Uhlelo lwesibili lwe-2016 NCCN Guidelines for Small Cell Lung Cancer (V2.2016) ikakhulukazi lubuyekeza izingxenye ezilandelayo ngokusekelwe ku-V2.2015:
Ukubuyekezwa kwesigaba sokuqala somdlavuza wamaphaphu
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I-SCL-2: Ezinye iziguli zingakhethelwa i-bone marrow aspiration. Inqubo yokukhetha ihlanganisa: ama-erythrocyte (RBC) anama-lobe ku-peripheral blood smear, i-neutropenia, noma i-thrombocytopenia, okuyisici sokungena komnkantsha we-tumor.
Ukubuyekezwa Kokwelashwa Kwasekuqaleni (SCL-5)
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Izinga lobufakazi be-intracranial preventive radiotherapy (PCI) ezigulini ezine-SCLC ebanzi lehlisiwe ukusuka ku-1 kuya ku-2A.
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I-Chest radiotherapy ingasetshenziswa njengendlela yokwelapha iziguli ezinezigaba eziningi ezahlukene.
Izimiso ze-chemotherapy zomdlavuza omncane wamaphaphu (SCL-C)
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I-Bendamustine ingasetshenziswa njengendlela yokwelashwa yomugqa wesibili, izinga lobufakazi 2B.
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Khansela ukwelashwa kwe-dosing kwezinsuku ezi-5 kwe-temozolomide.
Izimiso Zokwelapha Ngomsakazo Womdlavuza Weseli Encane Wamaphaphu (SCL-D)
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I-Radiotherapy yamaphaphu yamathumba esiteji esikhulu. Incazelo yento ye-1 yaguqulelwa ku-: “I-radiotherapy yokuhlanganiswa kwamaphaphu ingase izuze iziguli ezineziguli ze-SCLC ezikhethwe isikhathi eside futhi ziphendule ku-chemotherapy. Ucwaningo luye lwabonisa ukuthi iziguli zinokuqiniswa okuhle komdlavuza wamaphaphu Ukubekezelelana, kunganciphisa izinga lokuphindaphinda kwamaphaphu anezimpawu, futhi kungandisa isikhathi eside sokuphila kwezinye iziguli. Ukuhlolwa komtholampilo okungahleliwe kwe-CREST eJalimane kukhombisa ukuthi i-radiotherapy yesifuba enedosi emaphakathi ingathuthuka ezigulini ze-SCLC ezinesigaba esibanzi futhi zisebenza ngempumelelo ku-chemotherapy Izinga lokusinda leminyaka emi-2 kanye ne-PFS yezinyanga eziyisi-6, nakuba isiphetho esiyinhloko socwaningo, unyaka ongu-1 usuwonke. ukusinda, akuzange kukhule kakhulu. “
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I-Prophylactic craniocerebral radiotherapy (PCI), ukungena kwe-1 kwashintshwa kwaba: “Ezigulini ze-SCLC ezinezigaba ezilinganiselwe noma ezibanzi ezisabela kahle ku-chemotherapy, i-PCI inganciphisa izinga le-metastasis yobuchopho futhi ithuthukise ukusinda okuphelele. Kodwa-ke, naphezu kokuhola Ucwaningo lomtholampilo olungahleliwe lwe-PCI lubonise ukuthi i-PCI inganciphisa izinga lama-metastases ebuchosheni. Imiphumela yokuqala yocwaningo lwaseJapane ibonise ukuthi iziguli ezingenawo ama-metastases obuchopho aqinisekiswe yi-MRI azizange zibe nenzuzo enkulu ngemva kwe-PCI. Ezigulini ezingayitholi i-PCI, ukulandelela okuvamile kufanele kubhekwe njengokuhlolwa kwe-Brain imaging. “
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I-Prophylactic craniocerebral radiotherapy (PCI), ukungena kwe-2 kwaguqulwa kwaba: “Kunconyiwe: Umthamo we-PCI we-radiotherapy yobuchopho bonke kufanele ube yi-25Gy ihlukaniswe ngama-irradiation angu-10, i-30Gy ihlukaniswe ngama-irradiation angu-10-15, noma i-24Gy ihlukaniswe imisebe ye-8. Inkambo yokwelashwa emfushane (Isibonelo, i-20Gy ihlukaniswe yaba ukuchayeka okungu-5) ingase ifaneleke kakhulu ezigulini ezinohlu olubanzi lweziguli. Ucwaningo lwe-PCI99-01 luthole ukuthi iziguli ezithola imithamo ye-36Gy zinokufa okuphezulu kanye ne-neurotoxicity engapheli kuneziguli ezine-25Gy.
