Ua ʻike paha ʻoe he paʻakikī loa ka mālama ʻana i ka maʻi kanesa ke laha mai kekahi ʻāpana o ke kino a i kekahi. Akā mahalo i nā holomua o ka lāʻau lapaʻau i kēia lā, aia nā lāʻau lapaʻau kūikawā e hiki ke kuhikuhi i nā hunaola kanesa e like me ka missile a hōʻino wale iā lākou. I kēia lā, ke kamaʻilio nei mākou e pili ana i kahi ʻano lapaʻau holomua loa i hoʻohana ʻia e mālama i kahi ʻano maʻi kanesa i kapa ʻia ʻo 'neuroendocrine tumors (NETs). Ua kapa ʻia kēia ʻo PRRT, ʻo ia hoʻi ke kū nei no 'Peptide Receptor Radionuclide Therapy'.
I ka ʻōlelo maʻalahi, he aha ka lāʻau lapaʻau PRRT?
He lāʻau lapaʻau maʻi kanesa i kuhikuhi ʻia ka PRRT. Pili ia i ka hoʻouna ʻana i kahi mea radioactive pololei i loko o nā hunaola kanesa a me ka luku ʻana iā lākou. E noʻonoʻo e like me ka pepehi koho ʻana i nā hunaola kanesa me ka ʻole o ka hōʻeha ʻana i nā hunaola olakino i loko o ko kākou kino.
Pehea kēia e hana ai? He mea kupaianaha!
I mea e hoʻomaopopo ai i kēia, e lawe kākou i kahi laʻana liʻiliʻi. Loaʻa i kēlā me kēia cell kanesa nā mea loaʻa kūikawā ma kona ʻili, e like me ka puka kī ma ka puka. Ke hui pū nā protein kūikawā e kūlike me kēia mau mea loaʻa e like me ke kī, e wehe ʻia ka puka e hoʻokuʻu i nā mea i loko o ke kelepona.
Eia ka hana a ka lāʻau lapaʻau PRRT:
1. Ke hana ʻana i ke "kī": Hoʻokumu ʻia kahi protein (peptide) e kūlike pono me nā mea loaʻa ma ka ʻili o nā hunaola kanesa ma ka hale hana.
2. Ke hoʻopili ʻana i ka "pōkā": A laila, ua hoʻopili ʻia kahi mea radioactive i kapa ʻia ʻo radionuclide, ka mea e pepehi maoli i ke kelepona kanesa, i ka protein i hana ʻia.
3. Ka huakaʻi ʻana i ka pahuhopu: Ke hoʻokomo ʻia kēia lāʻau i loko o ke kino, loaʻa i ka protein kona ala a hoʻopaʻa i nā mea loaʻa ma nā hunaola kanesa.
4. Ka luku ʻia ʻana o ke kelepona kanesa: E like me ke kī e wehe ana i ka puka, ke hoʻopaʻa ka protein i ka mea loaʻa, komo ka lāʻau radioactive i loko o ke kelepona. Ke komo i loko, ʻo ka radioactivity i hoʻokuʻu ʻia e ia e hōʻino i ka DNA o ke kelepona kanesa, e luku ana i ke kelepona mai loko mai.
ʻO ka pōmaikaʻi nui o kēia ʻano hana, ʻo ia ke kuhikuhi wale nei i nā hunaola kanesa, no laila ua liʻiliʻi ka hōʻino ʻana i nā hunaola olakino a puni.
He aha nā ʻano PRRT i hoʻohana ʻia ma ka honua?
ʻO ka lāʻau PRRT nui i ʻāpono ʻia ma ka honua a hiki i kēia manawa ʻo ia ka `lutetium Lu 177 dotatate (LUTATHERA®).` Ma kēia, ua hoʻopili ʻia ka `dotatate`, kahi protein synthetic, i ka element radioactive `lutetium-177`.
Ua like kēia protein i kapa ʻia ʻo `dotatate` me ka hormone `somatostatin` i loko o ko kākou kino. Loaʻa i kekahi mau cell cancer ʻano `NET` nā mea loaʻa kikoʻī no kēia hormone `somatostatin`. Hele kēia protein i kapa ʻia ʻo `dotatate` i kēlā mau mea loaʻa a pipili paʻa. No laila, hele pololei ka lāʻau i loko o ke cell cancer.
Eia kekahi, ke noiʻi ʻia nei nā hui PRRT ʻē aʻe, a ʻo kekahi o ia mau mea ua kau ʻia i nā hoʻokolohua lapaʻau.
No wai kēia lāʻau lapaʻau PRRT e kūpono ai?
I kēia manawa, hoʻohana nui ʻia ka lāʻau lapaʻau PRRT no nā maʻi kanesa i kapa ʻia ʻo 'gastroenteropancreatic NETs', ʻo ia hoʻi nā maʻi kanesa e ulu ana i loko o ke ala ʻai. Eia kekahi laʻana:
- ʻO ka pancreas
- ʻUmiʻumi
- Nā ʻōpū liʻiliʻi a me nā ʻōpū nui
- ʻōpū
Inā kūpono kēia lāʻau lapaʻau no kekahi kanaka, pili ia i kekahi mau kumu. E nānā i ka papa ma lalo.
| Kūlana | Wehewehena |
|---|---|
| ʻAʻole kūpono no ke ʻoki kino | Inā ua pālahalaha ke kanesa ( metastasized ) i nā wahi he nui o ke kino, he paʻakikī ke ho'ōla me ke ʻoki kino wale nō. No nā poʻe he nui i ʻike ʻia me ka maʻi kanesa NET, ua pālahalaha mua ke kanesa. |
| ʻAʻole hiki ke pane i nā lāʻau lapaʻau ʻē aʻe | Inā ʻaʻole hiki ke ʻoki ʻia, hāʻawi pinepine ʻia ka lāʻau lapaʻau hormone. Eia nō naʻe, i kekahi poʻe, hoʻomau ka ulu ʻana o nā puʻupuʻu me ka ʻole o ka hoʻomalu ʻia ʻana me kēia mau lāʻau lapaʻau. |
| Ke alo o nā mea loaʻa Somatostatin i loko o nā pūnaewele kanesa | ʻO kēia ka mea nui loa. I mea e hana ai ka lāʻau PRRT, pono i nā hunaola kanesa ke loaʻa kēlā mau mea loaʻa kūikawā. E hana kāu kauka i kahi scan kūikawā, e like me ka octreotide scan, e hōʻoia inā loaʻa kēia mau mea loaʻa. |
Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?
Inā ʻoe e lawe nei i nā lāʻau lapaʻau ʻē aʻe no ka maʻi ʻaʻai NET, hiki i kāu kauka ke aʻo aku iā ʻoe e hoʻōki i kekahi o lākou ma mua o ka mālama ʻana iā PRRT.
- ʻO ka maʻamau, pono e hoʻōki ʻia nā inikini somatostatin hana lōʻihi ma ka liʻiliʻi he 4 mau pule ma mua o ka mālama ʻana.
- Ua hiki paha ke hoʻōki ʻia nā inikini somatostatin hana pōkole 24 mau hola ma mua o ka mālama ʻana.
- Eia kekahi, pono ʻoe e pale i ka lawe ʻana i nā steroids kiʻekiʻe e like me glucocorticosteroids i ka wā o kēia mālama ʻana.
I hoʻokahi pule ma mua o kēlā me kēia lāʻau lapaʻau, e hana ʻia kekahi mau hoʻāʻo koko e ʻike ai inā ua mākaukau kou kino no ia.
He aha ka mea e hana ʻia i ka lā o ka mālama ʻana?
ʻO ka maʻamau, hāʻawi ʻia ka lāʻau PRRT i kēlā me kēia ʻelua mahina no 4 mau kau ma luna o 8 mau mahina. He hana outpatient kēia, ʻo ia hoʻi, ʻaʻole pono ʻoe e noho i ka haukapila. ʻO ka lōʻihi o ke kaʻina hana holoʻokoʻa ma kahi o 5-6 mau hola.
1. ʻO ka mea mua, e hoʻokomo ʻia kahi cannula intravenous (IV) i loko o kahi aa koko ma kou lima.
2. Hāʻawi ʻia ka lāʻau lapaʻau e pale aku i ka nausea a me ka luaʻi ʻana i hoʻokahi hola ma mua o ka hoʻomaka ʻana o ka lāʻau lapaʻau.
3. A laila, e hāʻawi ʻia ʻoe i kahi hopena amino acid ma o kahi IV no kahi o 4 mau hola e pale ai i kou mau puʻupaʻa.
4. Ma kahi o 30 mau minuke ma hope o ka hoʻomaka ʻana o ka hopena amino acid, hāʻawi ʻia ka lāʻau lapaʻau PRRT ma o kahi IV ʻokoʻa ma luna o 30-45 mau minuke.
5. Ma hope o ka lawelawe ʻia ʻana o nā hoʻonā a pau, e wehe ʻia ka IV cannula.
I ka lā ma hope o ka lāʻau lapaʻau, hana ʻia kahi scan kūikawā e ʻike ai pehea i laha ai ka lāʻau lapaʻau ma ke kino holoʻokoʻa.
He aha nā pono a me nā pilikia o ka mālama ʻana iā PRRT?
He aha nā pono?
He lāʻau lapaʻau holomua loa ka PRRT. I loko o nā poʻe he nui e loaʻa ana iā ia, nalowale a oki paha ko lākou ulu ʻana i nā puʻupuʻu. ʻAe kēia i nā mea maʻi e ola lōʻihi a mālama i kahi ola maikaʻi .
Akā, hoʻokahi mea e hoʻomanaʻo ai, ʻaʻole ʻo PRRT ka lāʻau lapaʻau no ka maʻi kanesa. No nā kānaka he nui, hiki i ke kanesa ke hoʻi hou mai ma hope o kekahi manawa.
Nā pilikia a me nā hopena ʻaoʻao
ʻO ka luaʻi a me ka nausea nā hopena ʻaoʻao maʻamau o kēia lāʻau lapaʻau, akā hiki ke hoʻomalu nui ʻia e ka lāʻau i hāʻawi ʻia ma mua o ka lāʻau lapaʻau.
ʻO nā pilikia ʻē aʻe e hiki ke hana ʻia:
- Nā pilikia o ka puʻupaʻa a i ʻole ke akepaʻa.
- Haʻahaʻa ka helu o nā hunaola koko. Hiki i kēia ke hoʻopilikia i ka hanu ʻana, hoʻonui i ka pilikia o nā maʻi, a me ke kahe ʻana o ke koko a i ʻole ka palapū.
- Aia kahi pilikia kakaikahi loa o ka hoʻomohala ʻana i nā maʻi ʻaʻai koko e like me ka myelodysplastic syndrome a me ka leukemia.
E nānā kāu kauka iā ʻoe me nā hoʻāʻo koko maʻamau i loko o nā mahina 8 o ka mālama ʻana. Inā kū mai kekahi pilikia, e hoʻoholo ʻo ia e hoʻololi a hoʻōki paha i kāu mālama ʻana.
ʻO ke kūlana wikiwiki loa: Ka pilikia Carcinoid
He kūlana kakaikahi kēia akā koʻikoʻi, a hiki ke hoʻoweliweli i ke ola. Hoʻokumu ʻia ia e ka piʻi koke ʻana o nā hormones mai nā hunaola kanesa. ʻIke pinepine ʻia nā hōʻailona i loko o 48 mau hola o ka loaʻa ʻana o ka lāʻau lapaʻau.
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.
* Paʻakikī ka hanu ʻana
* ʻUlaʻula a wela paha ka ʻili ma ka maka a i ʻole ka ʻāʻī (flushing)
* Ke koko haʻahaʻa (Hypotension)
* Palpitations (puʻuwai wikiwiki)
* Ka maʻi pākī nui
Hoʻōla hou a me ke ola o kēlā me kēia lā
Hoʻomanawanui maikaʻi ka hapa nui o ka poʻe i ka mālama ʻana iā PRRT a hoʻōla koke.
Hiki iaʻu ke hoʻi i ka hana?
Hoʻohana ʻo PRRT i kahi liʻiliʻi loa o ka mea radioactive. Hoʻokuʻu ʻia kēia mea radioactive mai kou kino i loko o kou mimi a me ka ʻōpala no kekahi mau lā ma hope o ka mālama ʻana. E aʻo aku kāu kauka iā ʻoe e noho ma ka liʻiliʻi he hoʻokahi mika ka mamao mai nā poʻe ʻē aʻe i kēia manawa, ʻoiai nā wahine hāpai a me nā keiki ʻōpio . He mea nui hoʻi e holoi pinepine i kou mau lima.
Hiki ke hele i kēia manawa?
Aia paha he liʻiliʻi loa ka nui o ka radiation i loko o kou kino a hiki i 3 mau mahina ma hope o kāu mālama ʻana. Hiki ke ʻike ʻia kēia e nā lako hana nānā radiation ma nā kahua mokulele, no ka laʻana. E hāʻawi kāu kauka iā ʻoe i kahi kāleka kūikawā e hōʻike kikoʻī ana i ka mālama ʻana āu i loaʻa ai. He mea nui e mālama i kēia kāleka a me kahi kope o kāu mau memo mālama me ʻoe ma nā wahi āpau āu e hele ai a hiki i 3 mau mahina ma hope o kāu mālama ʻana.
Leka Lawe-Home
- ʻO ka PRRT kahi ʻano lapaʻau holomua e pili ana i nā hunaola kanesa wale nō a hoʻohana i ka radiation e luku iā lākou.
- Hoʻohana nui ʻia ia no nā ʻōpū neuroendocrine (NETs) i pālahalaha a puni ke kino a ʻaʻole pane i ke ʻoki ʻana a i ʻole nā lāʻau ʻē aʻe.
- ʻOiai ʻaʻole kēia he lāʻau e hoʻōla piha ai i ka maʻi kanesa, he mea kōkua nui ia i ka kaohi ʻana i ka maʻi a me ka hoʻomaikaʻi ʻana i ka manawa ola a me ke ʻano o ke ola.
- He mea nui e hahai i nā ʻōlelo a ke kauka e pale iā ʻoe iho mai ka radiation no kekahi mau lā ma hope o ka lāʻau lapaʻau.
- Inā loaʻa iā ʻoe nā hōʻailona o ka Carcinoid Crisis , e like me ka paʻakikī o ka hanu ʻana, ka ʻulaʻula o ka ʻili, a me ka wikiwiki o ka puʻuwai, e hele koke i ka Emergency Department (ETU) o ka haukapila .
- Inā kū mai kekahi mau pilikia a i ʻole nā hopena ʻaoʻao e pili ana i ka lāʻau lapaʻau, e kamaʻilio me kāu kauka e pili ana i ia mea.
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