Umhlaza wemiphunga omncinci we-Metastatic cell-01
NgoJuni ka-2022, isigulana esineminyaka engama-65 ubudala senziwa uvavanyo lwesiqhelo lomzimba, kwaye i-CT scan yatyhila iqhuqhuva elingaphantsi kwe-pleura kwilobe engasentla yomphunga. NgoJanuwari ka-2023, isigulana saqala ukuba neempawu ezinje ngokurhabaxa, ukukhohlela, kunye nokuphefumla nzima. NgoMeyi ka-2023, ukukhohlela kwakhe kunye nokuphefumla kwakhe kwaba mandundu. Izikena zibonise ukwandisa kakhulu umsebenzi we-metabolic kwiqhuqhuva lemiphunga le-lobe ephezulu, ephakamisa kakhulu umhlaza wemiphunga. Ukongezelela, ukwanda komsebenzi we-metabolic kwabonwa kwii-lymph nodes ezininzi, kubandakanywa ummandla we-supraclavicular ochanekileyo, i-mediastinum, i-trachea, indawo ye-para-aortic, kunye ne-vena cava engaphantsi. Imifanekiso ikwaveze ukuqina kwama-nodular amaninzi kwi-pleura elungileyo kunye nomsebenzi owandisiweyo we-metabolic. Iziphumo zovavanyo zibonise i-pleural metastasis echanekileyo kunye ne-pleural effusion, kwaye ukuxilongwa kokugqibela komhlaza wemiphunga we-metastatic encinci kwaqinisekiswa ngovavanyo lwe-pathological, imaging, kunye ne-immunohistochemistry. Isigulane ke safumana unyango ngokusebenzayo.
Kwiinyanga ezintlanu kamva, umthamo wethumba uncitshiswe kakhulu, kwaye uninzi lwezilonda zemetastatic zanyamalala. Irejimeni yonyango yayiquka i-atezolizumab immunotherapy yokuqala edityaniswe ne-anlotinib yonyango ekujoliswe kuyo. I-Atezolizumab yayilawulwa kwi-dose ye-1200 mg ngosuku lokuqala, ilandelwa yikhefu kunyango. I-Anlotinib inikwe ngomlomo kwi-dose ye-10 mg imihla ngemihla kwiiveki ezimbini ezilandelelanayo, ilandelwa lixesha lokuphumla leentsuku ezisixhenxe, ukwenza umjikelezo wonyango lweentsuku ze-21. Emva kweeseshoni ze-15 zonyango lwe-radiotherapy, imifanekiso ye-CT ibonise ukuncipha okubonakalayo kwi-lesion kwimiphunga elungileyo, kwaye i-mediastinum efanelekileyo kunye ne-lymph nodes nazo ziye zehla kakhulu. Ulandelelwano lwe-CT scan ngoSeptemba 10, 2023, lubonise utshintsho oluhle: ukucutheka kwe-pleural effusion, ukuncipha kwe-pleural thickening, kunye ne-mediastinal kunye ne-right supraclavicular lymph nodes, ngaphandle kokwandiswa kwe-lymph nodes zesisu kunye ne-retroperitoneal.
Xa kuthelekiswa neskeni ngoMeyi 7, 2023, iskena ngo-Oktobha 10, 2023, sibonise ukuncipha okuphawulweyo kwithumba. Ngokukodwa, i-shrinkage yabonwa kwi-nodule kwi-lobe ephezulu yasekunene kunye nakwii-lymph nodes ezininzi kufuphi ne-trachea, imithwalo yegazi, indawo ye-para-aortic, kunye ne-inferior vena cava. Ukuqina kwe-nodular ebonwe ngaphambili kwi-peritoneum yendawo, udonga lwesifuba sangaphambili sangaphambili, kunye ne-11th-12th intercostal space iye yehla kakhulu. Ukongeza, isithunzi se-nodular esinoxinaniso olusezantsi kwisihlunu sasekunene segxalaba siye sancipha kakhulu. Ezi ziphumo zibonisa ukuba irejimeni yonyango yenkqubo yayisebenza, kunye nezilonda ezininzi ze-metastatic zinyamalala kwaye izilonda eziseleyo ziyancipha kakhulu. Uphononongo lwemifanekiso lucebisa ukuba irejimeni yonyango ibe yimpumelelo, kwaye ithumba ngoku likwinqanaba lokuxolelwa kancinci.
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