Pamwe unoziva kuti kurapa kenza kana ikapararira kubva kune imwe nhengo yemuviri kuenda kune imwe kwakaoma zvikuru. Asi nekuda kwekufambira mberi kwekurapa nhasi, kune nzira dzakakosha dzinogona kurwisa masero ekenza senge chikopokopo uye dzinongokuvadza chete. Nhasi, tiri kutaura nezvenzira yekurapa yepamusoro-soro inoshandiswa kurapa mhando yekenza inonzi `neuroendocrine tumors (NETs). Iyi inonzi PRRT, iyo inomiririra `Peptide Receptor Radionuclide Therapy`.
Zvichitaurwa zviri nyore, chii chinonzi kurapwa kwePRRT?
PRRT mushonga wegomarara unonangwa. Unosanganisira kuisa chinhu chine mwaranzi zvakananga mumasero egomarara wobva waaparadza. Funga nezvazvo sekuuraya masero egomarara pasina kukuvadza masero ane hutano mumuviri wedu.
Izvi zvinoshanda sei? Zvinoshamisa!
Kuti tinzwisise izvi, ngatitorei muenzaniso mudiki. Sero rega rega regomarara rine mareceptor akakosha pamusoro paro, seburi rekiyi pamusuwo. Kana mapuroteni akakosha anoenderana nemareceptor aya chete akabatana sekiyi, musuwo unovhurika kuti zvinhu zvipinde musero.
Izvi ndizvo zvinoitwa nekurapa kwePRRT:
1. Kugadzira "kiyi": Puroteni (peptide) inoenderana nemareceptor ari pamusoro pemasero ekenza inogadzirwa murabhoritari.
2. Kubatanidza "bhomba": Zvadaro, chinhu chine radioactive chinonzi radionuclide, chinouraya sero rekenza, chinonamirwa kuprotein yakagadzirwa.
3. Kufamba uchienda kune chinangwa: Kana mushonga uyu ukapinzwa mumuviri, puroteni iyi inowana nzira yayo uye inosunga kune mareceptor ari pamasero ekenza.
4. Kuparadzwa kwesero rekenza: Sekiyi inovhura gonhi, kana puroteni yakabatana nereceptor, mushonga une radioactive unopinda musero. Kana wangopinda, radioactivity inoburitswa nayo inokuvadza DNA yesero rekenza, ichiparadza sero kubva mukati.
Chinhu chikuru chakanakira nzira iyi ndechekuti inongonanga masero ekenza chete, saka kukuvara kwemasero ane hutano ari pedyo kushoma.
Ndeapi marudzi ePRRT anoshandiswa pasi rose?
Mushonga mukuru wePRRT wakatenderwa pasi rose kusvika pari zvino ndi `lutetium Lu 177 dotatate (LUTATHERA®).` Muizvi, `dotatate`, puroteni yakagadzirwa, yakabatana nechinhu chine radioactive `lutetium-177`.
Puroteni iyi inonzi `dotatate` yakafanana nehomoni inonzi `somatostatin` iri mumuviri wedu. Mamwe masero ekenza emhando ye`NET` ane mareceptor chaiwo ehomoni iyi inonzi `somatostatin`. Puroteni iyi inonzi `dotatate` inoenda kumareceptor iwayo uye inonamira zvakasimba. Nokudaro, mushonga unopinda musero rekenza zvakananga.
Pamusoro pezvo, mamwe ma PRRT compounds ari kutsvakurudzwa, mamwe acho atove mukuyedzwa kwekiriniki.
Kurapa uku kwePRRT kwakakodzera ani?
Parizvino, kurapwa kwePRRT kunonyanya kushandiswa pagomarara rinonzi `gastroenteropancreatic NETs`, iro riri gomarara rinokura mudumbu. Semuenzaniso:
- Pancreas
- Muromo
- Ura hudiki nehukuru
- Dumbu
Kana mushonga uyu wakakodzera munhu zvichienderana nezvinhu zvakati wandei. Ona tafura iri pazasi.
| Chinzvimbo | Tsananguro |
|---|---|
| Kusakodzera kuvhiyiwa | Kana kenza yapararira ( yakapararira ) kunzvimbo dzakawanda mumuviri, zvinonetsa kurapa nekuvhiyiwa chete. Kune vanhu vazhinji vanoonekwa vaine kenza yeNET, kenza yacho yatopararira. |
| Kukundikana kupindura kune mamwe marapirwo | Kana kuvhiyiwa kusingagoneke, kurapwa nemahormone kunowanzoitwa. Zvisinei, mune vamwe vanhu, bundu iri rinoramba richikura zvisingadzoreki pasinei nekurapwa uku. |
| Kuvapo kweSomatostatin receptors mumasero ekenza | Ichi ndicho chinhu chakakosha. Kuti mushonga wePRRT ushande, masero egomarara anofanira kunge aine mareceptors chaiwo. Chiremba wako achaita scan yakakosha, senge octreotide scan, kuti aone kana mareceptors aya aripo. |
Unogadzirira sei usati warapwa?
Kana watove kutora mimwe mishonga yegomarara reNET, chiremba wako anogona kukukurudzira kuti urege mimwe yacho kwenguva pfupi usati warapwa nePRRT.
- Kazhinji, majekiseni e somatostatin anoshanda kwenguva refu anofanira kumira mavhiki mana asati asvika ekurapwa.
- Majekiseni e somatostatin anoshanda kwenguva pfupi anogona kunge akamiswa maawa makumi maviri nemana kurapwa kusati kwatanga .
- Uyewo, unofanira kudzivisa kutora mishonga ine mwero wakanyanya se `glucocorticosteroids` panguva yekurapwa uku.
Vhiki imwe chete usati watanga kurapwa, uchaongororwa ropa kakawanda kuti uone kana muviri wako wagadzirira kurapwa.
Chii chinoitika pazuva rekurapwa?
Kurapwa kwePRRT kunowanzoitwa mwedzi miviri yega yega kwezvikamu zvina mukati memwedzi misere. Uku kuvhiyiwa kwemurwere ari kunze kwechipatara, zvichireva kuti haufanirwe kugara muchipatara. Kuvhiyiwa kwese kunotora maawa angangoita mashanu kusvika matanhatu.
1. Kutanga, kanula yemutsinga (IV) ichaiswa mutsinga iri muruoko rwako.
2. Mushonga unopiwa kudzivirira kuda kurutsa nekurutsa awa imwe chete mushonga usati watanga.
3. Zvadaro, uchapihwa amino acid solution kuburikidza neIV kwemaawa angangoita mana kuti udzivirire itsvo dzako.
4. Anenge maminitsi makumi matatu mushure mekunge mushonga weamino acid watangwa, mushonga wePRRT unopihwa kuburikidza neIV yakasiyana kwenguva yemaminitsi makumi matatu kusvika makumi mana nemashanu.
5. Mushure mekunge mishonga yese yapihwa, IV cannula inobviswa.
Zuva rakatevera kurapwa, mushonga wacho unoongororwa kuti uone kuti mushonga wacho wapararira sei mumuviri wese.
Ndezvipi zvakanakira nengozi dzekurapa kwePRRT?
Ndezvipi zvakanakira?
PRRT mushonga unobudirira zvikuru. Muvanhu vazhinji vanouwana, bundu ravo rinopera kana kurega kukura. Izvi zvinoita kuti varwere vararame kwenguva yakareba uye varambe vaine hupenyu hwakanaka .
Asi chinhu chimwe chete chekurangarira ndechekuti PRRT haisi mushonga wekenza. Kune vanhu vazhinji, kenza inogona kudzoka mushure mechinguva.
Njodzi nemigumisiro
Kurutsa uye kuda kurutsa ndizvo zvinonyanya kukonzera mhedzisiro yekurapwa uku, asi zvinogona kudzorwa zvakanyanya nemishonga inopiwa usati warapwa.
Mamwe matambudziko anogona kuitika ndeaya:
- Matambudziko eitsvo kana chiropa.
- Kuwanda kwemasero eropa kwakaderera. Izvi zvinogona kukonzera kufema kwakaoma, kuwedzera njodzi yehutachiona, uye kubuda ropa kana mavanga.
- Pane njodzi isingawanzoitiki yekubatwa nekenza yeropa yakadai se myelodysplastic syndrome uye leukemia.
Chiremba wako achakutarisa nekuongororwa ropa nguva dzose mukati memwedzi misere yekurapwa. Kana paine matambudziko akamuka, achasarudza kuchinja kana kumira kurapwa kwako.
Mamiriro ezvinhu anonyanya kukurumidza: Dambudziko reCarcinoid
Ichi chirwere chisingawanzoitiki asi chakakomba, chinogona kuisa hupenyu pangozi. Chinokonzerwa nekuwanda kwemahormone kubva mumasero ekenza kamwe kamwe. Zviratidzo zvinowanzoonekwa mukati memaawa makumi mana nemasere mushure mekurapwa.
Kana ukaona chimwe chezviratidzo izvi, enda kuchipatara chiri pedyo neEmergency Department (ETU) nekukasika.
* Kuomerwa nekufema
* Kutsvuka kana kupisa kweganda pachiso kana pamutsipa (kusviba)
* Kuderera kweropa (Hypotension)
* Kurova kwemoyo nekukurumidza (kurova kwemoyo nekukurumidza)
* Manyoka akanyanya
Kupora uye hupenyu hwezuva nezuva
Vanhu vazhinji vanotsungirira kurapwa kwePRRT zvakanaka uye vanopora nekukurumidza.
Ndingadzokera kubasa here?
PRRT inoshandisa zvinhu zvishoma kwazvo zvine mwaranzi. Izvi zvinobuda mumuviri wako muweti netsvina yako kwemazuva mashoma mushure mekurapwa. Chiremba wako achakukurudzira kuti ugare kure nevamwe vanhu kanenge mita imwe chete panguva iyi, kunyanya vakadzi vane pamuviri nevana vadiki . Zvakakoshawo kugeza maoko ako nguva nenguva.
Zvinokwanisika here kufamba panguva ino?
Panogona kunge paine mwaranzi shoma mumuviri wako kwemwedzi inosvika mitatu mushure mekurapwa kwako. Izvi zvinogona kuonekwa nemidziyo yekuongorora mwaranzi panhandare dzendege, semuenzaniso. Chiremba wako achakupa kadhi rakakosha richatsanangura kurapwa kwawakaitwa. Zvakakosha kuchengeta kadhi iri nekopi yezvinyorwa zvako zvekurapwa newe kwese kwaunoenda kwemwedzi inosvika mitatu mushure mekurapwa kwako.
Mharidzo Yekuenda Nayo Kumba
- PRRT inzira yepamusoro yekurapa inongonanga masero ekenza chete uye inoshandisa mwaranzi kuaparadza.
- Inonyanya kushandiswa pazvirwere zve neuroendocrine (NETs) zvakapararira mumuviri wese uye hazvisi kupindura kuvhiyiwa kana kumwe kurapwa.
- Kunyangwe iyi isiri nzira yekurapa inorapa kenza zvachose, inobatsira zvikuru mukutonga chirwere ichi uye kuvandudza nguva yekurarama uye kunaka kwehupenyu.
- Zvakakosha kutevedzera mirairo yachiremba kuti uzvidzivirire kubva kumwaranzi kwemazuva mashoma mushure mekurapwa.
- Kana ukaona zviratidzo zveCarcinoid Crisis , zvakaita sekuoma kwekufema, kusviba kweganda, uye kurova kwemoyo nekukurumidza, enda kuchipatara nekukurumidza .
- Kana paine matambudziko kana migumisiro yakaipa pamusoro pekurapwa, taura nachiremba wako nezvazvo.
💬 Comments (0)
Hapana zvakataurwa parizvino. Isa mhinduro yako pano kekutanga.
Wedzera zvaunofunga