Uma wena noma othandekayo wakho kutholakala ukuthi unomdlavuza, kuvamile ukuzizwa wesaba futhi wethukile kancane lapho udokotela wakho ekhuluma ngokwelashwa okufana ne-R-CHOP. Kunemibuzo eminingi efika engqondweni, njengokuthi la magama asho ukuthini, ukuthi lokhu kwelashwa kunjani, nokuthi kuzokwenzekani ngenxa yalokho. Yingakho, njengokungathi umngane wakho ukuxoxela ngakho ngamazwi alula, sizoxoxa ngakho konke mayelana nokwelashwa kwe-R-CHOP namuhla.
Kalula nje, iyini i-R-CHOP?
I-R-CHOP iyindlela yokwelapha umdlavuza. Uma sikhuluma iqiniso, iyinhlanganisela yemithi emihlanu. Isetshenziswa ngqo ukwelapha uhlobo lomdlavuza olubizwa ngokuthi i-Non-Hodgkin Lymphoma . Le nhlanganisela yemithi ihlanganisa imithi emithathu ye-chemotherapy, umuthi wokwelapha oqondiwe, kanye ne-corticosteroid.
Uhlamvu ngalunye kuleli gama lumelela uhlobo oluthile lomuthi. Kulula kakhulu, bheka.
| Incwadi | Igama lomuthi | Kwenzekani ngalokhu? |
|---|---|---|
| R | I-Rituximab | Lokhu kuyindlela yokwelapha eqondiwe. Lokhu kusho ukuthi umuthi unamathela kuphrotheni ethile emaseli omdlavuza. Amasosha omzimba wethu angawathola futhi awabhubhise kalula lawa maseli omdlavuza. |
| C | I-Cyclophosphamide | Lona umuthi we-chemotherapy. Le mithi isebenza ngokubhubhisa amaseli ahlukana ngokushesha (njengamaseli omdlavuza). |
| H | I-Doxorubicin Hydrochloride | Lona futhi umuthi we-chemotherapy. |
| O | I-Vincristine Sulfate | Lona omunye umuthi we-chemotherapy. |
| P | I-Prednisone | Lolu uhlobo lwe-steroid (i-corticosteroid). Lusiza ukubulala amangqamuzana omdlavuza futhi lusiza ekunciphiseni ukusabela kokungezwani komzimba okungenzeka ngeminye imithi. |
Ngenxa yokuthi iningi lale mithi iyimithi yokwelapha ngamakhemikhali, abanye abantu babiza lokhu kwelashwa ngokuthi "i-R-CHOP chemo." Kodwa ngenxa yokuthi umuthi i-Rituximab usiza amasosha omzimba wethu, udokotela wakho angase awubize nangokuthi "i-immuno-chemotherapy."
Yiziphi izinhlobo zezifo ezisetshenziselwa ukwelashwa kwe-R-CHOP?
Odokotela basebenzisa kakhulu i-R-CHOP ukwelapha uhlobo lomdlavuza olubizwa nge -non-Hodgkin lymphoma . Futhi kuyindlela yokwelapha ephumelela kakhulu kwenye yezinhlobo ezivame kakhulu ze -lymphoma, i-diffuse large B-cell lymphoma (DLBCL) .
Ngaphezu kwalokho, i-R-CHOP isetshenziswa nasezimweni ezilandelayo:
- I-follicular lymphoma ethuthukisiwe
- I-Mantle cell lymphoma
- I-Waldenstrom macroglobulinemia
Kwenzeka kanjani ukwelashwa? (Umjikelezo Wokwelashwa)
Uzothola ukwelashwa kwe-R-CHOP ngemijikelezo. Umjikelezo ngamunye uvame ukuthatha amasonto amathathu (izinsuku ezingu-21). Lo mjikelezo uhlukaniswe izingxenye ezimbili:
1. Izinsuku zokwelapha: Izinsuku onikwa ngazo imithi.
2. Izinsuku zokuphumula: Izinsuku zokuvumela umzimba wakho ukuthi ululame, okungukuthi, ululame, ngaphambi komzuliswano olandelayo.
Zihamba kanjani izinsuku zokwelashwa?
Kuzodingeka uthathe umuthi izinsuku ezinhlanu. I-steroid ebizwa ngokuthi i-Prednisone (P) ithathwa njengephilisi. Eminye imithi emine (R, C, H, O) inikezwa wena ngokufaka i-intravenous infusion (IV). Lokhu kusho ukuthi inikezwa emithanjeni efana ne-saline. Kuzodingeka uye esibhedlela noma emtholampilo ukuze uthole lokhu.
Phakathi nalokhu kwelashwa, uzohlala esihlalweni. Umshini uzokunika umuthi ngepayipi lepulasitiki ungene emthanjeni ongalweni, esandleni, noma esifubeni sakho. Ngezinye izikhathi, ukuze kube lula ukuqhubeka nokwelashwa, idivayisi encane ebizwa ngokuthi i-chemo port ifakwa ngaphansi kwesikhumba sesifuba sakho.Ibizwa nangokuthi yinye.
Umjikelezo wokuqala wokwelashwa uvame ukuba kanje:
- Ngaphambi kokuba ukwelashwa kuqale, uzonikezwa imithi yokuqeda ukuhlanza kanye nesicanucanu .
- Futhi, imithi inikezwa ukuvimbela ukungezwani komzimba . Kuvamile ukuba nokusabela okuncane (isib., ukuzizwa ushisa, isiyezi) uma unikezwa umuthi i-Rituximab (R). Kodwa-ke, umuthi wangaphambilini uvimbela kakhulu ukusabela okukhulu.
Ukubaluleka kwezinsuku zokuphumula
Emjikelezweni ojwayelekile we-R-CHOP, uthola izinsuku ezingu-16 zokuphumula ngemva kwezinsuku ezinhlanu zokwelashwa. Lesi sikhathi sibaluleke kakhulu. Ngoba lapho i-R-CHOP ibhubhisa amangqamuzana omdlavuza, kuyakhathaza kakhulu nomzimba. Ngakho-ke kuyinto evamile ukuzizwa ukhathele kakhulu ngemva kokwelashwa. Phakathi nalezi zinsuku zokuphumula, kungumqondo omuhle ukucela ilungu lomndeni noma umngane ukuthi akusize ngemisebenzi yakho yansuku zonke.
Ngesikhathi sokululama kwakho, uma ukwazi ukusebenza kahle ngokomzimba, udokotela wakho angase akuncome ukuthi wenze imisebenzi emincane, njengokuhamba, ukuphuza amanzi amaningi, nokudla ukudla okunempilo.
Kufanele kwenziwe isikhathi esingakanani lokhu kwelashwa?
Iningi labantu lithola imijikelezo eyisithupha ye-R-CHOP. Umjikelezo ngamunye ungamasonto amathathu, ngakho-ke isikhathi sokwelashwa sisonke singamaviki ayi-18. Kodwa-ke, inani lemijikelezo oyidingayo lincike esimweni sakho. Abanye abantu bangadinga imijikelezo eyisishiyagalombili. Abanye odokotela bangancoma imijikelezo yamasonto amabili esikhundleni semijikelezo yamasonto amathathu.
Udokotela wakho ungumuntu ongcono kakhulu ukwenza lesi sinqumo . Uzochaza ngokucacile uhlelo lokwelashwa oludingayo.
Yiziphi izinzuzo zokwelashwa nge-R-CHOP?
Inzuzo enkulu yalokhu ukuthi akusiwo umuthi owodwa, kodwa inhlanganisela yemithi emihlanu. Umuthi ngamunye ubulala amangqamuzana omdlavuza ngezindlela ezahlukene. Ngakho-ke, esikhundleni sokuba isosha elilodwa lilwe, kufana nebutho lonke elihlangana ndawonye ukulwa nomdlavuza.
Izinga lempumelelo yokwelashwa kwe-R-CHOP liphezulu kakhulu . Isibonelo, abantu abangafika ku-70% abanohlobo lomdlavuza olubizwa nge-DLBCL bathola ukuphulukiswa okuphelele. Lokhu kusho ukuthi zonke izimpawu ziyanyamalala. Uma lesi sifo singaphinde sibuye iminyaka emihlanu, umdlavuza uvame ukubhekwa njengongenakuphinde ubuye.
Yiqiniso, lokhu kwelashwa akuqinisekisi ukuthi kuzowuqeda ngokuphelele umdlavuza noma kuwuvimbele ukuthi ungabuyi kuwo wonke umuntu. Kodwa-ke, i-R-CHOP ibhekwa njengenye yezindlela zokwelapha eziphephile nezisebenza kahle kakhulu ezitholakalayo ze-non-Hodgkin lymphoma.
Imiphumela Engemihle Nezingozi
Njenganoma yikuphi ukwelashwa, i-R-CHOP inemiphumela emibi. Kodwa ungakhathazeki. Udokotela wakho uzokunikeza imithi yokuvimbela le miphumela emibi emikhulu (njengokuhlanza) nokulawula izinto ezifana namaseli amhlophe egazi aphansi. Kubalulekile ukukhuluma ngokukhululekile ngalezi zingozi nodokotela wakho ngaphambi kokuqala ukwelashwa.
Ukusabela kokumnika
Abantu abaningi bangase babe nokusabela okuncane ku-Rituximab ngesikhathi sokwelashwa kwabo kokuqala. Yingakho odokotela benikeza umuthi kancane ekuqaleni. Kuvamile ukuzizwa unesiyezi noma ushisa, futhi kuzophela ngemva kwesikhashana. Kodwa-ke, uma unezimpawu zokusabela okukhulu, kufanele ufune usizo lwezokwelapha ngokushesha . Lezi zimpawu zifaka:
- Ukuqhuma kwesikhumba
- Ukuluma
- Ukuvuvukala komlomo noma izindebe
- Ukuzizwa sengathi umphimbo wakho unciphile
Abasebenzi bezokwelapha bazokuqapha ngenkathi unikezwa imithi. Kodwa-ke, uma uhlangabezana nanoma yiziphi zalezi zimpawu ngemuva kokuya ekhaya, hamba uye eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
Imiphumela emibi evamile
Zonke izidakamizwa eziku-R-CHOP zingadala imiphumela emibi. Kodwa akuwona wonke umuntu oyitholayo. Iyahlukahluka kuye ngomuntu nomuntu. Ake sibheke imiphumela emibi evame kakhulu nokuthi singabhekana kanjani nayo.
| Umphumela ongemuhle | Incazelo elula kanye nokuphathwa |
|---|---|
| Umchamo obomvu/opinki | I-Doxorubicin (H) umuthi obomvu. Ngakho-ke umchamo wakho ungase ube bomvu/ube pinki cishe amahora angu-48 ngemva kokwelashwa. Lokhu kuvamile, ungakhathazeki. |
| Isicanucanu nokuhlanza | Ngisho noma unikezwa umuthi wokuvimbela ukuhlanza, ngezinye izikhathi ungase uzizwe unesicanucanu. Thatha umuthi njengoba nje udokotela wakho ekuyalele. Futhi, gwema ukudla ukudla okuningi nokudla ukudla okunamafutha/okunongwe kakhulu. |
| Ukulahlekelwa izinwele | Lona umphumela ovamile we-chemotherapy. Ukulahlekelwa izinwele kungaqala cishe emavikini amathathu ngemva komthamo wokuqala womuthi.Izinwele zizokhula futhi ngemva kokuphela kokwelashwa. |
| Ukuba nomkhuhlane nokuthola umkhuhlane | Ukwelashwa ngamakhemikhali kunciphisa inani lamaseli amhlophe egazi. Lokhu kwandisa ingozi yokutheleleka. Uzonikezwa umjovo obizwa ngokuthi i-G-CSF, osiza ekukhiqizeni amaseli amhlophe egazi. Kodwa-ke, uma uba nomkhuhlane, tshela udokotela wakho ngokushesha. |
| Umsebenzi onzima nomzamo | Ukwelashwa nge-R-CHOP kungabangela ukwehla kwamangqamuzana abomvu egazi (i-anemia). Lokhu kungakwenza uzizwe ukhathele kakhulu. Cela usizo ngemisebenzi yansuku zonke. Ukuzivocavoca okulula, njengokuhamba cishe imizuzu engama-30 ngosuku, kuhle, kodwa phumula uma uzizwa ukhathele. |
| Ukopha okulula kanye nokudumba | Njengoba inani lama-platelet lehla, ngisho nokulimala okuncane kungabangela ukopha kanye nokuhuzuka. Qaphela ukuthi ungazilimazi. Tshela udokotela wakho uma unalezi zimpawu. |
| Ukuba ndikindiki emilenzeni | Ungase ube nokungezwani noma ukuqaqamba ezandleni nasezinyaweni zakho. Lokhu kubizwa ngokuthi i-peripheral neuropathy. Uma uhlangabezana nalezi zimpawu, tshela udokotela wakho. |
Ngaphezu kwalokho, kungase kube neminye imiphumela emibi:
- Izilonda zomlomo
- Ikhanda elibuhlungu
- Ukuqunjelwa noma isifo sohudo
- Isilungulela
- Ubuthakathaka bemisipha
- Ukungalali
- Izinguquko zesimo sengqondo
- Ukushaya kwenhliziyo
Imiphumela engaba khona yesikhathi eside ngemva kokwelashwa
Imiphumela eminingi emibi iyaphela ngokuhamba kwesikhathi ngemva kokuphela kokwelashwa.
Kodwa-ke, kuye ngezici ezifana namandla emithi oyitholayo, ukwelashwa kwe-R-CHOP kungandisa kancane ingozi yakho yokuthola isifo senhliziyo noma ezinye izinhlobo zomdlavuza esikhathini esizayo. Kungathinta nokuzala . Lokhu kusho ukuthi uma uhlela ukuba nezingane esikhathini esizayo, khuluma nodokotela wakho ngalokhu kusengaphambili. Ungase ukwazi ukuxoxa ngezinketho ezifana nokuqandisa amaqanda akho noma isidoda.
Uyini umehluko phakathi kwe-R-CHOP ne-CHOP?
Kalula nje, i-R-CHOP iyinguqulo ethuthukisiwe yokwelashwa kwe-CHOP. I-CHOP yethulwa ngawo-1990 futhi yayiyindlela engcono kakhulu yokwelapha i-non-Hodgkin lymphoma ngaleso sikhathi.
Kodwa ekuqaleni kwawo-2000, abacwaningi banezela umuthi wokwelapha oqondiwe i-Rituximab (R) ohlelweni lwe-CHOP. Lokhu kwengezwa kwandisa izinga lokwelapha nakakhulu. Namuhla, i-R-CHOP iyindlela yokwelapha ephumelela kakhulu, ithatha indawo ye-CHOP.
Umlayezo Wokuya Nawe Ekhaya
- I-R-CHOP iyinhlanganisela enamandla yemithi emihlanu ehlasela amangqamuzana omdlavuza evela ezindleleni ezahlukene.
- Lokhu kwelashwa kunikezwa ngemijikelezo. Umjikelezo ngamunye unezinsuku zokwelapha kanye nezinsuku zokuphumula.
- Imiphumela emibi ingase ivele, kodwa eminingi yayo ingalawulwa. Ungesabi ukutshela udokotela wakho nganoma yikuphi ukungakhululeki okutholayo.
- Uma uba nomkhuhlane, ubunzima bokuphefumula, noma ezinye izimpawu ezinzima, funa iseluleko sezokwelapha ngokushesha.
- Ukwelashwa kwe-R-CHOP kunezinga eliphezulu kakhulu lempumelelo ye-non-Hodgkin lymphoma. Lolu hambo lungaba nzima, kodwa ithimba lakho lezokwelapha kanye nabathandekayo bakho banawe.
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