Kope laposachedwa la World Health Organization's Classification of Soft Tissue and Bone Tumors, lofalitsidwa mu Epulo 2020, limagawamatenda a sarcomam'magulu atatu: szotupa zambiri za minofu, zotupa za mafupa, ndi zotupa za mafupa ndi minofu yofewa yokhala ndi maselo ang'onoang'ono ozungulira osagawanika(monga EWSR1-non-ETS fusion round cell sarcoma).
"Khansa Yoiwalika"
Sarcoma ndi mtundu wosowa wa matendakhansa mwa akuluakulu, kuwerengera pafupifupi1%khansa zonse za akuluakulu, zomwe nthawi zambiri zimatchedwa "Khansa Yoiwalika." Komabe, ndi khansa yocheperako.chofala mwa ana, kuwerengera pafupifupi15% mpaka 20%khansa yonse ya ana. Ikhoza kuchitika mbali iliyonse ya thupi, makamaka m'thupi lamanja kapena miyendo(60%), kutsatiridwa ndithunthu kapena mimba(30%), ndipo potsirizamutu kapena khosi(10%).
M'zaka zaposachedwapa, kuchuluka kwa zotupa za mafupa ndi minofu yofewa kwakhala kukuchulukirachulukira pang'onopang'ono. Zotupa zoyambirira za mafupa zimakhala zofala kwambiri mwa achinyamata ndi anthu azaka zapakati ndipo zimaphatikizapo osteosarcoma, Ewing sarcoma, chondrosarcoma, malignant fibrous histiocytoma, ndi chordoma, pakati pa zina. Zotupa zofala kwambiri za minofu yofewa zimaphatikizapo synovial sarcoma, fibrosarcoma, liposarcoma, ndi rhabdomyosarcoma. Kuchuluka kwa mafupa kumachitika kwambiri mwa anthu azaka zapakati ndi okalamba, ndipo zotupa zofala kwambiri ndi khansa ya m'mapapo, khansa ya m'mawere, khansa ya impso, khansa ya prostate, ndi khansa ya chithokomiro, pakati pa zina.
Kuzindikira Koyambirira, Chithandizo Choyambirira - Kuunikira "Zotupa" Zobisika
Chifukwa cha kuchuluka kwa ma sarcoma omwe amabwereranso, zotupa zambiri zimakhala ndi matenda osamveka bwino asanachite opaleshoni ndipo sizimayesedwa mwatsatanetsatane. Izi nthawi zambiri zimapangitsa kuti pakhale kupezeka kuti chotupacho sichili chophweka monga momwe zimayembekezeredwa musanachite opaleshoni, zomwe zimapangitsa kuti chichotsedwe bwino. Kubwereranso kapena kufalikira kwa khansa pambuyo pa opaleshoni kungachitike, zomwe zimapangitsa kuti odwala asaphonye mwayi wabwino kwambiri wochizira. Chifukwa chake,Kuzindikira msanga, kuzindikira molondola, ndi chithandizo cha panthawi yake zimakhudza kwambiri thanzi la odwala. Lero, tikufuna kukuwonetsani katswiri wolemekezeka yemwe ali ndi zaka pafupifupi 20 zakuchitikiramu matenda okhazikika komanso chithandizo chapadera cha sarcoma yofewa ya minofu, ndipo imayamikiridwa kwambiri ndi makampani komanso odwala -DokotalaLiu Jiayongkuchokera ku Dipatimenti ya Mafupa ndi Minofu Yofewa ku Chipatala cha Khansa cha Peking University.
Kuvumbulutsa Katswiri Wodziwa Kwambiri za Ululu wa Mafupa ndi Mnofu - Dr..Liu Jiayong
Dokotala wa Zamankhwala, Dokotala Wamkulu, Pulofesa Wothandizira. Anaphunzira ku Anderson Cancer Center ku United States.
Ukatswiri:Chithandizo chokwanira cha ma sarcoma a minofu yofewa (kuchotsa ndi kukonzanso minofu ndi mafupa otupa; chemotherapy, chithandizo cholunjika, ndi chithandizo cha immunotherapy); chithandizo cha opaleshoni ya melanoma.
Dokotala Liu Jiayong, yemwe ali ndi zaka pafupifupi 20 akugwira ntchito zachipatala, wakhala ndi luso lalikulu pa zamankhwala komanso opaleshoni.matenda okhazikika komanso mapulani ochiritsira omwe amapangidwira munthu aliyense payekhaMatenda a minofu yofewa monga sarcoma yosasinthika, liposarcoma, leiomyosarcoma, synovial sarcoma, adenocystic carcinoma-like sarcoma, epithelioid sarcoma, fibrosarcoma, angiosarcoma, ndi infiltrative fibromatosis.Waluso kwambiri pochiza mitsempha yamagazi ndi mitsempha panthawi yochotsa ziwalo za sarcoma, komanso kukonza ndikukonzanso zofooka za minofu yofewa pakhungu.Dokotala Liu amamvetsera moleza mtima wodwala aliyense, amafunsa mosamala za mbiri yawo yachipatala, ndipo amalemba zolemba zachipatala mosamala. Amasamala kwambiri za kusintha kwa mkhalidwe wa wodwalayo nthawi zosiyanasiyana, monga opaleshoni isanachitike komanso itatha, panthawi ya chithandizo, kutsatira, ndi kupita patsogolo kwa matenda, kupanga zigamulo zolondola komanso kusintha mapulani a chithandizo panthawi yake.
Dokotala Liu Jiayong pakadali pano ndi membala wa Soft Tissue Sarcoma and Melanoma Group ya Chinese Anti-Cancer Association, komanso membala wa Bone Tumor Group ya Beijing Society of Orthopedics ya Chinese Medical Association.Mu 2010, iye anali woyamba ku China kumasulira ndikufalitsa "NCCN Clinical Practice Guidelines in Soft Tissue Sarcoma," yomwe ikulimbikitsa chithandizo chokwanira cha ma sarcoma ofewa a minofu.Akupitirizabe kuyesetsa kupita patsogolo mu kafukufuku wazachipatala ndi sayansi, ngakhale kuti ali ndi odwala ambiri. Ndi wodzipereka komanso wodalirika pa wodwala aliyense amene amamuthandiza, ndipo panthawi ya mliriwu, adathetsa mavuto omwe odwala omwe akufuna chithandizo chamankhwala amakumana nawo poyankha mwachangu upangiri wa odwala, kuwunikanso zotsatira zake, ndikupereka malangizo oyenera a chithandizo kudzera pa nsanja zolumikizirana pa intaneti monga Good Doctor's Patient Group.
Mlandu Waposachedwa
Bambo Zhang, wodwala wazaka 35, mwadzidzidzi adataya masomphenya kumayambiriro kwa chaka cha 2019. Pambuyo pake, adachitidwa opaleshoni yochotsa diso lamanzere chifukwa cha kuwonjezeka kwa kuthamanga kwa magazi m'maso. Matenda a pambuyo pa opaleshoni adawonetsa chotupa chotupa. M'chilimwe cha chaka chomwecho, timibulu tambiri ta m'mapapo tinapezeka panthawi yowunikanso, koma palibe maselo a chotupa omwe adapezeka kudzera mu singano. Kuwunikanso kwina kunawonetsa kuti pali metastases yambiri ya mafupa ndi mapapo. Kufunsana m'zipatala zam'deralo komanso zapamwamba kunamupeza ndi chotupa chotupa cha myofibroblastic. Mu Ogasiti 2022, adapatsidwa mankhwala amphamvu kwambiri a chemotherapy, omwe adachepetsa ululu wake koma sanawonetse kusintha kulikonse pa zilonda atawunikanso. Mkhalidwe wake wakuthupi nawonso unafooka. Ngakhale izi, banja lake silinataye chiyembekezo. Atafufuza malingaliro angapo, adapita kwa Dokotala Liu Jiayong mu Novembala 2022. Atawunikanso mosamala mbiri yachipatala ya wodwalayo, zolemba zonse zachipatala, mayeso a matenda, ndi deta yojambula zithunzi,DokotalaLiu adapereka njira yothandizira mankhwala a chemotherapy yokhala ndi methotrexate yochepa ndi Changchun Ruibin.Mankhwala a chemotherapy awa ndi otsika mtengo ndipo alibe zotsatirapo zoyipa zambiri. Pambuyo pa masiku 35 akumwa mankhwala, CT scan yotsatira inasonyeza kuti chipolopolo chomwe chinali m'mapapo akumanja chinatha, zomwe zikusonyeza kuti chotupacho chinali cholimba bwino.Kufufuza kotsatira kwaposachedwa ku Beijing South Region Oncology Hospital kunasonyeza kuti mapapo ake ali bwino, ndipo Dokotala Liu analimbikitsa kuti azipita kukawonana ndi dokotala nthawi zonse. Wodwalayo ndi banja lake tsopano ali ndi chidaliro chachikulu pa chithandizo chotsatira, odzaza ndi chiyembekezo. Akumva kuti awona kuwala pang'ono paulendo wa chithandizo ndipo akuwonetsa kuyamikira kwawo kochokera pansi pa mtima popereka chikwangwani cha silika choyamikira.
Nthawi yotumizira: Ogasiti-25-2023