{"id":28461,"date":"2023-04-25T22:40:12","date_gmt":"2023-04-25T15:40:12","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28461"},"modified":"2023-04-25T22:40:33","modified_gmt":"2023-04-25T15:40:33","slug":"ung-thu-duong-vat-huong-dan-dieu-tri-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/ung-thu-duong-vat-huong-dan-dieu-tri-theo-bo-y-te\/","title":{"rendered":"Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt: H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb theo b\u1ed9 Y t\u1ebf"},"content":{"rendered":"

Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh l\u00fd hi\u1ebfm g\u1eb7p nh\u01b0ng l\u1ea1i nguy hi\u1ec3m \u0111\u1ed1i v\u1edbi nam gi\u1edbi. \u0110i\u1ec1u tr\u1ecb ung th\u01b0 d\u01b0\u01a1ng v\u1eadt gi\u00fap t\u0103ng c\u01a1 h\u1ed9i ch\u1eefa kh\u1ecfi b\u1ec7nh v\u00e0 n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft sau \u0111\u00e2y s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n c\u1ee7a ung th\u01b0 d\u01b0\u01a1ng v\u1eadt theo b\u1ed9 Y t\u1ebf.<\/strong><\/p>\n

1. \u0110\u1ea1i c\u01b0\u01a1ng v\u1ec1 ung th\u01b0 d\u01b0\u01a1ng v\u1eadt<\/h2>\n

Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt (UTDV) l\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 xu\u1ea5t ph\u00e1t t\u1eeb ni\u00eam m\u1ea1c bao quy \u0111\u1ea7u, quy \u0111\u1ea7u v\u00e0 sarcoma xu\u1ea5t ph\u00e1t t\u1eeb t\u1ebf b\u00e0o li\u00ean k\u1ebft c\u1ee7a d\u01b0\u01a1ng v\u1eadt. Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt h\u1ea7u h\u1ebft l\u00e0 ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o v\u1ea3y, sinh ra t\u1eeb l\u1edbp bi\u1ec3u m\u00f4 l\u00e1t t\u1ea7ng kh\u00f4ng s\u1eebng ho\u00e1, h\u1ea7u nh\u01b0 kh\u00f4ng g\u1eb7p ung th\u01b0 t\u1ebf b\u00e0o \u0111\u00e1y. Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh kh\u00f4ng ph\u1ed5 bi\u1ebfn v\u00e0 t\u1ea1i Vi\u1ec7t Nam t\u1ef7 l\u1ec7 m\u1eafc chu\u1ea9n theo tu\u1ed5i l\u00e0 0,67\/100.000 d\u00e2n. T\u1ef7 l\u1ec7 m\u1eafc thay \u0111\u1ed5i t\u00f9y theo nh\u00f3m ch\u1ee7ng t\u1ed9c, d\u00e2n t\u1ed9c v\u00e0 v\u1ecb tr\u00ed \u0111\u1ecba l\u00fd. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 quan tr\u1ecdng bao g\u1ed3m c\u00e1c th\u00f3i quen v\u0103n h\u00f3a v\u00e0 x\u00e3 h\u1ed9i c\u00e1c \u0111i\u1ec1u ki\u1ec7n v\u1ec7 sinh v\u00e0 t\u00edn ng\u01b0\u1ee1ng t\u00f4n gi\u00e1o.<\/p>\n

Nguy\u00ean nh\u00e2n hay g\u1eb7p nh\u1ea5t l\u00e0 h\u1eb9p bao quy \u0111\u1ea7u chi\u1ebfm t\u1ef7 l\u1ec7 kho\u1ea3ng 25-75% \u1edf nam gi\u1edbi. UTDV th\u01b0\u1eddng g\u1eb7p h\u01a1n tr\u00ean b\u1ec7nh nh\u00e2n c\u1eaft bao quy \u0111\u1ea7u mu\u1ed9n \u0111\u1ebfn tu\u1ed5i d\u1eady th\u00ec. C\u1ea3 ung th\u01b0 d\u01b0\u01a1ng v\u1eadt \u1edf nam gi\u1edbi v\u00e0 ung th\u01b0 c\u1ed5 t\u1eed cung \u1edf ph\u1ee5 n\u1eef \u0111\u1ec1u c\u00f3 li\u00ean quan \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng Papilloma virus (HPV)<\/a>. Typ virus HPV-16 v\u00e0 HPV-18 \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf m\u1ed9t ph\u1ea7n ba nam gi\u1edbi b\u1ecb ung th\u01b0 d\u01b0\u01a1ng v\u1eadt.<\/p>\n

\"minh-hoa-ung-thu-duong-vat\"
Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh l\u00fd hi\u1ebfm g\u1eb7p nh\u01b0ng nguy hi\u1ec3m \u1edf nam gi\u1edbi<\/figcaption><\/figure>\n

2. \u0110i\u1ec1u tr\u1ecb ung th\u01b0 d\u01b0\u01a1ng v\u1eadt<\/h2>\n

2.1. Nguy\u00ean t\u1eafc chung<\/h3>\n

\u0110i\u1ec1u tr\u1ecb tri\u1ec7t c\u0103n UTDV ch\u1ee7 y\u1ebfu b\u1eb1ng ph\u1eabu thu\u1eadt. M\u1ee5c ti\u00eau c\u1ee7a cu\u1ed9c m\u1ed5 l\u00e0 c\u1eaft h\u1ebft u v\u00e0 v\u00e9t s\u1ea1ch h\u1ea1ch khu v\u1ef1c. Di\u1ec7n c\u1eaft ph\u1ea3i c\u00e1ch xa b\u1edd kh\u1ed1i u. Ki\u1ec3m tra b\u1eb1ng m\u1eaft th\u1ea5y di\u1ec7n c\u1eaft l\u00e0 t\u1ed5 ch\u1ee9c l\u00e0nh, ki\u1ec3m tra vi th\u1ec3 kh\u00f4ng c\u00f3 t\u1ebf b\u00e0o ung th\u01b0. N\u1ebfu di\u1ec7n c\u1eaft ch\u01b0a s\u1ea1ch ung th\u01b0, ph\u1eabu thu\u1eadt vi\u00ean nh\u1ea5t thi\u1ebft ph\u1ea3i c\u1eaft l\u1ea1i cho \u0111\u1ee7 s\u1ea1ch v\u00ec kh\u00f4ng c\u00f3 bi\u1ec7n ph\u00e1p n\u00e0o t\u1ed1t h\u01a1n. H\u1ea1ch khu v\u1ef1c \u0111\u01b0\u1ee3c v\u00e9t m\u1ed9t c\u00e1ch c\u00f3 h\u1ec7 th\u1ed1ng. V\u00e9t c\u1ea3 hai b\u00ean b\u1eb9n, v\u00e9t h\u1ea1ch b\u1eb9n n\u00f4ng v\u00e0 h\u1ea1ch b\u1eb9n s\u00e2u. Tr\u01b0\u1eddng h\u1ee3p h\u1ea1ch b\u1eb9n b\u1ecb di c\u0103n, ph\u1ea3i v\u00e9t h\u1ea1ch v\u01b0\u1ee3t th\u00eam m\u1ed9t ch\u1eb7ng, ngh\u0129a l\u00e0 ph\u1ea3i v\u00e9t h\u1ea1ch ch\u1eadu. V\u00ec v\u1eady, khi v\u00e9t h\u1ea1ch b\u1eb9n, ph\u1eabu thu\u1eadt vi\u00ean c\u1ea7n \u0111\u00e1nh gi\u00e1 di c\u0103n h\u1ea1ch b\u1eb1ng m\u1eaft v\u00e0 b\u1eb1ng sinh thi\u1ebft t\u1ee9c th\u00ec \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh c\u00f3 v\u00e9t h\u1ea1ch ch\u1eadu hay kh\u00f4ng. Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt v\u00e0 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p m\u1ed5 ph\u1ea3i \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ed1t ngay t\u1eeb \u0111\u1ea7u, b\u1ea3o \u0111\u1ea3m sao cho \u00edt nh\u1ea5t kh\u00f4ng \u0111\u01b0\u1ee3c s\u00f3t ung th\u01b0 t\u1ea1i di\u1ec7n c\u1eaft d\u01b0\u01a1ng v\u1eadt v\u00e0 t\u1ea1i h\u1ea1ch khu v\u1ef1c.<\/p>\n

X\u1ea1 tr\u1ecb \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong 4 tr\u01b0\u1eddng h\u1ee3p. Th\u1ee9 nh\u1ea5t, giai \u0111o\u1ea1n Tl<\/sub>N0<\/sub>M0<\/sub> c\u1ea7n x\u1ea1 tr\u1ecb \u00e1p s\u00e1t \u0111\u1ec3 b\u1ea3o t\u1ed3n quy \u0111\u1ea7u, \u1edf n\u01b0\u1edbc ta \u00edt \u00e1p d\u1ee5ng v\u00ec kh\u00f3 th\u1ef1c hi\u1ec7n. Th\u1ee9 hai, h\u1ea1ch b\u1ecb di c\u0103n, sau khi v\u00e9t h\u1ea1ch c\u1ea7n x\u1ea1 tr\u1ecb b\u1ed5 tr\u1ee3 v\u00f9ng b\u1eb9n, v\u00f9ng ch\u1eadu hai b\u00ean ph\u00f2ng t\u00e1i ph\u00e1t h\u1ea1ch. Th\u1ee9 3, ph\u1ed1i h\u1ee3p v\u1edbi ho\u00e1 ch\u1ea5t trong tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 kh\u00f4ng c\u00f2n ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt. Th\u1ee9 4, x\u1ea1 tr\u1ecb gi\u1ea3m \u0111au v\u00f9ng di c\u0103n x\u01b0\u01a1ng, n\u00e3o.<\/p>\n

H\u00f3a tr\u1ecb c\u00f3 vai tr\u00f2 b\u1ed5 tr\u1ee3 ph\u1eabu thu\u1eadt. Ho\u00e1 tr\u1ecb tr\u01b0\u1edbc m\u1ed5 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi UTDV ph\u00e1t tri\u1ec3n nhanh, \u0111\u1ed9 m\u00f4 h\u1ecdc cao, c\u1ea7n ho\u00e1 ch\u1ea5t thu nh\u1ecf b\u1edbt u, h\u1ea1ch tr\u01b0\u1edbc khi m\u1ed5. Ho\u00e1 tr\u1ecb sau m\u1ed5 ch\u1ed1ng vi di c\u0103n c\u0169ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh nh\u01b0ng ch\u1ee7 y\u1ebfu \u0111\u1ed1i v\u1edbi ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y \u00edt bi\u1ec7t ho\u00e1. Tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 lan r\u1ed9ng kh\u00f4ng ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng h\u00f3a tr\u1ecb \u0111\u01a1n thu\u1ea7n ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi x\u1ea1 tr\u1ecb nh\u1eb1m gi\u1ea3m b\u1ec7nh, gi\u1ea3m tri\u1ec7u ch\u1ee9ng, k\u00e9o d\u00e0i th\u1eddi gian s\u1ed1ng th\u00eam nh\u01b0ng \u00edt khi \u0111\u1ea1t \u0111\u01b0\u1ee3c t\u00ednh ch\u1ea5t tri\u1ec7t c\u0103n.<\/p>\n

2.2. Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb<\/h3>\n

2.2.1. Ph\u1eabu thu\u1eadt<\/h3>\n
    \n
  • B\u1ea3o t\u1ed3n d\u01b0\u01a1ng v\u1eadt<\/li>\n<\/ul>\n

    \u0110i\u1ec1u tr\u1ecb kh\u1ed1i u nguy\u00ean ph\u00e1t c\u00f3 b\u1ea3o t\u1ed3n d\u01b0\u01a1ng v\u1eadt \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi giai \u0111o\u1ea1n s\u1edbm c\u1ee7a b\u1ec7nh, v\u1edbi x\u1ebfp lo\u1ea1i Tis<\/sub>,l<\/sub>N0<\/sub>M0<\/sub>. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi T2<\/sub>, T3<\/sub>, T4<\/sub> ho\u1eb7c b\u1ea5t c\u1ee9 T, c\u00f3 N1<\/sub>.<\/p>\n

    \u0110\u1ed1i v\u1edbi Tis<\/sub> l\u00e0 ung th\u01b0 ti\u1ec1n x\u00e2m l\u1ea5n, ch\u01b0a di c\u0103n h\u1ea1ch v\u00e0 di c\u0103n xa n\u00ean ch\u1ec9 c\u1ea7n c\u1eaft b\u1ecf h\u1ebft u l\u00e0 \u0111\u01b0\u1ee3c. N\u1ebfu u lan to\u1ea3 b\u1ec1 m\u1eb7t quy \u0111\u1ea7u th\u00ec c\u1eaft h\u1ebft l\u1edbp ni\u00eam m\u1ea1c quy \u0111\u1ea7u v\u00e0 bao quy \u0111\u1ea7u. N\u01b0\u1edbc ngo\u00e0i c\u00f3 d\u00f9ng x\u1ea1 \u00e1p s\u00e1t 55-60Gy nh\u01b0ng \u1edf n\u01b0\u1edbc ta \u00edt \u00e1p d\u1ee5ng.<\/p>\n

    \u0110\u1ed1i v\u1edbi T1<\/sub>N0<\/sub>M0<\/sub>, u khu tr\u00fa t\u1ea1i bao quy \u0111\u1ea7u n\u00ean ph\u1eabu thu\u1eadt c\u1eaft r\u1ed9ng bao quy \u0111\u1ea7u b\u1ea3o t\u1ed3n d\u01b0\u01a1ng v\u1eadt. N\u1ebfu u lan to\u1ea3 b\u1ec1 m\u1eb7t quy \u0111\u1ea7u kh\u00f4ng n\u00ean m\u1ed5 b\u1ea3o t\u1ed3n v\u00ec hay t\u00e1i ph\u00e1t t\u1ea1i ch\u1ed7. Trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec1u v\u00e9t h\u1ea1ch b\u1eb9n c\u00f3 h\u1ec7 th\u1ed1ng.<\/p>\n

      \n
    • C\u1eaft c\u1ee5t d\u01b0\u01a1ng v\u1eadt<\/li>\n<\/ul>\n

      C\u1eaft c\u1ee5t d\u01b0\u01a1ng v\u1eadt khi kh\u00f4ng c\u00f2n kh\u1ea3 n\u0103ng b\u1ea3o t\u1ed3n d\u01b0\u01a1ng v\u1eadt, \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi Tl<\/sub> lan to\u1ea3, T1<\/sub> c\u00f3 di c\u0103n h\u1ea1ch, T2,3<\/sub>N0-3<\/sub>M0<\/sub>. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi T4<\/sub> ho\u1eb7c ung th\u01b0 c\u00f3 nh\u00e2n ng\u1ea5m d\u01b0\u1edbi da, ngh\u0129a l\u00e0 c\u00f3 di c\u0103n theo m\u1ea1ng l\u01b0\u1edbi b\u1ea1ch huy\u1ebft d\u01b0\u1edbi da.<\/p>\n

      Ph\u1eabu thu\u1eadt c\u1eaft c\u1ee5t d\u01b0\u01a1ng v\u1eadt ph\u1ed1i h\u1ee3p v\u1edbi v\u00e9t h\u1ea1ch b\u1eb9n hai b\u00ean. N\u1ebfu c\u00f3 di c\u0103n h\u1ea1ch b\u1eb9n c\u1ea7n ph\u1ea3i v\u00e9t th\u00eam c\u1ea3 h\u1ea1ch ch\u1eadu. X\u1ea1 tr\u1ecb b\u1ed5 tr\u1ee3 sau m\u1ed5 t\u1ea1i h\u1ea1ch khu v\u1ef1c. H\u00f3a tr\u1ecb b\u1ed5 tr\u1ee3 sau m\u1ed5 \u0111\u1ed1i v\u1edbi ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y \u00edt bi\u1ec7t ho\u00e1, pN3<\/sub>.<\/p>\n

        \n
      • C\u1eaft b\u1ed9 ph\u1eadn sinh d\u1ee5c ngo\u00e0i<\/li>\n<\/ul>\n

        C\u1eaft to\u00e0n b\u1ed9 b\u1ed9 ph\u1eadn sinh d\u1ee5c ngo\u00e0i \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi T4<\/sub>N0-2<\/sub>M0<\/sub>. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi nh\u00e2n ng\u1ea5m d\u01b0\u1edbi da. Ph\u1eabu thu\u1eadt c\u1eaft b\u1ed9 ph\u1eadn sinh d\u1ee5c ngo\u00e0i + v\u00e9t h\u1ea1ch b\u1eb9n + v\u00e9t h\u1ea1ch ch\u1eadu hai b\u00ean. N\u1ebfu kh\u1ed1i u x\u00e2m l\u1ea5n tuy\u1ebfn ti\u1ec1n li\u1ec7t th\u00ec c\u1eaft th\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t, m\u1edf th\u00f4ng b\u00e0ng quang tr\u00ean x\u01b0\u01a1ng mu.<\/p>\n

          \n
        • Ph\u1eabu thu\u1eadt s\u1ea1ch s\u1ebd<\/li>\n<\/ul>\n

          Ph\u1eabu thu\u1eadt s\u1ea1ch s\u1ebd \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi b\u1ea5t c\u1ee9 T, N c\u00f3 M1<\/sub> ho\u1eb7c b\u1ea5t c\u1ee9 T, N, c\u00f3 M0<\/sub> nh\u01b0ng b\u1ec7nh nh\u00e2n qu\u00e1 gi\u00e0 y\u1ebfu, tu\u1ed5i tr\u00ean 85 kh\u00f3 ch\u1ea5p nh\u1eadn cu\u1ed9c m\u1ed5 r\u1ed9ng nh\u01b0 v\u00e9t h\u1ea1ch b\u1eb9n, v\u00e9t h\u1ea1ch ch\u1eadu.<\/p>\n

          V\u00e9t h\u1ea1ch b\u1eb9n hai b\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh theo nguy\u00ean t\u1eafc ph\u1eabu thu\u1eadt tri\u1ec7t c\u0103n. N0<\/sub>–2<\/sub> c\u1ea7n v\u00e9t h\u1ea1ch b\u1eb9n, N3<\/sub> c\u1ea7n v\u00e9t c\u1ea3 h\u1ea1ch b\u1eb9n v\u00e0 h\u1ea1ch ch\u1eadu. C\u00f3 quan ni\u1ec7m cho r\u1eb1ng N0<\/sub> kh\u00f4ng n\u00ean v\u00e9t h\u1ea1ch m\u00e0 c\u1ea7n theo d\u00f5i \u0111\u1ebfn khi N1<\/sub> m\u1edbi v\u00e9t. Th\u1ef1c t\u1ebf, nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p N0<\/sub> \u0111\u01b0\u1ee3c v\u00e9t v\u00e0 th\u1ea5y di c\u0103n h\u1ea1ch, x\u1ebfp pNl<\/sub>, th\u1eadm ch\u00ed l\u00e0 pN2<\/sub>. H\u01a1n n\u1eefa, b\u1ec7nh nh\u00e2n UTDV th\u01b0\u1eddng g\u1eb7p \u1edf ng\u01b0\u1eddi ngh\u00e8o, \u1edf n\u00f4ng th\u00f4n, hay b\u1ecf kh\u00e1m l\u1ea1i, th\u1eadm ch\u00ed th\u1ea5y h\u1ea1ch to l\u1ea1i t\u1ef1 \u0111i\u1ec1u tr\u1ecb cho \u0111\u1ebfn khi h\u1ea1ch v\u1ee1 ra da. V\u00ec v\u1eady, c\u1ea7n v\u00e9t h\u1ea1ch b\u1eb9n hai b\u00ean c\u00f3 h\u1ec7 th\u1ed1ng, k\u1ec3 c\u1ea3 N0<\/sub>.<\/p>\n

          2.2.2. X\u1ea1 tr\u1ecb<\/h4>\n

          2.2.2.1. X\u1ea1 tr\u1ecb chi\u1ebfu ngo\u00e0i<\/h5>\n

          * Ch\u1ec9 \u0111\u1ecbnh v\u00e0 li\u1ec1u l\u01b0\u1ee3ng<\/p>\n

            \n
          • Giai \u0111o\u1ea1n T1-2<\/sub>, N0<\/sub><\/li>\n<\/ul>\n

            Kh\u1ed1i u <4cm:<\/p>\n

            + X\u1ea1 tr\u1ecb ngo\u00e0i c\u00e1ch r\u00eca kh\u1ed1i u 2cm, li\u1ec1u 65-70Gy (ph\u00e2n li\u1ec1u 2Gy\/ng\u00e0y) ho\u1eb7c<\/p>\n

            + H\u00f3a x\u1ea1 tr\u1ecb \u0111\u1ed3ng th\u1eddi c\u00e1ch r\u00eca kh\u1ed1i u 2cm, li\u1ec1u 65-70Gy (ph\u00e2n li\u1ec1u 2Gy\/ng\u00e0y).<\/p>\n

            Kh\u1ed1i u \u22654cm:<\/p>\n

            + X\u1ea1 tr\u1ecb ngo\u00e0i tr\u01b0\u1eddng chi\u1ebfu r\u1ed9ng to\u00e0n b\u1ed9 d\u01b0\u01a1ng v\u1eadt, h\u1ea1ch ch\u1eadu, h\u1ea1ch \u0111\u00f9i li\u1ec1u x\u1ea1 tr\u1ecb 45-50,4Gy, n\u00e2ng li\u1ec1u x\u1ea1 c\u00e1ch r\u00eca u 2cm \u0111\u1ebfn t\u1ed5ng 65-70Gy (ph\u00e2n li\u1ec1u 1,8-2Gy\/ng\u00e0y)<\/p>\n

              \n
            • Giai \u0111o\u1ea1n T3-4<\/sub> ho\u1eb7c N+ (kh\u00f4ng ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c)<\/li>\n<\/ul>\n

              X\u1ea1 tr\u1ecb ngo\u00e0i tr\u01b0\u1eddng chi\u1ebfu r\u1ed9ng to\u00e0n b\u1ed9 d\u01b0\u01a1ng v\u1eadt, h\u1ea1ch ch\u1eadu, h\u1ea1ch \u0111\u00f9i li\u1ec1u x\u1ea1 tr\u1ecb 45-50,4Gy, n\u00e2ng li\u1ec1u x\u1ea1 c\u00e1ch r\u00eca u 2cm \u0111\u1ebfn t\u1ed5ng 65-70Gy (ph\u00e2n li\u1ec1u 1,8-2Gy\/ng\u00e0y).<\/p>\n

                \n
              • Giai \u0111o\u1ea1n T3-4 <\/sub>ho\u1eb7c N+ (ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c)<\/li>\n<\/ul>\n

                + N\u1ebfu kh\u00f4ng c\u00f2n u: x\u1ea1 tr\u1ecb di\u1ec7n ph\u1eabu thu\u1eadt li\u1ec1u 45-60Gy.<\/p>\n

                + N\u1ebfu c\u00f2n u: x\u1ea1 nh\u01b0 tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c.<\/p>\n

                  \n
                • H\u1ea1ch \u0111\u00f9i b\u1eb9n di c\u0103n:<\/li>\n<\/ul>\n

                  X\u1ea1 tr\u1ecb r\u1ed9ng di\u1ec7n h\u1ea1ch v\u00f9ng \u0111\u00f9i b\u1eb9n 45-50,4Gy, n\u00e2ng li\u1ec1u x\u1ea1 tr\u1ecb t\u1ea1i v\u1ecb tr\u00ed h\u1ea1ch di c\u0103n l\u00ean \u0111\u1ebfn 65-70Gy.<\/p>\n

                    \n
                  • X\u1ea1 tr\u1ecb tri\u1ec7u ch\u1ee9ng: x\u1ea1 tr\u1ecb gi\u1ea3m \u0111au, x\u1ea1 tr\u1ecb to\u00e0n n\u00e3o di c\u0103n n\u00e3o, x\u1ea1 tr\u1ecb ch\u1ed1ng ch\u00e8n \u00e9p. Li\u1ec1u x\u1ea1 30Gy ph\u00e2n li\u1ec1u 3Gy\/ng\u00e0y ho\u1eb7c 40Gy ph\u00e2n li\u1ec1u 2Gy\/ng\u00e0y.<\/li>\n<\/ul>\n

                    * M\u00f4 ph\u1ecfng: Ch\u1ee5p m\u00f4 ph\u1ecfng b\u1eb1ng CT, MRI ho\u1eb7c PET\/CT, PET\/MRI.<\/p>\n

                    * K\u1ef9 thu\u1eadt: C\u00f3 th\u1ec3 d\u00f9ng c\u00e1c k\u1ef9 thu\u1eadt th\u01b0\u1eddng quy 3D, ho\u1eb7c c\u00e1c k\u1ef9 thu\u1eadt x\u1ea1 tr\u1ecb ti\u00ean ti\u1ebfn gi\u00fap t\u0103ng hi\u1ec7u qu\u1ea3, \u0111\u1ed9 ch\u00ednh x\u00e1c v\u00e0 gi\u1ea3m thi\u1ec3u t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 x\u1ea1 tr\u1ecb \u0111i\u1ec1u bi\u1ebfn li\u1ec1u (IMRT), x\u1ea1 tr\u1ecb \u0111i\u1ec1u bi\u1ebfn th\u1ec3 t\u00edch (VMAT), x\u1ea1 tr\u1ecb h\u1ea1t n\u1eb7ng (Proton therapy, heavy ion).<\/p>\n

                    2.2.2.2. X\u1ea1 ph\u1eabu<\/h5>\n

                    X\u1ea1 ph\u1eabu c\u00f3 th\u1ec3 b\u1eb1ng dao gamma c\u1ed5 \u0111i\u1ec3n, dao gamma quay, CyberKnife\u2026 Nh\u00ecn chung, ung th\u01b0 d\u01b0\u01a1ng v\u1eadt r\u1ea5t hi\u1ebfm khi di c\u0103n n\u00e3o.<\/p>\n

                    X\u1ea1 ph\u1eabu \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 bi\u1ec3u m\u00f4 d\u01b0\u01a1ng v\u1eadt di c\u0103n n\u00e3o m\u1ed9t v\u00e0i \u1ed5 (Oligometastasis). Tu\u1ef3 theo v\u1ecb tr\u00ed, s\u1ed1 l\u01b0\u1ee3ng, k\u00edch th\u01b0\u1edbc \u1ed5 di c\u0103n li\u1ec1u x\u1ea1 ph\u1eabu c\u00f3 th\u1ec3 t\u1eeb 18-26Gy.<\/p>\n

                    2.2.2.3. C\u1ea5y h\u1ea1t ph\u00f3ng x\u1ea1 (Radioactive seed implant)<\/h5>\n

                    Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb kh\u1ed1i h\u1ea1ch di c\u0103n t\u00e1i ph\u00e1t sau ph\u1eabu thu\u1eadt, x\u1ea1 tr\u1ecb. H\u1ea1t ph\u00f3ng x\u1ea1 c\u00f3 th\u1ec3 d\u00f9ng l\u00e0 I-125 ho\u1eb7c 90<\/sup>Y.<\/p>\n

                    2.2.2.4. X\u1ea1 tr\u1ecb trong m\u1ed5 (Intraoperative Radiation Therapy: IORT)<\/h5>\n

                    IORT l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt \u0111\u1eb7c bi\u1ec7t c\u00f3 th\u1ec3 cung c\u1ea5p m\u1ed9t li\u1ec1u x\u1ea1 tr\u1ecb duy nh\u1ea5t, t\u1eadp trung cao li\u1ec1u b\u1ee9c x\u1ea1 t\u1ea1i n\u1ec1n kh\u1ed1i u sau ph\u1eabu thu\u1eadt ho\u1eb7c ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a kh\u1ed1i u kh\u00f4ng th\u1ec3 ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c, c\u00e1c kh\u1ed1i u t\u00e1i ph\u00e1t, di c\u0103n.<\/p>\n

                    Ch\u1ec9 \u0111\u1ecbnh: C\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u1eaft u ti\u1ebfp c\u1eadn, ho\u1eb7c c\u00e1c tr\u01b0\u1eddng h\u1ee3p di c\u0103n xa nh\u01b0 c\u1ed9t s\u1ed1ng, x\u01b0\u01a1ng ch\u1eadu.<\/p>\n

                    2.2.3. H\u00f3a tr\u1ecb<\/h4>\n

                    Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt th\u01b0\u1eddng g\u1eb7p lo\u1ea1i ung th\u01b0 bi\u1ec3u m\u00f4 v\u1ea3y, h\u00f3a tr\u1ecb kh\u00f4ng ph\u1ed5 bi\u1ebfn do \u00edt \u0111\u00e1p \u1ee9ng v\u1edbi ho\u00e1 ch\u1ea5t. \u0110i\u1ec1u tr\u1ecb ho\u00e1 ch\u1ea5t b\u1ed5 tr\u1ee3 tr\u01b0\u1edbc m\u1ed5 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi ung th\u01b0 ph\u00e1t tri\u1ec3n nhanh, \u0111\u1ed9 m\u00f4 h\u1ecdc cao. Tr\u01b0\u1eddng h\u1ee3p n\u00e0y ch\u01b0a n\u00ean m\u1ed5 ngay. \u0110i\u1ec1u tr\u1ecb ho\u00e1 ch\u1ea5t l\u00e0m tho\u00e1i lui kh\u1ed1i u v\u00e0 h\u1ea1ch, ti\u1ebfn h\u00e0nh m\u1ed5 s\u1ebd thu\u1eadn l\u1ee3i h\u01a1n, \u00edt kh\u1ea3 n\u0103ng lan tr\u00e0n t\u1ebf b\u00e0o ung th\u01b0 ra tr\u01b0\u1eddng m\u1ed5.<\/p>\n

                    \u0110i\u1ec1u tr\u1ecb ho\u00e1 ch\u1ea5t sau m\u1ed5 nh\u1eb1m ch\u1ed1ng vi di c\u0103n, nh\u1ea5t l\u00e0 \u0111\u1ed1i v\u1edbi ung th\u01b0 \u00edt ho\u1eb7c kh\u00f4ng bi\u1ec7t ho\u00e1. Tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 lan r\u1ed9ng kh\u00f4ng m\u1ed5 \u0111\u01b0\u1ee3c, \u0111i\u1ec1u tr\u1ecb h\u00f3a ch\u1ea5t \u0111\u01a1n thu\u1ea7n ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi x\u1ea1 tr\u1ecb nh\u1eb1m gi\u1ea3m tri\u1ec7u ch\u1ee9ng, duy tr\u00ec ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng.<\/p>\n

                    * M\u1ed9t s\u1ed1 ph\u00e1c \u0111\u1ed3 h\u00f3a tr\u1ecb<\/p>\n

                    Ph\u00e1c \u0111\u1ed3 TIP<\/strong><\/p>\n

                    Paclitaxel 175mg\/m2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1.<\/p>\n

                    Ifosfamide 1.200mg\/m2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1-3.<\/p>\n

                    Cisplatin 25mg\/m2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1-3.<\/p>\n

                    Chu k\u1ef3 3-4 tu\u1ea7n<\/p>\n

                    Ph\u00e1c \u0111\u1ed3 CF<\/strong><\/p>\n

                    Cisplatin 70-80mg\/m2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1.<\/p>\n

                    5-FU 800-1.000mg\/m2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1-4 ho\u1eb7c ng\u00e0y 2-5.<\/p>\n

                    Chu k\u1ef3 3-4 tu\u1ea7n<\/p>\n

                    *\u0110i\u1ec1u tr\u1ecb t\u00e2n b\u1ed5 tr\u1ee3<\/p>\n

                    Ch\u1ec9 \u0111\u1ecbnh: T4<\/sub> ho\u1eb7c Tx<\/sub>, N2-3<\/sub>, M0<\/sub>, ho\u1eb7c \u22654 h\u1ea1ch b\u1eb9n di c\u0103n.<\/p>\n

                    Ph\u00e1c \u0111\u1ed3: TIP x 4 chu k\u1ef3.<\/p>\n

                    *\u0110i\u1ec1u tr\u1ecb b\u1ed5 tr\u1ee3<\/p>\n

                    Ch\u1ec9 \u0111\u1ecbnh: di c\u0103n h\u1ea1ch ch\u1eadu ho\u1eb7c h\u1ea1ch ph\u00e1 v\u1ee1 v\u1ecf ho\u1eb7c di c\u0103n h\u1ea1ch b\u1eb9n 2 b\u00ean, ho\u1eb7c h\u1ea1ch di c\u0103n \u22654cm.<\/p>\n

                    Ph\u00e1c \u0111\u1ed3: TIP ho\u1eb7c CF.<\/p>\n

                    *\u0110i\u1ec1u tr\u1ecb h\u00f3a x\u1ea1 tr\u1ecb \u0111\u1ed3ng th\u1eddi<\/p>\n

                    Ph\u00e1c \u0111\u1ed3: Cisplatin ho\u1eb7c capecitabine.<\/p>\n

                    *\u0110i\u1ec1u tr\u1ecb t\u00e1i ph\u00e1t di c\u0103n<\/p>\n

                    Ph\u00e1c \u0111\u1ed3: TIP, CF.<\/p>\n

                    2.2.4. \u0110i\u1ec1u tr\u1ecb b\u1ec7nh t\u00e1i ph\u00e1t<\/h4>\n

                    T\u00e1i ph\u00e1t t\u1ea1i ch\u1ed7 sau m\u1ed5 b\u1ea3o t\u1ed3n d\u01b0\u01a1ng v\u1eadt c\u1ea7n c\u1eaft c\u1ee5t d\u01b0\u01a1ng v\u1eadt. Di\u1ec7n c\u1eaft c\u00e1ch xa u t\u00e1i ph\u00e1t \u00edt nh\u1ea5t 2cm v\u00e0 ph\u1ea3i \u0111\u01b0\u1ee3c ki\u1ec3m tra b\u1eb1ng m\u1eaft v\u00e0 b\u1eb1ng sinh thi\u1ebft t\u1ee9c th\u00ec, n\u1ebfu c\u00f2n s\u00f3t t\u1ebf b\u00e0o ung th\u01b0 ph\u1ea3i c\u1eaft l\u1ea1i cho s\u1ea1ch. T\u00e1i ph\u00e1t sau c\u1eaft c\u1ee5t d\u01b0\u01a1ng v\u1eadt, c\u1ea7n c\u1eaft to\u00e0n b\u1ed9 b\u1ed9 ph\u1eadn sinh d\u1ee5c ngo\u00e0i. T\u00e1i ph\u00e1t sau c\u1eaft to\u00e0n b\u1ed9 b\u1ed9 ph\u1eadn sinh d\u1ee5c ngo\u00e0i c\u00f3 th\u1ec3 kh\u00f4ng can thi\u1ec7p ho\u1eb7c ph\u1eabu thu\u1eadt s\u1ea1ch s\u1ebd.<\/p>\n

                    T\u00e1i ph\u00e1t t\u1ea1i h\u1ea1ch c\u1ea7n c\u1eaft b\u1ecf kh\u1ed1i h\u1ea1ch to. N\u1ebfu tr\u01b0\u1edbc \u0111\u00e2y ch\u01b0a x\u1ea1 tr\u1ecb th\u00ec n\u00ean x\u1ea1 tr\u1ecb sau m\u1ed5.<\/p>\n

                     <\/p>\n","protected":false},"excerpt":{"rendered":"

                    Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt l\u00e0 b\u1ec7nh l\u00fd hi\u1ebfm g\u1eb7p nh\u01b0ng l\u1ea1i nguy hi\u1ec3m \u0111\u1ed1i v\u1edbi nam gi\u1edbi. \u0110i\u1ec1u tr\u1ecb ung th\u01b0 d\u01b0\u01a1ng v\u1eadt gi\u00fap t\u0103ng c\u01a1 h\u1ed9i ch\u1eefa kh\u1ecfi b\u1ec7nh v\u00e0 n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n. B\u00e0i vi\u1ebft sau \u0111\u00e2y s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n c\u1ee7a ung th\u01b0 d\u01b0\u01a1ng […]<\/p>\n","protected":false},"author":43,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[],"yoast_head":"\nUng th\u01b0 d\u01b0\u01a1ng v\u1eadt: H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb theo b\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ung th\u01b0 d\u01b0\u01a1ng v\u1eadt theo b\u1ed9 Y t\u1ebf bao g\u1ed3m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p: \u0111i\u1ec1u tri\u1ec7t c\u0103n b\u1eb1ng ph\u1eabu thu\u1eadt, h\u00f3a tr\u1ecb v\u00e0 x\u1ea1 tr\u1ecb.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ung th\u01b0 d\u01b0\u01a1ng v\u1eadt: H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb theo b\u1ed9 Y t\u1ebf - 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