Makomborero uye Kukanganiswa Kwekusanganiswa Chemotherapy
Chii chinosanganiswa chemotherapy, rinoshandiswa riini, uye chii chakanaka uye kusagadzirisa kwekuita kwekurapa?
Overview
Kusanganiswa kwemakemikari kunoreva kushandiswa kwemishonga inopfuura imwechete chemotherapy panguva yekurapa kenza. Munguva yakapfuura, kenza yakawanzobatwa nemishonga imwe chete, asi mishonga yemaitiro akawanda emhando dzekenza inoshandisa kusanganiswa kwemishonga miviri kana kupfuura yakasiyana panguva imwe chete.
Nhoroondo yeKukanganiswa Chemotherapy
Kushandiswa kwemishonga yemakemikari yekurapa kenza kwakafuridzirwa muma1960 apo masayendisiti akashamisika kana nzira yekurapa chirwere chetachiona - kushandisa kusanganiswa kwemishonga inorwisa mabhakitiriya kuderedza dambudziko rekudzivisa - ingashanda kurapwa kwekenza zvakare. Kushandisa nzira iyi, marariya aimbova anenge akaparara pasi rose seaichetic lymphocytic leukemia uye Hodgkin's lymphoma yakawanda zvikuru. Kubva panguva iyoyo, kusanganiswa kwemakemikrasi kwakagamuchirwa kwekurapa mamwe akawanda kanzira pamwe chete.
Mumakore ekuma1970, kusanganiswa kwemakemikari kwakaratidzwa kuva yakakosha kune vanhu vane kenza yemapapu, uye vanobudirira kupfuura "sequential chemotherapy" kana kushandisa chemotherapy mishonga imwe panguva imwe chete, pane panguva imwe chete.
Kubatsirwa
Pane zvakawanda zvakakosha zvidzidzo zvekushandisa kusanganiswa kwemishonga yemakemikrasi panzvimbo pekushanda mashizha chete.
Zvimwe zvezvi zvinosanganisira:
- Kupedza mukana wekuti chirwere chichave chisingawirirani nekurapa. Kungofanana nekubatanidzwa kwemishonga inorwisa mabhakitiriya inogona kushandiswa kana imwe bhakitiriya isingagadziri kune imwe yemishonga, kushandisa maviri kana kupfuura chemotherapy mishonga inoderedza ngozi yokuti tumarara inenge isingadi kurapwa.
- Kuita kuti zvikwanise kupa mishonga yose nokukurumidza sezvinobvira muchirwere.
- Kuva akakwanisa kugadzirisa zvinangwa zvinokonzerwa nehutano hwekenza panguva imwe chete. Kanzira chirwere chakaoma chinosanganisira matanho mazhinji. Kushandiswa kwemishonga yemakemikari inoshandiswa pamakoromendi akasiyana-siyana, kana kuti inoratidza muitiro wekenza, inofanirwa, inokonzera mikana yokubvisa kenza.
- Tumhanho "heterogeneity" - Masayendisiti anoshandisa izwi rokuti tumor heterogeneity kurondedzera kuti masero emukenza mumaronda anobva sei kune mumwe. Nepo masero ekutanga ari nekenza ari "clones" - mune mamwe mazwi akafanana - kugoverana kupesana kunokonzera kuchinja mumasero. Zvimwe zvinokonzera masero mumumarara zvinogona kupindura kune imwe mishonga apo vamwe vangave vakanyanya kuteerera kune imwe mishonga.
- Munguva pfupi yapfuura kutsvakurudza kuri kutarisa nzira dzinoshandiswa pakushandisa kusanganiswa kwemishonga yemakemikari inogona kushandiswa kubvumira vashandisi vezvinyorwa kushandisa mamwe madhiragi pamadhora maduku, uye naizvozvo kuderedza mikana yezvinokonzera tsvina.
Muitiro, kushandiswa kwemakemikrasi pamwe chete nekenza yakawanda yakawanikwa kuvandudza kupona, kana kuti kuguma nemhinduro yakanaka pane kurapwa.
Kukanganisika
Zvimwe zvinokonzera kukanganisa kwekusanganiswa zvinosanganisira:
- Kuwedzera kwechimiro chemotherapy nemigumisiro -.Ichienda pasina kutaura kuti chero nguva mamwe mishonga inoshandiswa zvinowanzoita kuti migumisiro ichaitika.
- Kuoma kuziva chirwere chipi chakakonzera chikamu chimwe chemugumo - Kana murwere achikura nemagetsi apo mishonga yakawanda inoshandiswa, zvingave zvakaoma kuziva kuti ndeipi yemishonga inoshandiswa.
- Kubatana kwezvinodhaka - Dzimwe nguva migumisiro inokonzerwa kwete nekuda kweimwe mishonga, asi nekuda kwekupindurwa pakati pemishonga.
- Kuwedzerwa kwemigumisiro - Somuenzaniso, kana ukashandisa zvinodhaka zviviri zvinokonzera masero mashoma eropa ropa, chiitiko chemotherapy-induced neutropenia (yakaderedzwa nhamba yemhando yemasero machena anozivikanwa neutrophils) inowedzera.
Mienzaniso
Iko kune zvakawanda zvakabatana zve chemotherapy zvinoshandiswa pamhando dzakasiyana dzekenza. Muenzaniso wemukenza wemapapu uri kushandisa kusanganiswa kwePlatinol (cisplatin) uye Navelbine (vinorelbine) kubata chirwere chisingaiti chekenza yemapapu.
Dzimwe nguva shanduro inoshandiswa kurondedzera kusanganisira chemotherapy. Imwe muenzaniso ndeye ABVD yeHodgkin's disease iyo inomirira kusanganiswa kwemishonga yemakemikari Adriamycin (doxorubicin), Blenoxane (bleomycin), Oncovin (vinblastine) uye DTIC-Dome (dacarbazine).
Kutsungirira
Iva neruzivo rwemajoini evanhu vanowanzobatwa nemakemikari pamwe chete nemigumisiro yenguva refu yemakemikrasi , asi ramba uchifunga mupfungwa dzokuti nzira dzokudzora zviratidzo izvi dzakagadzirisa zvinoshamisa mumakore apfuura. Semuenzaniso, vanhu vazhinji havasati vava kunetseka uye kurutsa kunyange pamishonga inowanzokonzera zviratidzo izvi.
Kuita kuti iwe mazuva panguva yekutarisa chemo zvishoma zvishoma, tarisa zvinokosha mazita ezvokutakura chemotherapy .
Sources:
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DeVita, V. uye E. Chua. A History of Cancer Chemotherapy. Cancer Research . 2008. 68: 8643.
Hu, M., Huang, P., Wang, Y., Su, Y., Zhou, L., Zhu, X., uye D. Yan. Synergistic Combination Chemotherapy ye Camptothecin uye Floxuridine kuburikidza ne Self-Assembly of Amphiphilic Drug-Drug Conjugate. Bioconjugate Chemistry . 2015. 26 (12): 2497-506.
Zimmermann, G. et al. Multi-target therapeutics: iyo yose yakawanda kupfuura yakawanda yezvikamu. Kurapa Zvinodhaka Nhasi . 2007. 12 (1-2): 34-42.