Iyo yazvino edition yeWorld Health Organisation's Classification yeSoft Tissue uye Bone Tumors, yakaburitswa muna Kubvumbi 2020, inotsanangura.sarcomasmuzvikamu zvitatu: smamota akawanda ematishu, mamota ebhonzo, uye mapundu ezvose zviri zviviri bhonzo uye matishu akapfava ane masero madiki akatenderera asina kupatsanurwa.(zvakadai seEWSR1-isina-ETS fusion round cell sarcoma).
“Gonza Rakakanganwa”
Sarcoma inzira isingawanzoitikikenza muvanhu vakuru, accounting for about1%yekenza yese yevakuru, inowanzonzi "The Forgotten Cancer."Zvisinei, zvine mwerozvinowanzoitika muvana, accounting for around15% kusvika 20%yekenza dzose dzevana.Inogona kuitika mune chero chikamu chemuviri, kazhinji munemaoko kana makumbo(60%), ichiteverwa nehunde kana dumbu(30%), uye pakupedzisiramusoro kana mutsipa(10%).
Mumakore achangopfuura, chiitiko chemapfupa uye zvinyoro zvinyoro bundu zviri kuwedzera zvishoma nezvishoma.Primary malignant bone tumors inowanzoitika muvechiri kuyaruka uye vanhu vepakati uye vanosanganisira osteosarcoma, Ewing sarcoma, chondrosarcoma, malignant fibrous histiocytoma, uye chordoma, pakati pevamwe.Mamota akapfava akajairika anosanganisira synovial sarcoma, fibrosarcoma, liposarcoma, uye rhabdomyosarcoma.Bone metastases inowanzoitika muzera repakati nepakati uye vanhu vakuru, vane mamota ekutanga akajairika kuva kenza yemapapu, kenza yemazamu, kenza yeitsvo, kenza yeprostate, uye kenza yethyroid, pakati pevamwe.
Kuonekwa Kwekutanga, Kurapwa Kwekutanga - Kuvhenekera "Mamota" Akavanzika
Nekuda kweiyo yakakwira kudzokorora mwero we sarcomas, mabundu mazhinji ane preoperative yekuongorora uye kushaya akadzama ekufungidzira ekuongorora.Izvi zvinowanzo tungamira pakuwanikwa panguva yekuvhiyiwa kuti bundu harisi nyore sekufungidzirwa preoperative, zvichikonzera kusakwana kubviswa.Postoperative kudzokorora kana metastasis inogona kuitika, zvichiita kuti varwere vapotsa mukana wakakwana wekurapa.Naizvozvo,kuvhenekwa kwekutanga, kuongororwa kwakaringana, uye kurapwa nenguva kune zvakakosha zvakanyanya pakufungidzira kwevarwere. Nhasi, tinoda kusuma nyanzvi inoremekedzwa ine makore anoda kusvika makumi maviri echiitikomukuongororwa kwakamisikidzwa uye kurapwa kwakasarudzika kwezvinyoro zvinyoro sarcoma, uye inorumbidzwa zvikuru nevese indasitiri nevarwere -ChirembaLiu Jiayongkubva kuDhipatimendi reBone uye Soft Tissue paPeking University Cancer Hospital.
Kufumura Nyanzvi Neruzivo rwakadzama rweBone neNyama Marwadzo - Dr.Liu Jiayong
Chiremba weMishonga, Chiremba Mukuru, Associate Purofesa.Akadzidza kuAnderson Cancer Center muUnited States.
Hunyanzvi:Kurapa kwakazara kwezvinyoro zvinyoro sarcoma (kuvhiya resection uye kuvaka patsva; chemotherapy, chinangwa chekurapa, uye immunotherapy);Kuvhiya kurapwa kwe melanomas.
Neanoda kusvika makore makumi maviri eruzivo rwekurapa, Chiremba Liu Jiayong akaunganidza hunyanzvi hwekiriniki nekurapa kwekuvhiyastandardized kuongororwa uye zvirongwa zvekurapa zvemunhukune zvakajairika zvinyoro zvinyoro sarcomas senge undifferentiated pleomorphic sarcoma, liposarcoma, leiomyosarcoma, synovial sarcoma, adenocystic carcinoma-like sarcoma, epithelioid sarcoma, fibrosarcoma, angiosarcoma, uye infiltrative fibromatosis.Ari kunyanyainyanzvi pakubata tsinga netsinga panguva yemakumbo sarcoma resections, pamwe nekugadzirisa nekugadzirisa zvakare zvinyoro zvinyoro paganda.Chiremba Liu anoteerera nemoyo murefu kumurwere wega wega, achinyatso kubvunza nezve nhoroondo yavo yekurapa, uye anotora zvine hungwaru marekodhi ekurapa.Anonyanya kukoshesa kuchinja kwehutano hwemurwere panguva dzakasiyana-siyana, dzakadai sepamberi uye shure kwekuvhiyiwa, panguva yekurapa, kutevera, uye kufambira mberi kwechirwere, kuita mitongo chaiyo uye kugadzirisa panguva yezvirongwa zvekurapa.
Chiremba Liu Jiayong parizvino anoshanda senhengo yeSoft Tissue Sarcoma neMelanoma Group yeChinese Anti-Cancer Association, pamwe nenhengo yeBone Tumor Group yeBeijing Society of Orthopedics yeChinese Medical Association.Muna 2010, ndiye aive wekutanga muChina kushandura nekutsikisa “NCCN Clinical Practice Guidelines in Soft Tissue Sarcoma,” achikurudzira kurapa kwakamisikidzwa kweakapfava matishu sarcoma.Anoramba achiedza kufambira mberi mukutsvakurudza kwekliniki nesayenzi, pasinei nokuti ane mutoro mukuru wevarwere.Akazvipira uye ane mutoro kune wese murwere waanorapa, uye panguva yedenda, akagadzirisa matambudziko akatarisana nevarwere vari kutsvaga kurapwa nekukasira kupindura mukubvunzana kwevarwere, kuongorora mhedzisiro yekutevera, nekupa kurudziro yekurapa kwakakodzera kuburikidza nemapuratifomu ekubvunzana epamhepo senge. Boka revarwere rakanaka revarwere.
Recent Case
Mr. Zhang, murwere ane makore makumi matatu nemashanu, akangoerekana aona kurasikirwa kwemaonero mukutanga kwe 2019. Mushure mezvo, akavhiyiwa ziso rekuruboshwe nekuda kwekuwedzera kwakasimba mu intraocular pressure.Iyo postoperative pathology yakaratidza kuzvimba pseudotumor.Muzhizha regore rimwe chete, mazamu akawanda emapapu akawanikwa panguva yekuongororwa kwekutevera, asi hapana masero emamota akaonekwa kuburikidza netsono biopsies.Dzimwezve ongororo dzekutevera dzakaratidza akawanda mapfupa uye mapapu metastases.Kukurukurirana kuzvipatara zvemunharaunda uye zvepamusoro-soro kwakamuwana ane kuputika kwemyofibroblastic bundu.Muna Nyamavhuvhu 2022, akaitwa chemotherapy yakanyanya, iyo yakadzoreredza kurwadziwa kwake asi yakaratidza kusandura kunooneka mumaronda paakaongororwazve.Mamiriro ake omuviri akaperawo simba.Pasinei neizvi, mhuri yake haina kumbokanda mapfumo pasi.Mushure mekutsvaga pfungwa dzakawanda, vakauya kuna Chiremba Liu Jiayong munaNovember 2022. Mushure mekunyatsoongorora nhoroondo yehutano hwemurwere, zvinyorwa zvose zvehutano, kuongororwa kwepathological, uye imaging data,ChirembaLiu akakurudzira chemotherapy regimen inosanganisira yakaderera-dose methotrexate uye Changchun Ruibin.Iyi chemotherapy regimen inodhura-inoshanda uye ine mishoma mhedzisiro.Mushure memazuva makumi matatu nemashanu emushonga, yekutevera CT scan yakaratidza kuti huwandu mumapapu ekurudyi hwakanga hwanyangarika, zvichiratidza kutonga kwakanaka kwebundu.Ongororo ichangobva kuitika paBeijing South Region Oncology Hospital yakaratidza kugadzikana kwemapapu, uye Chiremba Liu vakakurudzira kushanya kwekutevera.Murwere nemhuri yake zvino vane chivimbo chikuru mukurapwa kunotevera, vakazadzwa netariro.Vanonzwa kuti vakaona kupenya kwechiedza murwendo rwokurapwa uye vanoratidza kuonga kwavo kwomwoyo wose nokuratidza mureza wesirika wokuonga.
Nguva yekutumira: Aug-25-2023