Newer Techniques Kununura Utachiona hweRadio Kunyanya
Radiation therapy inokosha mukurapa marudzi mazhinji evanhu vane kenza. Mhando dzakasiyana-siyana dzemasikirwo anoshandiswa kuedza kutarisa masero anonyangadza nemaviri. Kazhinji kacho, photons (x-rays) anoshandiswa mune imwe nzira inonzi kunze kwemahara rayation therapy, kana EBRT.
Kunewo marudzi akasiyana-siyana emishonga emishonga mitsva, uye vamwe vavo vakaratidza chivimbiso kuburikidza nechinangwa chekutarisa michina yekenza pavanoshandisa zvivako zvakapoteredza.
Matanho matsva Anosanganisira Proton Beams uye 4D Simulation
- PBT inoreva chirongwa cheproton chinorapa.
- 3D inoenderana neEBRT inoreva kubatanidzwa kwekombiyuta yekuongorora mafungiro kuronga kuendeswa kwemaziro emirasi zvakanyanya kunyatsoenderana nechinangwa chayo.
- IMRT inomirira kushandiswa kwema-modulated radiation therapy, uye iyi ndiyo imwe nzira yakagadzirirwa kuparadza mishonga yekenza asi kusachengetedza mhuka dzakapoteredza.
- IGRT inomirira kurapa kwemavara ekutungamirirwa nemifananidzo, uye inosanganisira kushandisa imaging scans munguva yekurapa kwemaawa, kutungamira mazaisai kumakontiro chaiwo ekufungidzira akatevedzwa panguva yekurapa kurapwa kwechirwere chemaawa.
- RMM inoreva kumapfupa ekufambisa maitiro ekugadzirisa maitiro mu radiotherapies iyo inofanirwa kufambisa rusvingo rwechifuva, mushupa wesimbi, nezvimwe zvivako zvinofamba panguva yekufema kuitira kuti miviri isati yasvika panzvimbo yakakodzera kunyange zvazvo nzvimbo inotaridzika iri kufamba.
- 4D CT kuenzanisa kunoshandisa shanduko yakafanana neyoMMM mune kuti scan inowanikwa apo murwere anofema, uye iyo inofungidzirwa inotarisa zvose zvinzvimbo zvechirwere panguva yekudzidza kufungidzira, nekufamba kwenguva.
Chii Chinonzi Proton Beam Therapy?
Mimwe mishonga yemukenza inotanga kushandiswa kwemishonga inonzi radiation iyo inopa proton mikoko panzvimbo yemapononi, kana x-ray.
Mapuroni emaprotoni ndiwo mafungiro akanaka anokonzerwa nehutachiwana hunopa simba mukati mishoma. Mune mafungiro, mapurotoni anogona kusvika kumakumbo mukati mukati memuviri asingakuvadzi zvakanyanya kumasukisi ari pedyo.
Masangano akadai seNational Comprehensive Cancer Network, kana NCCN, anotanga kuisa mushonga weproton, kana PBT, mumitemo uye mazano. Somuenzaniso, maererano nezvimwe zviitiko zvemuviri T-cell lymphomas, NCCN radiotherapy compendium inosanganisira kureva ma proton uye mamwe maitiro matsva kuti "... [ku] kugoverwa kwakanyanya kwekuenzanisa kwemazi anokosha kune vanorapa vanorarama kwenguva refu. " Mune mamwe mazwi, kune tarisiro yokuti kuendesa marwadzo kusvika kunzvimbo yakanyatsorongedzerwa uye kuvhara mhuka dzakapoteredza kuchaguma nemigumisiro iri nani uye zvishoma kudzvinyirira kwenguva refu kwehutachiona hwemaawa.
Ndezvipi Zvinobatsira Zvingaita Kuti Mishonga Iite sePBT Inopa?
Kusvika ikozvino, kushandiswa kwepabonde kwePBT hakukurudzirwi mukurapa kwemaitiro e-lymphoma. Kune varwere vane lymphoma, zvisinei, nzira yakadai seproton yeproton imwe nguva ingasarudzwa kuisa maonero mune dzimwe nguva uye nekuda kwezvikonzero zvakasiyana-siyana. Kunyange zvazvo zvichibudirira, chemotherapi inoshandiswa kurapa lymphomas inogona kuva nehupfu hwemwoyo nemapapu.
Kana majekesa akawedzerwa chemotherapy, njodzi kune nhengo dzakanaka dzinogona kuwedzerwa, sezvo mishonga iri pangozi inonzwisisa zvose zvinokonzerwa nekemotherapy uye mahara.
Chemotherapy uye mashizha zvinowanzogadzirirwa pamwe chete, asi zvinotarisirwa zvakasiyana, uye kazhinji, mumwe achazotevera mumwe mukurapa kwermia. Proton therapy yakagadzirirwa kuderedza kusvibiswa kune utachiona hwakanaka hunogona kuitika mukutsvaga kuipa. Varwere vakawanda vane lymphoma vashoma pavanoongororwa uye vanorarama upenyu hurefu mushure mekurapa, saka vari pangozi yekukurumidza kubuda, kwenguva yakareba migumisiro inobatanidza nemishonga inorapwa.
Kubva pane izvo zvinozivikanwa nezvehutano hweproton, vazhinji vanodavira migumisiro ichaderedzwa kana vachienzaniswa neruzhinji rwechirwere. Vanachiremba uye vanotsvakurudza vari kushandawo pamakemikirini emativi equation, vachitsvaga kushandiswa kwevanhu vatsva vasati vava nemigumisiro miviri, vachitarisa kune chero chinetso pamigumisiro yenguva refu uye mabizo ekupedzisira.
Varwere vane Hodgkin lymphoma , kunyanya, vane zvirwere zvakakura, asi vanowanzotanga kuwedzera marapirwo emishonga kubva chemotherapy uye mahara. Zvechokwadi, huduku hweHodgkin avo vanopona nhengo dzomukati ndeimwe yemapoka ari pangozi yakawanda yekutambudzika kana kuisa upenyu hunotyisa zvirwere zvisingagumi, zvakadai sekenza yechipiri kana chirwere chemwoyo . Izvi zvinowedzera njodzi dzinotendwa nokuti zvichida chikamu kusvika pakuguma kwekemotherapy uye kubva kudiotherapy.
Nokuti chirwere cheproton chinogadzirirwa kuva chakanyatsojeka mukuendesa mahara, tariro ndeyekuti chirwere chepfungwa chisingaverengeki uye kachipiri kechipiri chekenza chichakura. Kusvika ikozvino, mune rumwe ruzivo, chiitiko chekachipiri chekenza pakati pevaya vanobatwa neproton versus photon rayation yakaonekwa seichi, asi data haigone uye kutsvakurudza kwakawanda kunodiwa.
Shoko Rinobva
Oncologists vanosimbisa kushandiswa kwemishonga yeproton yeHodgkin lymphoma vakatsanangura kuenzanisa kunoitwa, pakati pekudzoka zvakare nekuda kwekushaya kukwana kurapa kune rumwe rutivi uye zvakanyanya kukonzerwa nehutachiona hunobva mukurapa kwakanyanya kune imwe.
Vamwe vanoti kana ukawedzera chemotherapy kuti uregere kutadza kuva nemishonga inopisa, iwe haungamboiti chero upi noupi maererano nehuwandu hwehutachiona. Uyezve, vanokurudzira kuti rusununguko rwechipiri rwezvekudzoka kwe lymphoma chinhu chinonyanya kukosha kuchengetedza mabhii, sezvinoita vatsvakurudzo munguva yemberi vanoedza kubudisa njodzi uye kubatsirika kwezvitsva zvitsva.
Maererano nekuongorora kwakaitwa naHoppe nevamwe vaishanda navo, chirwere cheproton chakapa miviri yakaderera yakawanda pamwoyo, mapapu, mazamu, mazamu, nezvimwe zvivako zvehuwandu hwevadzidzi vaHodgkin lymphoma. Nguva bedzi ichataura kana chirwere cheproton chichanyanya kuchinja.
> Sources:
> Chung CS, Yock TI, Nelson K, Xu Y, Keating NL, Tarbell NJ. Chiitiko chechipiri chekutuka pakati pevarwere vanobatwa neprotonton ne photon radiation. Int J Radiat Oncol Biol Phys. 2013; 87 (1): 46-52.
> Hoppe BS, Flampouri S, Su Z, et al. Kubudirira kwehutachiwana hunoita kuti zvivako zvemwoyo zvive nokushandisa ma proton akaenzaniswa ne 3DCRT uye IMRT muhutachi Hodgkin lymphoma. Int J Radiat Oncol Biol Phys 2012; 84: 449-455.
> NCCN Radiation Therapy Compendium. 2017.