Chotupa cha ubongo cha metastatic

Chotupa cha mu ubongo ndim khansa yomwe idayambira mbali ina ya thupi ndipo yafalikira ku ubongo.

Mitundu yambiri ya zotupa kapena khansa imatha kufalikira kuubongo. Ambiri ndi awa:

• Khansa ya m'mapapo
• Khansa ya m'mawere
• Khansa ya pakhungu
• Khansa ya impso
• Khansa ya m'matumbo
• Khansa ya m'magazi

Mitundu ina ya khansa imafalikira kuubongo, monga khansa ya prostate. Nthawi zina, chotupa chimatha kufalikira kuubongo kuchokera kumalo osadziwika. Izi zimatchedwa khansa ya pulayimale yosadziwika (CUP).

Kukula kwa zotupa zamaubongo kumatha kukakamiza magawo oyandikira aubongo. Kutupa kwa ubongo chifukwa cha zotupazi kumayambitsanso kupanikizika mkati mwa chigaza.

Zotupa zamaubongo zomwe zimafalikira zimasankhidwa kutengera komwe kuli chotupacho muubongo, mtundu wa minofu yomwe ikukhudzidwa, komanso komwe chotupacho chidakhala.

Zotupa zamaubongo zama metastatic zimachitika pafupifupi gawo limodzi mwa anayi (25%) a khansa yonse yomwe imafalikira mthupi. Amadziwika kwambiri kuposa zotupa zoyambirira zamaubongo (zotupa zomwe zimayamba muubongo).

Zizindikiro zimatha kuphatikizira izi:

• Kuchepetsa kulumikizana, kusakhazikika, kugwa
• Kudwala kapena kutopa
• Mutu, watsopano kapena wolimba kuposa masiku onse
• Kuiwala kukumbukira, kusaweruza bwino, kuthetsa mavuto
• Dzanzi, kumva kuwawa, kupweteka, ndi kusintha kwina pakumverera
• Umunthu umasintha
• Kusintha kwakanthawi kwamalingaliro kapena machitidwe achilendo
• Kulanda kwatsopano
• Mavuto ndi mawu
• Masomphenya amasintha, masomphenya awiri, masomphenya ochepa
• Kusanza, ndi kapena wopanda mseru
• Kufooka kwa thupi

Zizindikiro zenizeni zimasiyanasiyana. Zizindikiro zodziwika zamitundu yambiri yamatumbo am'mimba zimayambitsidwa chifukwa cha kukakamizidwa kwa ubongo.

Kuyeza kumatha kuwonetsa kusintha kwa ubongo ndi mitsempha kutengera komwe chotupacho chili muubongo. Zizindikiro zakuchulukirachulukira mu chigaza ndizofala. Zotupa zina sizitha kuwonetsa zizindikilo mpaka zitakhala zazikulu kwambiri. Kenako, amatha kuyambitsa kuchepa mwachangu kwamachitidwe amanjenje.

Chotupa choyambirira (choyambirira) chitha kupezeka pofufuza zotupa kuchokera kuubongo.

Mayeso atha kuphatikiza:

• Mammogram, CT amawunika pachifuwa, pamimba, ndi m'chiuno kuti apeze chotupa choyambirira
• CT scan kapena MRI yaubongo kutsimikizira kuti matendawa amapezeka ndikudziwika komwe kuli chotupacho (MRI nthawi zambiri imakhala yovuta kwambiri kupeza zotupa muubongo)
• Kuyesa kwa minofu yomwe idachotsedwa pachotupacho panthawi yochita opareshoni kapena CT scan- kapena biopsy motsogozedwa ndi MRI kutsimikizira mtundu wa chotupacho
• Lumbar kuboola (tapampopi)

Chithandizo chimadalira:

• Kukula ndi mtundu wa chotupacho
• Malo m'thupi kuchokera komwe amafalikira
• Thanzi labwino la munthuyo

Zolinga zamankhwala zitha kukhala kuti muchepetse zizindikilo, kukonza magwiridwe antchito, kapena kupereka chitonthozo.

Mankhwala onse a radiation (WBRT) amagwiritsidwa ntchito pochizira zotupa zomwe zafalikira kuubongo, makamaka ngati pali zotupa zambiri, ndipo kuchitidwa opaleshoni si njira yabwino.

Opaleshoni itha kugwiritsidwa ntchito pakakhala chotupa chimodzi ndipo khansa isafalikire mbali zina za thupi. Zotupa zina zimatha kuchotsedwa kwathunthu. Zotupa zomwe ndizakuya kapena zomwe zimafalikira m'minyewa yamaubongo zimatha kuchepetsedwa kukula (kutulutsa).

Kuchita maopareshoni kumachepetsa kupsinjika ndikuchotsa zizindikiritso zikafika poti chotupacho sichingachotsedwe.

Chemotherapy ya zotupa zamaubongo zama metastatic nthawi zambiri sizothandiza monga opaleshoni kapena radiation. Mitundu ina ya zotupa, imathandizidwa ndi chemotherapy.

Stereotactic radiosurgery (SRS) itha kugwiritsidwanso ntchito. Njira imeneyi yothandizira poizoniyu imayang'ana kwambiri ma x-ray pamagawo ang'onoang'ono a ubongo. Amagwiritsidwa ntchito ngati pali zotupa zochepa chabe.

Mankhwala azizindikiro zotupa muubongo ndi awa:

• Ma anticonvulsants monga phenytoin kapena levetiracetam ochepetsa kapena kupewa kugwidwa
• Corticosteroids monga dexamethasone yochepetsa kutupa kwa ubongo
• Osmotic diuretics monga hypertonic saline kapena mannitol kuti achepetse kutupa kwa ubongo
• Mankhwala opweteka

Khansara ikafalikira, chithandizo chitha kungokhalira kuchepetsa ululu ndi zizindikilo zina. Izi zimatchedwa chisamaliro chothandiza kapena chothandizira.

Njira zachitonthozo, njira zachitetezo, chithandizo chakuthupi, chithandizo chantchito, ndi zina zitha kusintha moyo wa wodwalayo. Anthu ena atha kufunafuna upangiri wazamalamulo kuti awathandize kupanga chitsogozo chamtsogolo ndi mphamvu ya loya pazachipatala.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Kwa anthu ambiri omwe ali ndi zotupa zamaubongo, khansa siyichiritsidwa. Pambuyo pake imafalikira kumadera ena a thupi. Kulosera kumatengera mtundu wa chotupa komanso momwe amachitira ndi mankhwala.

Mavuto omwe angabwere chifukwa chake ndi awa:

• Herniation ya ubongo (yakupha)
• Kutaya ntchito kapena kudzisamalira
• Kutaya kulumikizana
• Kutha kwamuyaya, kwamphamvu kwamanjenje komwe kumagwira ntchito kumawonjezeka pakapita nthawi

Itanani yemwe akukuthandizani ngati muli ndi mutu wopitilira muyeso kapena watsopano kwa inu.

Itanani omwe akukuthandizani kapena pitani kuchipinda chodzidzimutsa ngati inu kapena munthu wina amene mumamudziwa mwadzidzidzi mwayamba kuchita ulesi kapena kusintha masomphenya, kapena vuto la kulankhula, kapena ali ndi khunyu zatsopano kapena zosiyana.

Chotupa chaubongo - metastatic (sekondale); Khansa - chotupa chaubongo (metastatic)

• Kutulutsa kwa ubongo - kutulutsa
• Opaleshoni ya ubongo - kutulutsa
• Thandizo la radiation - mafunso omwe mungafunse dokotala wanu

• Ubongo
• MRI yaubongo

Clifton W, Reimer R. Metastatic zotupa zamaubongo. Mu: Chaichana K, Quiñones-Hinojosa A, eds. Kuwunikira Kwapafupipafupi Kwa Njira Zamakono Zopangira Opaleshoni Zotupa Zamkati Zam'mimba. Philadelphia, PA: Elsevier; 2019: mutu 8.

Dorsey JF, Salinas RD, Dang M, ndi al. Khansa yapakati yamanjenje. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 63.

Mkulu JB, Nahed BV, Linskey ME, Olson JJ. Kuwunika mwatsatanetsatane kwa Congress of Neurological Surgeons ndi upangiri wokhudzana ndi umboni wokhudzana ndi njira zomwe zikupezeka komanso njira zochiritsira zochiritsira achikulire omwe ali ndi zotupa zamaubongo zama metastatic. Kuchita opaleshoni. 2019; 84 (3): E201-E203. PMID 30629215 adatuluka.ncbi.nlm.nih.gov/30629215/.

Tsamba la National Cancer Institute. Chithandizo cha akulu chotupa chotupa chotupa (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/brain/hp/adult-brain-kuchiza-pdq. Idasinthidwa pa Januware 22, 2020. Idapezeka pa February 12, 2020.

Olson JJ, Kalkanis SN, Ryken TC. Congress of Neurological Surgeons Reviewatic Review ndi Maupangiri Okhazikika Pazithandizo la akulu omwe ali ndi zotupa zamaubongo zama metastatic: mwachidule. Kuchita opaleshoni. 2019; 84 (3): 550-552 (Adasankhidwa) PMID 30629218 pubed.ncbi.nlm.nih.gov/30629218/.

Patel AJ, Lang FF, Suki D, Wildrick DM, Sawaya R. Metastatic zotupa zamaubongo. Mu: Winn HR, mkonzi. Opaleshoni ya Youmans ndi Winn Neurological. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 146.