Hlahala ea boko - mathomo - batho ba baholo

Hlahala e ka sehloohong bokong ke sehlopha (boima) sa lisele tse sa tloaelehang tse qalang bokong.

Lihlahala tsa mantlha tsa boko li kenyelletsa hlahala efe kapa efe e qalang bokong. Lihlahala tsa mantlha tsa boko li ka qala ho tsoa liseleng tsa boko, lisele tse potileng boko (meninges), methapo kapa litšoelesa.

Lihlahala li ka senya lisele tsa boko ka kotloloho. Li ka boela tsa senya lisele ka ho hlahisa ho ruruha, ho beha khatello likarolong tse ling tsa boko, le ho eketsa khatello ka har'a lehata.

Lebaka la lihlahala tse ka sehloohong tsa boko ha le tsejoe. Ho na le mabaka a mangata a kotsi a ka bapalang karolo:

• Phekolo ea radiation e sebelisetsoang ho phekola mofetše oa boko e eketsa kotsi ea lihlahala tsa boko ho fihlela lilemo tse 20 kapa tse 30 hamorao.
• Maemo a mang a futsitsoeng a eketsa kotsi ea lihlahala tsa boko, ho kenyeletsoa neurofibromatosis, lefu la Von Hippel-Lindau, lefu la Li-Fraumeni le lefu la Turcot.
• Lymphomas e qalang bokong ho batho ba nang le boits'ireletso ba mmele bo fokolang ka linako tse ling e hokahantsoe le tšoaetso ea vaerase ea Epstein-Barr.

Tsena ha lia ipaka ho ba lisosa tsa kotsi:

• Ho pepesetsoa mahlaseli a kotsi mosebetsing, kapa ho lithapo tsa motlakase, mehala ea thekeng, mehala e se nang mohala, kapa lisebelisoa tse se nang mohala
• Likotsi tsa hlooho
• Ho tsuba
• Phekolo ea Hormone

LITLHAKU TSE KHABANE LITLHOKO

Lihlahala tsa boko li aroloa ho latela:

• Sebaka sa hlahala
• Mofuta oa lisele tse amehang
• Ebang ha ba na kankere (benign) kapa kankere (e kotsi)
• Lintlha tse ling

Ka linako tse ling, lihlahala tse qalang li le mabifi li ka fetola boits'oaro ba bona ba biologic mme tsa ba mabifi le ho feta.

Lihlahala li ka hlaha ka lilemo tsohle, empa mefuta e mengata e atile haholo sehlopheng se itseng sa lilemo. Ho batho ba baholo, li-gliomas le meningiomas ke tsona tse atileng haholo.

Li-gliomas li tsoa liseleng tse kang li-astrocyte, li-oligodendrocyte le lisele tsa ependymal. Li-gliomas li arotsoe ka mefuta e meraro:

• Lihlahala tsa Astrocytic li kenyelletsa astrocytomas (e kanna ea se ke ea baka kankere), anaplastic astrocytomas le glioblastomas.
• Lihlahala tsa Oligodendroglial. Tse ling tsa lihlahala tsa mantlha tsa boko li entsoe ka lihlahala tsa astrocytic le oligodendrocytic. Tsena li bitsoa li-gliomas tse tsoakiloeng.
• Glioblastomas ke mofuta o mabifi ka ho fetisisa oa hlahala ea mantlha ea boko.

Meningiomas le schwannomas ke mefuta e meng e 'meli ea lihlahala tsa boko. Lihlahala tsena:

• E etsahala hangata haholo lipakeng tsa lilemo tse 40 le 70.
• Hangata ha li na mofetše, empa li ntse li ka baka mathata a tebileng le lefu ho tloha boholo ba tsona kapa sebaka sa tsona. Ba bang ba na le kankere ebile ba mabifi.

Likokoana-hloko tse ling tse ka sehloohong tsa boko ho batho ba baholo ha li fumanehe hangata. Tsena li kenyelletsa:

• Li-Ependymomas
• Craniopharyngiomas
• Lihlahala tsa pituitary
• Mathomo (CNS) lymphoma
• Lihlahala tsa phaeneal
• Likokoana-hloko tsa lisele tsa mantlha tsa boko

Lihlahala tse ling ha li bake matšoao ho fihlela li le kholo haholo. Lihlahala tse ling li na le matšoao a hola butle.

Matšoao a ipapisitse le boholo ba hlahala, sebaka, hore na e hasane hakae, le hore na ho na le ho ruruha ha boko. Matšoao a atileng haholo ke ana:

• Liphetoho tšebetsong ea kelello ea motho
• Ho tšoaroa ke hlooho
• Ho oa (haholo-holo ho batho ba baholo)
• Bofokoli karolong enngwe ya mmele

Ho opeloa ke hlooho ho bakoang ke lihlahala tsa boko ho ka:

• Hobe le ho feta ha motho a tsoha hoseng, 'me u tsohe ka lihora tse' maloa
• Etsahala nakong ea boroko
• Etsahala ka ho hlatsa, pherekano, pono e habeli, bofokoli kapa ho ba shohlo
• Mpefala ka ho khohlela kapa ho ikoetlisa, kapa ka phetoho ea boemo ba mmele

Matšoao a mang a kenyeletsa:

• Fetola tlhokomeliso (ho kenyelletsa boroko, ho akheha le ho akheha)
• Liphetoho kutlo, tatso kapa monko
• Liphetoho tse amang ho ama le bokhoni ba ho utloa bohloko, khatello, lithemparetjha tse fapaneng, kapa tse ling tse susumetsang
• Pherekano kapa tahlehelo ea mohopolo
• Ho thata ho koenya
• Ho thata ho ngola kapa ho bala
• Botsoa kapa maikutlo a sa tloaelehang a ho sisinyeha (vertigo)
• Mathata a mahlo a kang ho koala mahlo, bana ba boholo bo fapaneng, ho sisinyeha ho sa laoleheng ha mahlo, ho thatafalloa ke pono (ho kenyeletsoa le pono e fokotsehileng, pono e habeli, kapa ho felloa ke pono ka botlalo)
• Ho thothomela ka letsoho
• Ho hloka taolo holim'a senya kapa mala
• Ho lahleheloa ke teka-tekano kapa tšebelisano, botsitso, mathata a ho tsamaea
• Bofokoli ba mesifa sefahlehong, letsohong kapa leotong (hangata ka lehlakoreng le le leng)
• Ho ba lerootho kapa ho hlohlona ka lehlakoreng le leng la 'mele
• Botho, maikutlo, boitšoaro, kapa liphetoho maikutlong
• Ho ba le bothata ba ho bua kapa ho utloisisa ba bang ba buang

Matšoao a mang a ka hlahang ka hlahala ea pituitary:

• Ho tsoa lero le sa tloaelehang
• Ho se be teng khoeli
• Kholiso ea matsoele ho banna
• Matsoho a atolositsoeng, maoto
• Moriri o feteletseng oa 'mele
• Liphetoho tsa sefahleho
• Khatello ea mali e tlase
• Botenya
• Ho nahanela mocheso kapa mohatsela

Liteko tse latelang li ka netefatsa boteng ba hlahala ea boko le ho fumana moo e leng teng:

• Tlhatlhobo ea hlooho ea CT
• EEG (ho lekanya tšebetso ea motlakase bokong)
• Ho hlahlojoa lisele tse tlositsoeng hlahala nakong ea ho buuoa kapa biopsy e tataisoang ke CT (ho ka netefatsa mofuta oa hlahala)
• Ho hlahlojoa ha cerebral spinal fluid (CSF) (ho ka bonts'a lisele tse nang le mofetše)
• MRI ea hlooho

Kalafo e ka kenyelletsa ho buuoa, kalafo ea radiation le chemotherapy. Lihlahala tsa boko li phekoloa hantle ke sehlopha se kenyeletsang:

• Ngaka-oncologist
• Phekolo ea methapo ea kutlo
• Ngaka ea oncologist
• Setsebi sa mahlaseli sa oncologist
• Bafani ba bang ba tlhokomelo ea bophelo bo botle, joalo ka lingaka tsa methapo le basebeletsi ba sechaba

Kalafo ea kapele e ntlafatsa menyetla ea sephetho se setle. Kalafo e ipapisitse le boholo le mofuta oa hlahala le bophelo ba hau ka kakaretso. Lipheo tsa kalafo e kanna ea ba ho phekola hlahala, ho kokobetsa matšoao, le ho ntlafatsa ts'ebetso ea kelello kapa matšeliso.

Hangata ho hlokahala ho buuoa bakeng sa lihlahala tse ngata tsa mantlha tsa boko. Lihlahala tse ling li ka tlosoa ka botlalo. Tse ka hare botebong ba 'mele kapa tse kenang liseleng tsa boko li kanna tsa ntšoa sebakeng sa hore li tlosoe. Debulking ke mokhoa oa ho fokotsa boholo ba hlahala.

Ho ka ba thata ho tlosa lihlahala ka botlalo ka ho buuoa u le mong. Lebaka ke hore hlahala e hlasela lisele tsa boko tse e potileng joalo ka metso ea semela e nameng mobung. Ha hlahala e sa khone ho tlosoa, ho buuoa ho ntse ho ka thusa ho fokotsa khatello le ho imolla matšoao.

Phekolo ea radiation e sebelisoa bakeng sa lihlahala tse itseng.

Chemotherapy e ka sebelisoa ka kalafo kapa kalafo ea radiation.

Meriana e meng e sebelisetsoang ho alafa lihlahala tsa mantlha tsa boko ho bana e ka kenyelletsa:

• Meriana e fokotsang ho ruruha ha boko le khatello
• Li-anticonvulsants ho fokotsa ho oa
• Meriana ea bohloko

Mehato ea boiketlo, mehato ea polokeho, kalafo ea 'mele le kalafo ea mosebetsing li ka hlokahala ho ntlafatsa bophelo. Keletso, lihlopha tsa ts'ehetso le mehato e ts'oanang e ka thusa batho ho sebetsana ka katleho le bothata bona.

U kanna oa nahana ho ingolisa tekong ea bongaka kamora ho bua le sehlopha sa hau sa kalafo.

Mathata a ka hlahisoang ke lihlahala tsa boko a kenyelletsa:

• Brain herniation (hangata e bolaeang)
• Ho lahleheloa ke bokhoni ba ho sebelisana kapa ho sebetsa
• Ho sa feleng, ho mpefala le ho senyeha ho matla ha tšebetso ea boko
• Ho khutla ha kholo ea hlahala
• Litla-morao tsa meriana, ho kenyelletsa chemotherapy
• Litla-morao tsa kalafo ea radiation

Bitsa mofani oa hau haeba u ba le hlooho e ncha, e phehellang kapa matšoao a mang a hlahala bokong.

Bitsa mofani oa hau kapa u ee kamoreng ea maemo a tšohanyetso haeba u qala ho oa, kapa ka tšohanyetso u hlasele (ho fokotsa ho falimeha), liphetoho tsa pono, kapa liphetoho tsa puo.

Glioblastoma multiforme - batho ba baholo; Ependymoma - batho ba baholo; Glioma - batho ba baholo; Astrocytoma - batho ba baholo; Medulloblastoma - batho ba baholo; Neuroglioma - batho ba baholo; Oligodendroglioma - batho ba baholo; Lymphoma - batho ba baholo; Vestibular schwannoma (acoustic neuroma) - batho ba baholo; Meningioma - batho ba baholo; Kankere - hlahala ea boko (batho ba baholo)

• Mahlaseli a boko - ho tsoa
• Ho buuoa ka bongoa - ho tsoa
• Chemotherapy - seo u lokelang ho se botsa ngaka ea hau
• Phekolo ea radiation - lipotso tseo u ka li botsang ngaka ea hau
• Stereotactic radiosurgery - ho tsoa

• Hlahala ea boko

Dorsey JF, Salinas RD, Dang M, le al. Kankere ea tsamaiso ea methapo e bohareng. Ka: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, bahlophisi. Abeloff's Clinical Oncology. La 6th. Philadelphia, PA: Elsevier; 2020: khaolo ea 63.

Michaud DS. Epidemiology ea lihlahala tsa boko. Ka: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, bahlophisi. Neurology ea Bradley ho Tloaelo ea Bongaka. La 7th. Philadelphia, PA: Elsevier; 2016: khaolo ea 71.

Webosaete ea National Cancer Institute. Kalafo ea batho ba baholo ea methapo ea kalafo (PDQ) - mofuta oa litsebi tsa bophelo bo botle. www.cancer.gov/types/brain/hp/culture-brain-treatment-pdq. E ntlafalitsoe ka la 22 Pherekhong 2020. E fihlile ka la 12 Mots'eanong.

Webosaete ea National Comprehensive Cancer Network. Litaelo tsa NCCN Clinical Practice in Oncology (NCCN Guidelines): kankere ea methapo ea kutlo. Mofuta oa 2.2020. www.nccn.org/professionals/physician_gls/pdf/cns.pdf. E ntlafalitsoe ka la 30 Mmesa, 2020. E fihlile ka la 12 Mphalane 2020.