Heerka IIIB Kansarka Sambabka - Qeexidda, Daaweynta, iyo Saadaalinta
Heerka 3B ee kansarka sanbabada unugyada yar-yar ayaa loo tixgeliyaa kansarka sambabada sare iyadoo la raacayo marxaladda 4, iyo inkastoo aan sida caadiga ah la daaweyn karin, waa daweyn. Qiyaastii boqolkiiba 20 dadka ayaa qaba cudurka kansarka sanbabada 3B waqtiga baaritaanka, iyada oo boqolkiiba 40 ee shakhsiyaadka horeba u soo baxeen heerka 4aad .
Guudmarka
Kansarka qanjidhka sambabada 3B waxaa lagu qeexay inuu yahay buro kasta oo ku faafay qulqulka qanjidhada ee fog ama uu ku soo weeraray dhismayaal kale oo laabta ah (sida wadnaha ama hunguriga.)
Dhakhtarrada Onkologists waxay isticmaalaan nidaamka TNM si loo sii qeexo marxaladaha kansarka sanbabada. Sharax fudud oo nidaamka TNM ah waxaa ka mid ah:
T oo tixraacaya cabbirka burooyinka:
- T1 : Buro waa wax ka yar 3 cm (1 ½ injir) cabbirka.
- T2 : Booggu wuxuu ka weyn yahay 3 cm balse ka yar 7 cm.
- T3 : Boogu wuxuu ka weyn yahay 7 cm ama wuxuu si toos ah u geli karaa mid ka mid ah kuwan soo socda: derbiga laabta, diaphragm , dareemaha kudhaca maqaarka (farsamada maskaxda), xuubka daboolaya meesha u dhexeysa laba sambab (lafdhabarta dhexdhexaad ah), ama mid ka mid ah xargaha wadnaha ( perikardium parietal ); ama buro ee kuuskuusan ugu yaraan 2 cm ka hooseeya carina; ama waxay la xiriirtaa burburka sambabada oo dhan ama qanjidhada qanjirada ee kala duwan ee isla lafaha.
- T4 : Tumor kasta oo ka mid ah kuwan soo socda: meel u dhaxaysa sambabada ( dhexdhexaadinta ), wadnaha, maraakiibta waawayn, trachea , mid ka mid ah dareemayaasha ku xidhan xadhigaha codka (dareemaha laf-dhabarka), neef-xummo , jidh-diid, ama meel halkaasoo trachea ay u kala baxdo labada bambo oo waaweyn (carina); ama qanjirro kala duwan oo qanjirada (s) ku jira lafo kala duwan oo dhinac ah ee laabta.
N waxa loola jeedaa qanjidhada qanjidhada:
- N0 : Lama oggola numbarada.
- N1 : Burka ayaa ku faafay noodhada agagaarka isla dhinaca laabta.
- N2 : Booggu wuxuu ku faafay noodhadhka meel fog, laakiin dhinaca kale ee xabadka.
- N3 : Unugyada kansarku waxay ku jiraan qanjirada noodarka dhinaca kale ee xabadka oo ka imanaya buro, ama qanjirrada ku dhow xiniinyaha qoorta ama qoorta.
M wuxuu u taagan yahay cudurkeenaha :
- M0 : Looma helin wax dhibco ah.
- M1 : Bukaanku wuxuu ku fidaa (kudheerta) gobollada kale ee jirka ama sambab kale.
Isticmaalka Nidaamka Nidaamka TNM ee Heerka 3B waxaa lagu sharaxay sida:
- Wax kasta oo T, N3, M0 : Macnaheedu waa buro kasta oo ku faafay limfa noodeska dhinaca kale ee laabta ka yimaada burka ama noodhka u dhow ee murqaha ama qoorta, laakiin aan ku faafin gobollada fog.
- T4, Wax kasta oo N, M0 : Macnaheedu waa buro wax kasta oo ku yaala hawada hawada, waxay ku soo weerareen dhismayaasha maxaliga ah sida wadnaha ama hunguriga ama uu leeyahay finan-jeexjeexin ilmagaleenka. Noodaha ama laga yaabo inaysan ku lug laheeyn, iyo marka ay saameeyeen, waxay u dhowaan kartaa buro ama meel ka sii dheer xabadka ama qoorta, laakiin buro kuma fido meelo fog oo jidhka ah.
Astaamaha
Calaamadaha caadiga ah ee marxaladda 3 kansarka sanbabada waxaa ka mid ah qufac joogto ah iyo neefta oo ku adkaata . Dhammaan dadka ku dhow hawo-mareenada hawadu waxay keeni karaan hemoptysis ( quficinta dhiig ). Marka burcaddu ay ku lug leedahay meelaha sida borotiinka iyo qaababka kale ee xabadka, dysfagia (dhibaatada liqitaanka) iyo xabeeb ayaa dhici karta. Xanuunka dhabarka, laabta, iyo feeraha ayaa ah mid caadi ah haddii finanku ku dhaco qanjirka, tani waxay keeni kartaa in ay sii kordhiso neefta oo gaabisa sidoo kale.
Calaamadaha guud ee kansarka sida daal iyo miisaan aan loola jeedin ayaa sidoo kale la heli karaa.
Daaweynta
Marka laga reebo marar dhif ah, marxaladda 3B ee kansarka sanbabada waxaa loo tixgeliyaa in aan la shaqeyn karin ( qaliinka ma daaweyn doono kansarka), laakiin maaha wax aan la daweyn karin. Kuwa loogu talagalay dadka caafimaadka qaba, daaweynta kemotherabi ama daaweynta kemotherabi iyo daaweynta shucaaca ayaa inta badan lagu taliyaa. Haddii shakhsiyaadka aan u adkeysan karin daaweynta kiimiko, daaweynta shucaaca waxaa loo isticmaali karaa kali. Inkastoo daaweynta shucaaca aan sida caadiga ah la siineynin ujeedada daaweynta kansarka, waxay caawin kartaa daaweynta calaamadaha sida xanuunka, neefta oo gaabisa, iyo qufac.
Daawooyinka cusub ee sida daawooyinka la beegsanayo iyo difaaca jirka ayaa isbedel ku samaynaya dadka qaba heerarka ugu sareeya ee kansarka sanbabada. Qof kasta oo qaba kansarka sanbabada unugyada yaryar ee unugyada yaryar waa inuu lahaadaa sheyga molecular (baaritaanka hiddaha) oo laga sameeyo burooyinkooda. Daawooyinka lagu daaweynayo isbeddellada EGFR , dib-u-habaynta ALK , iyo dib-u-habaynta ROS1 ayaa la ansixiyey, iyo daroogooyinka lagu beegsanayo isbeddellada kale ee lagu baranayo tijaabooyinka kiliinikada. Xaaladaha qaarkood, daawooyinkaas ayaa dadka u oggolaanaya inay ku noolaadaan kansarka sanbabada oo ah nooc ka mid ah cudurrada daba dheeraada.
Immunotherapy waa doorasho xiiso leh , daawooyinka ugu horeeya ee la ansixiyey sannadka 2015. Daawooyinkan waxay keeneen "jawaab celin joogto ah" - oo ah ereyo asal ah oo loo tarjuman karo micnaheedu yahay badbaadada mudada dheer - dadka qaarkiis qaba kansarka sambabada sare. Qaar ka mid ah daawooyinkan ayaa sidoo kale loo isticmaalaa si loo isticmaalo marxalado heer sare ah ee kansarka sanbabada. Sanadkii 2018 hal daroogo oo ah daawada difaaca jirka, Imfinzi (durvalumab) ayaa loo ogolaaday gaar ahaan daaweynta marxaladda aan la garowsaneyn 3 kaansarka unugyada yar-yar ee unugyada yaryar. Waxaa loo adeegsadaa ka dib daaweynta kiimikada iyo daaweynta shucaaca, waxaana lagu ogaaday in lagu wanaajinayo badbaadada sii socota.
Sababtoo ah natiijada daaweynta waa mid sabool ah , Machadka Qaranka ee Kansarka wuxuu sheegaa in dhammaan shakhsiyaadka qaba cudurka kansarka sanbabka 3 in loo tixgeliyo musharaxyo tijaabo ah oo daaweyn ah -kiyad ah oo qiimeynaya daaweyn cusub iyo daaweyn isku dhafan ee kansarka sanbabada.
Saadaasha
Heerka 5-sano ee badbaadada ee heerarka 3-da ah ee kansarka sanbabada ayaa ah mid murugo leh 5% oo keliya. Waqtiga badbaadada dhexdhexaadka ah (wakhtiga boqolkiiba 50 ee bukaannada ay nool yihiin iyo 50 boqolkiiba ay dhinteen) waa qiyaas ahaan 13 bilood daaweyn. Maskaxda ku hay in tirakoobyadani yihiin tirooyin la helay ka hor intaan la qaadan daawooyinka cusub - sida qaar ka mid ah dawooyinka la beegsaday iyo difaaca jirka - ayaa loo oggolaaday daaweynta kansarka sanbabada.
Taageero
Cilmi-baaristu waxay soo jeedinaysaa in aad baran karto waxa aad ka qaban karto kansarkaaga ku caawinaayo natiijada. Waxaa jira macluumaad badan oo internetka ah, laakiin way adkaan kartaa in la ogaado meesha aad raadinayso macluumaad wanaagsan. Iska hubi talooyinkan si aad u hesho macluumaad ku saabsan kansar macquul ah onlineka . Waxaa laga yaabaa in ugu muhiimsan ee aad sameyn karto waa inaad barato inaad u noqoto qof kuu doodaayo xanuunkaaga kansarka . Daaweynta kansarka sanbabada ayaa si dhakhso ah isu bedbeddela, waxayna ku adkaan kartaa xitaa dhakhaatiirta kansarka sanbabada inay sii joogaan baaritaanka dhammaan baaritaanada.
Habka ugu fiican ee loo raadsado taageerada iyo macluumaadka wanaagsan waa inaad ka qayb qaadatid koox taageera kansarka sanbabada ama bulshada masruufka .Waxaa laga yaabaa inaad ka maqnaatid wax yar oo ku saabsan kooxaha kansarka sanbabada marka loo eego tirooyinka, kooxaha kansarka naaska, laakiin waxa ay kooxahan ka yar yihiin tirada qoto dheer. Hashtag #LCSM waxay u taagan tahay warbaahinta bulshada ee kansarka sanbabada. Inta badan dhammaantood, ha lumin rajo. Heerka daaweynta iyo heerka badbaadada ee kansarka sanbabada labadaba way fiicnaanayaan. Sannadka 2015 waxaa jiray daweyno cusub oo loo oggolaaday kansarka sanbabada intii aan horay loo soo bixin, daaweyn dheeraad ah ayaa lagu qiimeeyaa tijaabooyinka kiliinikada.
Ilaha:
Society Cancer Society. Xaqiiqooyinka Kansarka iyo Sawirrada 2014 . Atlanta: Bulshada Mareykanka ee Kansarka; 2014. http://www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf
Society Cancer Society. Kansarka Sambabka (Unugyada Hoose-yar). Qiyaasaha Kansarka Cudurka Kansarka Cudurka aan-yareyn ee Qaybaha Heerka. La sii daayo 02/08/16 .. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-survival-rates
Guddiga Wadajirka ee Maraykanka ee Kansarka. Kansarka Lung Cancer. Warka 7aad. Gaaray 09/20/14. https://cancerstaging.org/references-tools/quickreferences/Documents/LungMedium.pdf
> Antonia, S., Villegas, A., Daniel, D. et al. Durvalumab Ka Dib Daaweynta Chemoradioterapia ee Heerka III Kansarka Qanjada Sambabka ee aan-yareyn. Wargeyska New England Journal of Medicine . 2017. 377: 1919-1929.
Edge, S. et al (Eds.). Buugga Dheecaanka Kansarka AJCC. Warka 7aad. Duufaan. New York, NY. 2010.
Faithi, A. iyo J. Brahmer. Daweynta kiimiko (chemotherapy) oo loogu talagalay heerka sare ee kansarka sanbabada unugyada yaryar. Seminarrada Qalliinka Thoracic iyo Qalitaanka wadnaha . 2008. 20 (3): 210-6.
Machadka Kansarka Qaranka. Daaweynta kaansarka sanbabada aan-yareyn (PDQ) La sii daayo 07/07/16. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq#section/all