Izimila eziyinhloko zihlukaniswa njenge-glial (eyakhiwe amaseli e-glial) noma i-non-glial (ithuthukiswe phezu noma ezakhiweni zobuchopho, okuhlanganisa izinzwa, imithambo yegazi nezindlala) kanye benign or okubi.

Izimila zobuchopho ze-Metastatic zihlanganisa izimila ezivela kwenye indawo emzimbeni (njengebele noma amaphaphu) futhi zithuthele ebuchosheni, ngokuvamile ngomjikelezo wegazi. Izimila ze-Metastatic zibhekwa njengomdlavuza futhi ziyingozi.

Metastatic tumors to the brain affect nearly one in four patients with cancer, or an estimated 150,000 people a year. Up to 40 percent of people with umdlavuza wamaphaphu will develop metastatic brain tumors. In the past, the outcome for patients diagnosed with these tumors was very poor, with typical survival rates of just several weeks. More sophisticated diagnostic tools, in addition to innovative surgical and radiation approaches, have helped survival rates expand up to years; and also allowed for an improved quality of life for patients following diagnosis.

Izinhlobo zama-Benign Brain Tumors

• Ama-Chordomas amathumba amahle, akhula kancane avame kakhulu kubantu abaneminyaka engama-50 kuya kwengama-60. Izindawo zabo ezivame kakhulu isisekelo sogebhezi kanye nengxenye engezansi yomgogodla. Nakuba lezi zimila ziyingozi, zingase zihlasele ithambo eliseduze futhi zicindezele izicubu zemizwa eseduze. Lawa amathumba angavamile, anikela kumaphesenti angu-0.2 kuphela azo zonke izimila zobuchopho eziyinhloko.
• I-Craniopharyngiomas ngokuvamile anempilo enhle, kodwa amathumba okunzima ukuwasusa ngenxa yendawo yawo eduze nezakhiwo ezibucayi ekujuleni kobuchopho. Ngokuvamile zivela engxenyeni ye- i-pituitary gland (isakhiwo esilawula amahomoni amaningi emzimbeni), ngakho cishe zonke iziguli zizodinga okuthile ukwelashwa esikhundleni se-hormone.
• I-Gangliocytomas, ama-gangliomas kanye ne-anaplastic ama-gangliogliomas yizimila ezingavamile ezihlanganisa i-neoplastic amangqamuzana ezinzwa ahluke kahle, atholakala ikakhulukazi kubantu abadala.
• Glomus jugul kukhonaizimila ngokuvamile azinabungozi futhi ngokuvamile zitholakala ngaphansi nje kwesisekelo sogebhezi, phezulu komthambo we-jugular. Ziyindlela ejwayelekile kakhulu ye isimila se-glomus. Kodwa-ke, izimila ze-glomus, ngokuvamile, zinomthelela kumaphesenti angu-0.6 kuphela ama-neoplasms ekhanda nentamo.
• Meningiomas yizimila eziyingozi ezivame kakhulu ezingaphakathi kwe-cranial, ezihlanganisa amaphesenti angu-10 kuya kwangu-15 awo wonke ama-neoplasms obuchopho, nakuba iphesenti elincane kakhulu liyingozi. Lezi zimila zivela ku- meninges, izakhi ezifana nolwelwesi ezizungeze ubuchopho nomgogodla.
• I-Pineocytomas ngokuvamile izilonda ezinobungozi ezivela ku- amaseli e-pineal, okwenzeka kakhulu kubantu abadala. Zivame ukuchazwa kahle, azihlanganisi, zi-homogeneous futhi zikhula kancane.
• I-pituitary adenoma are the most common intracranial tumors after ama-gliomas, meningiomas and schwannomas. The large majority of pituitary adenomas are benign and fairly slow-growing. Even malignant pituitary tumors rarely spread to other parts of the body. Adenomas are by far the most common disease affecting the pituitary. They commonly affect people in their 30s or 40s, although they are diagnosed in children, as well. Most of these tumors can be treated successfully.
• I-Schwannomas yizimila zobuchopho ezivamile kubantu abadala. Zisuka zihambisana nezinzwa, ezihlanganisa amangqamuzana avame ukuhlinzeka “ngokufakwa kukagesi” kwamangqamuzana ezinzwa. I-Schwannomas ivamise ukususa ingxenye esele yenzwa evamile esikhundleni sokuyihlasela. I-acoustic neuromas yi-schwannoma evame kakhulu, ephuma ku-cranial nerve yesishiyagalombili, noma I-vestibularcochlear nerve, esuka ebuchosheni iye endlebeni. Nakuba lezi zimila ziyingozi, zingabangela izinkinga ezinkulu ngisho nokufa uma zikhula futhi zinengcindezi ezinzwa futhi ekugcineni nasebuchosheni. Ezinye izindawo zihlanganisa umgogodla futhi, okungajwayelekile, eduze kwemizwa eya emilenzeni.

Izinhlobo Zezimila Zobuchopho Eziyingozi

I-Gliomas ziwuhlobo oluvame kakhulu lwesimila ebuchosheni obudala, esibalelwa kumaphesenti angama-78 ezimila ebuchosheni obuyingozi. Avela kumangqamuzana asekelayo obuchopho, abizwa ngokuthi i-glia. Lawa maseli ahlukaniswe yaba ama-astrocyte, amaseli ependymal futhi amaseli oligodendroglial (noma oligos). Izimila ze-glial zihlanganisa okulandelayo:

• I-Astrocytomas yi-glioma evame kakhulu, ebalelwa cishe ingxenye yawo wonke amathumba obuchopho nomgogodla. I-Astrocytomas ikhula isuka kumaseli e-glial amise okwenkanyezi abizwa ngokuthi ama-astrocyte, ingxenye yezicubu ezisekelayo zobuchopho. Zingase zenzeke ezingxenyeni eziningi zobuchopho, kodwa ngokuvamile ku-cerebrum. Abantu bayo yonke iminyaka bangakwazi ukuthuthukisa i-astrocytomas, kodwa bavame kakhulu kubantu abadala - ikakhulukazi amadoda aneminyaka ephakathi. I-Astrocytomas engaphansi kobuchopho ivame kakhulu ezinganeni noma kubantu abasha futhi ibangela iningi lamathumba ebuchosheni bezingane. Ezinganeni, iningi lalezi zimila zithathwa njengezinga eliphansi, kanti kubantu abadala, iningi lisezingeni eliphezulu.
• I-Ependymomas asuselwa ekuguqulweni kwe-neoplastic kwamaseli e-ependymal agxile uhlelo lwe-ventricular futhi abangela amaphesenti amabili kuya kwamathathu azo zonke izimila ebuchosheni. Eziningi zichazwe kahle, kodwa ezinye azichazwanga.
• I-Glioblastoma multiforme (GBM) uhlobo oluhlasela kakhulu lwesimila se-glial. Lezi zimila zivame ukukhula ngokushesha, zisakazekele kwezinye izicubu futhi zibe nokubikezela okubi. Angase akhiwe izinhlobo eziningana zamaseli, njenge-astrocyte nama-oligodendrocyte. I-GBM ivame kakhulu kubantu abaneminyaka engama-50 kuya kwengama-70 futhi ivame kakhulu emadodeni kunabesifazane.
• I-Medulloblastomas ngokuvamile zivela ku cerebellum, ngokuvamile ezinganeni. Ziyizimila ezisezingeni eliphezulu, kodwa ngokuvamile ziyasabela imisebe futhi imiphumela emibi yokwelashwa ngamakhemikhali.
• I-Oligodendrogliomas athathwe kumaseli akhayo i-myelin, okuyi-insulation yezintambo zobuchopho.

Ezinye Izinhlobo Zezimila Zobuchopho

• I-hemangioblastomas, ngokuvamile etholakala ku-cerebellum, amathumba akhula kancane. Zivela emithanjeni yegazi, zingaba zinkulu ngobukhulu, futhi zivame ukulandelwa yi-cyst. Kubantu abaneminyaka engu-40 kuya ku-60, lezi zimila zivame kakhulu futhi zivame kakhulu kwabesilisa kunabesifazane.
• Izimila ze-Rhabdoid yizimila ezingavamile ezinolaka kakhulu futhi zivame ukusabalala ohlelweni lwezinzwa oluphakathi. Zivame ukuvela emzimbeni ezindaweni eziningi, ikakhulukazi ezinso. Zivame kakhulu ezinganeni ezincane, kodwa kubantu abadala, zingenzeka futhi.

Izimila Zengqondo Yezingane

Ngokuvamile, izimila zobuchopho ezinganeni zivela ezicutshini ezahlukene kunalezo ezithinta abantu abadala. Ukwelashwa okubekezelelwa kahle ubuchopho obudala (njengokwelashwa ngemisebe) kungavimbela ubuchopho bengane ekukhuleni ngendlela evamile, ikakhulukazi ezinganeni ezingaphansi kweminyaka emihlanu ubudala.

Izingane ezingaba ngu-4,200 e-US kutholwe zinethumba ebuchosheni, ngokusho kwePediatric Brain Tumor Foundation. U-72% wezingane ezitholwe zinethumba ebuchosheni zingaphansi kweminyaka engu-15 ubudala. Ku-posterior fossa (noma emuva) yobuchopho, iningi lalezi zimila zobuchopho ziyakhula. Izingane zivame ukuba ne-hydrocephalus (ukunqwabelana koketshezi ebuchosheni) noma ubuso noma umzimba kungasebenzi kahle.

Ezinganeni, izinhlobo ezithile zezimila ebuchosheni zivame kakhulu kunabantu abadala. I-Medulloblastoma, i-astrocytoma yezinga eliphansi (i-pilocytic), i-ependymoma, i-craniopharyngioma kanye ne-brain stem glioma yizinhlobo ezivame kakhulu zamathumba ezingane.

Isistimu yokugreda yokubonisa ukonakala noma ukulunga kwesimila ngokusekelwe ezicini zayo zesayensi yezemvelo ngaphansi kwesibonakhulu lakhiwe yi-World Health Organization (WHO).

• Okuyingozi kakhulu
• Ukukhula ngokushesha, kunolaka
• Ingena kakhulu
• Ukuphindaphinda okusheshayo
• I-Necrosisprone

Izinhlobo Eziyinhloko Ze-Brain Tumor

Izinhlobo zamaseli ngaphakathi kwesimila zihlukanisa izimila zobuchopho. Uhlobo ngalunye lwesimila ebuchosheni lukhula ngendlela ethile futhi lwelashwe. Izinhlobo eziningi zezimila ebuchosheni, nakuba i-meningiomas ivame kakhulu kwabesifazane, ivame kakhulu emadodeni kunakwabesifazane.

I-Craniopharyngioma

Non-cancerous, slow growing tumors found near the pituitary gland are craniopharyngiomas. In children and middle-aged adults, craniopharyngioma usually occurs. Part solid and part fluid-filled cyst may be the tumor itself. Symptoms can include changes in vision and slow growth caused by the pituitary gland effect of the tumor. These tumors mainly require advanced surgery and likely post-surgery radiation therapy.

Ama-cysts e-dermoid kanye nezimila ze-epidermoid

Ukukhula okuhle okuvela kumangqamuzana e-epithelial akha ungqimba lwangaphandle lomzimba futhi kulandele ezinye izitho nezindlala ama-dermoid cysts nama-epidermoid tumors.

Angase akhule, kuhlanganise nesimiso sezinzwa esimaphakathi, ezingxenyeni ezihlukahlukene zomzimba. Zombili zikhula kancane, futhi ngokuvamile azizange zibonwe amashumi eminyaka. Ngokususwa ngokuhlinzwa, belashwa.

I-Glioma

I-Gliomas yisigaba sezimila zobuchopho eziyinhloko. Zingamanye amathumba ebuchosheni akhula ngokushesha. Izinhlobo ezahlukene ze-glioma zihlanganisa:

• I-Astrocytoma: I-Astrocytomas isakazeka ebuchosheni futhi ixubana nezicubu ezinempilo, okwenza kube nzima ukuyelapha. Kunezinhlobo eziningana ze-astrocytoma:
  • I-astrocytomas yezinga eliphansi: Lokhu kufaka phakathi i-astrocytoma ye-pilocytic yebanga I kanye ne-astrocytoma yebanga II. I-astrocytomas yeBanga I ayivamile ukubonakala kubantu abadala.
  • I-Anaplastic astrocytoma: I-astrocytoma yeBanga lesi-III yaziwa ngokuthi i-anaplastic astrocytoma. Lezi zimila zinodlame, umdlavuza wezinga eliphezulu.
  • I-Glioblastoma: I-astrocytomas yeBanga IV ibizwa ngokuthi i-glioblastoma noma i-GBM. I-Glioblastoma iyithumba ebuchosheni eliyingozi elivamile (elinomdlavuza) kanye nesinye sezimila ezikhula ngokushesha zesistimu yezinzwa emaphakathi.
• I-Ependymoma: Ama-ependymomas avela kumaseli e-ependymal ahlanganisa ama-ventricles obuchopho kanye nesikhungo somgogodla. Ama-ventricles angamagumbi obuchopho akhiqiza futhi athuthe uketshezi lwe-cerebrospinal, oluzungeza ubuchopho futhi luvikele. I-Ependymomas ingatholakala emgogodleni noma ebuchosheni. Ama-ependymomas ezinganeni avame ukubonakala futhi awavamile kubantu abadala.
• I-Oligodendroglioma: I-Oligodendroglioma ngokuvamile ikhula kancane. Kungatholakala njenge-tumor yebanga II noma i-grade III.

I-hemangioblastoma

Kusuka emangqamuzaneni emithambo yegazi, lezi zimila ezikhula kancane ziyakhula. Ngokuvamile, i-hemangioblastoma yakheka ku-brainstem kanye ne-cerebellum, kodwa ingase yenzeke kwezinye izindawo, kuhlanganise ne-retina. Isifo sikaVon Hippel Lindau, isifo sofuzo esixhunyaniswa nokuthuthukiswa kwezinhlobo eziningi zamathumba nomdlavuza, sihlotshaniswa cishe nengxenye yesine yalezi zifo.

I-Medulloblastoma

I-Medulloblastoma iyithumba ebuchosheni elivame kakhulu ezinganeni.

I-Meningioma

Isimila sobuchopho esivame kakhulu i-meningioma. Kuma-meninges, ungqimba oluvikelayo lwezicubu ezizungeze ubuchopho nomgogodla, lezi zimila zivela kumaseli. Iningi likhula kancane futhi lilungile. Nokho, ezinye zinonya futhi zinolaka. Ngokuvamile, ukuhlinzwa kuwukwelashwa kokuqala kwama-meningiomas akhula futhi abangele izimpawu.

I-Pineal Gland Tumors

I-pineal gland ijule ebuchosheni futhi ikhiqiza i-hormone melatonin, elawula ukulala. Izimila ze-pineal gland zingaba zimbi noma zibe yingozi. I-pineocytoma ne-pineoblastoma ihlanganisa izimila ze-pineal.

Ama-Tituational Tumors

Amathumba e-pituitary ngokuvamile ayizimila eziyingozi (ezingezona umdlavuza) ze-pituitary gland, ebizwa nangokuthi i-pituitary adenomas. Ingxenye eyinhloko yesistimu ye-endocrine, elawula ukukhula, i-pituitary gland. Ekhasini lethu le-pituitary tumor, funda kabanzi.

Sarcoma

Sarcomas, including cartilage, fat and muscle, are a broad category of tumors that form in the bones and soft tissues of the body. There are more common soft tissue scomcom than bone sarcomas. Types of bone sarcoma include the sarcoma and osteosarcoma of Ewing. Some gliomas have characteristics similar to sarcomas and are called gliosarcomas. Similar to glioblastomas, gliosarcomas act aggressively.

Ama-Sarcoma, kuhlanganise ne-chordoma, angase atholakale emgogodleni noma kusisekelo sogebhezi. I-Chordomas yizimila ezingavamile ze-sarcoma ezikhula ngaphansi komgogodla wogebhezi namathambo. Odokotela bakholelwa ukuthi bakhula besuka kumangqamuzana asele lapho isiguli sisakhula umbungu, asebenza njengohlaka lwesisekelo sogebhezi nomgogodla. Zingaphushela ebuchosheni futhi zidale izimpawu eziningi ezifanayo nezimila zobuchopho lapho ama-chordoma akheka ogebhezini lwekhanda, okuhlanganisa ubuhlungu bekhanda, isiyezi kanye nokudideka. Izinzwa eziningi ezibucayi kanye nemithambo yegazi ingabandakanyeka kuma-chordomas, okwenza kube nzima ukuyelapha. Ukwelashwa kungase kudinge ukusetshenziswa kokuhlinzwa okukhethekile, ukwelapha ngemisebe kanye/noma ukwelapha ngamakhemikhali.

Izici Eziyinhloko Zobungozi Be-Brain Tumor

Isici esiyingozi yinoma yini ekhulisa amathuba akho okuthola isimila ebuchosheni. Ucwaningo lusaqhubeka ngezimbangela zezimila zobuchopho kanye nezici zazo eziyingozi. Nakuba zingekho izici eziqondile zobungozi ezitholakele zezimila zobuchopho, ezinye izici zingase zikubeke engcupheni eyengeziwe, okuhlanganisa:

• Ukuchayeka emisebeni yangaphambili ebuchosheni, ngokuvamile njengokwelashwa komunye umdlavuza
• Umlando womndeni wezimo ezithile ezihlanganisa:
  • Uhlobo 1 lwe-Neurofibromatosis nohlobo 2
  • I-Tuberous sclerosis
  • von Hippel-Lindau isifo
  • Isifo se-Li-Fraumeni

Uma unomlando womndeni wezimo ezibalwe ngenhla, ezinye izinhlobo zamathumba obuchopho zingadluliswa zisuka kwesinye isizukulwane ziye kwesinye. Kuwena, ukwelulekwa ngofuzo kungase kulunge. Ekhasini lethu lokuhlola izakhi zofuzo, funda kabanzi mayelana nosongo kuwe nomndeni wakho.

Izimpawu zesimila ebuchosheni

Izimpawu ziyahlukahluka kuye ngendawo yesimila ebuchosheni, kodwa izinhlobo ezahlukene zezimila zobuchopho zingase zihambisane nalokhu okulandelayo:

• Ukuphathwa yikhanda okungase kube nzima kakhulu ekuseni noma kuvuse isiguli ebusuku
• ukuquleka or Ukudlikizela
• Ubunzima bokucabanga, ukukhuluma noma ukukhuluma
• Izinguquko zomuntu
• Ubuthakathaka noma ukukhubazeka engxenyeni eyodwa noma ohlangothini olulodwa lomzimba
• Ukulahlekelwa ibhalansi noma isiyezi
• Umbono uyashintsha
• Izinguquko zokuzwa
• Ukuba ndikindiki kobuso noma ukuluma
• Isicanucanu noma ukuhlanza, ubunzima bokugwinya
• Ukudideka nokudideka

Ukuxilongwa kwesimila ebuchosheni

Sophisticated methods of imagery can identify brain tumors. Computed tomography (CT or CAT scan) and imaging resonance magnetic (MRI) are diagnostic instruments (MRI). Based on the location of the normal nerve pathways of the brain, other MRI sequences can help the surgeon plan the tumor resection. Intraoperative MRI is also used to guide biopsies of tissues and tumor removal during surgery. The chemical profile of the tumor is examined and the nature of the lesions seen on the MRI is determined by magnetic resonance spectroscopy (MRS). Recurring brain tumors can be detected by positron emission tomography (PET scan).

Ngezinye izikhathi okuwukuphela kwendlela yokuthola ukuxilongwa okuqondile kwesimila sobuchopho ngokusebenzisa i-biopsy. I-neurosurgeon yenza i-biopsy bese i-pathologist ixilonga okokugcina, inquma ukuthi isimila sibonakala sisibi noma sibi, bese sisibeka ngokufanele.

Ukwelashwa Kwe-Brain Tumor

Amathumba ebuchosheni (kungakhathaliseki ukuthi ayinhloko noma ama-metastatic, ayingozi noma ayingozi) ngokuvamile aphathwa ngawodwa noma ngezinhlanganisela ezihlukahlukene, ngokuhlinzwa, ngemisebe, kanye/noma nokwelashwa ngamakhemikhali. Nakuba kuyiqiniso ukuthi imisebe yemisebe kanye nokwelashwa ngamakhemikhali kuvame ukusetshenziselwa izimila eziyingozi, ezisele noma eziphindelelayo, izinqumo zenziwa icala ngalinye futhi zincike ezintweni eziningi ukuthi iluphi uhlobo lokwelapha okufanele lusetshenziswe. Kunezingozi ezihlobene nohlobo ngalunye lokwelapha kanye nemiphumela engemihle.

Ukuhlinzwa kwesimila sobuchopho

Complete or almost complete surgical removal of a brain tumor is generally accepted to be beneficial for a patient. The challenge of the neurosurgeon is to remove as much tumor as possible without injuring brain tissue that is important for the neurological function of the patient (such as the ability to speak, walk, etc.). Traditionally, during a i-craniotomy, neurosurgeons open the skull to ensure they can reach the tumor and extract as much of it as possible. At the time of surgery, a drain (EVD) can be left in the brain fluid cavities to drain the normal brain fluid as the brain recovers from the surgery.

Enye inqubo evame ukwenziwa, ngokuvamile ngaphambi kwe-craniotomy, ibizwa ngokuthi i-stereotactic biopsy. Ukuze kwenziwe ukuxilongwa okunembile, le nqubo encane isiza odokotela ukuthi baqoqe izicubu. Uhlaka luvamise ukuxhunywa ekhanda lesiguli, kuthathwe iskena, bese isiguli siyiswa egunjini lokuhlinzelwa, lapho kubhojwa khona imbobo encane ogebhezini ukuze kuvunyelwe ukufinyelela endaweni engajwayelekile.

Ezinye izibhedlela zingenza le nqubo efanayo ngaphandle kokusebenzisa ifreyimu, kuye ngokuthi isilonda sikuphi. Ukuze kuhlaziywe ngaphansi kwe-microscope, isampula encane iyaqoqwa.

Imishini yekhompuyutha ebizwa ngokuthi ama-surgical navigation systems yasetshenziswa ekuqaleni kwawo-1990. I-neurosurgeon yayisekelwa yilawa madivayisi anesiqondiso, indawo yendawo kanye ne-tumor orientation. Lolu lwazi lwanciphisa ubungozi futhi lwandisa izinga lokususwa kwesimila. Ezimweni ezithile, amasistimu okuzulazula okuhlinza anikeze amandla ukunqunywa kwamathumba angasebenzi ngaphambilini anezingozi ezifanele. Ngaphandle kokudinga ukuxhuma ifreyimu kugebhezi, amanye alawa madivaysi angase asetshenziselwe ama-biopsies. Enye i-drawback yalezi zinhlelo ukuthi zisebenzisa i-scan (CT noma i-MRI) etholwe ukuqondisa udokotela ohlinzayo ngaphambi kokuhlinzwa. Ngakho-ke, abakwazi ukulandisa ngokunyakaza kobuchopho okungenzeka nge-intraoperative.

Ukusiza ukubuyekeza idatha yedivayisi yokuzulazula phakathi nokuhlinzwa, abaphenyi baklama amasu basebenzisa i-ultrasound futhi bahlinze izikena ze-MRI.

Ezigulini ezinamathumba athinta ukusebenza kolimi, njengama-gliomas amakhulu, abusa i-hemisphere-hemisphere, ukudwetshwa kwemephu yolimi ngaphakathi kokusebenza kubonakala kwabanye njengendlela ebaluleke kakhulu. Ukuhlinzwa esigulini esiphaphayo kanye nokwenza imephu ye-anatomy yomsebenzi waso wolimi ngesikhathi sokuhlinzwa kufakiwe kule nqubo. Khona-ke udokotela unquma ukuthi yiziphi izingxenye zesimila ezinempilo yokukhishwa kabusha. Ucwaningo lwakamuva lunqume ukuthi imephu yolimi lwekholamu ingasetshenziswa ukuthuthukisa ukukhishwa kwe-glioma kuyilapho kugcinwa amasayithi olimi abalulekile njengesijobelelo esivikelekile nesiphumelelayo.

Ezigulini ezithile zesimila ebuchosheni, kungase kudingeke i-ventriculoperitoneal shunting. Ngaphakathi kobuchopho nomgogodla, wonke umuntu unoketshezi lwe-cerebrospinal (CSF) olugeleza kancane ngaso sonke isikhathi. Amasaka aphethe uketshezi (ama-ventricles) angase avuvuke uma lokhu kugeleza kuvimbekile, kubangele ukwanda komfutho ngaphakathi kobuchopho, okubangele ukuphazamiseka okubizwa ngokuthi i-hydrocephalus. I-Hydrocephalus ingabangela ukulimala kwengqondo ngisho nokufa uma ingelashwa. Ukuqondisa kabusha uketshezi lomgogodla kude nobuchopho futhi ngaleyo ndlela kunciphise ingcindezi, udokotela ohlinzayo angase anqume ukusebenzisa i-shunt. I-peritoneal cavity ngokuvamile iyimbobo yomzimba lapho i-CSF iqondiswa khona kabusha (indawo ezungeze izitho zesisu). Ngokuvamile, i-shunt ingunaphakade. Uma ivinjiwe, izimpawu ziseduze nalezo ze-hydrocephalus disorder yokuqala futhi zingabandakanya, phakathi kokunye, ubuhlungu bekhanda, ukuhlanza, ubunzima bokubona kanye/noma ukukhathala noma ukukhathala. I-Endoscopic Third Ventriculostomy enye inqubo engasetshenziswa ukuqapha ukuvinjwa kwemigudu yoketshezi lobuchopho. Ngaphandle kwesidingo se-shunt, lokhu kuvumela uketshezi lobuchopho ukuthi luqondiswe kabusha ngokuvinjwa.

Ukwelashwa ngemisebe esimila ebuchosheni

Ukuze ucekele phansi amangqamuzana omdlavuza namangqamuzana obuchopho angajwayelekile futhi ashwabane izimila, ukwelashwa ngemisebe kusebenzisa ama-X-ray anamandla. Uma isimila singelashwa ngokwanele ngokuhlinzwa, ukwelashwa ngemisebe kungase kube enye indlela.

• Kusetshenziswa imishayo eminingi yemisebe I-Standard External Beam Radiotherapy ukusungula ukumbozwa ngokusemthethweni kwesimila kuyilapho ukhawulela ukuchayeka ezakhiweni ezizungezile ezijwayelekile. Ngezinhlelo zokulethwa ezithuthukisiwe, amathuba okulimala kwemisebe yesikhathi eside aphansi kakhulu. Ngaphandle kwe-3-dimensional conformal radiotherapy (3DCRT), izindlela zokulethwa kwesimanje zifaka i-radiotherapy ene-intensity-modulated (IMRT).
• Uhlobo oluthile lwemisebe lapho ama-proton, umthombo we-radioactivity, eqondiswe ngqo ku-tumor, isetshenziswa I-Proton Beam Therapy. Inzuzo iwukuthi ukulimala kubangelwa izicubu ezincane ezizungeze isimila.
• I-Stereotactic Radiosurgery (njenge-Gamma Knife, i-Novalis ne-Cyberknife) : Kuyindlela egxile esicubuni esiqondiwe esinemishayo eminingi ehlukene yemisebe. Le nqubo ibonakala yenza umonakalo omncane ezicutshini eziseduze zesimila. Okwamanje abukho ubufakazi obubonisa ukuthi indlela eyodwa yokulethwa ngokwemiphumela yomtholampilo iphakeme kunomunye, futhi ngayinye inezinzuzo zayo kanye nokubi.

I-Chemotherapy ku-brain tumor

I-Chemotherapy yezimila zezingane ezithile, i-lymphomas, namanye ama-oligodendroglioma ngokuvamile kuthathwa njengesebenzayo. Nakuba ukwelapha ngamakhemikhali kuye kwaboniswa ukuthuthukisa ukuphila okuphelele ezigulini ezinezimila zobuchopho eziyingozi kakhulu, lokho kwenza cishe ku-20% wazo zonke iziguli, futhi akulula ngodokotela ukubikezela ukuthi yiziphi iziguli ezizozuza ngaphambi kokwelashwa. Ngakho-ke, ngenxa yemiphumela emibi engase ibe khona, abanye odokotela bakhetha ukungasebenzisi i-chemotherapy (izibazi zamaphaphu, ukucindezelwa kwamasosha omzimba, isicanucanu, njll.).

Chemotherapy operates by causing damage to the cells that normal tissue repairs better than tumor tissue. Chemotherapy resistance may include the survival of tumor tissue that is unable to respond to the drug, or the drug’s inability to move into the brain from the bloodstream. There is a special barrier called the blood-brain barrier between the bloodstream and brain tissue. By destroying this barrier or by injecting the drug into the tumor or brain, some investigators have attempted to enhance the effect of chemotherapy. The purpose of another drug class is not to destroy the tumor cells, but rather to block further growth of the tumor. Development inhibitors (such as the umdlavuza webele treatment drug Tamoxifen) have been used in some cases to try to stop tumors from developing that are resistant to other treatments.

In 1996, the U.S. The use of chemotherapy-impregnated wafers, which can be used by a neurosurgeon at the time of surgery, has been approved by the Food and Drug Administration. The wafers slowly secrete the medication into the tumor, and with the systemic side effects of treatment, the patient receives chemotherapy.

I-Visualase

I-Laser thermal ablation iyindlela entsha esetshenziswa ezinye izikhungo ukwelapha izimila ezincane, ikakhulukazi ezindaweni lapho izinqubo zokuhlinzwa ezivulekile zangaphambilini kungase kube nzima ukufinyelela kuzo. Lokhu kuhlanganisa ukufaka i-catheter encane ngaphakathi kwesilonda, ngokunokwenzeka ukwenza i-biopsy, bese usebenzisa i-laser ukucisha isilonda ngokushisa. Le nqubo isetshenziswe kamuva nje ekwelapheni izimila zobuchopho, ngakho-ke ukusebenza kwesikhathi eside akuzange kubonakale.

Izindlela Zokwelapha Zokuphenya

Many types of new therapies are currently being studied, especially tumors for which the prognosis through established traditional therapies is typically low. Whether these treatments will work is unclear. These treatments are performed in accordance with a protocol and include various types of immunotherapy, selective toxin therapy, anti-angiogenesis therapy, gene therapy, and differentiation therapy. Combinations of therapies may also be able to boost patient outlook, while reducing adverse side effects.

Izidakamizwa zingafakwa ngqo ku-cerebrospinal fluid (CSF, uketshezi olugeza ubuchopho nomgogodla) kungaba sebuchosheni noma ku-canal yomgogodla ngaphansi komgogodla kwezinye izimila zobuchopho. Ukuze usize ngalokhu phakathi nokuhlinzwa okuncane, ishubhu elincanyana elaziwa ngokuthi i-catheter yokufinyelela i-ventricular ingase ifakwe embotsheni encane yogebhezi kanye nase-ventricle yobuchopho.

Ingasetshenziswa nini i-chemotherapy?

In general, for faster-growing brain tumors, chemo is used. Some types of brain tumors tend to respond to chemo better than others such as i-medulloblastoma and lymphoma. Chemo is not as effective in the treatment of many other types of cancers, such as tumors of the spinal cord, so it is used less often for these tumors.

I-Chemo, kanye nezinye izindlela zokwelapha ezinjengokuhlinzwa kanye/noma ukwelapha ngemisebe, isetshenziswa kakhulu. I-Chemo ingasetshenziswa yodwa, ikakhulukazi kumathumba asethuthuke kakhulu noma kumathumba abuye ngemuva kwezinye izindlela zokwelapha.

Izidakamizwa ze-Chemo ezisetshenziselwa ukwelapha izimila zobuchopho nomgogodla

Ezinye zezidakamizwa ze-chemo ezisetshenziselwa ukwelapha izimila zobuchopho nomgogodla zihlanganisa:

• I-Carboplatin
• I-Carmustine (BCNU)
• Cisplatin
• ICyclophosphamide
• I-Etoposide
• I-Irinotecan
• I-Lomustine (CCNU)
• I-Methotrexate
• I-Procarbazine
• I-Temozolomide
• UVincristine

Kuye ngohlobo lwesimila ebuchosheni, le mithi ingasetshenziswa yodwa noma izinhlanganisela. I-Chemo ilethwa ngezigaba, isigaba ngasinye sokwelashwa sihambisana nesikhathi sokuphumula ukuze kuvunyelwe isikhathi somzimba ukuthi ululame. Ngokuvamile, umjikelezo ngamunye uhlala amasonto ambalwa.

I-Carmustine (Gliadel) wafers : Umuthi we-chemo i-Carmustine uhlanganisa lawa ma-wafers ancibilikayo (BCNU). Ama-wafers kufanele abekwe ngokuqondile noma eduze kwezingxenye zesimila ezingakwazi ukususwa ngemva kokuba udokotela ohlinzayo ekhiphe ingxenye enkulu yesimila ebuchosheni ngangokunokwenzeka phakathi ne-craniotomy. Lolu hlobo lokwelapha lugxilisa umuthi endaweni yesimila, ngokungafani ne-IV noma i-chemo yomlomo engena kuzo zonke izindawo zomzimba, ibangele imiphumela engemihle emincane kwezinye izingxenye zomzimba.

Imiphumela emibi engaba khona ye-chemotherapy

Imiphumela engemihle ingabangelwa imithi ye-chemo. Lokhu kuncike efomini nesilinganiso somuthi kanye nobude bokwelashwa. Imiphumela engemihle evamile ingabandakanya:

• Ukulahlekelwa izinwele
• Izilonda zomlomo
• Ukulahlekelwa kwesifiso
• I-nausea nokuhlanza
• Uhudo
• Ukwanda kwamathuba okutheleleka (kusukela ekubeni namaseli amhlophe egazi ambalwa kakhulu)
• Ukulimala kalula noma ukopha (ngenxa yokuba nama-platelet egazi ambalwa kakhulu)
• Ukukhathala (ukuba namaseli abomvu egazi ambalwa kakhulu, izinguquko kumetabolism, noma ezinye izici)

Eminye yemithi ephumelela kakhulu ngokumelene nezimila zobuchopho ivame ukuba nemiphumela engemihle embalwa kunezinye izidakamizwa ezivamile ze-chemo. Imiphumela eminingi engemihle ngokuvamile iyaphela ngemva kokuphela kokwelashwa. Kuvame ukuba nezindlela zokunciphisa le miphumela emibi. Isibonelo, izidakamizwa ngokuvamile zingasiza ukuvimbela noma ukunciphisa isicanucanu nokuhlanza.

Ezinye izidakamizwa ze-chemo nazo zingadala ezinye, imiphumela engemihle engavamile. Isibonelo, i-cisplatin ne-carboplatin nazo zingadala ukulimala kwezinso nokulahlekelwa ukuzwa. Udokotela wakho uzohlola ukusebenza kwezinso zakho kanye nokuzwa uma uthola le mithi. Eminye yale miphumela engemihle ingase ihlale ngemva kokumiswa kokwelashwa.

Qiniseka ukuthi ubika noma yimiphi imiphumela emibi ethimbeni lakho lezokwelapha ngenkathi uthola i-chemo, ukuze welashwe ngokushesha. Kwesinye isikhathi, imithamo yemithi ingase idinge ukuncishiswa noma ukwelashwa kungase kudingeke ukubambezelwe noma kumiswe ukuze kuvinjelwe imiphumela ukuba ibe mibi kakhulu.

I-Immunotherapy esimila ebuchosheni

I-Immunotherapy inikeza izinketho zokwelashwa komdlavuza wobuchopho ezithembisayo, ngokwesiko ukwelashwa ngamakhemikhali, ukwelashwa ngemisebe, nokuhlinzwa. I-Temozolomide (Temodar®) chemotherapy yavunywa ngo-2005 ukuze zelashwe iziguli ezisanda kutholwa ezine-glioblastoma (GBM) ngesisekelo sohlolo lomtholampilo lwesigaba III esingahleliwe olubonisa ukuthi lwengeze izinyanga ezingu-2.5 ekusindeni kwesiguli esimaphakathi. Ngaphezu kwe-50% yamathumba e-GBM, nokho, akhiqiza iphrotheni yokulungisa i-DNA ebizwa ngokuthi i-MGMT (methylguanine methyltransferase) eyenza i-chemotherapy ingasebenzi kahle nge-temozolomide. Lezi ziguli zithola inzuzo encane yokwelapha lapho i-temozolomide yengezwa ekwelashweni kwazo.

I-Immunotherapy uhlobo lokwelapha olusiza ukubulala amangqamuzana omdlavuza ngokusebenzisa amasosha omzimba womuntu. Ngomdlavuza wobuchopho nowohlelo lwezinzwa, okwamanje kunezinketho ezimbili ezigunyazwe yi-FDA ze-immunotherapy.

Ama-antibodies Aqondisiwe

• I-Bevacizumab (Avastin®): i-monoclonal antibody eqondise indlela ye-VEGF/VEGFR futhi ivimbele ukukhula kwemithambo yegazi yesimila; kugunyazwe i-glioblastoma ethuthukisiwe.
• IDinutuximab (Unituxin®): a monoclonal antibody that targets the GD2 pathway; approved for first-line treatment of high-risk pediatric i-neuroblastoma.