{"id":24910,"date":"2023-04-21T07:02:33","date_gmt":"2023-04-21T00:02:33","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=24910"},"modified":"2023-04-21T09:41:18","modified_gmt":"2023-04-21T02:41:18","slug":"cac-phuong-phap-dieu-tri-ung-thu-vu-di-can-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/cac-phuong-phap-dieu-tri-ung-thu-vu-di-can-nao\/","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa di c\u0103n n\u00e3o"},"content":{"rendered":"

Di c\u0103n n\u00e3o x\u1ea3y ra \u1edf 15% \u0111\u1ebfn 24% ph\u1ee5 n\u1eef b\u1ecb ung th\u01b0 v\u00fa di c\u0103n. \u0110i\u1ec1u kh\u00f3 kh\u0103n trong ph\u01b0\u01a1ng ph\u00e1p trong \u0111i\u1ec1u tr\u1ecb di c\u0103n n\u00e3o l\u00e0 nhi\u1ec1u lo\u1ea1i thu\u1ed1c kh\u00f4ng th\u1ec3 xuy\u00ean qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o. Mong r\u1eb1ng b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y c\u00f3 th\u1ec3 cung c\u1ea5p m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p v\u1ec1 b\u1ec7nh.<\/span><\/p>\n

\"Di
Kh\u1ed1i u di c\u0103n n\u00e3o<\/figcaption><\/figure>\n

1. Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb to\u00e0n th\u00e2n<\/strong><\/h2>\n

C\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb to\u00e0n th\u00e2n l\u00e0 nh\u1eefng l\u1ef1a ch\u1ecdn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 b\u1ea5t k\u1ec3 kh\u1ed1i u n\u1eb1m t\u1ea1i c\u01a1 quan n\u00e0o trong c\u01a1 th\u1ec3 b\u1ea1n. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb to\u00e0n th\u00e2n c\u00f3 th\u1ec3 bao g\u1ed3m:<\/span><\/p>\n

1.1 H\u00f3a tr\u1ecb<\/strong><\/h3>\n

H\u00f3a tr\u1ecb th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho b\u1ec7nh ung th\u01b0 v\u00fa di c\u0103n, th\u01b0\u1eddng s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c v\u1edbi nh\u1eefng lo\u1ea1i thu\u1ed1c \u0111\u00e3 d\u00f9ng n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 h\u00f3a tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3.\u00a0<\/span><\/p>\n

Nh\u01b0 \u0111\u00e3 l\u01b0u \u00fd, nhi\u1ec1u t\u00e1c nh\u00e2n h\u00f3a tr\u1ecb kh\u00f4ng xuy\u00ean qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o, nh\u01b0ng th\u01b0\u1eddng di c\u0103n \u0111\u1ebfn c\u00e1c v\u00f9ng kh\u00e1c c\u00f9ng v\u1edbi di c\u0103n n\u00e3o. N\u00f3 c\u0169ng c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m nguy c\u01a1 di c\u0103n xa h\u01a1n l\u00ean n\u00e3o.<\/span><\/p>\n

1.2 Li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft t\u1ed1<\/strong><\/h3>\n

Li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft t\u1ed1 cho ung th\u01b0 v\u00fa di c\u0103n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb n\u1ebfu kh\u1ed1i u d\u01b0\u01a1ng t\u00ednh v\u1edbi th\u1ee5 th\u1ec3 estrogen. Vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c c\u00f3 s\u1eed d\u1ee5ng li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft t\u1ed1 tr\u01b0\u1edbc \u0111\u00f3 hay kh\u00f4ng v\u00e0 n\u1ebfu c\u00f3 th\u00ec \u0111ang s\u1eed d\u1ee5ng lo\u1ea1i thu\u1ed1c n\u00e0o.\u00a0<\/span><\/p>\n

Khi ung th\u01b0 v\u00fa di c\u0103n, kh\u00f4ng c\u00f3 g\u00ec l\u1ea1 khi t\u00ecnh tr\u1ea1ng th\u1ee5 th\u1ec3 thay \u0111\u1ed5i (V\u00ed d\u1ee5: m\u1ed9t kh\u1ed1i u d\u01b0\u01a1ng t\u00ednh v\u1edbi th\u1ee5 th\u1ec3 estrogen tr\u01b0\u1edbc \u0111\u00e2y c\u00f3 th\u1ec3 l\u00e0 th\u1ee5 th\u1ec3 estrogen \u00e2m t\u00ednh v\u00e0 ng\u01b0\u1ee3c l\u1ea1i. Ng\u01b0\u1eddi ta th\u01b0\u1eddng cho r\u1eb1ng n\u1ebfu \u0111ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng m\u1ed9t li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft t\u1ed1 c\u1ee5 th\u1ec3 khi ung th\u01b0 di c\u0103n, th\u00ec kh\u1ed1i u s\u1ebd kh\u00e1ng l\u1ea1i lo\u1ea1i thu\u1ed1c \u0111\u00f3. Kh\u00f4ng gi\u1ed1ng nh\u01b0 nhi\u1ec1u l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb, tamoxifen<\/strong> v\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf aromatase<\/strong> d\u01b0\u1eddng nh\u01b0 v\u01b0\u1ee3t qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o.<\/span><\/p>\n

1.3 Li\u1ec7u ph\u00e1p nh\u1eafm m\u1ee5c ti\u00eau<\/strong><\/h3>\n

C\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh ung th\u01b0 v\u00fa d\u01b0\u01a1ng t\u00ednh v\u1edbi HER2 di c\u0103n ph\u1ee5 thu\u1ed9c v\u00e0o lo\u1ea1i thu\u1ed1c b\u1ec7nh nh\u00e2n \u0111\u00e3 s\u1eed d\u1ee5ng khi kh\u1ed1i u di c\u0103n, n\u1ebfu c\u00f3. Gi\u1ed1ng nh\u01b0 tr\u1ea1ng th\u00e1i th\u1ee5 th\u1ec3 estrogen, tr\u1ea1ng th\u00e1i HER2 c\u00f3 th\u1ec3 thay \u0111\u1ed5i, do \u0111\u00f3 kh\u1ed1i u d\u01b0\u01a1ng t\u00ednh v\u1edbi HER2 tr\u01b0\u1edbc \u0111\u00f3 c\u00f3 th\u1ec3 \u00e2m t\u00ednh v\u1edbi HER2 khi n\u00f3 lan \u0111\u1ebfn n\u00e3o v\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/span><\/p>\n

Hai trong s\u1ed1 c\u00e1c lo\u1ea1i thu\u1ed1c m\u1edbi h\u01a1n, \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 r\u1ea5t hi\u1ec7u qu\u1ea3 l\u00e0:<\/span><\/p>\n

    \n
  • Tukysa (tucatinib):<\/strong> HER2 l\u00e0 m\u1ed9t lo\u1ea1i protein \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 kinase. Tukysa l\u00e0 m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf kinase, do \u0111\u00f3 n\u00f3 ng\u0103n ch\u1eb7n c\u00e1c protein n\u00e0y. N\u00f3 \u0111\u01b0\u1ee3c d\u00f9ng \u1edf d\u1ea1ng thu\u1ed1c vi\u00ean, th\u01b0\u1eddng l\u00e0 hai l\u1ea7n m\u1ed9t ng\u00e0y v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng c\u00f9ng v\u1edbi trastuzumab v\u00e0 thu\u1ed1c h\u00f3a tr\u1ecb capecitabine sau khi th\u1eed \u00edt nh\u1ea5t m\u1ed9t lo\u1ea1i thu\u1ed1c nh\u1eafm m\u1ee5c ti\u00eau ch\u1ed1ng HER2 kh\u00e1c.<\/span><\/li>\n
  • Enhertu (fam-trastuzumab deruxtecan):<\/strong>\u00a0 H\u1ed7n h\u1ee3p kh\u00e1ng th\u1ec3-thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa HER2 d\u01b0\u01a1ng t\u00ednh v\u00e0 HER2 th\u1ea5p kh\u00f4ng th\u1ec3 ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf ho\u1eb7c \u0111\u00e3 di c\u0103n. N\u00f3 \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd b\u1edfi IV, th\u01b0\u1eddng l\u00e0 sau khi \u00edt nh\u1ea5t m\u1ed9t lo\u1ea1i thu\u1ed1c ho\u1eb7c h\u00f3a tr\u1ecb li\u1ec7u nh\u1eafm m\u1ee5c ti\u00eau ch\u1ed1ng HER2 kh\u00e1c \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1eed.<\/span><\/li>\n<\/ul>\n

    \u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi tr\u01b0\u1edbc \u0111\u00e2y ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb nh\u1eafm m\u1ee5c ti\u00eau HER2, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Herceptin (trastuzumab) ho\u1eb7c Perjecta (pertuzumab) c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t. N\u1ebfu di c\u0103n n\u00e3o ph\u00e1t tri\u1ec3n trong khi \u0111ang d\u00f9ng Herceptin (ho\u1eb7c trong v\u00f2ng 12 th\u00e1ng sau khi ng\u1eebng thu\u1ed1c), thu\u1ed1c T-DM1 (trastuzumab emtansine) \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n l\u00e0 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t. Th\u1eadt kh\u00f4ng may, c\u00e1c li\u1ec7u ph\u00e1p nh\u1eafm m\u1ee5c ti\u00eau HER2 th\u01b0\u1eddng kh\u00f4ng v\u01b0\u1ee3t qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o.<\/span><\/p>\n

    S\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a Tykerb (lapatinib) v\u00e0 Xeloda (capecitabine) c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, nh\u01b0ng d\u01b0\u1eddng nh\u01b0 ch\u1ec9 d\u1eabn \u0111\u1ebfn s\u1ef1 c\u1ea3i thi\u1ec7n khi\u00eam t\u1ed1n v\u1edbi \u0111\u1ed9c t\u00ednh \u0111\u00e1ng k\u1ec3 (m\u1eb7c d\u00f9 nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y d\u01b0\u1eddng nh\u01b0 v\u01b0\u1ee3t qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o). C\u00f3 v\u1ebb nh\u01b0 Tykerb c\u00f3 th\u1ec3 ho\u1ea1t \u0111\u1ed9ng t\u1ed1t h\u01a1n khi k\u1ebft h\u1ee3p v\u1edbi Xeloda so v\u1edbi khi s\u1eed d\u1ee5ng ri\u00eang l\u1ebb.<\/span><\/p>\n

    Hi\u1ec7n nay, s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb tr\u00ean, c\u0169ng nh\u01b0 c\u00e1c lo\u1ea1i thu\u1ed1c m\u1edbi h\u01a1n nh\u01b0\u00a0 thu\u1ed1c tr\u1ecb li\u1ec7u mi\u1ec5n d\u1ecbch v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf PARP, \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u trong\u00a0 c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u1ed1i v\u1edbi b\u1ec7nh ung th\u01b0 v\u00fa giai \u0111o\u1ea1n 4<\/span><\/p>\n

    2. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ea1i ch\u1ed7\u00a0<\/strong><\/h2>\n

    \u0110\u00e2y ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb di c\u0103n n\u00e3o t\u1ea1i v\u1ecb tr\u00ed c\u1ee5 th\u1ec3 v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb nh\u1ea5t n\u1ebfu di c\u0103n n\u00e3o g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u00e1ng k\u1ec3 ho\u1eb7c n\u1ebfu ch\u1ec9 c\u00f3 m\u1ed9t v\u00e0i di c\u0103n v\u1edbi m\u1ee5c ti\u00eau lo\u1ea1i b\u1ecf di c\u0103n. Khi c\u00f3 nhi\u1ec1u di c\u0103n, m\u1ee5c ti\u00eau l\u00e0 gi\u1ea3m tri\u1ec7u ch\u1ee9ng (gi\u1ea3m nh\u1eb9). Ch\u1ec9 v\u1edbi m\u1ed9t v\u00e0i di c\u0103n, vi\u1ec7c lo\u1ea1i b\u1ecf di c\u0103n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u1edbi m\u1ee5c ti\u00eau c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t (v\u1edbi m\u1ee5c \u0111\u00edch ch\u1eefa b\u1ec7nh).\u00a0<\/span><\/p>\n

    N\u00f3i chung, ng\u01b0\u1eddi ta c\u1ea3m th\u1ea5y r\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ea1i ch\u1ed7 chuy\u00ean s\u00e2u h\u01a1n (ch\u1eb3ng h\u1ea1n nh\u01b0 SBRT (x\u1ea1 tr\u1ecb l\u1eadp th\u1ec3) v\u00e0 ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf di c\u0103n) n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t ch\u1ee7 y\u1ebfu cho nh\u1eefng ng\u01b0\u1eddi \u0111\u01b0\u1ee3c cho l\u00e0 s\u1ebd s\u1ed1ng s\u00f3t sau h\u01a1n 6 \u0111\u1ebfn 12 th\u00e1ng.<\/span><\/p>\n

    2.1 X\u1ea1 tr\u1ecb to\u00e0n b\u1ed9 n\u00e3o (WBRT)<\/h3>\n

    X\u1ea1 tr\u1ecb to\u00e0n b\u1ed9 n\u00e3o (Whole Brain Radiation Therapy) \u0111\u00e3 kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y v\u00ec c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 .\u0110\u01b0\u1ee3c khuy\u00ean d\u00f9ng hi\u1ec7n nay cho nh\u1eefng ng\u01b0\u1eddi b\u1ecb di c\u0103n n\u00e3o lan r\u1ed9ng \u0111ang g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u00e1ng k\u1ec3. Nh\u1eefng thay \u0111\u1ed5i v\u1ec1 nh\u1eadn th\u1ee9c, ch\u1eb3ng h\u1ea1n nh\u01b0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tr\u00ed nh\u1edb, kh\u1ea3 n\u0103ng nh\u1edb l\u1ea1i ngay l\u1eadp t\u1ee9c v\u00e0 kh\u1ea3 n\u0103ng n\u00f3i l\u01b0u lo\u00e1t l\u00e0 r\u1ea5t ph\u1ed5 bi\u1ebfn v\u00e0 g\u00e2y kh\u00f3 ch\u1ecbu cho nh\u1eefng ng\u01b0\u1eddi ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u00e0y. V\u00ec ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng t\u1ed1t th\u01b0\u1eddng l\u00e0 m\u1ee5c ti\u00eau quan tr\u1ecdng nh\u1ea5t trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa di c\u0103n, n\u00ean vi\u1ec7c s\u1eed d\u1ee5ng WBRT c\u1ea7n \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc c\u1ea9n th\u1eadn v\u1ec1 l\u1ee3i \u00edch v\u00e0 r\u1ee7i ro.<\/span><\/p>\n

    2.2 X\u1ea1 tr\u1ecb c\u01a1 th\u1ec3 l\u1eadp th\u1ec3 (SBRT)<\/h3>\n

    SBRT (Stereotactic Body Radiation Therapy) s\u1eed d\u1ee5ng m\u1ed9t li\u1ec1u ph\u00f3ng x\u1ea1 cao \u0111\u1ebfn m\u1ed9t v\u00f9ng m\u00f4 nh\u1ecf \u0111\u1ec3 c\u1ed1 g\u1eafng lo\u1ea1i b\u1ecf di c\u0103n. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi ch\u1ec9 c\u00f3 m\u1ed9t v\u00e0i di c\u0103n, nh\u01b0ng m\u1ed9t s\u1ed1 trung t\u00e2m \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb cho nh\u1eefng ng\u01b0\u1eddi c\u00f3 t\u1edbi 10 di c\u0103n c\u00f9ng m\u1ed9t l\u00fac. Quy tr\u00ecnh n\u00e0y c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c di c\u0103n b\u1ed5 sung hi\u1ec7n c\u00f3 ho\u1eb7c x\u1ea3y ra theo th\u1eddi gian.\u00a0<\/span><\/p>\n

    SBRT c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n so v\u1edbi ph\u1eabu thu\u1eadt \u0111\u1ed1i v\u1edbi nh\u1eefng di c\u0103n n\u1eb1m s\u00e2u trong n\u00e3o ho\u1eb7c \u1edf nh\u1eefng v\u00f9ng nh\u1ea1y c\u1ea3m m\u00e0 ph\u1eabu thu\u1eadt s\u1ebd g\u00e2y ra qu\u00e1 nhi\u1ec1u t\u1ed5n th\u01b0\u01a1ng cho m\u00f4 n\u00e3o kh\u1ecfe m\u1ea1nh. Hi\u1ec7u qu\u1ea3 nh\u1ea5t v\u1edbi c\u00e1c di c\u0103n nh\u1ecf v\u00e0 ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 l\u00e0 l\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n cho c\u00e1c di c\u0103n c\u00f3 \u0111\u01b0\u1eddng k\u00ednh l\u1edbn h\u01a1n 3 cm. SBRT l\u00e0m suy gi\u1ea3m nh\u1eadn th\u1ee9c \u00edt h\u01a1n so v\u1edbi x\u1ea1 tr\u1ecb to\u00e0n b\u1ed9 n\u00e3o, m\u1ed9t s\u1ed1 t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n nh\u01b0 ho\u1ea1i t\u1eed do b\u1ee9c x\u1ea1.<\/span><\/p>\n

    2.3 Ph\u1eabu thu\u1eadt khi ung th\u01b0 v\u00fa di c\u0103n n\u00e3o<\/strong><\/p>\n

    Ph\u1eabu thu\u1eadt \u0111\u1ec3 lo\u1ea1i b\u1ecf m\u1ed9t ho\u1eb7c ch\u1ec9 m\u1ed9t v\u00e0i di c\u0103n (\u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf di c\u0103n) \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y v\u00e0 c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho nh\u1eefng ng\u01b0\u1eddi ph\u00f9 h\u1ee3p v\u1edbi th\u1ee7 thu\u1eadt (ch\u1ec9 c\u00f3 m\u1ed9t v\u00e0i di c\u0103n v\u00e0 c\u00f3 s\u1ee9c kh\u1ecfe t\u1ed1t). Ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn t\u1ed1t h\u01a1n (so v\u1edbi SBRT) \u0111\u1ed1i v\u1edbi c\u00e1c di c\u0103n l\u1edbn (\u0111\u01b0\u1eddng k\u00ednh l\u1edbn h\u01a1n 3 cm).\u00a0<\/span><\/p>\n

    Kh\u00f4ng gi\u1ed1ng nh\u01b0 SBRT, ph\u1eabu thu\u1eadt c\u00f3 k\u1ebft qu\u1ea3 ngay l\u1eadp t\u1ee9c c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m ph\u00f9 n\u00e3o. Tuy nhi\u00ean, c\u00f3 nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh cao h\u01a1n, c\u0169ng nh\u01b0 nguy c\u01a1 “l\u00e2y lan kh\u1ed1i u” (l\u00e2y lan c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 qua n\u00e3o) khi ph\u1eabu thu\u1eadt.<\/span><\/p>\n

    3. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c<\/strong><\/h2>\n

    Khi di c\u0103n n\u00e3o lan r\u1ed9ng ho\u1eb7c k\u00e8m theo di c\u0103n lan r\u1ed9ng \u1edf c\u00e1c v\u1ecb tr\u00ed kh\u00e1c d\u1eabn khi vi\u1ec7c \u0111i\u1ec1u tr\u1ecb kh\u00f4ng c\u00f2n \u00fd ngh\u0129a. L\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 \u0111\u1ec3 ki\u1ec3m so\u00e1t c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 duy tr\u00ec ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng t\u1ed1t nh\u1ea5t v\u1edbi th\u1eddi gian c\u00f2n l\u1ea1i v\u1eabn c\u1ef1c k\u1ef3 quan tr\u1ecdng.\u00a0<\/span><\/p>\n

    L\u1ef1a ch\u1ecdn ng\u1eebng \u0111i\u1ec1u tr\u1ecb, kh\u00f4ng can thi\u1ec7p kh\u00f4ng c\u00f3 ngh\u0129a l\u00e0 \u0111ang t\u1eeb b\u1ecf. Thay v\u00e0o \u0111\u00f3, \u0111i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 \u0111ang l\u1ef1a ch\u1ecdn \u0111\u1ec3 c\u00f3 m\u1ed9t cu\u1ed9c s\u1ed1ng ch\u1ea5t l\u01b0\u1ee3ng nh\u1ea5t \u1edf h\u00e0nh tr\u00ecnh cu\u1ed1i \u0111\u1eddi.\u00a0<\/span><\/p>\n

    4. Ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh<\/strong><\/h2>\n

    Di c\u0103n n\u00e3o c\u00f3 xu h\u01b0\u1edbng ph\u00e1t tri\u1ec3n nhanh. Tuy nhi\u00ean, di c\u0103n n\u00e3o do ung th\u01b0 v\u00fa c\u00f3 ti\u00ean l\u01b0\u1ee3ng t\u1ed1t h\u01a1n so v\u1edbi di c\u0103n n\u00e3o do m\u1ed9t s\u1ed1 b\u1ec7nh ung th\u01b0 kh\u00e1c.<\/span><\/p>\n

    Tr\u01b0\u1edbc \u0111\u00e2y, th\u1eddi gian s\u1ed1ng s\u00f3t v\u1edbi di c\u0103n n\u00e3o ch\u1ec9 kho\u1ea3ng 6 th\u00e1ng nh\u01b0ng \u0111i\u1ec1u n\u00e0y \u0111ang thay \u0111\u1ed5i. M\u1ed9t nghi\u00ean c\u1ee9u n\u0103m 2016 cho th\u1ea5y t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t chung \u0111\u1ed1i v\u1edbi b\u1ec7nh ung th\u01b0 v\u00fa di c\u0103n n\u00e3o (t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i k\u1ebft h\u1ee3p) l\u00e0 h\u01a1n 2 n\u0103m m\u1ed9t ch\u00fat, v\u1edbi k\u1ef3 v\u1ecdng s\u1ed1ng l\u00e0 3 n\u0103m \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 kh\u1ed1i u d\u01b0\u01a1ng t\u00ednh v\u1edbi HER2.\u00a0<\/span><\/p>\n

    5. K\u1ebft lu\u1eadn\u00a0<\/strong><\/h2>\n

    C\u1ea7n c\u00e2n nh\u1eafc l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t cho m\u1ed7i b\u1ec7nh nh\u00e2n ph\u1ee5 thu\u1ed9c v\u00e0o nhi\u1ec1u y\u1ebfu t\u1ed1, bao g\u1ed3m tu\u1ed5i, t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe, t\u1ea7n su\u1ea5t v\u00e0 th\u1eddi gian xu\u1ea5t hi\u1ec7n c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng.\u00a0<\/span><\/p>\n

    Quan tr\u1ecdng l\u00e0 b\u1ec7nh nh\u00e2n c\u1ea7n th\u01b0\u1eddng xuy\u00ean \u0111i kh\u00e1m, ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 theo d\u00f5i t\u00ecnh tr\u1ea1ng b\u1ec7nh \u0111\u1ec3 c\u00f3 nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi v\u00e0 hi\u1ec7u qu\u1ea3 nh\u1ea5t.<\/span><\/p>\n

    Ngu\u1ed3n verywellhealth<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    Di c\u0103n n\u00e3o x\u1ea3y ra \u1edf 15% \u0111\u1ebfn 24% ph\u1ee5 n\u1eef b\u1ecb ung th\u01b0 v\u00fa di c\u0103n. \u0110i\u1ec1u kh\u00f3 kh\u0103n trong ph\u01b0\u01a1ng ph\u00e1p trong \u0111i\u1ec1u tr\u1ecb di c\u0103n n\u00e3o l\u00e0 nhi\u1ec1u lo\u1ea1i thu\u1ed1c kh\u00f4ng th\u1ec3 xuy\u00ean qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o. Mong r\u1eb1ng b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y c\u00f3 th\u1ec3 cung c\u1ea5p m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p […]<\/p>\n","protected":false},"author":57,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"\nC\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa di c\u0103n n\u00e3o - Vinmec<\/title>\n<meta name=\"description\" content=\"Di c\u0103n n\u00e3o x\u1ea3y ra 15% \u0111\u1ebfn 24% ph\u1ee5 n\u1eef b\u1ecb ung th\u01b0 v\u00fa di c\u0103n. 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