Ingxenye yebele brachytherapy

I-Brachytherapy yomdlavuza webele ifaka ukubeka izinto ezinemisebe ngqo endaweni lapho umdlavuza webele ususwe khona ebeleni.

Amaseli womdlavuza anda ngokushesha kunamaseli ajwayelekile emzimbeni. Ngoba imisebe iyingozi kakhulu kumaseli akhula ngokushesha, ukwelashwa ngemisebe kulimaza amangqamuzana omdlavuza kalula kunamaseli ajwayelekile. Lokhu kuvimbela amangqamuzana omdlavuza ukuthi angakhuli futhi ahlukane, futhi kuholele ekufeni kweseli.

I-Brachytherapy ihambisa ukwelashwa ngemisebe ngqo lapho kutholakala khona amangqamuzana omdlavuza ngaphakathi kwebele. Kungabandakanya ukubeka umthombo we-radioactive endaweni yokuhlinzwa ngemuva kokuba udokotela ohlinzayo esuse isigaxa sesifuba. Imisebe ifinyelela endaweni encane ezungeze indawo yokuhlinzwa. Aliliphilisi lonke ibele, yingakho libizwa ngokuthi yi-"temporary breast" therapy noma i-brachytherapy yamabele ebeleni. Umgomo ukukhawulela imiphumela emibi yemisebe ibe yivolumu encane yezicubu ezijwayelekile.

Kunezinhlobo ezahlukahlukene ze-brachytherapy. Kunezindlela okungenani ezimbili zokuletha imisebe evela ngaphakathi ebeleni.

BRACHYTHERAPY WOMHLABA (IMB)

• Izinaliti ezincane eziningana ezinamashubhu abizwa ngokuthi ama-catheters zifakwa esikhunjeni kwizicubu zesifuba ezungeze indawo ye-lumpectomy. Lokhu kuvame ukwenziwa emavikini ayi-1 kuya kwamabili ngemuva kokuhlinzwa.
• Kusetshenziswa i-Mammography, ultrasound, noma i-CT ukubeka izinto ezinemisebe lapho zizosebenza kangcono ukubulala umdlavuza.
• Izinto ezinemisebe efakwa kuma-catheters futhi zihlala isonto elilodwa.
• Kwesinye isikhathi imisebe ingalethwa kabili ngosuku izinsuku ezi-5 ngomshini olawulwa kude.

INTRACAVITARY BRACHYTHERAPY (IBB)

• Ngemuva kokususwa kwesigaxa sesifuba, kukhona umgodi lapho umdlavuza wasuswa khona. Umshini oqukethe ibhaluni le-silicone kanye nethubhu eneziteshi ezisebenza kuyo kungafakwa kulo mbobo. Ezinsukwini ezimbalwa ngemuva kokubekwa, imisebe yesimo samaphilisi amancane anemisebe ingangena eziteshini, ihambise imisebe evela ngaphakathi kubhaluni. Lokhu kuvame ukwenziwa kabili ngosuku izinsuku ezinhlanu. Kwesinye isikhathi i-catheter ibekwa ngesikhathi sokuhlinzwa kokuqala ngenkathi ulele.
• Izikena ze-Ultrasound noma ze-CT zisetshenziselwa ukuqondisa ukubekwa ngqo kwento enemisebe lapho izosebenza kangcono ukubulala umdlavuza ngenkathi ivikela izicubu eziseduze.
• I-catheter (ibhaluni) ihlala endaweni ezungeze amasonto ayi-1 kuya kwangu-2 futhi isuswa ehhovisi lomhlinzeki wakho. Ukuthunga kungadingeka ukuvala umgodi lapho kukhishwa khona ipayipi.

I-Brachytherapy inganikezwa ngokuthi "umthamo ophansi" noma "umthamo omkhulu."

• Labo abathola imishanguzo ephansi bagcinwa esibhedlela egumbini elizimele. Imisebe ihanjiswa kancane ngaphezu kwamahora kuye ezinsukwini.
• Imithi yokwelashwa okuphezulu inikezwa njengesiguli esingaphandle sisebenzisa umshini okude, futhi kaningi ngaphezulu kwezinsuku ezi-5 noma ngaphezulu. Kwesinye isikhathi ukwelashwa kulethwa amahlandla amabili ngosuku olulodwa, kuhlukaniswe amahora amane kuya kwayisithupha phakathi kweseshini. Umuthi ngamunye uthatha cishe imizuzu eyi-15 kuye kwengu-20.

Amanye amasu afaka:

• Ukufakelwa kwembewu yebele unomphela (i-PBSI), lapho imbewu enomsakazo ifakwa ngazinye ngenaliti emgodini webele emasontweni ambalwa ngemuva kwe-lumpectomy.
• Ukwelashwa ngemisebe ye-intraoperative kulethwa egumbini lokuhlinza ngenkathi ulele ngemuva kokususwa kwezicubu zamabele. Ukwelashwa kuqedwa esikhathini esingaphansi kwehora. Lokhu kusebenzisa umshini omkhulu we-x-ray ngaphakathi kwegumbi lokusebenza.

Ochwepheshe bathola ukuthi umdlavuza othile kungenzeka ukuthi ubuye eduze nendawo yokuqala yokuhlinzwa. Ngakho-ke, kwezinye izimo, lonke ibele kungenzeka lingadingi ukuthola imisebe. Imisebe yebele engaphelele iphatha kuphela amanye kodwa hhayi lonke ibele, igxile endaweni lapho umdlavuza kungenzeka ubuyele khona.

I-brachytherapy yebele isiza ukuvimbela umdlavuza webele ukuthi ungabuyi. Ukwelashwa ngemisebe kunikezwa ngemuva kwe-lumpectomy noma i-mastectomy eyingxenye. Le ndlela ibizwa ngokuthi i-adjuvant (eyengeziwe) yokwelapha ngemisebe ngoba ingeza ukwelashwa okudlula ukuhlinzwa.

Ngoba lezi zindlela azifundwa kahle njengokwelapha ngemisebe yebele lonke, akukho sivumelwano esigcwele mayelana nokuthi ngubani ongazuza kakhulu.

Izinhlobo zomdlavuza webele ongaphathwa ngemisebe yebele engaphelele ibandakanya:

• I-Ductal carcinoma in situ (DCIS)
• Umdlavuza webele ohlaselayo

Ezinye izinto ezingaholela ekusetshenzisweni kwe-brachytherapy zifaka:

• Usayizi wesimila ongaphansi kuka-2 cm kuye ku-3 cm (cishe nge-intshi)
• Akunabufakazi besimila eceleni kwemikhawulo yesifanekiso sesimila esisusiwe
• Ama-lymph node awathandeki ngesimila, noma i-node eyodwa kuphela enamanani amancane

Tshela umhlinzeki wakho ukuthi iyiphi imithi oyiphuzayo.

Gqoka izingubo ezikugudlukela ekwelashweni.

Ukwelashwa ngemisebe nakho kungalimaza noma kubulale amaseli aphilile. Ukufa kwamaseli aphilile kungaholela emiphumeleni emibi. Le miphumela emibi incike kumthamo wemisebe, nokuthi uthola ukwelashwa kangaki.

• Ungaba nokufudumala noma ukuzwela eduze kwesiza sokuhlinzwa.
• Ungahlakulela ububomvu, ubumnene, noma ukutheleleka.
• Iphakethe elinoketshezi (i-seroma) lingakhula endaweni yokuhlinzwa futhi lingadinga ukukhishwa.
• Isikhumba sakho endaweni ephethwe singashintsha sibe bomvu noma sibe mnyama ngombala, ikhasi, noma ukulunywa.

Imiphumela emibi yesikhathi eside ingafaka:

• Ukwehla kobukhulu besifuba
• Ukwanda okuqinile kwesifuba noma i-asymmetry ethile
• Ukubomvu kwesikhumba nokushintsha kombala

Azikho izifundo ezisezingeni eliphakeme eziqhathanisa i-brachytherapy nemisebe ephelele yebele. Kodwa-ke, ezinye izifundo zikhombisile ukuthi imiphumela iyafana nakwabesifazane abanomdlavuza webele owenziwe endaweni.

Umdlavuza webele - ukwelashwa ngemisebe ngokwengxenye; I-carcinoma yebele - ukwelashwa ngemisebe ngokwengxenye; I-brachytherapy - isifuba; Imisebe ye-Adjuvant ngokwengxenye yebele - brachytherapy; I-APBI - brachytherapy; I-irradiation yebele esheshayo esheshayo - i-brachytherapy; Ukwelashwa kwemisebe yebele okungafani - i-brachytherapy; Ukutshala imbewu yesifuba unomphela; PBSI; I-radiotherapy yedosi ephansi - isifuba; I-radiotherapy ephezulu - isifuba; I-elektroniki ibhaluni brachytherapy; EBB; I-brachytherapy yangaphakathi; IBB; I-brachytherapy yangaphakathi; IMB

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza webele (omdala) (PDQ) - inguqulo yezempilo. www.cancer.gov/types/breast/hp/ Ukwelashwa kwesibeletho-pdq. Kubuyekezwe ngoFebhuwari 11, 2021. Kufinyelelwe ngoMashi 11, 2021.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa ngemisebe kanye nawe: ukusekelwa kwabantu abanomdlavuza. www.cancer.gov/publications/patient-education/radiationttherapy.pdf. Kubuyekezwe u-Okthoba 2016. Kufinyelelwe ngo-Okthoba 5, 2020.

U-Otter SJ, uHolloway CL, u-O'Farrell DA, u-PMlin Devlin, uStewart AJ. I-Brachytherapy. Ku: Tepper JE, Foote RL, Michalski JM, eds. IGunderson neTepper’s Clinical Radiation Oncology. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2021: isahluko 20.

Shah C, Harris EE, Holmes D, Vicini FA. Ukukhanya kwesifuba okuyingxenye: kusheshisiwe futhi kungenziwa ngokuhlinzwa. Ku: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, ama-eds. Isifuba: Ukuphathwa Okuphelele Kwezifo ZeBenign Nezimbi. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2018: isahluko 51.