Iyini i-theranostics?
I-Theranostics igama lenhlanganisela yezindlela zokwelapha nokuxilongwa (kusetshenziswa i-radionuclide eyodwa ukuze kufanekiswe izimila kanye ne-radionuclide yesibili ukwelapha izimila ngokuletha imisebe ebulala umdlavuza). Ngokuyisisekelo, kusho ukukhomba i-molecule eyodwa ye-receptor kumaseli omdlavuza anama-radionuclide amabili ahlukene (i-imaging kanye nokwelapha). Lokhu okokufeza isu lokwelapha elinembile neliqondene nawe.
Isigaba sokuxilonga seTheranostics
Amangqamuzana e-tumor anegobolondo, elibizwa ngokuthi ulwelwesi; kukhona amaprotheni athile afana ne-somatostatin receptor (SSTR2) ku-membrane ye-tumor cell engasebenza njengenhloso yezidakamizwa zomdlavuza.
I-Ga-68 DOTATOC iyisidakamizwa sokuxilonga ngemisebe eqondiswe ku-SSTR2. I-Ga-68 DOTATOC ijova emithanjeni yesiguli futhi ihambe kuwo wonke umgudu wegazi iye kuzo zonke izitho nezicubu zomzimba. Uma isiguli sinesimila se-neuroendocrine esine-SSTR2 kulwelwesi lweseli lwesimila, i-Ga-68 DOTATOC izobophezela ku-SSTR2 futhi isimila sizokhanya ku-PET scan.
Isigaba sokwelapha se-Theranostics
Uma umdlavuza we-neuroendocrine usutholakele kusetshenziswa i-Ga68-DOTATOC PET scan, i-Ga-68 ingathathelwa indawo enye i-radionuclide, efana ne-lutetium-177 (Lu-177) noma i-yttrium-90 (Y-90), engaqondisa futhi ibulale amaseli wesimila. abane-SSTR2 kulwelwesi lwabo.
Ukwelapha i-Y-90-DOTATOC kanye ne-Lu-177-DOTATATE kokubili kungajovwa emithanjeni yesiguli futhi kuhambe kunoma iyiphi ingxenye yomzimba enamaprotheni e-SSTR2. Le mithi yokwelapha ibophezela kumaprotheni e-SSTR2 njengokhiye kukhiye, okuvumela umuthi ukuthi ungene kumaseli wesimila futhi uwubulale ngokulimaza i-DNA yalelo ngqamuzana. Amaseli anempilo azungeze isimila angenawo amaprotheni e-SSTR2 kulwelwesi lwawo awathintwa umuthi.
Isu elinjalo livumela odokotela bama-oncologist ukuthi babone ngokuphelele izicubu zomdlavuza olaphekayo, bakhethe iziguli ukuze bafake izicelo zokwelapha, babone kahle lapho ama-ejenti okwelapha azolethwa khona, futhi baqaphe ikhono le-ejenti yokwelapha ukushwabana isimila ngokuhamba kwesikhathi. I-Theranostics inikeza ama-oncologists inoveli namathuluzi asebenza kahle kakhulu okwenza amasu okwelapha anembayo futhi abikezele izinzuzo zokwelashwa okuthile okusekelwe ezigulini eziyingqayizivele yephrofayili yamangqamuzana ne-genomic.
ITHERANOSTIC: UKUBONA ESIKUPHATHAYO—UKUPHATHA ESIKUBONAYO
Lokhu kubizwa futhi ukwelashwa okuhlosiwe kwe-radionuclide njengoba iqondiswe ekuhlosweni kwemolekyuli yamangqamuzana omdlavuza asebenzayo. Ngakho-ke, umthamo ophezulu wemisebe ungaqondiswa esimila ngaphandle kokuthinta amangqamuzana amaningi anempilo avamile.
Ingabe i-theranostic ihluke kangakanani ku-radiotherapy yendabuko?
Ukwelashwa ngemisebe kungasebenza kahle kakhulu ekwelapheni umdlavuza, noma ekudambiseni izimpawu ezigulini ezinomdlavuza wesigaba esithuthukile ongelapheki. Cishe ingxenye yazo zonke iziguli ezinomdlavuza zizothola ukwelashwa ngemisebe esikhathini esithile ekwelapheni kwazo, okusebenzisa ama-x ray alethwe ngaphandle noma ngaphakathi, ama-proton noma ezinye izinhlayiya zamandla aphezulu ukuze ziqondise futhi zibhubhise amangqamuzana omdlavuza. Nakuba izindlela zobuchwepheshe ezithuthukisiwe zehlise ukuwohloka kwezicubu ezinempilo, ukwelashwa nge-radiotherapy okungokwesiko kusabangela imiphumela engemihle engase kube nzima kwezinye iziguli ukuyibekezelela. Ngaphezu kwalokho, i-radiotherapy yendabuko ayikwazi ukukhomba indawo engaphezu kweyodwa yezifo, ikhawulela ukusetshenziswa kwayo ezigulini ezinomdlavuza we-metastatic. Kodwa-ke, i-radiotherapy yendabuko ihlala ingelinye lamathuluzi okwelapha anamandla e-oncology.
Le ndlela entsha yokwelashwa kwesimila - ukwelashwa kwe-radionuclide okuhlosiwe - ivuselela ukusetshenziswa kwemithi yokwelashwa ngemisebe ngokunemba kwe-oncology futhi ilethe isigaba esisha sokwelashwa komdlavuza. Umgomo wokuthuthukiswa kokwelashwa kwe-radionuclide ukuhlanganisa ama-isotopi akhipha izinhlayiyana ze-alpha-, beta- noma i-gamma - noma ama-radionuclides - nama-peptide, amasosha omzimba, noma ama-molecule amancane, ukuze kuthuthukiswe izindlela zokwelapha ezinemininingwane ephezulu yezinhlobo ezithile zezimila. Ilethwa esigulini ngomthambo, imishanguzo ye-radionuclide ehlosiwe yakhelwe ukuthi ihambe iqonde esimila ukuze ilethe imisebe yokwelapha ngokunemba okuphezulu. Lokhu kunemba kuhloselwe ukugxila ekulethweni kwemisebe esicutshini sesimila kuyilapho kunciphisa ukuchayeka emisebeni esicutshini evamile.
Hlobo luni lomdlavuza olungelashwa nge-theranostics?
I-Theranostics ingasebenza ngempumelelo ekwelapheni i-metastatic, izimila ezingasebenzi esigabeni esithuthukisiwe sesifo kufaka phakathi umdlavuza wendlala yesinye, izimila ze-neuroendocrine zezitho ezahlukahlukene ezinjengesisu, amanyikwe, amathumbu amancane namakhulu namaphaphu. Okokugcina, ukukhishwa kwe-post-operative ablation kwensalela ye-thyroid esele kanye nokwelashwa komdlavuza we-thyroid metastatic nakho ku-gamut ye-theranostics.
Le midlavuza engenhla inobufakazi obanele obukhona njengamanje bokuthi kunenzuzo eqinisekile ekusebenziseni ukwelapha nge-radionuclide. Kodwa-ke, eminye imidlavuza eminingi ingase ibe nenzuzo lapho iveza izinhlobo ezithile zama-receptors okuqondiwe njenge-fibroblast activation protein (FAP) kanye nama-chemokine receptors (CXCR4), angaqondiswa nge-theranostics.
I-Molecular and targeted Radionuclide Theranostics yethu ihlanganisa:
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- I-PRRT : I-Lutetium -177 DOTA Therapy
I-Actinium – 225 DOTA Therapy
I-Yttrium- 90 DOTA Therapy ye-Neuro endocrine tumors - I-PRLT : I-Lutetium -177 PSMA Therapy for Prostate cancers
- I-TARE : I-Yttrium- 90 SIR sphere therapy yomdlavuza wesibindi / ama-metastases esibindi
- I-FAPI : I-Fibroblast activation I-Protein inhibitor Therapy
I-Lutetium-177 FAPI Therapy kanye
I-Actinium -225 FAPI Therapy yezinhlobo ezingaba ngu-28 zomdlavuza oseqophelweni eliphezulu
- I-PRRT : I-Lutetium -177 DOTA Therapy
- FUTHI : I-I - 131 Radio Iodine Therapy for thyroid cancersSamarium – 153 Pain Palliation Therapy for bone metastases.I-131 MIBG therapy for pheochromocytoma
Kucatshangelwa kuphela ezimweni zomtholampilo ezihlukile ngezizathu zozwelo kusukela manje.
Landa Ipheshana
Ukunqoba Umdlavuza nge-Apollo Proton Cancer Center
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