Kuvanhu vakawanda mazuva ano, chemotherapy inoreva rudzi rwe cytotoxic, kana se-kuuraya, mushonga unoshandiswa kurapa kenza. Pakutanga, zvakadaro, chemotherapy yaiva izwi rakagadzirwa nemakemikari wechiGermany Paul Ehrlich, uyo akashandisa iro kureva kungoshandiswa kwemakemikari kuti apore zvirwere. Nokudaro, zvekuti "chemotherapy" inogona kusanganisira chinhu kubva pamishonga inorwisa mabhakitiriya kana kunyange kukwanisa, mararamiro emishonga yemasikirwo , sezvo ane makemikari uye ari kushandiswa kurapa zvirwere.
Mazuva ano, vamwe vanofunga nezve " chinangwa chekurapa kenza " pakati pevaya vane zvishoma zvingava nemigumisiro. Zvisinei, inowanzotarisa kuti idzi mishonga mitsva inoshandiswa musangano pamwe chete nemaitiro emakemikrasi, kwete oga. Uye, kunyange kutarirwa mishonga yemishonga haina kuchinja muviri nenzira imwechete iyo yakakwana chemotherapy agents vanoita, vanogona kuita kuti zvive nemigumisiro. Kanzera dzemawere dzinogona kuva nezvimwe zvekugamuchira kana kuti chinangwa kune masero ane hutano - izvo zvinotarirwa mishonga zvingashandisa - asi masero ane utano angaramba akachinjwa.
The Magic Bullet
Chirwere chekenza chaiyo chaizova chinhu chakafanana nemashiripiti, uye nokuda kwezvakaipa zvakawanda, kurapa kwakanaka hakuchina. Mukupera kwema1800 uye kutanga kwema1900, masayendisiti akatanga kudzidza nezvebhakitiriya uye zvirwere zvinotapukira zvezvirwere. Paul Ehrlich akanga ari chiremba uyo aishanda nemaabhakitiriya, uye akatenda kuti, sezvo aigona kukanganisa mabhakitiriya uye achivaona pasi pe microscope, anofanira kunge akakwanisa kurwisa majemisi aya kana akawana kemikisi inogona kuzvibatanidza pachayo nemishonga uye uzviuraye, uchisiye zvose zvisingabatsiri.
Akadana makemikisi akadaro 'magic bullets.'
Nhasi, tine shanduro dzemashiripiti aya anozivikanwa semishonga inorwisa mabhakitiriya, asi kunyange kunyoroka kwemishonga inorwisa mabhakitiriya inogona kuva nemigumisiro-kana kuti yakaipisisa, inogona kukonzera ngozi kune vamwe vanhu vanonzi hypersensitivity. Izvi hazvirevi kuperesa pane pfungwa yemashiripiti, zvisinei.
Kubudirira nekusvibisa
Zvinosuruvarisa, vazhinji vanobudirira mishonga yekenza inobatanidzwawo nehuwandu hwehutachiona. Kanzerini masero anowanzobuda mumasero anowanikwa, akaenzana nemasero ane hutano akawana zvikanganiso-zvichiita kuti kukura kusingadzorwi. Izvo zvakasiyana zvakakwana kubva kumasero ezvisikwa izvo vanachiremba vanogona kushandisa mishonga kuti zviparadze masero emukenza zvakakura kupfuura masero ane utano, asi mamwe masero ane hutano haatombogadziriswa; izvi zvinodhaka zvinotsigirwa nevarwere uye zvinotarisirwa navanachiremba, mune zvekuuraya masero ekenza uye kuedza kuwedzera hupenyu hwemunhu.
Dzimwe nguva kune hukama hwakananga pakati pekuwedzera kupesana nekupedza kenza uye kuwedzera kuora. Kune rumwe rutivi, masayendisiti anoongorora zvigumisiro zvekuongororwa kwekliniki nguva dzose ari kutaridzirwa kwemashoko apo kuwedzerwa kwechirwere chechirwere hakuiti chinhu chinowanikwa asi kunosanganiswa nehuwandu hwehutsvina. Kazhinji kacho, chirongwa chekuenzanisa icho vanachiremba nevarwere vanoita pamwe chete - vachida kuita zvakakosha zvikuru nehuwandu hwehutano hunogamuchirwa, kuitira kuti vawane nguva yakareba.
Vakwegura Varwere
Kunyange zvazvo zvingave zvinotyisa kune vakawanda, mamwe mimwe miedzo yekenza inoshandisa makore makumi matanhatu nemakumi matanhatu nemashanu sechikumbaridzo chevarwere "vakwegura".
Zviri pachena kuti shoko rakwegura rinogona kuva nguva yekuzvipira sevamwe vanhu vari mumakore makumi mapfumbamwe nemakumi matanhatu nemakore makumi mapfumbamwe nemakore vari muhutano hwakanaka kudarika vanhu vakawanda vane makumi emakore vaduku. Sezvatinokwegura, zvakadaro, tinowanzokudziridza hukama husingaperi hwehutano, sekuwedzera kweropa. Uye itsvo dzedu dzinowanzosava dzakakosha pakutsvaga ropa redu sezvavakambove. Nokuda kwezvikonzero izvi uye kune zvimwe zvakasiyana-siyana, kukwanisa kwedu kubvumira zvakasimba chemotherapy, pamusana, hazvina kunaka pazera remakore makumi 85 sekunge rave riri nemakore makumi maviri.
Kupararira kukuru B-cell lymphoma (DLBCL) nemamwe marudzi ekenza zvinogona kunge zvakajairika kune vanhu vakwegura mumakore.
Zvechokwadi, nhamba yevanhu vane makore makumi mapfumbamwe nemapfumbamwe kana apfuura nechisimba B-cell isiri Hodgkin lymphoma (B-NHL) yakawedzera mumakiriniki. Mishonga yokurapa yeDLBCL kuvanhu vaduku inenge yakarongeka kana yakagadziriswa, kunyanya panguva ino. Kuedza kugadzirisa kuenzanisa kwekuita pakati pekubudirira uye chepfu ikozvino kwave kune vanhu vakwegura, zvakare.
Less Poison
Bhuku reasayendisiti rinozivikanwa munyika yose yekutsvakurudza kwe lymphoma - Groupe d'Etude des Lymphomes de l'Adult (GELA) - akaongorora mubvunzo uyu kuvanhu vane DLBCL vane makore 80 kusvika ku95. Vakatarisirwa kuongorora kubudirira nekuchengeteka kwe kuderedza chiyero chechiOP (doxorubicin, cyclophosphamide, vincristine, uye prednisone) chemotherapy nemutengo unowanikwa we rituximab - a monoclonal antibody targeting cells ane CD20 'tag' - muvatana vakwegura vane DLBCL.
Kusvika ikozvino, pamakore maviri kubva, zvigaro zvave zviri kukurudzira, zvakare kusimbisa kukosha kwemamiriro ega ega yevarwere mune boka rezera iri. Apo chirwere chemukati chemotherapy regimen, kana R- "miniCHOP," yakashandiswa, kubudirira kwakaratidzika kunge kwakangoenzana nemakore maviri kusvika kumazinga akaenzana, asi nehuwandu hwakaderedzwa hwechipatro-yakabatwa hospital hospital.
Miedzo inopfuurira iri kuongororawo mubvunzo wekuti itsva itsva yemuviri inodzivirira inhibitor uye inorapwa inogona kubatanidzwa kuderedza doro panguva yekurapa kenza kune vakwegura varwere.
Sources
Peyrade F, Jardin F, Thieblemont C, et al. Groupe d'Etude des Lymphomes de l'Adult (GELA) vatsva. Yakagadziriswa immunochemotherapy regimen (R-minichOP) muvakwegura vakwegura vakwegura kune makore makumi masere nemasere ane maitiro makuru akadai B-cell lymphoma. Lancet Oncol . 2011; 12 (5): 460-8.
Iioka F, Izumi K, Kamoda Y, et al. Migumisiro yevarwere vakwegura zvikuru vane utsinye B-cell kwete-Hodgkin lymphoma inobatwa nechechi-inonzi chemotherapy. Int J Clin Oncol. 2015 Gumiguru 13. [Epub mberi of print]
Sayenzi-Based Based Medicine. https://www.sciencebasedmedicine.org/chemotherapy-doesnt-work-not-so-fast-a-lesson-from-history/. Yakasvika muna January 2016.
Kuongorora History of Medicine. Magic Bullet. Yakasvika muna January 2016.