Yini i-Gefitinib: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Gefitinib iyikhambi lomdlavuza eliqondiswe ngqo elivimba amaprotheni athile asiza imidlavuza ethile yamaphaphu ukuthi ikhule. Iyingxenye yeqembu lemithi ebizwa ngokuthi ama-tyrosine kinase inhibitors, asebenza njengamakhi athile aqondile afaka ngaphakathi kwamaseli omdlavuza ukuze amise ukukhula kwawo. Le mithi edliwayo iye yaba yindlela ebalulekile yokwelapha abantu abanezinhlobo ezithile zomdlavuza wamaphaphu ongancane, inikeza ithemba ngendlela yayo eqondiswe ngqo.

Yini i-Gefitinib?

I-Gefitinib iyikhambi elinikezwa ngudokotela elenzelwe ukwelapha umdlavuza wamaphaphu ongancane (NSCLC) oqhubekayo. Ingaphansi kohlobo lwemithi ebizwa ngokuthi ama-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors. Cabanga ngayo njenge-molecular blocker evimbela amaseli omdlavuza ekutholeni izimpawu abazidingayo ukuze zande futhi zisakale.

Le mithi iza ngamaphilisi adliwayo, okwenza kube lula kakhulu kunezinye izindlela zokwelapha umdlavuza ezidinga ukuvakashelwa esibhedlela ukuze kufakwe imithi. I-Gefitinib iqondise ngqo amaseli omdlavuza anezinguquko ezithile zofuzo, ikakhulukazi izinguquko ze-EGFR, ezitholakala cishe ku-10-15% yemidlavuza yamaphaphu e-United States kanye no-50% kwabanye abantu base-Asia.

Isetshenziselwani i-Gefitinib?

I-Gefitinib isetshenziswa ikakhulukazi ukwelapha umdlavuza wamaphaphu ongancane oqhubekayo ezigulini ezinamathumba anezinguquko ezithile ze-EGFR. Udokotela wakho uzohlola izicubu zakho zomdlavuza ukuze aqinisekise ukuthi lezi zinguquko zikhona ngaphambi kokunikeza le mithi. Le nqubo yokuhlola ibalulekile ngoba i-gefitinib isebenza kahle kakhulu uma lezi zinguquko ezithile zofuzo zitholakala kumaseli akho omdlavuza.

Umuthi uvame ukunikezwa uma umdlavuza wamaphaphu usabalale kwezinye izindawo zomzimba noma uma ukuhlinzwa kungewona umkhuba. Ngokuvamile isetshenziswa njengokwelashwa kokuqala kubantu abanomdlavuza wamaphaphu we-EGFR-positive, okusho ukuthi kungase kube umuthi wokuqala womdlavuza udokotela wakho ongawuncoma. Odokotela abathile bangase bawunike futhi ngemva kokuthi ezinye izindlela zokwelapha zingasebenzi ngempumelelo.

Isebenza Kanjani I-Gefitinib?

I-Gefitinib isebenza ngokuvimba iphrotheni ye-EGFR, esebenza njengokushintsha kokukhula ngaphakathi kwamaseli omdlavuza. Lapho le phrotheni isebenza ngokweqile ngenxa yokuguqulwa kwemvelo, ithumela izimpawu eziqhubekayo zokuthi "khula futhi wandise" kumaseli omdlavuza. I-Gefitinib empeleni icisha le switch, isiza ukunciphisa noma ukumisa ukukhula komdlavuza.

Lo muthi uthathwa njengokwelashwa komdlavuza okuqinile ngokulinganisela ngendlela eqondiwe. Ngokungafani ne-chemotherapy yendabuko ethinta kokubili amaseli anempilo nawomdlavuza, i-gefitinib iqondisa ngqo amaphrotheni aguquliwe kumaseli omdlavuza. Lesi senzo esiqondiwe ngokuvamile sisho imiphumela emincane uma iqhathaniswa nokwelashwa kwe-chemotherapy ebanzi, nakuba iseyilapha elinamandla elidinga ukuqashwa ngokucophelela.

Isenzo sokuvimba senzeka ezingeni leselula, lapho i-gefitinib incintisana khona nezinto zokukhula zemvelo zokubopha izindawo kuphrotheni ye-EGFR. Uma i-gefitinib ibopha kulezi zindawo esikhundleni salokho, ivimbela amaseli omdlavuza ekutholeni izimpawu zokukhula, okungenzeka ukuthi abenze bayeke ukuhlukanisa noma bafe.

Kufanele Ngiyithathe Kanjani I-Gefitinib?

Thatha i-gefitinib ngendlela eqondile njengoba unikezwe ngudokotela wakho, ngokuvamile kanye ngosuku ngesikhathi esifanayo nsuku zonke. Ungayithatha ngaphandle noma ngaphandle kokudla, kodwa ukuyithatha nokudla kungasiza ukunciphisa ukuphazamiseka kwesisu uma uhlangabezana nanoma yikuphi. Gwinya ithebhulethi yonke ngengilazi yamanzi egcwele, futhi ungayichobozi, uyihlafune, noma uyiphule.

Uma unenkinga yokugwinya amaphilisi, ungaqeda i-gefitinib emanzini acacile. Lahla ithebhulethi engxenyeni yengilazi yamanzi, uvuse kuze kuncibilike ngokuphelele, bese uphuza le ngxube ngokushesha. Geza ingilazi ngamanzi amaningi futhi uphuze nalokho ukuze uqiniseke ukuthi uthola umthamo ogcwele.

Zama ukuthatha i-gefitinib ngesikhathi esifanayo nsuku zonke ukuze ugcine amazinga aqhubekayo emzimbeni wakho. Abantu abaningi bakuthola kuwusizo ukuxhuma ukuthatha imithi yabo emsebenzini wansuku zonke, njengokudla kwasekuseni noma ukuxubha amazinyo. Lokhu kuvumelana kusiza ekuqinisekiseni ukuthi imithi isebenza ngempumelele kakhulu.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Gefitinib?

Ubude bokwelashwa nge-gefitinib buhlukahluka kakhulu kumuntu nomuntu futhi kuncike ekutheni umdlavuza wakho usabela kahle kangakanani emuthini. Abanye abantu bangayithatha izinyanga eziningana, kanti abanye bangase baqhubeke nokwelashwa iminyaka. Udokotela wakho uzoqapha impendulo yakho ngokuskena njalo nokuhlolwa kwegazi ukuze anqume ubude bokwelashwa obungcono kakhulu esimweni sakho.

Ngokuvamile uzoqhubeka nokuthatha i-gefitinib uma nje ilawula umdlavuza wakho futhi ubekezelela imiphumela emibi kahle. Udokotela wakho uzohlola njalo ukuthi imithi isasebenza ngempumelelo yini ngokusebenzisa izivivinyo zokucabanga njenge-CT scans noma i-PET scans, ngokuvamile njalo emva kwezinyanga ezi-2-3 ekuqaleni.

Uma umdlavuza wakho uyeka ukusabela ku-gefitinib noma uma uthola imiphumela emibi kakhulu, udokotela wakho uzosebenza nawe ukulungisa uhlelo lwakho lokwelapha. Lokhu kungase kuhlanganise ukushintsha umthamo, ukuthatha amakhefu okwelapha, noma ukushintshela kwenye imithi. Umgomo uhlale ukuthola ukulinganisela okulungile phakathi kokulawula umdlavuza wakho nokugcina izinga lempilo yakho.

Yini Imiphumela Emibi Ye-Gefitinib?

Njengazo zonke izidakamizwa zomdlavuza, i-gefitinib ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kangcono kune-chemotherapy yendabuko. Imiphumela emibi evame kakhulu ngokuvamile ilawuleka ngokunakekelwa okufanele nokuqapha. Ukuqonda okulindelekile kungakusiza ukuthi uzizwe ulungiseleleke futhi uqiniseke ngemithi yakho.

Nawa imiphumela emibi ebikwa kaningi ethinta abantu abaningi abathatha i-gefitinib:

• Izinkinga zesikhumba: Ukuqubuka okufana ne-acne, isikhumba esomile, noma ukucasuka kwesikhumba, ikakhulukazi ebusweni nasengxenyeni engenhla yomzimba
• Izinkinga zokugaya ukudla: Ukuhuda, isicanucanu, ukuhlanza, noma ukulahlekelwa isifiso sokudla
• Ushintsho lwezipikili: Izikhonkwane ezibuthakathaka, eziqhekekile, noma ezinamathambo
• Izilonda zomlomo: Izilonda ezincane noma ukucasuka ngaphakathi emlonyeni
• Ukukhathala: Ukuzizwa ukhathele kunokujwayelekile noma ukuntula amandla
• Izinkinga zamehlo: Amehlo omile, ukucasuka, noma ukwanda kokuzwela ekukhanyeni

Iningi lale miphumela emibi ejwayelekile ilula kuya kokulingene futhi ivame ukuthuthuka njengoba umzimba wakho ujwayela imithi. Ithimba lakho lezempilo linganikeza amasu athile okuphatha ngempumelelo ngasinye salezi zimpawu.

Abanye abantu bangase babe nemiphumela emibi engathi sína edinga ukunakekelwa kwezempilo ngokushesha. Nakuba lokhu kungavamile, kubalulekile ukwazi ukuthi yini okufanele uyibheke:

• Izinkinga zokuphefumula ezinzima: Ukuphefumula okusha noma okubi kakhulu, ukukhwehlela, noma ubuhlungu besifuba
• Izinkinga zesibindi: Ukuphuzi kwesikhumba noma amehlo, umchamo omnyama, noma ubuhlungu obukhulu besisu
• Ukuphendula kwesikhumba okunzima: Ukuqubuka okusabalale, ukuvuvukala, noma ukuxebuka kwesikhumba
• Izinkinga zenhliziyo: Ukushaya kwenhliziyo okungajwayelekile, ubuhlungu besifuba, noma ukuvuvukala emilenzeni noma ezinyaweni
• Ukuhuda okunzima: Izihlalo ezingaphezu kuka-6 ezixekile ngosuku noma izimpawu zokuphelelwa amanzi emzimbeni

Uma uhlangabezana nanoma yimaphi alawa maphuzu amabi, xhumana nodokotela wakho ngokushesha noma funa ukwelashwa okuphuthumayo. Lezi zimpawu, nakuba zingavamile, zidinga ukunakekelwa ngokushesha ukuqinisekisa ukuphepha kwakho nokuphila kahle.

Kukhona futhi nemiphumela emibi engavamile kodwa engaba yingozi evela ngesilinganiso esincane sabantu. Lokhu kufaka phakathi ukuvuvukala okukhulu kwamaphaphu (isifo samaphaphu esiphakathi), ukulimala okukhulu kwesibindi, noma izinkinga ezinkulu zamehlo ezingathinta umbono. Udokotela wakho uzokuhlola njalo ngezivivinyo zegazi nokuhlolwa ukuze abambe noma yiziphi zalezi zinkinga ngokushesha.

Ubani Ongafanele Athathe I-Gefitinib?

I-Gefitinib ayifanele wonke umuntu, futhi izimo ezithile zezokwelapha noma izimo zingase zikwenze kungaphephile ukuthatha lo muthi. Udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha kanye nesimo sakho sempilo samanje ngaphambi kokukuyalela i-gefitinib. Lokhu kuhlola okuphelele kusiza ekuqinisekiseni ukuthi umuthi uphephile futhi ufanele isimo sakho esithile.

Akufanele uthathe i-gefitinib uma wazi ukuthi unokungezwani komzimba nomuthi noma yiziphi izithako zawo. Izimpawu zokungezwani komzimba zingase zihlanganise ukuqubuka okukhulu, ubunzima bokuphefumula, noma ukuvuvukala kobuso bakho, izindebe, ulimi, noma umphimbo. Uma uke waba nokungezwani komzimba emithini efanayo esikhathini esidlule, qiniseka ukutshela udokotela wakho.

Izimo ezithile zezokwelapha zidinga ukucatshangelwa okukhethekile noma zingase zikwenze ukuthi i-gefitinib ingakulungele. Lezi zimo zidinga ukuhlolwa ngokucophelela yithimba lakho lezempilo:

• Isifo sesibindi esiqinile: Isibindi sakho sisebenzisa i-gefitinib, ngakho izinkinga ezinkulu zesibindi zingaba yingozi
• Isifo sezinso esiqinile: Nakuba kungavamile, izinkinga zezinso zingase zithinte indlela umzimba wakho oqhubula ngayo imithi
• Ukutheleleka kwamaphaphu okusebenzayo: Lokhu kungase kudidaniswe noma kuqiniswe yimiphumela emibi yamaphaphu engaba khona
• Izinkinga zenhliziyo ezinzima: I-Gefitinib ngezinye izikhathi ingathinta ukushaya kwenhliziyo noma ukusebenza kwayo
• Ukutheleleka kwamehlo okusebenzayo: Umuthi ungabangela izinkinga zamehlo, ezingase zibe nzima ngokutheleleka okukhona

Ukukhulelwa nokuncelisa ngamabele kudinga ukunakwa okukhethekile uma kucatshangelwa i-gefitinib. Lo muthi ungalimaza izingane ezisakhula, ngakho-ke uma ukhulelwe noma uhlela ukukhulelwa, xoxa lokhu ngokucophelela nodokotela wakho. Bobabili abesilisa nabesifazane abathatha i-gefitinib kufanele basebenzise izindlela zokulawula inzalo ezisebenzayo ngesikhathi sokwelashwa kanye nasezinyangeni eziningana ngemva kokuyeka umuthi.

Uma uncelisa, cishe uzodinga ukuyeka ngaphambi kokuqala i-gefitinib, njengoba umuthi ungangena obisini futhi ulimaze ingane yakho. Udokotela wakho angakusiza ukuthi ulinganise izingozi nezinzuzo futhi axoxe ngesikhathi uma uhlela ukuncelisa ngamabele esikhathini esizayo.

Amagama Omkhiqizo we-Gefitinib

I-Gefitinib itholakala kakhulu ngaphansi kwegama lomkhiqizo elithi Iressa. Leli yigama lomkhiqizo lokuqala elalisetshenziswa lapho umuthi uqala ukugunyazwa futhi lihlala igama elaziwa kakhulu le-gefitinib emhlabeni wonke. Uma udokotela wakho ekunika i-gefitinib, cishe uzobona kokubili "gefitinib" noma "Iressa" ebhodleleni lakho lemithi.

Emazweni athile, i-gefitinib ingase itholakale ngaphansi kwamagama ahlukene emikhiqizo noma njengezinhlobo ezivamile. Uma uhamba noma uthola imiyalelo yokugcwalisa ezindaweni ezihlukene, kuyasiza ukwazi kokubili igama elivamile (gefitinib) negama lomkhiqizo (Iressa) ukuze ugweme ukudideka. Njalo qinisekisa kumakhemisi wakho ukuthi uthola imithi efanele.

Ezinye izindlela ze-Gefitinib

Eminye imithi eminingi isebenza ngendlela efana ne-gefitinib yokwelapha umdlavuza wamaphaphu we-EGFR-positive. Lezi ezinye izindlela zingase zicatshangelwe uma i-gefitinib ingasebenzi kahle, uma uba nokumelana nayo, noma uma uba nemiphumela engathandeki. Udokotela wakho uzosiza ekunqumeni enye indlela engcono kakhulu ngokusekelwe ezintweni ezithile zomdlavuza wakho kanye nomlando wokwelashwa.

Ezinye izindlela ezivamile zihlanganisa ezinye izithiyo ze-EGFR ezifana ne-erlotinib (Tarceva) kanye ne-afatinib (Gilotrif). Le mithi isebenza ngezindlela ezifanayo kodwa ingase ibe nemiphumela ehlukene noma amaphethini okusebenza kahle. Abanye abantu abangaphenduli kahle ku-gefitinib bangase babe nempumelelo engcono ngalezi ezinye izindlela.

Kubantu abanomdlavuza okhula ukumelana nezithiyo ze-EGFR zesizukulwane sokuqala njenge-gefitinib, imithi emisha efana ne-osimertinib (Tagrisso) ingase inconywe. Lesi sithiyo se-EGFR sesizukulwane sesithathu sivame ukunqoba izinhlobo ezithile zokumelana ezikhula ngokwelashwa nge-gefitinib.

Ezinye izinketho zokwelashwa zingase zihlanganise i-chemotherapy yendabuko, i-immunotherapy, noma ukwelashwa okuhlanganisiwe, kuye ngezici ezithile zomdlavuza wakho kanye nempilo yakho yonke. Udokotela wakho we-oncologist uzosebenza nawe ukudala uhlelo lokwelashwa olubanzi olucabangela zonke izinketho ezitholakalayo.

Ingabe i-Gefitinib ingcono kune-Erlotinib?

Kokubili i-gefitinib ne-erlotinib ziyizithiyo eziphumelelayo ze-EGFR, futhi ucwaningo lubonisa ukuthi zisebenza ngendlela efanayo ekwelapheni umdlavuza wamaphaphu we-EGFR-positive. Ukukhetha phakathi kwazo kuvame ukuncika ezintweni zomuntu ngamunye njengokubekezelelana nemiphumela emibi, izintandokazi zokulinganisa, nezici ezithile zomdlavuza kunokuthi enye ibe “ngcono” ngokucacile kunenye.

Ezinye izifundo zikhomba umehluko omncane emiphumeleni emibi. I-Gefitinib ingase ibangele isifo sohudo esingagqamile nezinkinga zesikhumba kwabanye abantu, kanti i-erlotinib ingase ihlotshaniswe namaphethini ahlukene emiphumeleni emibi. Noma kunjalo, le mihluko ivamise ukuba mincane, futhi izimpendulo zomuntu ngamunye zingahluka kakhulu.

Isinqumo phakathi kwe-gefitinib ne-erlotinib ngokuvamile sincike esimweni sakho esithile, okuhlanganisa iphrofayili yofuzo yomdlavuza wakho, impilo yakho yonke, eminye imithi oyithathayo, nezintandokazi zakho. Udokotela wakho we-oncologist uzocabangela zonke lezi zici lapho encoma umuthi ofanele kakhulu kuwe.

Yomibili imithi inezindlela ezifakazelwe zokwelapha umdlavuza wamaphaphu we-EGFR-positive, futhi yomibili ingathuthukisa kakhulu imiphumela yabantu abanalo hlobo lomdlavuza. Ukukhetha “okungcono” ngempela yilokho okusebenza kahle kakhulu esimweni sakho esiyingqayizivele nokuthi ungakwazi ukukubekezelela kahle ngokuhamba kwesikhathi.

Imibuzo Evame Ukubuzwa Mayelana ne-Gefitinib

Q1. Ingabe i-Gefitinib iphephile kubantu abanesifo sikashukela?

I-Gefitinib ngokuvamile ingasetshenziswa ngokuphepha kubantu abanesifo sikashukela, kodwa idinga ukuqapha okucophelelayo nokuxhumana phakathi kukadokotela wakho we-oncologist nethimba lokunakekela isifo sikashukela. Umuthi awuthinti ngokuqondile amazinga kashukela egazini, kodwa eminye imiphumela emibi efana nezinguquko ekudleni, isicanucanu, noma isifo sohudo ingase ithinte amaphethini akho okudla nokulawula ushukela wegazi.

Odokotela bakho bazofuna ukuqapha amazinga kashukela egazini lakho ngokuqinile uma uqala i-gefitinib, ikakhulukazi emasontweni ambalwa okuqala okwelashwa. Uma uhlangabezana nesicanucanu esikhulu noma izinguquko ekudleni, ungase udinge ukulungiswa emithini yakho yesifo sikashukela noma ekuhleleni ukudla ukuze ugcine ukulawulwa okuhle kukashukela egazini.

Q2. Kufanele Ngenzeni Uma Ngisebenzisa I-Gefitinib Eningi Ngengozi?

Uma ngengozi uthatha i-gefitinib eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa kahle. Ukuthatha i-gefitinib eningi kungakhuphula ingozi yakho yemiphumela emibi, ikakhulukazi isifo sohudo esibi, izinkinga zesikhumba, noma izinkinga zesibindi. Ungalindi ukubona ukuthi izimpawu ziyavela ngaphambi kokufuna usizo.

Uma ushayela ucela usizo, yiba nebhodlela lakho lemithi nawe ukuze ukwazi ukunikeza imininingwane eqondile mayelana nokuthi uthathe malini nokuthi nini. Uma kungenzeka, futhi ube nohlu lwemithi yakho ekhona. Ungalokothi uzame

Kufanele uyeke kuphela ukuthatha i-gefitinib ngaphansi kokuqondiswa okuqondile kwe-oncologist yakho. Isinqumo sokuyeka sincike ezintweni eziningana, okuhlanganisa ukuthi imithi ikulawula kahle kangakanani umdlavuza wakho, yiziphi imiphumela emibi oyitholayo, nokuthi umdlavuza wakho usukwazi yini ukumelana nokwelashwa. Ungalokothi uyeke ukuthatha i-gefitinib ngokwakho, ngisho noma uzizwa ungcono.

Udokotela wakho uzohlola njalo ukuthi usabela kanjani ku-gefitinib ngezivivinyo zokuthwebula izithombe, ukuhlolwa kwegazi, nokuhlolwa komzimba. Uma umdlavuza wakho ungasasabeli emuthini noma uma uthola imiphumela emibi engalawuleki, udokotela wakho uzosebenza nawe ukuze uguqukele endleleni ehlukile yokwelapha ngokuphepha.

Q5. Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Gefitinib?

Ngenkathi kungekho ukusebenzisana okuqondile phakathi kwe-gefitinib notshwala, kuvamile ukunconywa ukuthi unciphise noma ukugweme utshwala ngesikhathi sokwelashwa komdlavuza. Kokubili i-gefitinib notshwala kungathinta isibindi sakho, futhi ukukuhlanganisa kungase kwandise ingozi yezinkinga zesibindi. Ngaphezu kwalokho, utshwala bungase buqhubekisele phambili eminye imiphumela emibi efana nesicanucanu, ukukhathala, noma ukushoda kwamanzi emzimbeni.

Uma ukhetha ukuphuza utshwala ngezikhathi ezithile, xoxa ngalokhu nodokotela wakho kuqala. Bangakunikeza isiqondiso esiqondene nawe ngokusekelwe empilweni yakho yonke, ukusebenza kwesibindi, nokuthi uyikwazi kanjani i-gefitinib. Udokotela wakho angase ancome ukugwema utshwala ngokuphelele noma ukulunciphisa ezingxenyeni ezincane kakhulu ngezikhathi ezingavamile.