Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza: Isiqondisi esibanzi 

Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza kuyindlela yokwelashwa egxile emithini ngqo endaweni ye-tumor. Le ndlela ihlose ukuthuthukisa ukusebenza kwempilo ngenkathi inciphisa imiphumela emibi ehlelekile ehambisana ne-chemotherapy yendabuko.

Isingeniso ekuletheni izidakamizwa ezenziwe zasendaweni

Ukwelashwa komdlavuza wendabuko okufana ne-chemotherapy kuvame ukubandakanya ukuphathwa kwezidakamizwa, okusho ukuthi umuthi uhamba kuwo wonke umzimba. Ngenkathi esebenza ngempumelelo ekubhekeni amaseli omdlavuza, le ndlela nayo ingalimaza amaseli anempilo, okuholela emiphumeleni emibi ebalulekile. Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza Inikeza indlela ebhekiswe kakhudlwana, ukuletha umuthi ngqo kwisiza se-tumor.

Le ndlela ingafaka amasu ahlukahlukene, kufaka phakathi:

• Ukujova okuqondile kwezidakamizwa esiswini.
• Ukubekwa kwezimila noma ama-wafers asungula izidakamizwa.
• Ukusetshenziswa kwama-nanoparticles ahlosiwe ukuletha izidakamizwa ngqo kumaseli womdlavuza.
• I-Chemotherapy yesifunda, lapho izidakamizwa ziphathwa khona endaweni ethile yomzimba equkethe isimila.

Izinzuzo Zokulethwa Kwezidakamizwa Esendaweni

Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza inikeza izinzuzo ezimbalwa ezibalulekile ngaphezulu kwezokwelapha ezihlelekile:

• Imiphumela emibi encishisiwe: Ngokugxila kwesidakamizwa endaweni ye-tumor, ukuvezwa kwezicubu ezinempilo kuncishisiwe, kuholele emiphumeleni emibi embalwa futhi engaphansi.
• Ukwanda kokuhlushwa kwezidakamizwa ngesimila: Ukulethwa kwasendaweni kungafinyelela ukugxila kwezidakamizwa okuphezulu ngaphakathi kwesimila, ngokuthuthuka ngempumelelo yokwelashwa.
• Ikhwalithi Yeziguli Ethuthukisiwe Yokuphila: Imiphumela emibi encishisiwe kanye nemiphumela yokwelashwa okuthuthukile ingakhulisa kakhulu impilo yeziguli ngesikhathi sokulashwa umdlavuza.
• Amathuba okuhlanganiswa nalapha: Ukulethwa kwasendaweni kungahlanganiswa nezinye izindlela zokwelashwa, njengokuhlinzwa, ukwelashwa kwemisebe, kanye ne-systemic chemotherapy, ukufeza imiphumela yokusebenzisa.

Amasu wokulethwa kwezidakamizwa okwenziwe endaweni

Kusetshenziselwa amasu ambalwa Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza, ngasinye sinezinzuzo nokulinganiselwa kwaso:

Umjovo oqondile

Lokhu kufaka phakathi ukujova umuthi ngokuqondile ku-isimila. Kuyindlela elula futhi engabizi kakhulu efanelekile ama-tumors atholakalayo. Ukuholwa kwe-Ultrasound noma i-CT kungasetshenziselwa ukuqinisekisa ukubekwa okuqondile. Izibonelo zifaka umjovo wamagciwane acolytic noma ama-chemotherapeapeutic agents.

Izimila ezifuywayo ezidakamizwa kanye nama-wafers

Lawa madivaysi afakwe ngokuqondile emzimbeni noma eduze kwesimila. Bakhipha umuthi kancane kancane ngokuhamba kwesikhathi, banikeze umphumela wokwelapha oqhubekayo. Indizo eyisigqoko^? Ama-Wafers, aqukethe i-Carmustine (BCNU), isibonelo esaziwayo esisetshenziswa ngemuva kokuvunyelwa kokuhlinzwa kwamathumbu obuchopho.

Ama-Nanoparticles

Ama-nanoparticles ayizinhlayiya ezincane ezenzelwe ukuletha izidakamizwa ngqo kumaseli womdlavuza. Bangakwazi ukubhekisa ukuqondisa amamaki athile kumaseli womdlavuza, ukuthuthukisa ukunqwabelana kwezidakamizwa endaweni ye-tumor futhi kunciphise imiphumela ye-off-okuqondiwe. Ama-Liposomes, ama-nanoparticles we-polymeric, kanye nama-nanoparticles wensimbi ajwayele ukusetshenziswa.

I-Chemotherapy Yesifunda

Lokhu kufaka ukuletha izidakamizwa ze-chemotherapy esifundeni esithile somzimba oqukethe isimila. Izibonelo zifaka:

• I-Hepatic Artery inflision (Hai): Kusetshenziselwa ukwelapha umdlavuza wesibindi ngokuletha i-chemotherapy ngqo esibindini nge-hepatic artery.
• I-intraperoneal chemotherapy (IP): Isetshenziselwa ukwelapha umdlavuza we-ovarian ngokuletha i-chemotherapy ngqo emgodini wesisu.
• I-Ilbolated Limb Perfesion (ILP): Kusetshenziselwa ukwelapha i-melanoma ne-sarcoma yemilenze ngokuhlukanisa ukusakazwa kwe-limb kanye nokuletha imithamo ephezulu ye-chemotherapy ngqo endaweni ethintekile.

Izibonelo Zokulethwa Kwezidakamizwa Esendaweni Ezokwelashwa Umdlavuza

Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza isetshenziswa ekwelapheni izinhlobo ezahlukahlukene zomdlavuza. Nazi izibonelo ezimbalwa:

Ama-Prain Tumors

Indizo eyisigqoko^? Ama-Wafers afakwe ebuchosheni ngemuva kokususwa okuphezulu kwe-gliomas ephezulu. Lezi zangameli zikhipha i-Cormustine (BCNU), isidakamizwa se-chemotherapy, ngqo esinqeni sokuhlinza, ukubulala noma yimaphi amaseli omdlavuza asele. Ucwaningo olushicilelwe e-The * Journal of Clinical Oncology * Ukhombise lokho gliadel^? Ama-Wafers athuthuke kakhulu ekusindeni ezigulini ezisanda kutholakala amabanga aphezulu.¹

Umdlavuza wesibindi

I-Hepatic Artery infusion (Hai) iyindlela yesifunda ye-chemotherapy esetshenziselwa ukwelapha umdlavuza wesibindi. Kubandakanya ukuletha izidakamizwa ze-chemotherapy ngqo esibindini nge-hepatic artery, umkhumbi omkhulu wegazi ohlinzeka isibindi. Lokhu kuvumela ukugxila okuphezulu kwesidakamizwa ukufinyelela isimila ngenkathi kunciphisa imiphumela emibi ehleliwe. Ucwaningo luye lwabonisa ukuthi i-Hai ingathuthukisa ukusinda ezigulini ezinomdlavuza wesibindi ongaphenduleki. Ochwepheshe at I-Shandong Baafa Cancer Research Institute Sebenzisa kakhulu le ndlela.

Umdlavuza we-ovarian

I-intraperoneal chemotherapy (IP) iyindlela yesifunda ye-chemotherapy esetshenziselwa ukwelapha umdlavuza we-ovari. Kubandakanya ukuletha izidakamizwa ze-chemotherapy ngqo emgodini wesisu, lapho umdlavuza we-ovari uvame ukusakazeka khona. Lokhu kuvumela ukugxila okuphezulu kwesidakamizwa ukufinyelela amaseli womdlavuza esiswini. Ucwaningo lukhombisile ukuthi i-Chemotherapy ye-IP ingathuthukisa ukusinda ezigulini ezinomdlavuza we-ovari athuthukile.

Izinselelo nezinkomba zesikhathi esizayo

Lapho Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza Inikeza izinzuzo eziningi, kukhona nezinselelo zokunqoba:

• ArTOR HETOGENEINITY: Amaseli womdlavuza ngaphakathi kwesimila angahlukahluka ngozalo, okwenza kube nzima ukuqondisa wonke amaseli ngempumelelo.
• Ukumelana Nemithi: Amangqamuzana omdlavuza angakhulisa ukumelana nezidakamizwa ze-chemotherapy, kunciphisa ukusebenza ngempumelelo kokulethwa kwasendaweni.
• Izithiyo zokulethwa: Eminye imibumba kunzima ukufinyelela noma izithiyo ezingokomzimba ezivimbela izidakamizwa ukuthi zingafinyeleli kuwo wonke amaseli omdlavuza.
• Izingqinamba Zokukhiqiza Nezilawuli: Ukuthuthukisa kanye nokwakha izinhlelo ezihlelwe ngezidakamizwa zasendaweni kungaba yinkimbinkimbi futhi kubizeke.

Ucwaningo lwesikhathi esizayo lugxile ekubhekaneni nalezi zinselelo ngo:

• Ukuhlakulela amasu wokuqondisa ama-posistic anqobile ukunqoba isimila i-heterogeneity.
• Ukuhlanganisa ukulethwa kwezidakamizwa okwenziwe ngezidakamizwa okwenziwe ngezinto zokwelapha, njengokuthi i-Im-Im-imzwe
• Ukuthuthukisa amasistimu amasha wokulethwa kwezidakamizwa okungangena ekuthambekeni ngempumelelo.
• Ukuqondisa izinqubo zokukhiqiza nezinhlelo zokulawula zezinhlelo zasendaweni zokulethwa kwezidakamizwa.

Ukugcina

Ukulethwa kwezidakamizwa okwenziwe ngomdlavuza kuyindlela ethembisayo engathuthukisa ukusebenza ngempumelelo yokwelashwa futhi inciphise imiphumela emibi. Njengoba ucwaningo luqhubeka, le ndlela kungenzeka ukuthi idlale indima ebaluleke kakhulu ekwelashweni komdlavuza. Ngokuqondisa izidakamizwa ngqo kwisiza se-tumor, ukulethwa kwasendaweni kunganikeza ithemba elisha leziguli ezilwela lesi sifo esibhubhisayo.

Uhlu lwamagama

Ukunqubekela phambili

1. UWestphal, uM., Hilt, D. C., Bortey, E. del Mastro, R. F., Kieser, M. Isivivinyo esingu-3 secala le-chermistapy yendawo nge-biodergradable Carmustine Carmustine (BCNU) Wafers (Gliadel Wafers) ezigulini ezine-Glignant Glimant. * I-Journal of Clinical Oncology *, * 21 * (24), 4414-4419.