Peptide Receptor Radionuclide Therapy (PRRT) ndi mankhwala omwe amakhudza maselo a khansa.

Mwina mukudziwa kuti kuchiza khansa ikafalikira kuchokera mbali imodzi ya thupi kupita ku ina n'kovuta kwambiri. Koma chifukwa cha kupita patsogolo kwa zamankhwala masiku ano, pali mankhwala apadera omwe angayang'ane maselo a khansa ngati chida ndikungowawononga. Lero, tikulankhula za njira yochizira yapamwamba kwambiri yomwe imagwiritsidwa ntchito pochiza mtundu wa khansa yotchedwa `neuroendocrine tumors (NETs). Izi zimatchedwa PRRT, zomwe zikutanthauza `Peptide Receptor Radionuclide Therapy`.

Mwachidule, kodi chithandizo cha PRRT n'chiyani?

PRRT ndi njira yothandizira khansa. Imafuna kupereka mankhwala owopsa mwachindunji m'maselo a khansa ndikuwawononga. Taganizirani izi ngati kupha maselo a khansa mwa kusankha popanda kuvulaza maselo athanzi m'thupi lathu.

Kodi izi zimagwira ntchito bwanji? Ndi zodabwitsa!

Kuti timvetse izi, tiyeni titenge chitsanzo chaching'ono. Selo lililonse la khansa lili ndi ma receptors apadera pamwamba pake, ngati bowo la kiyi pakhomo. Pamene mapuloteni apadera omwe amafanana ndi ma receptors awa okha asonkhana pamodzi ngati kiyi, chitseko chimatseguka kuti zinthu zilowe mu selo.

Izi ndi zomwe chithandizo cha PRRT chimachita:

1. Kupanga "kiyi": Puloteni (peptide) yomwe imagwirizana ndendende ndi ma receptor pamwamba pa maselo a khansa imapangidwa mu labotale.

2. Kulumikiza "bomba": Kenako, chinthu chowopsa chomwe chimatchedwa radionuclide, chomwe chimapha maselo a khansa, chimalumikizidwa ku puloteni yopangidwa.

3. Kuyenda kupita ku cholinga: Mankhwalawa akalowetsedwa m'thupi, puloteniyo imapeza njira yake ndipo imalumikizana ndi ma receptors omwe ali pa maselo a khansa.

4. Kuwonongeka kwa selo la khansa: Monga kiyi yotsegulira chitseko, pamene puloteniyo imamatira ku cholandirira, mankhwala owopsa amalowa mu selo. Akalowa mkati, mphamvu ya poizoni yomwe imatulutsidwa ndi iyo imawononga DNA ya selo la khansa, ndikuwononga selo kuchokera mkati.

Ndi mitundu iti ya PRRT yomwe imagwiritsidwa ntchito padziko lonse lapansi?

Mankhwala akuluakulu a PRRT omwe avomerezedwa padziko lonse lapansi mpaka pano ndi `lutetium Lu 177 dotatate (LUTATHERA®).` Mu izi, `dotatate`, puloteni yopangidwa, imalumikizidwa ku chinthu chowopsa cha radioactive `lutetium-177`.

Puloteni iyi yotchedwa `dotatate` ndi yofanana ndi homoni ya `somatostatin` m'thupi lathu. Maselo ena a khansa amtundu wa `NET` ali ndi ma receptor enieni a homoni ya `somatostatin` iyi. Puloteni iyi yotchedwa `dotatate` imapita ku ma receptor amenewo ndipo imamatira mwamphamvu. Chifukwa chake, mankhwalawa amalowa mu selo ya khansa.

Kuphatikiza apo, mankhwala ena a PRRT akufufuzidwa, ena mwa iwo ali kale m'mayesero azachipatala.

Kodi chithandizo cha PRRT ichi ndi choyenera kwa ndani?

Pakadali pano, chithandizo cha PRRT chimagwiritsidwa ntchito makamaka pa khansa yotchedwa `gastroenteropancreatic NETs`, yomwe ndi khansa yomwe imayamba m'mimba. Mwachitsanzo:

• Pancreas
• Rectum
• Matumbo ang'onoang'ono ndi akuluakulu
• Mimba

Ngati chithandizochi chili choyenera kwa munthu wina zimadalira zinthu zingapo. Onani tebulo ili m'munsimu.

Kodi mumakonzekera bwanji musanalandire chithandizo?

Ngati mukumwa kale mankhwala ena a khansa ya NET, dokotala wanu angakulangizeni kuti musiye kumwa mankhwala ena kwakanthawi musanalandire chithandizo cha PRRT.

• Kawirikawiri, jakisoni wa somatostatin wogwira ntchito kwa nthawi yayitali uyenera kuyimitsidwa osachepera milungu inayi chithandizo chisanachitike .
• Jakisoni wa somatostatin wogwira ntchito kwakanthawi kochepa mwina unayimitsidwa maola 24 chithandizo chisanachitike .
• Komanso, muyenera kupewa kumwa mankhwala amphamvu monga glucocorticosteroids panthawi ya chithandizochi.

Sabata imodzi musanayambe chithandizo chilichonse, mudzayesedwa magazi kangapo kuti muwone ngati thupi lanu lakonzeka.

Kodi chimachitika ndi chiyani tsiku la chithandizo?

Chithandizo cha PRRT nthawi zambiri chimaperekedwa miyezi iwiri iliyonse kwa nthawi zinayi kwa miyezi 8. Iyi ndi njira yochizira matenda osapita kuchipatala, zomwe zikutanthauza kuti simuyenera kukhala m'chipatala. Njira yonseyi imatenga pafupifupi maola 5-6.

1. Choyamba, kannula ya mtsempha (IV) idzalowetsedwa mu mtsempha womwe uli m'dzanja lanu.

2. Mankhwala amaperekedwa kuti apewe nseru ndi kusanza ola limodzi chithandizo chisanayambe.

3. Kenako, mudzapatsidwa amino acid kudzera mu IV kwa maola pafupifupi 4 kuti muteteze impso zanu.

4. Patatha mphindi 30 kuchokera pamene amino acid yayamba kugwiritsidwa ntchito, mankhwala a PRRT amaperekedwa kudzera mu IV ina kwa mphindi 30-45.

5. Mankhwala onse akaperekedwa, kannula ya IV imachotsedwa.

Tsiku lotsatira chithandizo, amajambula chithunzi chapadera kuti awone momwe mankhwalawo afalikira m'thupi lonse.

Kodi ubwino ndi zoopsa za chithandizo cha PRRT ndi ziti?

Kodi ubwino wake ndi wotani?

PRRT ndi mankhwala opambana kwambiri. Mwa anthu ambiri omwe amalandira mankhwalawa, zotupa zawo zimatha kapena kusiya kukula. Izi zimathandiza odwala kukhala ndi moyo wautali ndikukhala ndi moyo wabwino .

Zoopsa ndi zotsatira zake

Kusanza ndi nseru ndi zotsatira zoyipa kwambiri za chithandizochi, koma zimatha kulamulidwa kwambiri ndi mankhwala operekedwa chithandizo chisanachitike.

Mavuto ena omwe angakhalepo ndi awa:

• Mavuto a impso kapena chiwindi.
• Kuchuluka kwa maselo m'magazi kutsika. Izi zingayambitse kupuma movutikira, chiopsezo chowonjezeka cha matenda, komanso kutuluka magazi kapena kuvulala.
• Pali chiopsezo chosowa kwambiri chotenga khansa ya m'magazi monga myelodysplastic syndrome ndi leukemia.

Dokotala wanu adzakuyang'anirani ndi mayeso a magazi nthawi zonse m'miyezi 8 ya chithandizo. Ngati pabuka vuto lililonse, adzasankha kusintha kapena kusiya chithandizo chanu.

Vuto lofunika kwambiri: Vuto la Carcinoid

Uwu ndi matenda osowa koma oopsa, omwe angawononge moyo. Amayamba chifukwa cha kuchuluka kwa mahomoni ochokera ku maselo a khansa. Zizindikiro nthawi zambiri zimawonekera mkati mwa maola 48 kuchokera pamene munthu walandira chithandizo.

Kuchira ndi moyo watsiku ndi tsiku

Anthu ambiri amalandira bwino chithandizo cha PRRT ndipo amachira msanga.

Kodi ndingabwerere kuntchito?

PRRT imagwiritsa ntchito zinthu zochepa kwambiri zotulutsa ma radiation. Zinthuzi zimatuluka m'thupi lanu mu mkodzo ndi ndowe zanu kwa masiku angapo mutalandira chithandizo. Dokotala wanu adzakulangizani kuti mukhale kutali ndi anthu ena osachepera mita imodzi panthawiyi, makamaka amayi apakati ndi ana aang'ono . Ndikofunikiranso kusamba m'manja pafupipafupi.

Kodi n'zotheka kuyenda panthawiyi?

Pakhoza kukhala kuwala kochepa kwambiri m'thupi lanu kwa miyezi itatu mutalandira chithandizo. Izi zitha kuzindikirika pogwiritsa ntchito zida zoyezera kuwala m'mabwalo a ndege, mwachitsanzo. Dokotala wanu adzakupatsani khadi lapadera lomwe lidzafotokoza bwino chithandizo chomwe mwalandira. Ndikofunikira kusunga khadi ili ndi kopi ya zolemba zanu zamankhwala kulikonse komwe mupita kwa miyezi itatu mutalandira chithandizo.