Igama elithi "umdlavuza" lingasenza sonke sizizwe sinokwesaba okukhulu. Kodwa ngokuthuthuka kwesayensi yezokwelapha, manje sekukhona izindlela zokwelapha ezinamandla kakhulu zokulwa nalesi sifo. Kungenzeka ukuthi uke wezwa nge-chemotherapy, okuwukunikezwa kwemithi ebhubhisa ngqo amangqamuzana omdlavuza. Futhi, ukwelashwa okusha okukhulunywa ngakho kakhulu njengamanje yi-immunotherapy. Lokhu kuhilela ukuvuselela amasosha omzimba wethu nokwenza alwe nomdlavuza. Kodwa ngezinye izikhathi kungaba nzima ukufeza imiphumela oyifunayo ngokwelashwa okukodwa nje. Yingakho umqondo "wokunakekelwa okuhlanganisiwe" esikhuluma ngawo namuhla uvela phambili.
Kungani kuhlanganiswa lezi zindlela zokwelapha?
Kalula nje, iqembu lamaqhawe anamakhono ahlukahlukene linamathuba amaningi okunqoba kuneqhawe elilodwa elilwa lodwa. Kunjalo nasekwelashweni komdlavuza. Uma ukwelashwa okukodwa noma ngaphezulu kusetshenziswa ndawonye, amathuba okulawula umdlavuza, ukuwulapha ngokuphelele, noma ukwandisa impilo yesiguli ayakhula.
Lezi zindlela zokwelapha ezihlanganisiwe zibaluleke kakhulu kumdlavuza onzima noma othuthukile, njengomdlavuza wamaphaphu kanye ne-melanoma yesikhumba.
Yiziphi izinto ezilindelwe kakhulu ekuhlanganiseni lezi zindlela zokwelapha?
- Ukuqinisa ukulwa kwamasosha omzimba wethu nomdlavuza: Ezinye izindlela zokwelapha zisiza amasosha omzimba ukuba aqaphele kalula amangqamuzana omdlavuza.
- Ukuphazamisa ikhono lamaseli omdlavuza "lokucashela" ohlelweni lokuzivikela komzimba: Amaseli omdlavuza angamaseli anobuqili kakhulu. Asebenzisa amasu ahlukahlukene ukugwema uhlelo lwethu lokuzivikela komzimba. Izindlela zokwelapha ezihlanganisiwe zingaphazamisa lawa masu.
- Ukunciphisa inani lamaseli omdlavuza noma usayizi wesimila: Uma ukwelashwa okukodwa kunciphisa isimila, kuba lula ukuthi okunye ukwelashwa kubhubhise amaseli asele.
Izindlela zokwelapha ezihlanganisiwe ezisetshenziswa kakhulu
Odokotela bahlanganisa izindlela zokwelapha ezahlukene. Ake sibheke ezimbalwa zazo.
1. Uhlobo olukhethekile lwe-immunotherapy olubizwa ngokuthi i-Checkpoint Inhibitors
Lokhu kuyindlela yokwelapha ethakazelisa kakhulu. Cabanga ngesimiso sethu somzimba sokuzivikela njengebutho elivikela izwe. Lawa maseli empi (amaseli e-T) angabona futhi ahlasele amangqamuzana esitha. Kodwa ngezinye izikhathi amangqamuzana omdlavuza avala "izindawo zokuhlola" kula maseli empi futhi adlale iqhinga, ethi, "Ngingomunye wenu, ningangihlaseli."
Lokho okwenziwa yimithi ebizwa ngokuthi 'i-Checkpoint Inhibitors' ukuguqula iswishi esivulwe amaseli omdlavuza. Ngemuva kwalokho amasosha omzimba wethu angawabona amaseli omdlavuza bese eqala ukuwahlasela.
Ngaphezulu kwama-75% ocwaningo lwe-immunotherapy namuhla luhlanganisa lawa ma-checkpoint inhibitors nezinye izindlela zokwelapha. Le ndlela isiza ekunciphiseni izinhlobo eziningi zomdlavuza, inikeze imiphumela yesikhathi eside enemiphumela emibi embalwa.
Isibonelo, inhlanganisela yemithi emibili yokuvimbela i-checkpoint, i-ipilimumab kanye ne-nivolumab, isetshenziswe ngempumelelo iminyaka eminingi ukwelapha i-melanoma enamandla esakazekele ebuchosheni.
Le nhlanganisela manje isivunyelwe izinso, amathumbu amakhulu, isibindi, amaphaphu, kanye nezinye izinhlobo eziningana zomdlavuza.
2. Ukuhlanganisa i-Immunotherapy kanye ne-Chemotherapy
Lena futhi indlela ebonise imiphumela ephumelela kakhulu. Nakuba i-chemotherapy ibhubhisa amangqamuzana omdlavuza, i-immunotherapy isiza amasosha omzimba ukuthola nokubhubhisa amangqamuzana asele.
| Uhlobo lomdlavuza | Inzuzo yokwelashwa okuhlanganisiwe |
|---|---|
| Umdlavuza Webele | Ezinye izinhlobo zomdlavuza webele kunzima ukuthi amasosha omzimba azibone, kodwa ukuhlanganisa i-immunotherapy ne-chemotherapy (isib. i-Taxol) kubonise imiphumela emihle kakhulu. |
| Umdlavuza we-Pancreatic | Ukuhlanganisa imithi yokwelapha nge-immunotherapy efana ne-nivolumab kanye ne-chemotherapy kuveze imiphumela emihle yomdlavuza we-pancreatic osakazeke emzimbeni wonke. |
| Umdlavuza Wegazi | Ukwelashwa okufana nokwelashwa ngamaseli e-CAR T kuphumelela kakhulu emdlavuza wegazi ofana ne-leukemia. Ngaphezu kwalokho, ukuhlanganisa imithi yokuvimbela ukuhlolwa kanye ne-chemotherapy sekuphindeke kabili izinga lempumelelo leziguli ezingasabelanga ekwelashweni. |
| Umdlavuza Wesibeletho | Kumdlavuza ophinde ubuye ngemva kokwelashwa ngamakhemikhali kanye nemisebe, ukwengezwa kwe-immunotherapy kuye kwandisa kakhulu ukusinda kweziguli. |
3. Ukuhlanganisa Ukwelashwa Ngezifo Ezingahlosiwe kanye Nokwelashwa Okuqondiwe
`Ukwelashwa Okuqondiwe` kuyindlela ehlukile kune-chemotherapy. Ukwelashwa ngamakhemikhali kungathinta wonke amaseli ahlukana ngokushesha (amangqamuzana omdlavuza kanye namaseli anempilo). Kodwa-ke, `Ukwelashwa Okuqondiwe` kuhlasela futhi kuhlasele isici esithile sofuzo noma seprotheni esibangela ukuba amaseli omdlavuza akhule.
Ukuhlanganisa le ndlela nokwelashwa nge-immunotherapy manje sekukhombisa imiphumela ethembisayo. Isibonelo, lezi zindlela zokwelapha ezihlanganisiwe manje sezivunyelwe umdlavuza wezinso kanye nomdlavuza we-endometrial.
4. Ukuhlinzwa nge-Immunotherapy
Lena futhi indlela ebaluleke kakhulu.
- Ngaphambi kokuhlinzwa: I-immunotherapy inganciphisa ubukhulu bomdlavuza, yenze ukuhlinzwa kube lula futhi inciphise inani lezicubu okufanele zisuswe.
- Ngemva kokuhlinzwa: Ukwelashwa nge-immunotherapy kungasiza amasosha omzimba ukuba abhubhise amangqamuzana amancane kakhulu omdlavuza (ama-micrometastases) angase ahlale engabonakali emehlweni ngemva kokuhlinzwa. Lokhu kunciphisa ingozi yokuthi umdlavuza uphinde ubuye.
Le ndlela ibonise imiphumela emihle kakhulu yomdlavuza wobuchopho, wamaphaphu, wamabele, wamathumbu amakhulu kanye nowomlomo.
5. Ukwelashwa Ngezifo Ezingalawuleki Ngokwelashwa Ngemisebe
Ukwelashwa ngemisebe kunciphisa izimila. Abacwaningi bakholelwa nokuthi izimpawu ezikhishwa amangqamuzana omdlavuza akhanyiswe ngemisebe zenza kube lula ukuthi amasosha omzimba aqaphele umdlavuza. Ngakho-ke, ucwaningo lusaqhubeka ukuze kubonwe ukuthi ukuhlanganisa i-immunotherapy nokwelashwa ngemisebe kungathuthukisa yini ukusebenza kahle kokwelashwa.
Okubaluleke kakhulu: Uma wena noma othile oseduze nawe enomdlavuza, kubalulekile ukuba nengxoxo evulekile nejulile nodokotela wakho mayelana nokuthi yikuphi ukwelashwa okungcono kakhulu kuwe, ukuthi ngabe ukwelashwa okuhlanganisiwe kuyadingeka yini, nokuthi yiziphi izinzuzo nezingozi. Ulwazi oluku-inthanethi lungolwezinjongo zolwazi kuphela futhi akufanele lubhekwe njengoluthatha indawo yeseluleko sezokwelapha.
Umlayezo Wokuya Nawe Ekhaya
- Ukunakekelwa okuxubile kuvame ukunikeza imiphumela ephumelela kakhulu kunokwelashwa okukodwa komdlavuza.
- Izinhlelo zokwelapha zakhiwe ngokuhlanganisa izindlela ezifana ne-immunotherapy, i-chemotherapy, ukwelashwa okuqondisiwe, ukuhlinzwa, kanye nokwelashwa ngemisebe ngezindlela ezahlukene.
- Lezi zindlela zokwelapha ezihlanganisiwe zingafeza imigomo efana nokubhubhisa amangqamuzana omdlavuza, ukuqinisa amasosha omzimba, nokuvimbela ukuphinda kuvele umdlavuza.
- Lona umkhakha othuthuka ngokushesha, onezinhlanganisela zokwelapha ezintsha nezisebenza kahle ezifakwa njalo.
- Udokotela wakho womdlavuza kuphela onganquma uhlelo lokwelashwa olungcono kakhulu kuwe, ngakho xoxa ngazo zonke izinqumo nodokotela wakho.
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