Inqanaba 4 I-Renal Cell Carcinoma: Unyango kunye nokuqonda

Umxholo

• Izinketho zonyango lwe-RCC
• Ugqirha
• Unyango lwe-Immunotherapy
• Inhibitors zokujonga
• I-Interleukin-2
• I-alpha yangaphakathi
• Unyango ekujoliswe kulo
• I-mTOR inhibitors
• Unyango ngemitha
• Unyango ngamayeza
• Uvavanyo lwezonyango
• I-Renal cell carcinoma isiteji
• Imbonakalo

I-Renal cell carcinoma (RCC) luhlobo lomhlaza oluchaphazela iiseli zezintso. I-RCC lolona hlobo luqhelekileyo lomhlaza wezintso. Zininzi izinto ezinobungozi zokuphuhlisa i-RCC, kubandakanya:

• Imbali yosapho ngesi sifo
• ukutshaya
• ukutyeba kakhulu
• igazi elonyukayo
• Isifo sezintso se-polycystic

Okukhona ifunyenwe kwangoko, kokukhona liya kukhula ithuba lakho lonyango olusebenzayo.

Izinketho zonyango lwe-RCC

Nangona inqanaba 4 i-RCC ichazwa njengenqanaba eliphambili lomhlaza, zisekho iindlela zonyango ezikhoyo.

Ugqirha

Kwezinye iimeko, xa i-tumor ephambili isuswe kwaye umhlaza ungasasazekanga ngokubanzi, i-nephrectomy enkulu ingenziwa. Oku kubandakanya ukususwa ngotyando uninzi okanye zonke izintso ezichaphazelekayo.

Ukususwa kotyando lwamanye amathumba kunokufuneka kubantu abanomhlaza wemastastatic. Iqela leengcali liya kuthatha isigqibo sokuba ngaba amathumba e-metastasized angasuswa ngaphandle komngcipheko omkhulu.

Ukuba utyando alunakwenzeka, ukudityaniswa kwethumba kunokusetyenziswa. Le nkqubo inciphisa ukunikezelwa kwegazi kwi-tumor, elinceda ukunciphisa iimpawu.

Nje ukuba kwenziwe utyando ukususa amathumba endawo, abantu abaninzi banokufuna unyango lwenkqubo. Olu hlobo lonyango lunyanga umhlaza emzimbeni. Inokukunceda ukunciphisa ukubuyela umhlaza kwakhona.

Inkqubo yonyango yenqanaba 4 RCC ibandakanya i-immunotherapy, unyango ekujoliswe kulo, imitha kunye nekhemotherapy.

Unyango lwe-Immunotherapy

I-Immunotherapy yinkqubo yonyango ejolise ekuvuseleleni amajoni omzimba ukuba ahlasele iiseli zomhlaza. Asinguye wonke umntu one-RCC osabela kakuhle kwi-immunotherapy, kwaye iziphumo ebezingalindelekanga zinokuba mandundu.

I-Immunotherapy, okanye unyango lwe-biologic, lunyango olunceda amajoni akho omzimba ahlasele umhlaza. Ihlala ingeniswa xa i-RCC ingenakususwa ngotyando.

I-Immunotherapy isebenzisa iintlobo ezimbalwa ezahlukeneyo zamachiza:

Inhibitors zokujonga

Amajoni akho omzimba asebenzisa inkqubo “yokujonga” ukwahlula phakathi kweeseli ezisempilweni kunye nomhlaza. I-Checkpoint inhibitors ijonge ukunceda amajoni akho omzimba afumane iiseli zomhlaza ezifihle kumajoni akho omzimba.

I-Nivolumab (i-Opdivo) yindawo yokutshekisha elawulwa nge-IV esele ikunyango lwe-RCC kule minyaka idlulileyo.

Iziphumo ziquka:

• irhashalala
• ukudinwa
• urhudo
• isicaphucaphu
• intloko ebuhlungu
• irhashalala
• intlungu edibeneyo
• intlungu zesisu
• ingxaki yokuphefumla

I-Interleukin-2

I-Interleukin-2 (IL-2, Proleukin) ikopi engeyiyo yeeproteni ezibizwa ngokuba zii-cytokines ezijolise ekwenzeni amajoni akho omzimba ahlasele iiseli zethumba.

Kubonakalisiwe ukuba nakho ukubanakho. Inokuba neziphumo ebezingalindelekanga ezimandundu ukuze isetyenziswe kuphela kubantu abasempilweni abanokuthi banyamezele iziphumo ebezingalindelekanga.

Enye yokusebenza ngokubalaseleyo kumadoda amhlophe anefomathi ye-RCC yabona inqanaba lokusinda eliphezulu ngokusetyenziswa kwedosi ephezulu ye-interleukin-2.

Iziphumo ziquka:

• ukudinwa
• ukopha
• Ukugodola
• ifiva
• uxinzelelo lwegazi oluphantsi
• ulwelo emiphungeni
• umonakalo kwizintso

I-alpha yangaphakathi

Ii-interferon zine-antiviral, antiproliferative (inqanda ukukhula komhlaza weseli), kunye ne-immunomodulatory (ichaphazela amajoni omzimba) iipropathi. I-Interferon alpha ijonge ukumisa iiseli zethumba ekuhlukaniseni nasekukhuleni.

I-Interferon ngamanye amaxesha inikwa nezinye iziyobisi, njenge-bevacizumab (Avastin).

Imiphumo emibi ye-interferon iquka:

• isicaphucaphu
• Iimpawu ezinjengomkhuhlane
• ukudinwa

Ii-interferon ziye zathathelwa indawo ikakhulu lonyango ekujolise kulo. Unyango lwe-interferon yearhente enye ayisasetyenziswa.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo kwi-RCC kuthetha ukusebenzisa iziyobisi ezijolise ngqo kwiiseli zomhlaza. Iziyobisi ekujoliswe kuzo ziyanqweneleka kuba azenzakalisi okanye zibulale iiseli ezisempilweni emzimbeni.

Kukho amayeza ekujolise kuwo aliqela kwinqanaba le-4 RCC elisebenza ukuthintela ukukhula kweseli. Bajolise kwiprotein ebizwa ngokuba yi-vascular endothelial growth factor (VEGF) ekhuthaza ukukhula kweeseli zomhlaza.

Ukuphuhliswa kwala machiza kujolise kuwo kuncede ukwandisa ubomi bezinye izigulana zenqanaba lesi-4. Unyango lubonakalise luthembisa ngokwaneleyo ukuba abaphandi bayaqhubeka nokuphuhlisa amachiza amatsha ekujoliswe kuwo.

Iyeza bevacizumab (Avastin) iibhloko ze-VEGF kwaye zilawulwa ngomthambo.

Iziphumo ziquka:

• urhudo
• ukuhla ukusinda
• isiqaqa
• ukungabi namdla wokutya
• isilungulela
• izilonda zomlomo

I-tyrosine kinase inhibitor (TKI) iyeka ukukhula kwenqanawa entsha yegazi kwizilonda kwaye iza kwifom yepilisi. Imizekelo yolu hlobo lweziyobisi ibandakanya:

• sorafenib (Nexavar)
• cabozantinib (iCabometyx)
• ipazopanib (Votrient)
• sunitinib (Sutent)

Iziphumo ebezingalindelekanga ze-TKIs zibandakanya:

• igazi elonyukayo
• isicaphucaphu
• urhudo
• iintlungu ezandleni nasezinyaweni

I-mTOR inhibitors

Ujoliso lobuchwephesha be-rapamycin (mTOR) inhibitors ijolise kwiprotein ye-mTOR, ekhuthaza ukukhula komhlaza weseli kwezintso.

Oku kubandakanya:

• i-temsirolimus (Torisel), yenziwa nge-IV
• i-everolimus (Afinitor), ithathwa ngomlomo kwifom yepilisi

Iziphumo ziquka:

• irhashalala
• ubuthathaka
• ukungabi namdla wokutya
• izilonda zomlomo
• ulwelo olwakhiwe ebusweni okanye emilenzeni
• iswekile yegazi ephezulu kunye ne-cholesterol

Unyango ngemitha

Imitha isebenzisa amandla e-X-ray aphezulu ukubulala iiseli zomhlaza. Imitha inokusetyenziswa emva kotyando ukubulala nayiphi na iiseli zomhlaza ezishiyeke emva konyango.

Kwi-RCC ephambili, ihlala isetyenziselwa ukukhulula iimpawu ezinjengeentlungu okanye ukudumba. Olu hlobo lonyango lubizwa ngokuba yinkathalo.

Iziphumo ezichaphazela umbane zibandakanya:

• isisu esibuhlungu
• ubomvu besikhumba
• ukudinwa
• urhudo

Unyango ngamayeza

I-Chemotherapy yindlela yonyango yesiko yeentlobo ezininzi zomhlaza. Kubandakanya ukusebenzisa ichiza okanye indibaniselwano yamachiza ukubulala iiseli zomhlaza.

Amachiza e-Chemotherapy akajoliswanga, nangona kunjalo, ke ayabulala iiseli ezisempilweni kwaye avelise iziphumo ebezingalindelekanga ezininzi.

I-Chemotherapy ihlala ingasebenzi kakuhle kubantu abane-RCC. Nangona kunjalo, ugqirha wakho unokucebisa ukuba unyango lwe-immunotherapy kunye nonyango olujolisiweyo alusebenzanga.

Olu nyango luthathwa ngokufakwa ngaphakathi okanye ngefomathi yepilisi. Inikwa ngemijikelezo eneexesha lokuphumla. Ngokuqhelekileyo ufuna ukufumana i-chemotherapy inyanga nenyanga okanye zonke iinyanga ezimbalwa.

Iziphumo ziquka:

• ukudinwa
• izilonda zomlomo
• isicaphucaphu nokugabha
• urhudo okanye ukuqhina
• ukulahleka kweenwele
• ukungabi namdla wokutya
• ukwanda komngcipheko wosulelo

Uvavanyo lwezonyango

Olunye ukhetho kubantu abanenqanaba 4 i-RCC kukuzibandakanya kuvavanyo lweklinikhi. Uvavanyo lwezonyango luvavanyo lonyango lokuvavanywa kwamachiza amatsha kunye nonyango.

Ungaxoxa ngezilingo zangoku zeklinikhi- kunye nemingcipheko yazo kunye nezibonelelo-nogqirha wakho okanye umboneleli wezempilo.

I-Renal cell carcinoma isiteji

Oogqirha abachonga nokunyanga i-RCC kunye nezinye iintlobo zomhlaza basebenzisa inkqubo yokuqokelela. Umntu ngamnye ophethe i-RCC unikwa inani elichongiweyo ukusuka kwi-1 ukuya kwi-4.

Ukuqokelela i-RCC kusekwe:

• ubungakanani be-tumor yokuqala kwizintso
• ukusasazeka kweeseli ezinomhlaza ukusuka kwithumba lokuqala ukuya kwizicubu ezikufuphi
• isidanga se metastasis
• ukusasazeka komhlaza kwamanye amalungu emzimbeni

Inqanaba 4 i-RCC inokubandakanya indibaniselwano yeekhrayitheriya zokulinganisa:

• Xa ithumba lokuqala likhulu kwaye sele lisasazekile kwizintso nakwizicubu ezikufutshane. Kule meko, iiseli zomhlaza zisenokuthi okanye zingasasazeki kwamanye amalungu omzimba.
• Xa umhlaza uphelise kwaye ukhona kwizitho ezikude. Kule meko, ithumba lokuqala linokuba nabuphi na ubungakanani, kwaye kunokubakho okanye kungabikho nawuphi na umhlaza kwizicwili ezikufutshane nezintso.

Imbonakalo

Inqanaba leminyaka emi-5 lokusinda kwesihlobo sabantu abanesigaba se-4 RCC yipesenti ezili-12. Nangona kunjalo, iimeko ezahlukeneyo zinokubangela amazinga aphezulu okusinda.

Abantu abakwaziyo ukwenza utyando ukuze kususwe amathumba e-metastatic banamazinga okusinda angcono, kwaye uninzi olunyangwa ngamayeza ekujoliswe kuwo luphila ixesha elide kunalawo angenalo.