Theem 4 Renal Cell Carcinoma: Kho thiab Tsim Kho

Zoo Siab

• Cov kev kho mob RCC
• Kev phais mob
• Kev Txhaj Tshuaj Tiv Thaiv
• Cov chaw kuaj xyuas inhibitors
• Interleukin-2
• Tshuaj interferon
• Cov hom phiaj kho
• mTOR inhibitors
• Kev siv hluav taws xob
• Kws khomob
• Cov chaw kuaj mob
• Carcinoma lub raum cell
• Outlook

Mob raum cell carcinoma (RCC) yog ib hom mob cancer uas cuam tshuam rau lub hlwb ntawm lub raum. RCC yog hom feem ntau ntawm cov mob raum. Muaj ntau yam kev pheej hmoo rau kev tsim RCC, suav nrog:

• tsev neeg muaj keeb kwm muaj tus kab mob
• haus luam yeeb
• rog dhau
• ntshav siab
• polycystic mob raum

Thaum kuaj tau pom ntxov, koj muaj feem ntau los kho tus mob kom zoo.

Cov kev kho mob RCC

Txawm hais tias theem 4 RCC tau faib ua theem siab kawg ntawm kev mob qog noj ntshav, tseem muaj cov kev kho mob ua tau.

Kev phais mob

Qee qhov xwm txheej, thaum lub qog loj tau tshem tau thiab cov qog mob cancer tsis kis mus thoob plaws, ib qho tshuaj tua kab mob radical nephrectomy tuaj yeem ua. Qhov no cuam tshuam rau kev phais tshem tawm feem ntau lossis tag nrho cov mob raum.

Kev phais mob tawm ntawm lwm cov qog yuav xav tau rau cov neeg uas muaj mob cancer metastatic. Pab neeg tshwj xeeb yuav txiav txim siab seb puas yuav ua cov hlav metastasized tuaj yeem tshem tawm yam tsis muaj kev pheej hmoo heev.

Yog tias phais tsis tau, qog nqaij hlav los ntshav yuav raug siv. Txoj kev ua no txiav tawm cov ntshav xa mus rau cov qog, uas yuav pab txo qis cov tsos mob.

Thaum ib txoj kev phais tau raug tshem tawm cov qog hauv zos, ntau tus neeg yuav xav tau kev kho mob qis. Hom kev khomob no kho cov kabmob thoob plaws lub cev. Nws tuaj yeem pab txo qis kev mob qog noj ntshav.

Kev kho kab mob rau theem 4 RCC suav nrog kev kho mob tiv thaiv, kho hom phiaj, hluav taws xob, thiab kev siv tshuaj kho.

Kev Txhaj Tshuaj Tiv Thaiv

Kev Siv Tshuaj Tiv Thaiv yog ib txoj kev kho mob uas lub hom phiaj ua kom lub zog tiv thaiv kab mob los tua cov qog nqaij hlav cancer. Tsis yog txhua tus neeg nrog RCC teb tau zoo rau kev kho mob siab, thiab cov kev mob tshwm sim tuaj yeem yog mob hnyav.

Kev siv tshuaj tiv thaiv kabmob, lossis kev siv tshuaj lom neeg, yog ib txoj kev kho mob uas pab koj lub nruab zog tiv thaiv qog noj ntshav. Nws nquag qhia thaum RCC tsis tuaj yeem raug tshem tawm nrog kev phais mob.

Kev Siv Tshuaj Tiv Thaiv Siv ob peb hom tshuaj sib txawv:

Cov chaw kuaj xyuas inhibitors

Koj lub cev tiv thaiv kab mob siv ib qho system ntawm "chaw kuaj mob" kom paub qhov txawv ntawm lub hlwb noj qab haus huv thiab qog noj ntshav. Checkpoint inhibitors tsom txhawm rau pab koj lub cev tiv thaiv kab mob nrhiav cov kabmob kheesxaws uas khiav nkaum ntawm koj lub cev tsis muaj zog.

Nivolumab (Opdivo) yog ib qho kev ntsuam xyuas cov tshuaj tiv thaiv kab mob los ntawm ib qho IV uas tau dhau los hauv RCC kev kho mob hauv xyoo tsis ntev los no.

Cov kev phiv nrog:

• ua pob
• nkees
• zawv plab
• xeev siab
• mob taub hau
• daim tawv nqaij ua pob
• mob tej pob txha
• mob plab
• teeb meem ua pa

Interleukin-2

Interleukin-2 (IL-2, Proleukin) yog ib daim qauv theej ntawm cov protein hu ua cytokines uas yog lub hom phiaj ua kom koj lub cev tiv thaiv kab mob mus tua cov qog ntshav.

Nws pom tias muaj qhov ua tau. Nws tuaj yeem muaj kev phiv loj heev yog li tsuas yog siv rau cov neeg noj qab nyob zoo uas muaj peev xwm zam ntau cov kev mob tshwm sim.

Ib qhov kev ua tau zoo ntawm feem ntau cov txiv neej dawb nrog kev txhoj puab heev ntawm RCC puas pom qhov muaj sia nyob ntau dua nrog kev siv tshuaj interleukin-2 ntau dua.

Cov kev phiv nrog:

• nkees
• los ntshav
• ua daus no
• ua npaws
• ntshav siab
• kua hauv lub ntsws
• raum puas tsuaj

Tshuaj interferon

Cov tshuaj interferons muaj antiviral, antiproliferative (inhibits kev loj hlob ntawm tes mob hlwb), thiab immunomodulatory (cuam tshuam rau lub cev tiv thaiv kab mob) cov khoom. Interferon alpha hom phiaj yog ua kom txwv cov qog ua hlav los ntawm kev faib thiab loj hlob.

Qee zaum tshuaj Interferon tau muab nrog lwm cov tshuaj noj, xws li bevacizumab (Avastin).

Cov tshuaj phiv los cuam tshuam nrog:

• xeev siab
• cov tsos mob khaub thuas zoo li
• nkees

Cov tshuaj Interferons feem ntau tau hloov kho los ntawm ib tus neeg sawv cev rau kev kho mob. Ib qho kev pab cuam interferon kev kho mob ib txwm tsis siv ntxiv lawm.

Cov hom phiaj kho

Kev kho hom phiaj rau RCC txhais tau tias siv cov tshuaj uas tshwj xeeb rau cov mob hlwb. Cov tshuaj yuav tsum tsim nyog vim tias lawv tsis ua kom raug mob lossis tua cov hlwb noj qab haus huv hauv lub cev.

Muaj ntau lub hom phiaj tshuaj rau theem 4 RCC uas ua haujlwm los tiv thaiv kev loj hlob ntawm tes. Lawv tsom ib cov protein hu ua vascular endothelial growth factor (VEGF) uas txhawb kev loj hlob ntawm cov qog nqaij hlav cancer.

Kev tsim cov hom phiaj tshuaj no tau pab txuas lub neej ntawm qee theem 4 cov neeg mob. Cov kev kho mob tau ua pov thawj pom zoo txaus tias cov kws tshawb nrhiav txuas ntxiv txhim kho cov tshuaj tshiab.

Cov tshuaj bevacizumab (Avastin) thaiv VEGF thiab raug tswj hwm los ntawm cov leeg ntshav.

Cov kev phiv nrog:

• zawv plab
• poob phaus
• tsaus muag
• qab los noj mov poob
• Kev mob siab
• qhov ncauj tawm

Tus mob tyrosine kinase inhibitor (TKI) nres cov hlab ntshav tshiab txoj kev loj hlob hauv cov qog thiab los hauv cov ntsiav tshuaj. Piv txwv ntawm cov hom tshuaj no suav nrog:

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

Kev phiv los ntawm TKIs suav nrog:

• ntshav siab
• xeev siab
• zawv plab
• mob hauv koj txhais tes thiab taw

mTOR inhibitors

Cov ntsiab lus tseem ceeb ntawm rapamycin (mTOR) inhibitors tsom mTOR protein, uas pab txhawb txoj kev mob qog nqaij hlav hauv hlwb.

Cov no suav nrog:

• temsirolimus (Torisel), tswj hwm los ntawm IV
• everolimus (Afinitor), noj ntawm ncauj hauv tshuaj ntsiav

Cov kev phiv nrog:

• ua pob
• tsis muaj zog
• qab los noj mov poob
• qhov ncauj tawm
• kua buildup ntsej muag lossis ceg
• ntshav siab thiab cov roj cholesterol

Kev siv hluav taws xob

Hluav taws xob siv hluav taws xob ntau xoo hluav taws xob tua kab mob tua cov qog nqaij hlav cancer. Kev siv hluav taws xob kuj tseem siv tau tom qab kev phais txhawm rau tua txhua cov qog mob cancer tom qab kho.

Hauv RCC siab heev, feem ntau nws siv los daws cov tsos mob zoo li mob los yog o. Hom kev khomob no hu ua kev saib xyuas palliative care.

Kev phiv ntawm hluav taws xob suav nrog:

• mob plab dhau
• daim tawv nqaij liab
• nkees
• zawv plab

Kws khomob

Kev siv tshuaj kho mob yog ib txoj kev kho mob ib txwm muaj rau ntau hom mob qog nqaij hlav. Nws suav nrog kev siv tshuaj lossis kev sib txuam tshuaj los tua cov qog nqaij hlav cancer.

Kev siv tshuaj kho mob tsis raug tsom, txawm li cas los xij, yog li lawv tua cov hlwb zoo thiab ua rau ntau cov kev mob tshwm sim.

Kev zuaj tshuaj feem ntau tsis zoo rau cov neeg uas muaj RCC. Txawm li cas los xij, koj tus kws kho mob tuaj yeem pom zoo nws yog tias kev siv tshuaj tiv thaiv thiab kev kho mob tsis ua haujlwm.

Qhov kev kho no yog noj rau hauv qhov quav lossis hauv ntsiav tshuaj daim ntawv. Nws muab nyob rau hauv cov voj voog nrog lub sijhawm sib nrug ntawm kev so. Koj ib txwm yuav tsum tau muaj tshuaj kho mob txhua lub hlis lossis ob peb hlis.

Cov kev phiv nrog:

• nkees
• qhov ncauj tawm
• xeev siab thiab ntuav
• raws plab lossis quav tawv
• plaub hau poob
• qab los noj mov poob
• nce kev pheej hmoo kis mob

Cov chaw kuaj mob

Lwm qhov kev xaiv rau cov neeg muaj qib 4 RCC yog los koom nrog hauv kev sim kuaj mob. Cov chaw kuaj mob yog tshawb nrhiav kev sim tshuaj tshiab thiab kho mob tshiab.

Koj tuaj yeem sib tham txog cov kev sim kho mob tam sim no - nrog rau lawv cov kev pheej hmoo thiab cov txiaj ntsig zoo - nrog koj tus kws kho mob lossis tus kws kho mob.

Carcinoma lub raum cell

Cov kws kho mob uas kuaj thiab kho RCC thiab lwm yam mob qog nqaij hlav siv txheej txheem sau tseg. Txhua tus neeg uas muaj RCC raug muab tus lej xaiv los ntawm 1 txog 4. Theem 1 yog qhov ntxov ntawm tus kab mob thiab theem 4 yog qhov tshiab thiab tshaj plaws.

Staging rau RCC yog raws:

• qhov loj ntawm cov thawj qog ua haujlwm hauv lub raum
• kev sib kis ntawm cov kab mob qog ntshav ntawm thawj qog mus rau cov nqaij mos
• degree ntawm metastasis
• kev hloov ntawm tus kabmob mus rau lwm yam kabmob hauv lub cev

Theem 4 RCC tuaj yeem suav nrog sib txawv sib txawv ntawm cov qib staging:

• Thaum thawj lub qog loj thiab tau kis thoob plaws lub raum thiab mus rau hauv cov ntaub so ntswg. Hauv qhov ua piv txwv no, cov qog nqaij hlav cancer yuav lossis tsis kis mus rau lwm qhov hauv lub cev.
• Thaum mob cancer tau metastasized thiab nyob rau hauv cov kabmob uas nyob deb. Hauv qhov no, thawj lub qog yuav muaj qhov loj me, thiab tej zaum yuav los yog tsis muaj mob qog nqaij hlav hauv cov nqaij mos tam sim puag ncig lub raum.

Outlook

Tus nqi 5 xyoo ntawm kev muaj sia nyob rau cov neeg uas nyob nrog theem 4 RCC yog 12 feem pua. Txawm li cas los xij, cov xwm txheej sib txawv yuav ua rau muaj ntau dua kev muaj sia nyob.

Cov neeg uas tuaj yeem tau txais kev phais kom tshem tawm cov mob qog nqaij hlav tau muaj txoj sia nyob zoo dua, thiab ntau tus neeg tau txais kev kho mob nrog cov tshuaj muaj sia nyob ntev dua li cov uas tsis siv.