Inxalenye yebele brachytherapy

I-Brachytherapy yomhlaza webele ibandakanya ukubeka izinto ezinemitha ye-radio ngqo kwindawo apho umhlaza webele ususwe khona ebeleni.

Iiseli zomhlaza zanda ngokukhawuleza kuneeseli eziqhelekileyo emzimbeni. Ngenxa yokuba i-radiation iyingozi kakhulu kwiiseli ezikhula ngokukhawuleza, unyango lwe-radiation lonakalisa iiseli zomhlaza ngokulula kuneeseli eziqhelekileyo. Oku kuthintela iiseli zomhlaza ekubeni zikhule kwaye zahlule, kwaye zikhokelele ekufeni kweseli.

I-Brachytherapy ihambisa unyango ngemitha ngqo apho kukho iiseli zomhlaza ngaphakathi kwebele. Ingabandakanya ukubeka umthombo we-radioactive kwindawo yotyando emva kokuba ugqirha esusa iqhuma lebele. Imitha efikelela kuphela kwindawo encinci ejikeleze indawo yotyando. Ayilunyangi lonke ibele, yiyo loo nto ibizwa ngokuba "yinxalenye yebele" unyango lwemitha okanye inxenye yebreachytherapy yebele. Injongo kukuthintela iziphumo ebezingalindelekanga zemitha kwimithamo encinci yezihlunu eziqhelekileyo.

Kukho iintlobo ezahlukeneyo zonyango lwebrachytherapy. Zimbini iindlela zokuhambisa imitha ngaphakathi kwebele.

IBRACHYTHERAPY YAMAZIKO (IMB)

• Iinaliti ezincinci ezininzi ezineetyhubhu ezibizwa ngokuba zii-catheters zibekwa ngolusu kwizicwili zesifuba ezijikeleze indawo ekumila kuyo. Oku kuhlala kwenziwa rhoqo kwiiveki ezi-1 ukuya kwezi-2 emva kotyando.
• Mammography, ultrasound, okanye CT scans zisetyenziselwa ukubeka izinto ezinemitha ye radioactive apho izakusebenza ngcono ukubulala umhlaza.
• Izinto ezinokusasazeka ngemitha zifakwa kwii-catheters kwaye zihlala iiveki ezi-1.
• Ngamanye amaxesha i-radiation inokuhanjiswa kabini ngemini kangangeentsuku ezi-5 ngomatshini olawulwa kude.

INTRACAVITARY BRACHYTHERAPY (IBB)

• Emva kokususwa kwesigaqa samabele, kukho indawo apho umhlaza ususwe khona. Isixhobo esiqulathe ibhaluni yesilicone kunye netyhubhu enamajelo asebenza kuyo inokufakwa kulo mngxunya. Kwiintsuku ezimbalwa emva kokubekwa, imitha ngohlobo lweepellets ezincinci ezinemitha ye-radio zinokungena kumajelo, zikhuphe imitha evela ngaphakathi kwibhaluni. Oku kuhlala kwenziwa kabini ngemini kangangeentsuku ezintlanu. Ngamanye amaxesha i-catheter ibekwa ngexesha lotyando lokuqala ngelixa ulele.
• Izikena ze-Ultrasound okanye ze-CT zisetyenziselwa ukukhokela ekubekweni ngqo kwezinto ezinemitha ye-radioactive apho iya kusebenza ngcono ukubulala umhlaza ngelixa ikhusela izicubu ezikufutshane.
• I-catheter (ibhaluni) ihlala isendaweni eyi-1 ukuya kwezi-2 iiveki kwaye isuswe kwi-ofisi yomboneleli wakho. Ukuthunga kunokufuneka ukuvala umngxunya apho kususwa khona i-catheter.

Unyango lwebrachytherapy lunokunikwa "njengedosi ephantsi" okanye "idosi ephezulu."

• Abo bafumana unyango lweedosi ezisezantsi bagcinwa esibhedlele kwigumbi labucala. Imitha ihanjiswa kancinci ngaphezulu kweeyure ukuya kwiintsuku.
• Unyango lwedosi ephezulu lubonelelwa njengesigulana esingaphandle sisebenzisa umatshini okude, kwakhona sihlala ngaphezulu kwe-5 okanye kangangeentsuku. Ngamanye amaxesha unyango luhanjiswa izihlandlo ezibini ngosuku olunye, kwahlulwe ngeyure ezi-4 ukuya kwezi-6 phakathi kweseshoni. Unyango ngalunye luthatha imizuzu eli-15 ukuya kwengama-20.

Ezinye iindlela zibandakanya:

• Ukufakelwa kwembewu esisigxina esisigxina (PBSI), apho imbewu ye-radioactive ifakwe nganye ngenaliti kwisifuba seveki kwiiveki ezimbalwa emva kwe-lumpectomy.
• Unyango lwe-intraoperative radiation luhanjiswa kwigumbi lokusebenza ngelixa ulele emva kokuba izicubu zamabele zisusiwe. Unyango lugqityiwe ngaphantsi kweyure. Oku kusebenzisa umatshini omkhulu we-x-ray ngaphakathi kwigumbi lokusebenza.

Iingcali ziye zafunda ukuba umhlaza othile kunokwenzeka ukuba ubuyele kufutshane nendawo yoqhaqho. Ke ngoko, kwezinye iimeko, lonke ibele lisenokungafuneki lifumane imitha. Ubuncinci besifuba sonyango siphatha kuphela ezinye kodwa ayisiwo onke amabele, egxile kwindawo apho umhlaza kunokwenzeka ukuba ubuye khona.

I-brachytherapy yebele inceda ukuthintela umhlaza wamabele ekubuyeni. Unyango lwemitha lunikezelwa emva kwe-lumpectomy okanye i-mastectomy ekhethekileyo. Le ndlela ibizwa ngokuba yi-adjuvant (eyongezelelweyo) unyango lwemitha kuba yongeza unyango olungaphaya kotyando.

Kuba ezi ndlela azifundiswanga kakuhle njengonyango lwe-radiation lwebele lonke, akukho sivumelwano sipheleleyo malunga nokuba ngubani onokufumana inzuzo.

Iindidi zesifo somhlaza webele ezinokuphathwa nge-radiation yebele ekhethekileyo zibandakanya:

• Iductal carcinoma in situ (DCIS)
• Umhlaza webele ohlaselayo

Ezinye izinto ezinokukhokelela ekusetyenzisweni kwe-brachytherapy zibandakanya:

• Ubungakanani besisu esingaphantsi kwe-2 cm ukuya kwi-3 cm (malunga ne-intshi)
• Akukho bungqina bethumba ecaleni komda weempawu zethumba ezisusiweyo
• Iilymph node azilunganga ngenxa yethumba, okanye inode enye kuphela enamanani amancinci

Xelela umboneleli wakho ukuba ngawaphi amayeza owasebenzisayo.

Nxiba iimpahla ezikhululekileyo kunyango.

Unyango ngemitha lungonakalisa okanye lubulale iiseli ezisempilweni. Ukufa kweeseli ezisempilweni kunokukhokelela kwiziphumo ebezingalindelekanga. Iziphumo ebezingalindelekanga zixhomekeke kwidosi yemitha, kwaye unalo unyango kangaphi.

• Unokuba nobushushu okanye ubuntununtunu kwindawo yokuhlinzwa.
• Unokuphuhlisa ubomvu, ukuthamba, okanye usulelo.
• Ipokotho enamanzi (seroma) inokukhula kwindawo yoqhaqho kwaye inokufuna ukukhutshwa.
• Ulusu lwakho ngaphezulu kwendawo ephathwayo lunokuba bomvu okanye lube mnyama ngombala, ipeyinti, okanye ukurhawuzelela.

Iziphumo ebezingalindelekanga zexesha elide zinokubandakanya:

• Ukunciphisa ubungakanani besifuba
• Ukuqina kokuqina kwebele okanye i-asymmetry ethile
• Ubomvu besikhumba kunye nombala

Akukhange kubekho zifundo zikumgangatho ophezulu ngokuthelekisa unyango lwe-brachytherapy kwimitha yonke yebele. Nangona kunjalo, olunye uphononongo lubonise iziphumo ukuba ziyafana kwabasetyhini abanomhlaza wamabele wasekhaya.

Umhlaza webele-unyango lwenxalenye yelanga; I-carcinoma yebele - unyango lwenxalenye yelanga; Brachytherapy - ibele; Imitha eyanceda incindi yebele - brachytherapy; APBI - brachytherapy; Ukukhawuleziswa okukhawulezileyo kwamabele webele-brachytherapy; Unyango olukhethekileyo lwe-radiation yebele - brachytherapy; Ukumiliselwa kwembewu esisigxina esisigxina; PBSI; I-radiotherapy yedosi ephantsi - ibele; I-dose ephezulu ye-radiotherapy - isifuba; Ibhaluni ye-elektroniki brachytherapy; I-EBB; I-brachytherapy yangaphakathi; IBB; Unyango lwe-brachytherapy; IMB

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lomhlaza wamabele (umntu omdala) (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/breast/hp/ Unyango-esifo-pdq. Ukuhlaziywa ngoFebruwari 11, 2021. Kufumaneka ngo-Matshi 11, 2021.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango ngemitha kunye nawe: inkxaso kubantu abanomhlaza. www.cancer.gov/publications/patient-education/radiationttherapy.pdf. Ukuhlaziywa kwe-Okthobha ka-2016. Ifikeleleke ngo-Okthobha u-5, 2020.

U-Otter SJ, uHolloway CL, u-O'Farrell DA, u-PM we-Devlin, uStewart AJ. Unyango ngonyango. Ku: Tepper JE, Foote RL, Michalski JM, ii-eds. Gunderson kunye neTepper's Clinical Radiation Oncology. Umhla we-5. IPhiladelphia, PA: Elsevier; 2021: isahluko 20.

Shah C, Harris EE, Holmes D, Vicini FA. Inxalenye yebele ye-irradiation: ukukhawulezisa kunye nokungenelela. Ku: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, ii-eds. Isifuba: Ulawulo oluBanzi lwezifo ezinobungozi kunye nezifo ezinobungozi. Umhla we-5. IPhiladelphia, PA: Elsevier; I-2018: isahluko 51.