Uhlelo lwakamuva lwe-World Health Organisation's Classification of Soft Tissue and Bone Tumors, olwanyatheliswa ngo-Ephreli 2020, luhlukanisaama-sarcomazibe izigaba ezintathu: sizimila zezicubu eziningi, izimila zamathambo, kanye nezimila zezicubu zamathambo nezithambile ezinamaseli amancane ayindilinga angahlukaniswanga(njenge-sarcoma yeseli eliyi-fusion round cell ye-EWSR1-non-ETS).
"Umdlavuza Okhohliwe"
I-Sarcoma uhlobo olungavamile lwesifoumdlavuza kubantu abadala, okubalwa cishe1%yazo zonke izinhlobo zomdlavuza zabantu abadala, ezivame ukubizwa ngokuthi “umdlavuza okhohliwe.” Kodwa-ke, uma kuqhathaniswa, ziyafana.okuvamile ezinganeni, ukubala cishe15% kuya ku-20%yazo zonke izinhlobo zomdlavuza wezingane. Kungavela kunoma iyiphi ingxenye yomzimba, ikakhulukaziizingalo noma imilenze(60%), kulandelwa yi-isiqu noma isisu(30%), futhi ekugcineniikhanda noma intamo(10%).
Eminyakeni yamuva nje, ukwanda kwezimila zamathambo nezicubu ezithambile kuye kwanda kancane kancane. Izimila zamathambo ezibulalayo eziyinhloko zivame kakhulu entsheni nakubantu abaseminyakeni ephakathi futhi zifaka phakathi i-osteosarcoma, i-Ewing sarcoma, i-chondrosarcoma, i-malignant fibrous histiocytoma, kanye ne-chordoma, phakathi kwezinye. Izimila ezivamile ezibulalayo ezitholakala ezicubu ezithambile zifaka phakathi i-synovial sarcoma, i-fibrosarcoma, i-liposarcoma, kanye ne-rhabdomyosarcoma. Ukwanda kwezicubu zamathambo kuvame kakhulu kubantu abaseminyakeni ephakathi kanye nasebekhulile, kanti izimila ezivamile eziyinhloko ziwumdlavuza wamaphaphu, umdlavuza webele, umdlavuza wezinso, umdlavuza wendlala yesinye, kanye nomdlavuza we-thyroid, phakathi kwezinye.
Ukutholwa Kwasekuqaleni, Ukwelashwa Kwasekuqaleni - Ukukhanyisa “Amathumba” Afihliwe
Ngenxa yesilinganiso esiphezulu sokuphindeka kwama-sarcomas, izimila eziningi azicaci kahle ngaphambi kokuhlinzwa futhi azinazo izivivinyo ezinemininingwane yezithombe. Lokhu kuvame ukuholela ekutholakaleni ngesikhathi sokuhlinzwa ukuthi isimila asilula njengoba kulinganiselwa ngaphambi kokuhlinzwa, okuholela ekususweni okungaphelele. Ukuphinda noma ukusabalala kwamangqamuzana ngemva kokuhlinzwa kungase kwenzeke, okubangela ukuthi iziguli ziphuthelwe ithuba lokwelashwa elifanele. Ngakho-ke,Ukutholwa kusenesikhathi, ukuxilongwa okunembile, kanye nokwelashwa ngesikhathi esifanele kunomthelela obaluleke kakhulu ekubikezelweni kweziguli. Namuhla, singathanda ukwethula uchwepheshe ohlonishwayo onolwazi olucishe lube yiminyaka engama-20.ekuxilongweni okujwayelekile kanye nokwelashwa komuntu siqu kwe-sarcoma yezicubu ezithambile, futhi idunyiswa kakhulu yimboni kanye neziguli –UdokotelaU-Liu Jiayongevela eMnyangweni Wezihlunu Nezicubu Ezithambile ePeking University Cancer Hospital.
Ukuveza Uchwepheshe Onolwazi Olujulile Ngobuhlungu Bamathambo Nenyama – UDkt..U-Liu Jiayong
Udokotela Wezokwelapha, Udokotela Oyinhloko, uSolwazi Ohlangene. Wafunda e-Anderson Cancer Center e-United States.
Ubuchwepheshe:Ukwelashwa okuphelele kwama-sarcoma ezicubu ezithambile (ukususwa nokwakhiwa kabusha ngokuhlinzwa; i-chemotherapy, ukwelashwa okuqondiwe, kanye ne-immunotherapy); ukwelashwa ngokuhlinzwa kwama-melanoma.
Njengoba enolwazi lwezokwelapha olucishe lube yiminyaka engama-20, uDokotela uLiu Jiayong uqoqe ulwazi oluningi lokwelapha ngezokwelapha kanye nokuhlinzwa e-United States.ukuxilongwa okujwayelekile kanye nezinhlelo zokwelapha ezenzelwe wenakuma-sarcomas avamile ezicubu ezithambile njenge-pleomorphic sarcoma engahlukanisiwe, i-liposarcoma, i-leiomyosarcoma, i-synovial sarcoma, i-adenocystic carcinoma-like sarcoma, i-epithelioid sarcoma, i-fibrosarcoma, i-angiosarcoma, kanye ne-infiltrative fibromatosis. Uyi-Unekhono lokuphatha imithambo yegazi kanye nemizwa ngesikhathi sokuhlinzwa kwe-sarcoma yemilenze, kanye nokulungisa nokwakha kabusha amaphutha ezicubu ezithambile esikhumbeni.UDokotela Liu ulalela isiguli ngasinye ngesineke, ubuza ngokucophelela ngomlando waso wezokwelapha, futhi uthatha amarekhodi ezokwelapha ngokucophelela. Unaka kakhulu izinguquko esimweni sesiguli ngezikhathi ezahlukene, njengangaphambi nangemva kokuhlinzwa, ngesikhathi sokwelashwa, ukulandelwa, kanye nokuqhubeka kwesifo, enza izinqumo ezinembile kanye nokulungiswa ngesikhathi esifanele kwezinhlelo zokwelapha.
UDokotela uLiu Jiayong okwamanje ukhonza njengelungu le-Soft Tissue Sarcoma and Melanoma Group ye-Chinese Anti-Cancer Association, kanye nelungu le-Bone Tumor Group ye-Beijing Society of Orthopedics ye-Chinese Medical Association.Ngo-2010, waba ngowokuqala eShayina ukuhumusha nokushicilela “Iziqondiso Zomkhuba Wezokwelapha ze-NCCN ku-Soft Tissue Sarcoma,” ekhuthaza ukwelashwa okujwayelekile okuphelele kwama-sarcoma ezicubu ezithambile.Uyaqhubeka nokulwela intuthuko ocwaningweni lwezokwelapha nolwesayensi, naphezu kokuba nesiguli esiningi. Uzinikele futhi unesibopho saso sonke isiguli aselaphayo, futhi ngesikhathi sobhubhane, wabhekana nobunzima obubhekene neziguli ezifuna ukunakekelwa kwezokwelapha ngokuphendula ngokushesha ekubonisaneni neziguli, ukubukeza imiphumela yokulandelela, kanye nokunikeza izincomo zokwelashwa ezifanele ngokusebenzisa amapulatifomu okubonisana aku-inthanethi njenge-Good Doctor's Patient Group.
Icala Lakamuva
UMnu. Zhang, isiguli esineminyaka engu-35 ubudala, walahlekelwa umbono ngokuzumayo ekuqaleni kuka-2019. Ngemva kwalokho, wahlinzwa ngeso lesobunxele ngenxa yokwanda okuqhubekayo kwengcindezi yangaphakathi kweso. I-pathology yangemva kokuhlinzwa yaveza i-pseudotumor evuvukele. Ehlobo lonyaka ofanayo, kwatholakala amaqhubu amaningi emaphashini ngesikhathi sokuhlolwa okulandelayo, kodwa awekho amangqamuzana esimila atholakala nge-biopsies yenaliti. Ukuhlolwa okulandelayo kwaveza ukusabalala kwamathambo amaningi namaphaphu. Ukubonisana ezibhedlela zasendaweni nezisezingeni eliphezulu kwamthola enesimila se-myofibroblastic esivuvukele. Ngo-Agasti 2022, wenziwa i-chemotherapy yomthamo ophezulu, eyanciphisa kakhulu ubuhlungu bakhe kodwa ayizange ibonise ukuthuthuka okubonakalayo ezilondeni lapho ehlolwa kabusha. Isimo sakhe somzimba naso saba buthaka. Naphezu kwalokhu, umndeni wakhe awuzange ulahle ithemba. Ngemva kokufuna imibono eminingi, bafika ekunakekelweni kukaDokotela uLiu Jiayong ngoNovemba 2022. Ngemva kokubukeza ngokucophelela umlando wezokwelapha wesiguli, wonke amarekhodi ezokwelapha, ukuhlolwa kwe-pathological, kanye nedatha yezithombe,UdokotelaULiu uphakamise uhlelo lokwelapha ngamakhemikhali oluhlanganisa i-methotrexate enomthamo ophansi kanye ne-Changchun Ruibin.Lolu hlobo lokwelashwa ngamakhemikhali lushibhile futhi alunamiphumela emibi eminingi. Ngemva kwezinsuku ezingu-35 zokwelashwa, ukuhlolwa kwe-CT okulandelayo kubonise ukuthi inqwaba ephashini lesokudla yayinyamalele, okubonisa ukulawulwa okuhle kwesimila.Ukuhlolwa kokulandelela kwakamuva eBeijing South Region Oncology Hospital kubonise isimo samaphaphu esizinzile, futhi uDokotela Liu watusa ukuvakashelwa njalo kokulandelela. Isiguli nomndeni waso manje sebenethemba elikhulu ekwelashweni okulandelayo, begcwele ithemba. Banomuzwa wokuthi babone ukukhanya ohambweni lokwelashwa futhi babonisa ukubonga kwabo okusuka enhliziyweni ngokunikeza ibhanela lesilika lokwazisa.
Isikhathi sokuthunyelwe: Agasti-25-2023