Stage IIIB Ciwon daji na huhu - Definition, Jiyya, da Fassarar
Sashe na 3B marasa ciwon ƙwayar cutar ciwon huhu ne ake dauke da cutar ciwon huhu tare da mataki na 4, kuma ko da yake ba za'a iya magance shi ba, yana da kyau. Kimanin kashi 20 cikin 100 na mutanen da ke fama da cutar kanjamau 3B a lokacin ganewar asali, tare da kashi 40 cikin dari na mutanen da suka riga sun ci gaba zuwa mataki na 4 .
Bayani
Sakin ciwon huhu na 3B an bayyana shi azaman ƙwayar kowane nau'i wanda ya yada zuwa gajerun ƙwayar lymph mai nisa ko ya mamaye sauran sifofi (kamar zuciya ko esophagus).
Masu binciken ilimin halitta sunyi amfani da tsarin TNM don kara bayyana ƙananan ciwon daji na huhu. Bayani mai sauƙi na tsarin TNM ya hada da:
T cewa yana nufin girman tumo:
- T1 : Kyakkyawan yana kasa da 3 cm (1 ½ inci) a cikin girman.
- T2 : Ciwon sukari ya fi girma 3 cm amma kasa da 7 cm.
- T3 : Tsari ya fi girma fiye da 7 cm ko kuma kai tsaye ya mamaye kowane ɗayan waɗannan: murfin kirji, diaphragm , jijiyar da ke kula da diaphragm (jijiya na phrenic), membrane rufe sararin samaniya tsakanin matuka biyu (mahimmancin layi), ko ɗayan membranes zuciya ( pericard pericardium ); ko tumo a cikin babban maschus akalla 2 cm a kasa da motar; ko kuma hade da haɗuwa da dukan ƙwayar cuta ko ƙananan ƙwayoyin tumatir (s) a cikin wannan nau'i na huhu.
- T4 : Tumo na kowane nau'i wanda ya mamaye wani daga cikin wadannan: sarari a tsakanin huhu ( mediastinum ), zuciya, manyan tasoshin, trachea , daya daga cikin jijiyoyin da ke yin amfani da layin murya (jijiyar laryngeal), esophagus , vertebral jiki, ko wurin inda trachea ya ragargaje a cikin manyan manya biyu (carina); ko rarraba ƙwayoyin tumatir (s) a cikin ƙwayar lobe daban-daban a gefe ɗaya na kirji.
N tana nufin ƙwayoyin lymph:
- N0 : Ba a taɓa shafewa ba.
- N1 : Turar ta yada zuwa ga kwanto a kusa da kirji.
- N2 : Ciwon ya warwatsa zuwa ƙuƙwalwa gaba ɗaya amma a gefe guda na kirji.
- N3 : Kwayoyin ciwon daji sun kasance a cikin ƙwayoyin lymph a gefe ɗaya daga cikin kirji daga ƙwayar cuta, ko kuma a cikin kusurwa kusa da ƙwanƙarar ko ƙunƙolin wuyansa.
M wakiltar cutar metastatic :
- M0 : Babu matakan ganyayyaki.
- M1 : Ciwon sukari ya yada (metastasized) zuwa wasu yankuna na jiki ko sauran ƙwayar.
Amfani da Sashen Sashen TNM 3B an bayyana shi kamar:
- Kowane T, N3, M0 : Yana nufin ƙwayar ƙwayar kowane nau'i wanda ya yada zuwa ƙananan lymph a gefe ɗaya daga cikin kirji daga kututture ko zuwa kusoshi a kusa da ƙwanƙara ko wuyan wuyansa, amma bai yada zuwa yankuna masu nisa na jiki ba.
- T4, Duk N, M0 : Yana nufin ƙwayar ƙwayar kowane nau'in da ke cikin ƙananan hanyoyi, ya mamaye hanyoyi na gida kamar zuciya ko esophagus ko yana da mummunar lalacewa. Nodes zasu iya ko ba zasu shiga ciki ba, kuma lokacin da ya shafa, zai iya zama kusa da ƙwayar ko ci gaba a cikin kirji ko wuyansa, amma ƙwayar ba ta yada zuwa yankuna masu nisa ba.
Cutar cututtuka
Kwayoyin cuta guda 3 na ciwon huhu na huhu 3 sun haɗa da tari da kuma rashin ƙarfi na numfashi . Tumors a kusa da hanyoyi na iska na iya haifar da hemoptysis ( jinin jini ). Lokacin da kututtukan ya shafi yankunan kamar sophagus da sauran nau'in kwakwalwa, dysphagia (wahalar haɗuwa) da kuma hoarseness zai iya faruwa. Pain a baya, kirji, da haƙarƙari na yau da kullum idan an sami cikakkiyar bayani, wannan zai iya haifar da rashin ƙarfi na numfashi.
Gabalar bayyanar cututtukan ciwon daji irin su gajiya da rashin asarar hasara ba za a iya kasancewa ba.
Jiyya
Tare da ƙananan ƙananan, an yi la'akari da ciwon daji na 3B na ciwon huhu a cikin rashin aiki ( aikin tiyata ba zai warke ciwon daji ba), amma ba a iya gwada shi ba. Ga wa] anda ke da lafiya, haɗarin chemotherapy ko chemotherapy da radiation far ne sau da yawa shawarar. Idan mutane ba su iya jure cutar chemotherapy ba, ana iya amfani da farfadowar radiation kadai. Duk da yake ba a bayar da magungunan radiation ba tare da manufar maganin ciwon daji, zai iya taimakawa wajen magance cututtuka irin su zafi, rashin ƙarfi na numfashi, da kuma tari.
Sabbin sababbin jiyya kamar maganin kwantar da hankali da kuma immunotherapy suna haifar da bambanci ga mutanen dake da ciwon daji na ciwon huhu. Duk wanda ke fama da ciwon huhu na ƙananan ciwon ƙwayar cuta ya kamata ya sami labarun kwayoyin (gwajin gwaji) akan ƙwayar su. Magunguna don biyan maye gurbin EGFR , gyare-gyaren ALK , da ROS1 sake dawowa an yarda, kuma ana amfani da kwayoyi masu amfani da wasu maye gurbi a gwaji. A wasu lokuta, wadannan jiyya sun ba mutane damar zama tare da ciwon huhu da ciwon huhu kamar yadda cutar ta ciwo.
Immunotherapy wani zaɓi ne mai ban sha'awa , tare da farautar kwayoyi da aka amince da shi a shekara ta 2015. Wadannan kwayoyi sun haifar da "martani mai dorewa" -an lokaci ne wanda zai iya fassarawa na nufin rayuwa mai tsawo - ga wasu mutanen da ke fama da ciwon huhu na huhu. Wasu daga cikin wadannan kwayoyi suna amfani da su don haɗuwa da ciwon ciwon daji na ciwon huhu. A shekara ta 2018 an yi amfani da miyagun ƙwayoyi na rigakafin immunotherapy, Imfinzi (durvalumab) musamman domin maganin cutar marasa ciwon ƙwayar cutar kwayar cutar marasa lafiya. An yi amfani da ita bayan shan magani da kuma radiation, kuma an samu don inganta rayuwar cigaba.
Saboda sakamakon maganin rashin lafiya , Cibiyar Ƙwararren Ciwon Ƙwayar ta Amurka ta bayyana cewa duk wanda ke fama da ciwon huhu na 3 ya kamata a dauki 'yan takara don gwajin gwaji-masu bincike da suka gwada sababbin jiyya da kuma maganin jiyya don ciwon huhu na huhu.
Faɗakarwa
Halin shekaru 5 na rayuwa tare da ciwon daji na 3B na huhu shine bakin ciki kawai kashi 5. Lokacin sauye-sauye (lokacin da kashi 50 cikin 100 na marasa lafiya ke da rai kuma kashi 50 cikin dari sun wuce) yana da watanni 13 da magani. Ka tuna cewa waɗannan lambobi ne lambobin da aka samu kafin sababbin magunguna-irin su wasu hanyoyin da aka tsara da kuma rigakafi - an yarda don maganin cutar kanjamau.
Taimako
Nazarin ya nuna cewa sanin abin da zaka iya game da ciwon daji ke taimakawa tare da sakamakon. Akwai wadataccen bayani a kan layi, duk da haka yana da wuya a san inda za a nemi kyakkyawan bayani. Bincika waɗannan shawarwari don gano bayanan ciwon daji akan labaran yanar gizo . Zai yiwu abu mafi mahimmanci da za ka iya yi shi ne ka koyi zama mai ba da shawara a cikin kulawar ciwon daji . Magunguna ga ciwon daji na huhu suna canzawa da sauri, kuma yana iya wahala ga magungunan ciwon daji na ƙwayar rigakafi don su kasance a cikin dukan bincike.
Kyakkyawan hanyar neman duk goyon baya da kuma kyakkyawan bayani shine shiga cikin kungiya ta goyan baya na kwakwalwa ta jiki ko goyan bayan al'umma .Ya iya ji karar game da ciwon daji na mahaukacin mahaifa fiye da maganganun, ƙungiyoyin ciwon nono, amma abin da waɗannan kungiyoyin basu da lambobin da suka yi a zurfin. Hashtag #LCSM yana tsaye ne ga kafofin watsa labarun ciwon daji na huhu. Yawancin haka, kada ku rasa bege. Dukkanin jiyya da kuma rayuwa don cutar kanjamau sun inganta. A shekara ta 2015 akwai sababbin jiyya da aka yarda da cutar ciwon huhu a cikin kullun baya, kuma ana gwada sauran jiyya a gwaji.
Sources:
Cibiyar Cancer na Amurka. Cancer Facts da Figures 2014 . Atlanta: Cibiyar Cancer na Amurka; 2014. http://www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf
Cibiyar Cancer na Amurka. Ciwon daji na huhu (ƙananan ƙwayoyin cuta) Updated 02/08/16 .. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-survival-rates
Cibiyar hadin gwiwa ta Amirka kan cutar kanjamau. Lung Cancer Tsarin. Edition 7th. Samun shiga 09/20/14. https://cancerstaging.org/references-tools/quickreferences/Documents/LungMedium.pdf
> Antonia, S., Villegas, A., Daniel, D. et al. Durvalumab Bayan Chemoradiotherapy a Stage III Ciwon Ƙwayar Ciwon Kwayoyin Ƙananan Ƙananan Cututtuka. Jaridar New England Journal of Medicine . 2017. 377: 1919-1929.
Edge, S. et al (Eds.). AJCC Canjin Tsarin Kwayar Cancer. Edition 7th. Springer. New York, NY. 2010.
Faithi, A. da J. Brahmer. Chemotherapy don ci gaba da cigaba marasa ciwon kwayar cutar ciwon huhu. Seminars a cikin Thoracic da Tiyata na zuciya . 2008. 20 (3): 210-6.
Cibiyar Cancer ta Kasa. Ƙunƙasar Ciwon Kwayoyin Wutar Cutar Kan Ƙasar Kanana (PDQ) - Shafin Farko na Lafiya. Updated 07/07/16. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq#section/all