Mhlawumbi uyazi ukuba ukunyanga umhlaza xa usasazeka ukusuka kwelinye icala lomzimba ukuya kwelinye kunzima kakhulu. Kodwa ngenxa yenkqubela phambili kwezonyango namhlanje, kukho unyango olukhethekileyo olunokuthi lujolise kwiiseli zomhlaza ezifana ne-missile kwaye zonakalise kuphela. Namhlanje, sithetha ngendlela yonyango ephucukileyo kakhulu esetyenziswa ukunyanga uhlobo lomhlaza olubizwa ngokuba yi-'neuroendocrine tumors (NETs). Oku kubizwa ngokuba yi-PRRT, emele i-'Peptide Receptor Radionuclide Therapy'.
Ngamafutshane, yintoni unyango lwe-PRRT?
I-PRRT lunyango lomhlaza olujoliswe kulo. Lubandakanya ukuhambisa into enemisebe ngqo kwiiseli zomhlaza nokuzitshabalalisa. Cinga ngayo njengokubulala iiseli zomhlaza ngokukhetha ngaphandle kokulimaza iiseli eziphilileyo emzimbeni wethu.
Isebenza njani le nto? Iyamangalisa!
Ukuze siqonde oku, masithathe umzekelo omncinci. Iseli nganye yomhlaza inee-receptors ezikhethekileyo kumphezulu wayo, njengomngxuma wesitshixo emnyango. Xa iiproteni ezikhethekileyo ezihambelana nezi receptors kuphela zidibana njengesitshixo, ucango luyavuleka ukuze izinto zingene kwiseli.
Nantsi into eyenziwa lunyango lwe-PRRT:
1. Ukudala "isitshixo": Iproteni (ipeptide) ehambelana ngqo nee-receptors kumphezulu weeseli zomhlaza yenziwa kwilebhu.
2. Ukuncamathisela "ibhombu": Emva koko, into enemisebe ebizwa ngokuba yi-radionuclide, ebulala iseli yomhlaza, incamathiselwa kwiproteni eyenziweyo.
3. Ukuhamba uye kwindawo ekujoliswe kuyo: Xa eli yeza lingeniswa emzimbeni, iproteni iyazifumana ize ibopheleleke kwii-receptors ezikwiiseli zomhlaza.
4. Ukutshatyalaliswa kweseli yomhlaza: Njengesitshixo esivula ucango, xa iproteni ibopha kwi-receptor, iyeza elinomhlaza lingena kwiseli. Nje ukuba lingene, i-radioactivity ekhutshwa yiyo yonakalisa i-DNA yeseli yomhlaza, itshabalalise iseli ngaphakathi.
Eyona nzuzo inkulu yale ndlela kukuba ijolise kwiiseli zomhlaza kuphela, ngoko ke umonakalo kwiiseli eziphilileyo ezijikelezileyo uncinci.
Zeziphi iintlobo zePRRT ezisetyenziswayo ehlabathini?
Iyeza eliphambili le-PRRT elivunyiweyo kwihlabathi ukuza kuthi ga ngoku yi-`lutetium Lu 177 dotatate (LUTATHERA®).` Kule nto, i-`dotatate`, iproteni yokwenziwa, incamathiselwe kwi-radioactive element `lutetium-177`.
Le protein ibizwa ngokuba yi-'dotatate' ifana ne-hormone ethi 'somatostatin' emizimbeni yethu. Ezinye iiseli zomhlaza zohlobo lwe-'NET' zine-receptors ezithile zale hormone ethi 'somatostatin'. Le protein ebizwa ngokuba yi-'dotatate' iya kwezo receptors kwaye inamathela ngokuqinileyo. Ke ngoko, iyeza lingena ngqo kwiseli yomhlaza.
Ukongeza, ezinye iikhompawundi zePRRT ziyaphandwa, ezinye zazo sele zisezilingweni zeklinikhi.
Ngubani ofanelekileyo kolu nyango lwePRRT?
Okwangoku, unyango lwe-PRRT lusetyenziswa kakhulu kwiimhlaza ezibizwa ngokuba yi-`gastroenteropancreatic NETs`, eziziimhlaza ezikhula kwindlela yokugaya ukutya. Umzekelo:
- I-Pancreas
- Ingxolo
- Amathumbu amancinci namakhulu
- Isisu
Ukuba olu nyango lufanelekile na kumntu othile kuxhomekeke kwizinto ezahlukeneyo. Jonga itheyibhile engasezantsi.
| Imeko | Inkcazo |
|---|---|
| Ukungafaneleki kotyando | Ukuba umhlaza usasazeke ( ususulwe ) kwiindawo ezininzi emzimbeni, kunzima ukuwunyanga ngotyando lodwa. Kwabaninzi abantu abafunyaniswe benomhlaza we-NET, umhlaza sele usasazeke. |
| Ukungaphumeleli ukuphendula kwezinye iindlela zonyango | Ukuba utyando alunakwenzeka, unyango lweehomoni ludla ngokunikezelwa. Nangona kunjalo, kwabanye abantu, iithumba ziyaqhubeka nokukhula ngendlela engalawulekiyo nangona olu nyango lunjalo. |
| Ubukho bee-Somatostatin receptors kwiiseli zomhlaza | Le yeyona nto ibalulekileyo. Ukuze iyeza lePRRT lisebenze, iiseli zomhlaza kufuneka zibe nezo receptor zikhethekileyo. Ugqirha wakho uza kwenza iskeni ekhethekileyo, efana neskeni ye-octreotide, ukuqinisekisa ukuba ezi receptors zikhona na. |
Ulungiselela njani ngaphambi konyango?
Ukuba sele usebenzisa amanye amayeza omhlaza we-NET, ugqirha wakho unokukucebisa ukuba uyeke okwethutyana amanye awo ngaphambi kokuba unyango lwe-PRRT luqale.
- Ngokwesiqhelo, iinaliti ze-somatostatin ezisebenza ixesha elide kufuneka ziyekwe ubuncinane kwiiveki ezi-4 ngaphambi konyango.
- Iinaliti ze-somatostatin ezisebenza ixesha elifutshane zisenokuba ziyekile kwiiyure ezingama-24 ngaphambi konyango.
- Kwakhona, kufuneka uphephe ukuthatha ii-steroids ezinedosi ephezulu ezifana ne-'glucocorticosteroids' ngeli xesha lonyango.
Iveki ngaphambi konyango ngalunye, uza kuhlolwa igazi izihlandlo ezininzi ukuze ubone ukuba umzimba wakho ukulungele na.
Kwenzeka ntoni ngomhla wonyango?
Unyango lwe-PRRT ludla ngokunikezelwa rhoqo emva kweenyanga ezimbini kangangeeseshoni ezi-4 kwixesha leenyanga ezi-8. Le yinkqubo yokulaliswa ngaphandle, oko kuthetha ukuba akufuneki uhlale esibhedlele. Lonke olu nyango luthatha malunga neeyure ezi-5-6.
1. Okokuqala, i-cannula efakwa ngemithambo yegazi (IV) iya kufakwa kumthambo osengalweni yakho.
2. Kunikwa amayeza okuthintela isicaphucaphu nokuhlanza iyure enye ngaphambi kokuba unyango luqale.
3. Emva koko, uza kunikwa isisombululo se-amino acid nge-IV malunga neeyure ezi-4 ukukhusela izintso zakho.
4. Malunga nemizuzu engama-30 emva kokuba isisombululo se-amino acid siqalisiwe, amayeza e-PRRT anikwa nge-IV eyahlukileyo kwixesha lemizuzu engama-30-45.
5. Emva kokuba zonke izisombululo zinikwe, i-IV cannula iyasuswa.
Ngosuku olulandelayo emva konyango, kwenziwa iskeni ekhethekileyo ukuze kubonwe ukuba iyeza lisasazeke njani emzimbeni wonke.
Zithini iingenelo kunye neengozi zonyango lwe-PRRT?
Zithini iingenelo?
I-PRRT lunyango oluphumelele kakhulu. Kubantu abaninzi abalufumanayo, iithumba zabo ziyanyamalala okanye ziyeke ukukhula. Oku kuvumela izigulane ukuba ziphile ixesha elide kwaye zigcine umgangatho wobomi obuhle .
Kodwa into enye ekufuneka uyikhumbule kukuba i-PRRT ayilonyango lomhlaza. Kubantu abaninzi, umhlaza ungabuya emva kwexesha elithile.
Iingozi kunye nemiphumo emibi
Ukugabha kunye nokucaphuka zezona ziphumo zixhaphakileyo zolu nyango, kodwa zinokulawulwa kakhulu ngamayeza anikwayo ngaphambi konyango.
Ezinye iingxaki ezinokubakho zezi:
- Iingxaki zezintso okanye zesibindi.
- Inani eliphantsi leeseli zegazi. Oku kunokubangela ubunzima bokuphefumla, ukwanda komngcipheko wosulelo, kunye nokopha okanye ukukrweleka.
- Kukho umngcipheko ongaqhelekanga wokuba nomhlaza wegazi ofana ne-myelodysplastic syndrome kunye ne-leukemia.
Ugqirha wakho uza kukujonga ngovavanyo lwegazi rhoqo kwiinyanga ezisi-8 zonyango. Ukuba kukho naziphi na iingxaki, uza kugqiba ekubeni atshintshe okanye ayeke unyango lwakho.
Eyona meko ingxamisekileyo: Ingxaki yeCarcinoid
Le yimeko engaqhelekanga kodwa imbi kakhulu, enokuba yingozi ebomini. Ibangelwa kukwanda okukhulu kweehomoni ezivela kwiiseli zomhlaza. Iimpawu zihlala zibonakala kwiiyure ezingama-48 emva kokufumana unyango.
Ukuba ufumana naziphi na kwezi mpawu, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngoko nangoko.
* Ubunzima bokuphefumla
* Ubomvu okanye ukutsha kwesikhumba ebusweni okanye entanyeni (ukuhlanjwa)
* Uxinzelelo lwegazi oluphantsi (iHypotension)
* I-Palpitations (ukubetha kwentliziyo okukhawulezayo)
* Urhudo oluqatha
Ukubuyisela ubomi kunye nobomi bemihla ngemihla
Uninzi lwabantu luyanyamezela unyango lwe-PRRT kakuhle kwaye luyaphola ngokukhawuleza.
Ndingabuyela emsebenzini?
I-PRRT isebenzisa inani elincinci kakhulu lezinto ezine-radioactive. Ezi zinto zine-radioactive zikhutshwa emzimbeni wakho kumchamo nakwindle yakho kangangeentsuku ezimbalwa emva konyango. Ugqirha wakho uya kukucebisa ukuba uhlale ubuncinane imitha enye kude nabanye abantu ngeli xesha, ingakumbi abafazi abakhulelweyo nabantwana abancinci . Kubalulekile ukuhlamba izandla zakho rhoqo.
Ngaba kunokwenzeka ukuhamba ngeli xesha?
Kunokubakho inani elincinci kakhulu lemitha emzimbeni wakho ukuya kuthi ga kwiinyanga ezi-3 emva konyango lwakho. Oku kunokubonwa ngezixhobo zokuhlola imitha kwizikhululo zeenqwelo-moya, umzekelo. Ugqirha wakho uza kukunika ikhadi elikhethekileyo eliza kuchaza unyango olufumeneyo. Kubalulekile ukugcina eli khadi kunye nekopi yamanqaku akho onyango nawe naphi na apho uya khona ukuya kuthi ga kwiinyanga ezi-3 emva konyango lwakho.
Umyalezo Wokuya Ekhaya
- I-PRRT yindlela yonyango ephucukileyo ejolise kuphela kwiiseli zomhlaza kwaye isebenzisa imitha ukuze izitshabalalise.
- Isetyenziswa kakhulu kwii-neuroendocrine tumors (ii-NET) ezisasazeke emzimbeni wonke kwaye ezingaphenduliyo kutyando okanye kwezinye iindlela zonyango.
- Nangona olu nyango lungelulo unyango oluphilisa umhlaza ngokupheleleyo, luluncedo kakhulu ekulawuleni esi sifo nasekuphuculeni ixesha lokusinda kunye nomgangatho wobomi.
- Kubalulekile ukulandela imiyalelo kagqirha ukuze uzikhusele kwimitha yelanga kangangeentsuku ezimbalwa emva konyango.
- Ukuba ubonakalisa iimpawu zeCarcinoid Crisis , ezinje ngobunzima bokuphefumla, ukurhawuzelela ulusu, kunye nokubetha kwentliziyo ngokukhawuleza, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko .
- Ukuba kukho naziphi na iingxaki okanye iziphumo ebezingalindelekanga malunga nonyango, thetha nogqirha wakho ngalo mba.
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