ʻOihana 4 Renal Cell Carcinoma: Hana a me ka Prognosis

Anter

• Nā koho lapaʻau no RCC
• ʻOki kino
• Immunotherapy
• Nā mea kāohi checkpoint
• Interleukin-2
• Interferon alpha
• Pahuhopu kau ʻia
• nā mea kāohi mTOR
• Lapaʻau hoʻomākala
• ʻO Chemotherapy
• Nā hoʻāʻo hoʻokolohua
• Ke hoʻokau nei ʻo carcinoma cell cell
• Outlook

ʻO Renal cell carcinoma (RCC) kahi ʻano o ka maʻi ʻaʻai e hoʻopili i nā hunaola o ka puʻupaʻa. ʻO RCC ka ʻano maʻamau o ke kanesa maʻi ʻaʻai. Nui a hewahewa nā kumu no ka hoʻomohala ʻana i ka RCC, me:

• moʻolelo ʻohana o ka maʻi
• puhipaka
• momona
• kahe koko kiʻekiʻe
• maʻi maʻi polycystic

ʻO ka mea i ʻike ʻia ma mua, ʻo ka nui o kou manawa kūpono no ka mālama pono ʻana.

Nā koho lapaʻau no RCC

ʻOiai ua hoʻonohonoho ʻia ka pae 4 RCC ma ke ʻano he pae holomua o ka maʻi ʻaʻai, eia nō ke loaʻa nā koho lapaʻau.

ʻOki kino

I kekahi mau hihia, ke hemo ka tumo nui a ʻaʻole pālahalaha nui ka maʻi ʻaʻai, hiki ke hana ʻia kahi nephrectomy radical. Hoʻopili kēia i ka wehe ʻana i ka hapa nui a i ʻole o nā kolokolo āpau.

ʻO ka hemo ʻana o nā tumors ʻē aʻe e pono ai no ka poʻe me ka maʻi ʻaʻai metastatic. E hoʻoholo i kahi hui o nā loea inā hiki ke hemo i nā tumors metastasized me ka ʻole o ka nui o ka makaʻu.

Inā hiki ʻole ke ʻoki, hoʻohana ʻia paha ka embolization tumo. ʻO kēia kaʻina hana e hōʻoki i ke kahe o ke koko i ka tumo, kahi mea e kōkua ai e hōʻemi i nā ʻōuli.

I ka manawa e hana ʻia ai ke ʻoki e wehe ai i nā tumors kūloko, pono paha i nā poʻe he nui i ka systemic therapy. Mālama kēia ʻano lapaʻau i ka maʻi ʻaʻai ma loko o ke kino. Hiki ke kōkua i ka hōʻemi ʻana i ka hoʻi hou ʻana o ka maʻi ʻaʻai.

ʻO ka ʻōnaehana ʻōnaehana no ka pae 4 RCC e komo pū ana me ka immunotherapy, ka lāʻau hoʻomāka ʻia, radiation, a me ka chemotherapy.

Immunotherapy

ʻO ka Immunotherapy kahi ʻano hana e hoʻomohala i ka ʻōnaehana pale pale e hoʻouka aku i nā hunaola maʻi ʻaʻai. ʻAʻole maikaʻi nā kānaka āpau me RCC i ka pale maʻi immunotherapy, a hiki i nā hopena ʻino ke koʻikoʻi.

ʻO Immunotherapy, a i ʻole biologic therapy, kahi lapaʻau e kōkua i kāu ʻōnaehana pale pale i ka maʻi ʻaʻai. Hoʻolauna pinepine ʻia ia ke hiki ʻole ke hemo i ka RCC me ka ʻoki kino.

Hoʻohana ka Immunotherapy i kekahi mau ʻano lāʻau like ʻole:

Nā mea kāohi checkpoint

Hoʻohana kāu ʻōnaehana pale ʻōnaehana i kahi ʻōnaehana o "checkpoints" e hoʻokaʻawale i waena o nā ʻola olakino a me nā maʻi maʻi ʻaʻai. Kūpono nā mea hoʻopale helu Checkpoint e kōkua i kāu ʻōnaehana pale maʻi e ʻike i nā hunaola maʻi ʻaʻai e hūnā mai kāu ʻōnaehana pale maʻi.

ʻO Nivolumab (Opdivo) kahi mea nānā i ka mea nānā i lawelawe ʻia ma o ka IV i lilo i loko o ka mālama ʻana o RCC i nā makahiki i hala iho nei.

Nā hopena pili me:

• hūwī
• luhi
• pāhoehoe
• nausea
• ʻeha poʻo
• ʻāwīwī o ka ʻili
• ʻeha pū
• abdominal eha
• pilikia hanu

Interleukin-2

ʻO Interleukin-2 (IL-2, Proleukin) kahi kope kope o nā protein i kapa ʻia he cytokines e manaʻo e hoʻoheheʻe i kāu ʻōnaehana pale pale e hoʻouka aku i nā hunaola tumele.

Hōʻike ʻia ka mea hiki ke loaʻa. Hiki iā ia ke loaʻa nā hopena ʻino koʻikoʻi no laila hoʻohana wale ʻia i nā kānaka olakino e hoʻomanawanui i nā hopena ʻaoʻao.

ʻO kekahi o ka maikaʻi ma luna o nā kāne keʻokeʻo nui me kahi ʻano kolohe o RCC i ʻike i kahi piʻi ola kiʻekiʻe me ka hoʻohana ʻana o ka interleukin-2 kiʻekiʻe.

Nā hopena pili me:

• luhi
• kahe ana ke koko
• haʻalulu
• fiva
• haʻahaʻa haʻahaʻa haʻahaʻa
• wai i loko o nā akemāmā
• hōʻino kīhāpai

Interferon alpha

Loaʻa nā Interferons i ka antiviral, antiproliferative (kaohi i ka ulu ʻana o ka maʻi ʻaʻai), a me ka immunomodulatory (pili i ka ʻōnaehana pale o ke kino) nā waiwai. Hoʻopaʻa ʻo Interferon alpha i ka hoʻōki ʻana i nā hunaola tumora mai ka hoʻokaʻawale ʻana a me ka ulu ʻana.

Hāʻawi ʻia ʻo Interferon i kekahi manawa me nā lāʻau ʻē aʻe, e like me bevacizumab (Avastin).

Nā hopena ʻē aʻe o interferon pū:

• nausea
• nā ʻōuli like flu
• luhi

Ua hoʻololi ʻia ka poʻe interferons e ka lāʻau hoʻomoana hoʻokahi. Hoʻohana pinepine ʻole ʻia ʻo interferon therapy i hoʻokahi manawa.

Pahuhopu kau ʻia

Hoʻopaʻa kaulike ʻia no RCC ʻo ia hoʻi ka hoʻohana ʻana i nā lāʻau e kuhikuhi pono i nā hunaola maʻi ʻaʻai. Makemake ʻia nā lāʻau i māka ʻia no ka mea ʻaʻole lākou e hana ʻino a pepehi ʻole i nā hunaola olakino i ke kino.

Nui nā lāʻau i māka ʻia no ka pae 4 RCC e hana e kāohi i ka ulu ʻana o ka cell. Kūleʻa lākou i kahi protein i kapa ʻia vascular endothelial factor factor (VEGF) e hoʻoulu ai i ka ulu ʻana o nā hunaola maʻi ʻaʻai.

ʻO ka hoʻomohala ʻana o kēia mau lāʻau i māka ʻia i kōkua i ka hoʻolōʻihi ʻana i nā ola o kekahi mau maʻi maʻi pae 4. Ua hōʻoia ka lapaʻau ʻana i ka lawa pono o ka hoʻomau ʻana o ka poʻe noiʻi i ka hoʻomohala ʻana i nā lāʻau hou i māka ʻia.

ʻO ka lāʻau bevacizumab (Avastin) ālai i ka VEGF a lawelawe ʻia ma o ke aa.

Nā hopena pili me:

• pāhoehoe
• Kaumaha emi
• maule ana
• poho ʻai
• puʻuwai puʻuwai
• ʻeha nā waha

Hoʻopau kahi mea kālaki kinase tyrosine kinase (TKI) i ka ulu ʻana o nā kīʻaha koko hou i nā tumors a hele mai i kahi ʻano pill. Eia kekahi laʻana o kēia ʻano lāʻau:

• sorafenib (Nexavar)
• cabozantinib (Cabometyx)
• pazopanib (Votrient)
• sunitinib (Sutent)

Loaʻa nā hopena ʻē aʻe o TKI:

• kahe koko kiʻekiʻe
• nausea
• pāhoehoe
• ʻeha ma kou mau lima a me kou mau wāwae

nā mea kāohi mTOR

ʻO ka pahuhopu mīkini o ka rapamycin (mTOR) mea pale i ka mTOR protein, kahi e paipai ai i ka ulu ʻana o ka maʻi ʻaʻai pūpū.

Pākuʻi ʻia kēia mau mea:

• temsirolimus (Torisel), lawelawe ʻia ma o IV
• everolimus (Afinitor), lawe waha ʻia i loko o ka pila pill

Nā hopena pili me:

• hūwī
• nāwaliwali
• poho ʻai
• ʻeha nā waha
• ka hoʻoulu wai i ka maka a i ʻole nā ​​wāwae
• ke kō kiʻekiʻe a me ka kōpaʻa

Lapaʻau hoʻomākala

Hoʻohana ka uila i nā kukuna X-ray ikaika loa e pepehi i nā hunaola maʻi ʻaʻai. Hiki ke hoʻohana ʻia ka pāhawewe ma hope o ke kaha ʻana e pepehi i nā hunaola maʻi ʻea i waiho ʻia ma hope o ka lāʻau.

I ka holomua RCC, hoʻohana pinepine ʻia ia e hōʻoluʻolu i nā hōʻailona e like me ka ʻeha a i ʻole ka pehu. Kapa ʻia kēia ʻano lapaʻau ʻo mālama palliative.

Nā hopena o ka pāhawewe pū kekahi:

• huhū ka ʻōpū
• ʻulaʻula ʻili
• luhi
• pāhoehoe

ʻO Chemotherapy

ʻO Chemotherapy kahi hana lapaʻau kuʻuna no nā ʻano maʻi ʻaʻai. Pili ia i ka hoʻohana ʻana i ka lāʻau a i ʻole ka hui ʻana o nā lāʻau e pepehi i nā hunaola maʻi ʻaʻai.

ʻAʻole i māka ʻia nā lāʻau Chemotherapy, eia nō naʻe, pepehi lākou i nā pūnaewele olakino pū kekahi a hana i nā hopena he nui.

ʻAʻole hana maikaʻi ʻo Chemotherapy i ka poʻe me RCC. Eia nō naʻe, hiki i kāu kauka ke koi aku iā ia inā ʻaʻole i holo ka hana immunotherapy a me nā mea i hoʻolālā ʻia.

Lawe pinepine ʻia kēia lāʻau lapaʻau a i ʻole ma ka ʻano pila. Hāʻawi ʻia ia i nā pōʻaiapuni me nā wā hoʻomaha o ka hoʻomaha. Pono ʻoe e loaʻa i ka chemotherapy i kēlā me kēia mahina a i kēlā me kēia mau mahina.

Nā hopena pili me:

• luhi
• ʻeha nā waha
• nausea a me ka luaʻi
• pāhoehoe a i ʻole ka paʻa paʻa
• poho lauoho
• poho ʻai
• hoʻonui i ka makaʻu no nā maʻi

Nā hoʻāʻo hoʻokolohua

ʻO kekahi koho ʻē aʻe no nā poʻe me ka pae 4 RCC e komo i nā hoʻokolohua hoʻokolohua. ʻO nā hoʻokolohua hoʻokolohua nā hoʻokolohua noiʻi no ka hoʻāʻo ʻana i nā lāʻau hou a me nā lāʻau lapaʻau.

Hiki iā ʻoe ke kūkākūkā i nā hoʻokolohua hoʻokolohua o kēia manawa - a me nā hopena a me nā pono kūpono - me kāu kauka a mea lawelawe olakino paha.

Ke hoʻokau nei ʻo carcinoma cell cell

ʻO nā kauka nāna e hōʻoia a mālama iā RCC a me nā ʻano maʻi ʻē aʻe e hoʻohana i kahi ʻōnaehana hoʻonohonoho. Hāʻawi ʻia kēlā me kēia kanaka me RCC i kahi inoa inoa mai 1 a 4. ʻO ke kahua 1 ka pae mua loa o ka maʻi a ʻo ka pae 4 ka mea hou loa a ʻoi loa.

Hoʻokumu ʻia ke kahua no RCC ma:

• ka nui o ka tumor mua i ka hakuʻala
• ka hoʻolaha ʻana o nā hunaola maʻi maʻi mai ka tumo mua i nā aʻa kokoke
• kekelē o ka metastasis
• ka hoʻolaha ʻana o ka maʻi ʻaʻai i nā mea ʻē aʻe i loko o ke kino

Hiki i ka pae 4 RCC ke hoʻopili i nā hui like ʻole o nā pae hoʻohālikelike:

• Ke nui ka tumo mua a ua hohola i loko o ke kola a i loko o nā aʻa kokoke. I kēia manawa, ua pāhola a ʻaʻole paha i hoʻolaha ʻia nā hunaola maʻi ʻino i loko o nā kino ʻē aʻe i loko o ke kino.
• Ke metastasized ka maʻi ʻaʻai a aia i loko o nā meaola mamao. I kēia hihia, he ʻano nui paha ke tumo mua, a aia a ʻaʻole paha he maʻi ʻaʻai i loko o nā aʻa e hoʻopuni koke ana i ka puʻupaʻa.

Outlook

ʻO ka helu ola 5 mau makahiki no ka poʻe me ka pae 4 RCC he 12 pakeneka. Eia nō naʻe, hiki i nā hiʻohiʻona ʻokoʻa ke hopena i nā helu ola kiʻekiʻe.

ʻO ka poʻe i hiki ke hana ʻoki ʻia e wehe i nā tumo metastatic ʻoi aku ka maikaʻi o ke ola, a he nui nā mea e mālama ʻia me nā lāʻau i hoʻopaʻa ʻia e ola ʻoi aku ka lōʻihi ma mua o ka poʻe ʻaʻole.