Cishe uyazi ukuthi ukwelapha umdlavuza uma usakazeka usuka kwenye ingxenye yomzimba uye kwenye kuyinselele kakhulu. Kodwa ngenxa yentuthuko kwezokwelapha namuhla, kunezindlela zokwelapha ezikhethekile ezingahlasela amangqamuzana omdlavuza njenge-missile futhi ziwalimaze kuphela. Namuhla, sikhuluma ngendlela yokwelapha ethuthuke kakhulu esetshenziswa ukwelapha uhlobo lomdlavuza olubizwa ngokuthi 'ama-neuroendocrine tumors (ama-NET). Lokhu kubizwa ngokuthi i-PRRT, okusho ukuthi 'i-Peptide Receptor Radionuclide Therapy'.
Kalula nje, kuyini ukwelashwa kwe-PRRT?
I-PRRT iyindlela yokwelapha umdlavuza eqondiwe. Ihilela ukuletha into enomsebe ngqo emangqamuzaneni omdlavuza bese iwabhubhisa. Cabanga ngayo njengokubulala amangqamuzana omdlavuza ngokukhetha ngaphandle kokulimaza amangqamuzana anempilo emzimbeni wethu.
Kusebenza kanjani lokhu? Kuyamangalisa!
Ukuze siqonde lokhu, ake sithathe isibonelo esincane. Iseli ngalinye lomdlavuza linezamukeli ezikhethekile ebusweni balo, njengembobo yokhiye emnyango. Lapho amaprotheni akhethekile afana nalawa ma-receptor kuphela ehlangana njengesihluthulelo, umnyango uyavuleka ukuze kungeniswe izinto esitokisini.
Yilokhu okwenziwa ukwelashwa kwe-PRRT:
1. Ukudala "ukhiye": Iphrotheni (i-peptide) efanelana ncamashi nama-receptor ebusweni bamaseli omdlavuza idalwa elabhorethri.
2. Ukuhlanganisa "ibhomu": Bese kuthi, i-radionuclide, empeleni ebulala iseli lomdlavuza, inamathele kuphrotheni eklanywe ngendlela ehlelekile.
3. Ukuya endaweni okuqondiswe kuyo: Uma lo muthi ufakwa emzimbeni, iphrotheni iyazifihla bese ibopha kuma-receptor asemaseli omdlavuza.
4. Ukubhujiswa kweseli lomdlavuza: Njengesihluthulelo esivula umnyango, lapho iphrotheni ibopha i-receptor, umuthi okhipha imisebe ungena eseli. Uma usungaphakathi, i-radioactivity ekhishwa yiwo ilimaza i-DNA yeseli lomdlavuza, ibhubhise iseli ngaphakathi.
Inzuzo enkulu yale ndlela ukuthi ihlose amangqamuzana omdlavuza kuphela, ngakho-ke umonakalo kumaseli aphilile azungezile mncane kakhulu.
Yiziphi izinhlobo ze-PRRT ezisetshenziswa emhlabeni?
Umuthi oyinhloko we-PRRT ovunyelwe emhlabeni kuze kube manje yi-`lutetium Lu 177 dotatate (LUTATHERA®).` Kulokhu, i-`dotatate`, iphrotheni yokwenziwa, inamathele ku-element enemisebe `lutetium-177`.
Le phrotheni ebizwa ngokuthi i-'dotatate' ifana ne-hormone ethi 'somatostatin' emizimbeni yethu. Amanye amangqamuzana omdlavuza wohlobo lwe-'NET' anezitho zokwamukela ezithile zale hormone ethi 'somatostatin'. Le phrotheni ebizwa ngokuthi i-'dotatate' iya kulawo ma-receptor futhi inamathele ngokuqinile. Ngakho-ke, umuthi ungena ngqo engqamuzaneni lomdlavuza.
Ngaphezu kwalokho, amanye ama-compound e-PRRT ayacwaningwa, amanye awo asevele esezivivinyweni zemitholampilo.
Ubani ofanelekela lolu hlobo lokwelashwa lwe-PRRT?
Njengamanje, ukwelashwa kwe-PRRT kusetshenziselwa kakhulu umdlavuza obizwa ngokuthi 'ama-NET e-gastroenteropancreatic', okuyimidlavuza ekhula endleleni yokugaya ukudla. Isibonelo:
- I-Pancreas
- I-Rectum
- Amathumbu amancane namakhulu
- Isisu
Ukuthi lokhu kwelashwa kuyamfanele yini umuntu kuncike ezintweni eziningana. Bheka ithebula elingezansi.
| Isimo | Incazelo |
|---|---|
| Ukungafaneleki kokuhlinzwa | Uma umdlavuza ususakazeke ( ususakazeke kakhulu ) ezindaweni eziningi emzimbeni, kunzima ukuwulapha ngokuhlinzwa kuphela. Kwabaningi abatholakale benomdlavuza we-NET, umdlavuza usuvele usakazeke. |
| Ukwehluleka ukuphendula kwezinye izindlela zokwelapha | Uma ukuhlinzwa kungenzeki, kuvame ukunikezwa ukwelashwa ngama-hormone. Kodwa-ke, kwabanye abantu, izimila ziyaqhubeka nokukhula ngendlela engalawuleki naphezu kwalezi zindlela zokwelapha. |
| Ukuba khona kwama-Somatostatin receptors kumaseli omdlavuza | Lokhu kuyinto ebaluleke kakhulu. Ukuze umuthi we-PRRT usebenze, amangqamuzana omdlavuza kumele abe nalawo ma-receptor akhethekile. Udokotela wakho uzokwenza ukuskena okukhethekile, njengokuskena kwe-octreotide, ukuqinisekisa ukuthi la ma-receptor akhona yini. |
Uzilungiselela kanjani ngaphambi kokwelashwa?
Uma usuvele uthatha eminye imithi yomdlavuza we-NET, udokotela wakho angase akucebise ukuthi uyeke okwesikhashana eminye yayo ngaphambi kokwelashwa kwe-PRRT.
- Ngokuvamile, imijovo ye-somatostatin esebenza isikhathi eside kumele iyekwe okungenani amasonto ama-4 ngaphambi kokwelashwa.
- Imijovo ye-somatostatin esebenza ngokushesha kungenzeka ukuthi yayekiwe emahoreni angama-24 ngaphambi kokwelashwa.
- Futhi, kufanele ugweme ukuthatha ama-steroid anemithamo ephezulu njenge-'glucocorticosteroids' phakathi nalokhu kwelashwa.
Isonto ngaphambi kokwelashwa ngakunye, uzobe uhlolwa igazi kaningana ukuze ubone ukuthi umzimba wakho usukulungele yini.
Kwenzekani ngosuku lokwelashwa?
Ukwelashwa kwe-PRRT kuvame ukunikezwa njalo ezinyangeni ezimbili izikhathi ezine esikhathini esiyizinyanga eziyi-8. Lena inqubo yokulaliswa esibhedlela, okusho ukuthi akudingeki uhlale esibhedlela. Yonke inqubo ithatha cishe amahora ama-5-6.
1. Okokuqala, i-cannula ye-intravenous (IV) izofakwa emthanjeni osengalweni yakho.
2. Umuthi unikezwa ukuvimbela isicanucanu nokuhlanza ihora elilodwa ngaphambi kokuqala kokwelashwa.
3. Ngemuva kwalokho, uzonikezwa isisombululo se-amino acid nge-IV cishe amahora amane ukuvikela izinso zakho.
4. Cishe imizuzu engama-30 ngemuva kokuthi kuqalwe isisombululo se-amino acid, umuthi we-PRRT unikezwa nge-IV ehlukile esikhathini semizuzu engama-30-45.
5. Ngemva kokuba zonke izixazululo sezinikezwe, i-IV cannula iyasuswa.
Ngosuku olulandelayo ngemva kokwelashwa, kwenziwa ukuhlolwa okukhethekile ukuze kubonwe ukuthi umuthi usakazeke kanjani emzimbeni wonke.
Yiziphi izinzuzo nezingozi zokwelashwa kwe-PRRT?
Yiziphi izinzuzo?
I-PRRT iyindlela yokwelapha ephumelela kakhulu. Kwabaningi abayitholayo, izimila zabo ziyanyamalala noma ziyeke ukukhula. Lokhu kuvumela iziguli ukuthi ziphile isikhathi eside futhi zilondoloze izinga elihle lempilo .
Kodwa into eyodwa okufanele uyikhumbule ukuthi i-PRRT ayilona ikhambi lomdlavuza. Kwabaningi, umdlavuza ungabuya ngemva kwesikhashana.
Izingozi nemiphumela emibi
Ukuhlanza kanye nesicanucanu yimiphumela emibi evame kakhulu yalokhu kwelashwa, kodwa ingalawulwa kakhulu ngemithi enikezwa ngaphambi kokwelashwa.
Ezinye izinkinga ezingaba khona yilezi:
- Izinkinga zezinso noma zesibindi.
- Inani eliphansi lamaseli egazi. Lokhu kungabangela ubunzima bokuphefumula, ukwanda kwengozi yokutheleleka, kanye nokopha noma ukuklwebheka.
- Kukhona ingozi engavamile kakhulu yokuthola umdlavuza wegazi njenge-myelodysplastic syndrome kanye ne-leukemia.
Udokotela wakho uzokugada ngokuhlolwa kwegazi njalo phakathi nezinyanga ezingu-8 zokwelashwa. Uma kuvela izinkinga, uzonquma ukushintsha noma ukuyeka ukwelashwa kwakho.
Isimo esiphuthumayo kakhulu: Inkinga Yomdlavuza
Lesi yisimo esingavamile kodwa esibi kakhulu, esingasongela impilo. Sibangelwa ukwanda okungazelelwe kwama-hormone avela kumaseli omdlavuza. Izimpawu zivame ukuvela zingakapheli amahora angu-48 ngemva kokuthola ukwelashwa.
Uma uhlangabezana nanoma yiziphi zalezi zimpawu, hamba ngokushesha eMnyangweni Wezimo Eziphuthumayo (ETU).
* Ubunzima bokuphefumula
* Ukubomvu noma umuzwa wokushisa kwesikhumba ebusweni noma entanyeni (ukusha)
* Umfutho wegazi ophansi (i-Hypotension)
* Ukushaya kwenhliziyo okusheshayo (ukushaya kwenhliziyo okusheshayo)
* Uhudo olubi kakhulu
Ukululama nokuphila kwansuku zonke
Iningi labantu libekezelela ukwelashwa kwe-PRRT kahle futhi lilulama ngokushesha.
Ngingabuyela emsebenzini?
I-PRRT isebenzisa inani elincane kakhulu lezinto ezikhipha imisebe. Le mpahla ekhipha imisebe ikhishwa emzimbeni wakho emchameni nasendle izinsuku ezimbalwa ngemva kokwelashwa. Udokotela wakho uzokweluleka ukuthi uhlale okungenani imitha elilodwa kude nabanye abantu phakathi nalesi sikhathi, ikakhulukazi abesifazane abakhulelwe nezingane ezincane . Kubalulekile futhi ukugeza izandla zakho njalo.
Kungenzeka yini ukuhamba phakathi nalesi sikhathi?
Kungase kube khona inani elincane kakhulu lemisebe emzimbeni wakho kuze kube yizinyanga ezi-3 ngemva kokwelashwa kwakho. Lokhu kungatholakala ngemishini yokuhlola imisebe ezikhumulweni zezindiza, isibonelo. Udokotela wakho uzokunika ikhadi elikhethekile elizochaza ukwelashwa okutholile. Kubalulekile ukugcina leli khadi kanye nekhophi yamanothi akho okwelashwa nawe noma ngabe uya kuphi kuze kube yizinyanga ezi-3 ngemva kokwelashwa kwakho.
Umlayezo Wokuya Nawe Ekhaya
- I-PRRT iyindlela yokwelapha ethuthukisiwe ehlose amangqamuzana omdlavuza kuphela futhi isebenzisa imisebe ukuwabhubhisa.
- Isetshenziswa kakhulu kuma-neuroendocrine tumors (ama-NET) asakazeke emzimbeni wonke futhi angaphenduli ekuhlinzweni noma kwezinye izindlela zokwelapha.
- Nakuba lokhu kungesona ukwelashwa okwelapha umdlavuza ngokuphelele, kuyasiza kakhulu ekulawuleni lesi sifo nasekuthuthukiseni isikhathi sokusinda kanye nekhwalithi yokuphila.
- Kubalulekile ukulandela imiyalelo kadokotela ukuze uzivikele emisebeni izinsuku ezimbalwa ngemva kokwelashwa.
- Uma uba nezimpawu ze -Carcinoid Crisis , njengobunzima bokuphefumula, ukusha kwesikhumba, kanye nokushaya kwenhliziyo okusheshayo, hamba ngokushesha uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela .
- Uma kuvela izinkinga noma imiphumela emibi mayelana nokwelashwa, khuluma nodokotela wakho ngakho.
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