Tej zaum koj yuav paub tias kev kho mob qog noj ntshav thaum nws kis los ntawm ib feem ntawm lub cev mus rau lwm qhov yog qhov nyuaj heev. Tab sis ua tsaug rau kev nce qib hauv kev kho mob niaj hnub no, muaj kev kho mob tshwj xeeb uas tuaj yeem tsom mus rau cov hlwb qog noj ntshav zoo li lub foob pob hluav taws thiab tsuas yog ua rau lawv puas tsuaj. Niaj hnub no, peb tab tom tham txog txoj kev kho mob siab heev uas siv los kho ib hom qog noj ntshav hu ua 'neuroendocrine tumors (NETs). Qhov no hu ua PRRT, uas sawv cev rau 'Peptide Receptor Radionuclide Therapy'.
Hais yooj yim xwb, kev kho mob PRRT yog dab tsi?
PRRT yog kev kho mob qog noj ntshav uas tsom mus rau ib qho chaw. Nws cuam tshuam nrog kev xa cov tshuaj radioactive ncaj qha mus rau hauv cov qog noj ntshav thiab rhuav tshem lawv. Xav txog nws zoo li xaiv tua cov qog noj ntshav yam tsis ua rau cov qog noj ntshav zoo hauv peb lub cev puas tsuaj.
Qhov no ua haujlwm li cas? Zoo kawg nkaus li!
Yuav kom nkag siab qhov no, cia peb muab ib qho piv txwv me me. Txhua lub cell mob qog noj ntshav muaj cov receptors tshwj xeeb ntawm nws qhov chaw, zoo li lub qhov rooj tseem ceeb hauv lub qhov rooj. Thaum cov protein tshwj xeeb uas phim cov receptors no tsuas yog sib koom ua ke zoo li tus yuam sij, lub qhov rooj qhib kom cia cov khoom nkag mus rau hauv lub cell.
Nov yog qhov kev kho mob PRRT ua:
1. Tsim "tus yuam sij": Ib qho protein (peptide) uas phim cov receptors ntawm qhov chaw ntawm cov hlwb qog noj ntshav tau tsim nyob rau hauv chav kuaj mob.
2. Txuas lub "foob pob": Tom qab ntawd, ib qho khoom siv hluav taws xob hu ua radionuclide, uas tua tau lub cell mob qog noj ntshav, raug txuas rau cov protein uas tau tsim.
3. Kev Mus Ncig Mus Rau Lub Hom Phiaj: Thaum cov tshuaj no raug txhaj rau hauv lub cev, cov protein nrhiav nws txoj kev thiab khi rau cov receptors ntawm cov hlwb qog noj ntshav.
4. Kev rhuav tshem lub cell mob qog noj ntshav: Ib yam li tus yuam sij qhib lub qhov rooj, thaum cov protein khi rau lub receptor, cov tshuaj radioactive nkag mus rau hauv lub cell. Thaum nkag mus rau hauv, cov radioactivity uas nws tso tawm ua rau lub cell mob qog noj ntshav DNA puas tsuaj, thiab rhuav tshem lub cell los ntawm sab hauv.
Qhov zoo tshaj plaws ntawm txoj kev no yog tias nws tsuas yog tsom rau cov hlwb qog noj ntshav xwb, yog li qhov kev puas tsuaj rau cov hlwb noj qab haus huv nyob ib puag ncig yog tsawg heev.
Cov hom PRRT twg siv hauv ntiaj teb?
Cov tshuaj PRRT tseem ceeb uas tau pom zoo hauv ntiaj teb txog tam sim no yog 'lutetium Lu 177 dotatate (LUTATHERA®).' Hauv qhov no, 'dotatate', ib qho protein tsim, txuas nrog rau cov khoom siv radioactive 'lutetium-177'.
Cov protein no hu ua 'dotatate' zoo ib yam li cov tshuaj hormone 'somatostatin' hauv peb lub cev. Qee cov hlwb qog noj ntshav hom 'NET' muaj cov receptors tshwj xeeb rau cov tshuaj 'somatostatin' no. Cov protein no hu ua 'dotatate' mus rau cov receptors ntawd thiab lo rau nruj nreem. Yog li ntawd, cov tshuaj mus rau hauv cov hlwb qog noj ntshav.
Tsis tas li ntawd xwb, lwm cov tshuaj PRRT tseem tab tom raug tshawb fawb, qee qhov twb nyob hauv kev sim tshuaj lawm.
Kev kho mob PRRT no haum rau leej twg?
Tam sim no, kev kho mob PRRT feem ntau yog siv rau cov mob qog noj ntshav hu ua 'gastroenteropancreatic NETs', uas yog cov mob qog noj ntshav uas tshwm sim hauv txoj hnyuv plab. Piv txwv li:
- Pancreas
- Qhov quav
- Cov hnyuv me thiab cov hnyuv loj
- Plab
Seb qhov kev kho mob no puas haum rau ib tus neeg nyob ntawm ntau yam. Saib lub rooj hauv qab no.
| Xwm txheej | Kev piav qhia |
|---|---|
| Tsis tsim nyog rau kev phais mob | Yog tias tus mob qog nqaij hlav tau kis mus rau ntau qhov chaw hauv lub cev, nws nyuaj rau kho nrog kev phais xwb. Rau ntau tus neeg uas kuaj pom tias muaj mob qog nqaij hlav NET, tus mob qog nqaij hlav twb kis mus rau lwm qhov lawm. |
| Tsis teb rau lwm yam kev kho mob | Yog tias phais tsis tau, feem ntau yuav muab kev kho mob hormone. Txawm li cas los xij, rau qee tus neeg, cov qog nqaij hlav tseem loj hlob tsis tuaj yeem tswj tau txawm tias muaj kev kho mob no los xij. |
| Muaj Somatostatin receptors hauv cov hlwb qog noj ntshav | Qhov no yog qhov tseem ceeb tshaj plaws. Rau cov tshuaj PRRT kom ua haujlwm tau, cov hlwb qog nqaij hlav yuav tsum muaj cov receptors tshwj xeeb. Koj tus kws kho mob yuav ua qhov kev luam theej tshwj xeeb, xws li kev luam theej octreotide, kom paub tseeb tias cov receptors no puas muaj. |
Koj npaj li cas ua ntej kev kho mob?
Yog tias koj twb noj lwm yam tshuaj rau mob qog noj ntshav NET lawm, koj tus kws kho mob yuav qhia koj kom tsum tsis txhob noj qee yam tshuaj ntawd ib ntus ua ntej kho PRRT.
- Feem ntau, kev txhaj tshuaj somatostatin uas ua haujlwm ntev yuav tsum tau tsum tsawg kawg 4 lub lis piam ua ntej kev kho mob.
- Tej zaum yuav tsum tsis txhob txhaj tshuaj somatostatin ua haujlwm luv luv 24 teev ua ntej kev kho mob.
- Tsis tas li ntawd, koj yuav tsum tsis txhob noj cov tshuaj steroids ntau xws li glucocorticosteroids thaum lub sijhawm kho mob no.
Ib lub lim tiam ua ntej txhua qhov kev kho mob, koj yuav muaj ntau qhov kev kuaj ntshav kom pom tias koj lub cev puas npaj txhij rau nws.
Muaj dab tsi tshwm sim rau hnub kho mob?
Kev kho mob PRRT feem ntau yog muab txhua ob lub hlis rau 4 zaug hauv lub sijhawm 8 lub hlis. Qhov no yog kev kho mob sab nraud, txhais tau tias koj tsis tas yuav nyob hauv tsev kho mob. Tag nrho cov txheej txheem siv sijhawm li 5-6 teev.
1. Ua ntej, yuav muab ib rab koob txhaj tshuaj (IV) tso rau hauv cov leeg ntshav hauv koj txhais caj npab.
2. Muab tshuaj rau kom tsis txhob xeev siab thiab ntuav ib teev ua ntej pib kho mob.
3. Tom qab ntawd, koj yuav tau txais cov kua amino acid los ntawm IV li ntawm 4 teev los tiv thaiv koj lub raum.
4. Kwv yees li 30 feeb tom qab pib siv cov tshuaj amino acid, cov tshuaj PRRT raug muab los ntawm kev txhaj tshuaj IV sib cais rau lub sijhawm 30-45 feeb.
5. Tom qab muab tag nrho cov tshuaj lawm, ces muab lub raj IV tshem tawm.
Hnub tom qab kev kho mob, yuav muaj kev tshuaj xyuas tshwj xeeb los saib seb cov tshuaj tau kis mus thoob plaws lub cev li cas.
Cov txiaj ntsig thiab kev pheej hmoo ntawm kev kho mob PRRT yog dab tsi?
Cov txiaj ntsig yog dab tsi?
PRRT yog ib txoj kev kho mob zoo heev. Hauv ntau tus neeg uas tau txais nws, lawv cov qog nqaij hlav ploj mus lossis tsis loj hlob lawm. Qhov no tso cai rau cov neeg mob kom nyob ntev dua thiab tswj tau lub neej zoo .
Tiam sis muaj ib qho uas yuav tsum nco ntsoov yog tias PRRT tsis yog kev kho mob qog noj ntshav. Rau ntau tus neeg, qog noj ntshav tuaj yeem rov qab los tom qab ib ntus.
Kev pheej hmoo thiab cov kev mob tshwm sim
Ntuav thiab xeev siab yog cov kev mob tshwm sim tam sim ntawd feem ntau ntawm kev kho mob no, tab sis feem ntau lawv tuaj yeem tswj tau los ntawm cov tshuaj uas tau muab ua ntej kev kho mob.
Lwm yam teeb meem uas yuav tshwm sim tau yog:
- Teeb meem raum lossis siab.
- Cov qe ntshav tsawg. Qhov no tuaj yeem ua rau ua pa nyuaj, muaj feem kis kab mob ntau dua, thiab los ntshav lossis mob nqaij.
- Muaj ib qho kev pheej hmoo tsawg heev uas yuav muaj mob qog ntshav xws li myelodysplastic syndrome thiab leukemia.
Koj tus kws kho mob yuav saib xyuas koj nrog kev kuaj ntshav tsis tu ncua thoob plaws 8 lub hlis ntawm kev kho mob. Yog tias muaj teeb meem tshwm sim, nws yuav txiav txim siab hloov lossis tsum koj txoj kev kho mob.
Qhov xwm txheej ceev tshaj plaws: Carcinoid Crisis
Qhov no yog ib qho mob uas tsis tshua muaj tab sis loj heev, uas yuav ua rau tuag taus. Nws yog tshwm sim los ntawm kev nce ntxiv ntawm cov tshuaj hormones los ntawm cov hlwb qog nqaij hlav. Cov tsos mob feem ntau tshwm sim hauv 48 teev tom qab tau txais kev kho mob.
Yog tias koj muaj ib qho ntawm cov tsos mob no, mus rau chav kho mob ceev (ETU) ze tshaj plaws tam sim ntawd.
* Ua pa nyuaj
* Liab los yog kub hnyiab ntawm daim tawv nqaij ntawm lub ntsej muag los yog caj dab (ntxhov siab)
* Ntshav siab qis (Hypotension)
* Lub plawv dhia ceev (palpitations)
* Raws plab hnyav heev
Kev kho mob thiab lub neej txhua hnub
Feem ntau cov neeg zam kev kho mob PRRT zoo thiab rov zoo sai.
Kuv puas rov qab mus ua haujlwm tau?
PRRT siv cov khoom siv radioactive me me heev. Cov khoom siv radioactive no raug tso tawm ntawm koj lub cev hauv koj cov zis thiab quav rau ob peb hnub tom qab kev kho mob. Koj tus kws kho mob yuav qhia koj kom nyob deb tsawg kawg ib 'meter' ntawm lwm tus neeg thaum lub sijhawm no, tshwj xeeb tshaj yog cov poj niam cev xeeb tub thiab cov menyuam yaus . Nws tseem ceeb heev uas yuav tsum ntxuav koj txhais tes ntau zaus.
Puas mus ncig tau thaum lub sijhawm no?
Tej zaum yuav muaj me ntsis hluav taws xob nyob hauv koj lub cev txog li 3 lub hlis tom qab koj kho mob. Piv txwv li, qhov no tuaj yeem kuaj pom los ntawm cov khoom siv tshuaj ntsuam hluav taws xob ntawm tshav dav hlau. Koj tus kws kho mob yuav muab daim npav tshwj xeeb rau koj uas yuav piav qhia txog kev kho mob uas koj tau txais. Nws yog ib qho tseem ceeb uas yuav tsum khaws daim npav no thiab daim qauv ntawm koj cov ntawv kho mob nrog koj txhua qhov chaw koj mus txog li 3 lub hlis tom qab koj kho mob.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- PRRT yog ib txoj kev kho mob siab heev uas tsuas yog tsom rau cov hlwb qog noj ntshav thiab siv hluav taws xob los rhuav tshem lawv.
- Nws feem ntau yog siv rau cov qog neuroendocrine (NETs) uas tau kis thoob plaws lub cev thiab tsis teb rau kev phais lossis lwm yam kev kho mob.
- Txawm hais tias qhov no tsis yog kev kho mob uas kho tau mob qog noj ntshav tag nrho los xij, nws pab tau zoo heev rau kev tswj tus kab mob thiab txhim kho lub sijhawm muaj sia nyob thiab lub neej zoo.
- Nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li cov lus qhia ntawm tus kws kho mob kom tiv thaiv koj tus kheej ntawm kev siv hluav taws xob rau ob peb hnub tom qab kev kho mob.
- Yog tias koj muaj cov tsos mob ntawm Carcinoid Crisis , xws li ua pa nyuaj, tawv nqaij liab, thiab lub plawv dhia ceev, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd .
- Yog tias muaj teeb meem lossis cov kev mob tshwm sim txog kev kho mob, nrog koj tus kws kho mob tham txog qhov ntawd.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus