{"id":29335,"date":"2023-04-29T13:50:11","date_gmt":"2023-04-29T06:50:11","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29335"},"modified":"2023-05-14T10:16:06","modified_gmt":"2023-05-14T03:16:06","slug":"dieu-tri-ung-thu-vu-xam-nhap-hoa-tri-bo-tro-tan-bo-tro","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/dieu-tri-ung-thu-vu-xam-nhap-hoa-tri-bo-tro-tan-bo-tro\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa x\u00e2m nh\u1eadp: ho\u00e1 tr\u1ecb, b\u1ed5 tr\u1ee3, t\u00e2n b\u1ed5 tr\u1ee3"},"content":{"rendered":"<p><strong><a href=\"https:\/\/www.vinmec.com\/vi\/ung-buou-xa-tri\/thong-tin-suc-khoe\/nhung-thong-tin-can-biet-truoc-khi-quyet-dinh-dieu-tri-ung-thu\/\"> Ung th\u01b0 v\u00fa<\/a> (UTV) l\u00e0 lo\u1ea1i ung th\u01b0 th\u01b0\u1eddng g\u1eb7p v\u00e0 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong h\u00e0ng \u0111\u1ea7u do ung th\u01b0 \u1edf ph\u1ee5 n\u1eef tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. M\u1ed7i n\u0103m n\u01b0\u1edbc ta c\u00f3 kho\u1ea3ng h\u01a1n 15.230 ph\u1ee5 n\u1eef m\u1edbi m\u1eafc v\u00e0 h\u01a1n 6.100 ng\u01b0\u1eddi t\u1eed vong do UTV. Ung th\u01b0 v\u00fa nam chi\u1ebfm kho\u1ea3ng 1% c\u00e1c tr\u01b0\u1eddng h\u1ee3p UTV. Vi\u1ec7c s\u1eed d\u1ee5ng m\u1ed9t hay nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00eau tr\u00ean c\u0103n c\u1ee9 v\u00e0o giai \u0111o\u1ea1n v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh h\u1ecdc tr\u00ean t\u1eebng b\u1ec7nh nh\u00e2n c\u1ee5 th\u1ec3. B\u00e0i vi\u1ebft d\u01b0\u1edbi d\u00e2y s\u1ebd h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb tr\u1ecb b\u1eb1ng h\u00f3a tr\u1ecb v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00edch b\u1ed5 tr\u1ee3, t\u00e2n b\u1ed5 tr\u1ee3 ung th\u01b0 v\u00fa x\u00e2m nh\u1eadp <\/strong><\/p>\n<h2>1. \u0110i\u1ec1u tr\u1ecb trong tr\u01b0\u1eddng h\u1ee3p HER2 \u00e2m t\u00ednh<\/h2>\n<h4>1.1 C\u00e1c ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb \u01b0u ti\u00ean<\/h4>\n<ul>\n<li>4AC (doxorubicin\/cyclophosphamide) li\u1ec1u d\u00e0y -&gt; 4P (paclitaxel) li\u1ec1u d\u00e0y (chu k\u1ef3 2 tu\u1ea7n). K\u00e8m theo thu\u1ed1c k\u00edch th\u00edch d\u00f2ng b\u1ea1ch c\u1ea7u h\u1ea1t (G-CSF) d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t.<\/li>\n<\/ul>\n<p>+ Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<figure id=\"attachment_28313\" aria-describedby=\"caption-attachment-28313\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-28313\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-11-1-300x300.png\" alt=\"Ung th\u01b0 v\u00fa\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-11-1-300x300.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-11-1-1024x1024.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-11-1-150x150.png 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-11-1-768x768.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-11-1-1536x1536.png 1536w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-11-1.png 2048w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-28313\" class=\"wp-caption-text\">Ung th\u01b0 v\u00fa<\/figcaption><\/figure>\n<ul>\n<li><strong>Chu k\u1ef3 14 ng\u00e0y x 4 chu k\u1ef3. Theo sau:<\/strong><\/li>\n<\/ul>\n<p>+ Paclitaxel 175 mg\/m<sup>2<\/sup>\/tu\u1ea7n, truy\u1ec1n t\u0129nh m\u1ea1ch trong 3 gi\u1edd, chu k\u1ef3 14 ng\u00e0y x 4 chu k\u1ef3<\/p>\n<ul>\n<li>4AC (doxorubicin\/cyclophosphamide) li\u1ec1u d\u00e0y -&gt;\u00a0 12 tu\u1ea7n paclitaxel. K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t khi d\u00f9ng AC li\u1ec1u d\u00e0y.<\/li>\n<\/ul>\n<p>+ Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>Chu k\u1ef3 14 ng\u00e0y x 4 chu k\u1ef3. Theo sau:<\/p>\n<p>+ Paclitaxel 80mg\/m<sup>2<\/sup>\/tu\u1ea7n, truy\u1ec1n t\u0129nh m\u1ea1ch trong 1 gi\u1edd, chu k\u1ef3 m\u1ed7i tu\u1ea7n x 12 tu\u1ea7n<\/p>\n<ul>\n<li>4AC (doxorubicin\/cyclophosphamide) -&gt; 4P (paclitaxel), chu k\u1ef3 3 tu\u1ea7n.<\/li>\n<\/ul>\n<p>+ Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<ul>\n<li><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3. Theo sau:<\/strong><\/li>\n<\/ul>\n<p>+ Paclitaxel 175 mg\/m<sup>2<\/sup>\/tu\u1ea7n, truy\u1ec1n t\u0129nh m\u1ea1ch trong 3 gi\u1edd, chu k\u1ef3 21ng\u00e0y x 4 chu k\u1ef3<\/p>\n<ul>\n<li>TC (docetaxel\/cyclophosphamide). K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t.<\/li>\n<\/ul>\n<p>+ Doxetaxel 75mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3.<\/p>\n<h4>1.2 C\u00e1c ph\u00e1c \u0111\u1ed3\u00a0\u0111i\u1ec1u tr\u1ecb kh\u00e1c<\/h4>\n<ul>\n<li>AC (doxorubicin\/cyclophosphamide) chu k\u1ef3 3 tu\u1ea7n.<\/li>\n<\/ul>\n<p>+ Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y, \u0111i\u1ec1u tr\u1ecb 4-6 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>AC (doxorubicin\/cyclophosphamide) chu k\u1ef3 2 tu\u1ea7n. K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t<\/li>\n<\/ul>\n<p>+ Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>Cyclophosphamide 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 14 ng\u00e0y, \u0111i\u1ec1u tr\u1ecb 4-6 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>4AC (doxorubicin\/cyclophosphamide) chu k\u1ef3 2-3 tu\u1ea7n &#8211; 4D (docetaxel) chu k\u1ef3<\/li>\n<\/ul>\n<p>3 tu\u1ea7n.<\/p>\n<p>+ Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 14 ho\u1eb7c 21 ng\u00e0y x 4 chu k\u1ef3. Theo sau:<\/strong><\/p>\n<p>+ Docetaxel 100mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1. Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3.<\/p>\n<ul>\n<li>4AC (doxorubicin\/cyclophosphamide) chu k\u1ef3 3 tu\u1ea7n 0 12 tu\u1ea7n paclitaxel<\/li>\n<\/ul>\n<p>+ Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3. Theo sau:<\/strong><\/p>\n<p>+ Paclitaxel 80mg\/m<sup>2<\/sup>\/tu\u1ea7n, truy\u1ec1n t\u0129nh m\u1ea1ch 1 gi\u1edd, cho \u0111\u1ebfn 12 tu\u1ea7n.<\/p>\n<p>EC (epirubicin\/cyclophosphamide)<\/p>\n<p>+ Epirubicin 100mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 830mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 8 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>4EC (epirubicin\/cyclophosphamide) -&gt; 4D (Docetaxel)<\/li>\n<\/ul>\n<p>+ Epirubicin 90mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3.<\/strong><\/p>\n<p>+ Docetaxel 100 mg\/m<sup>2<\/sup> da, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3<\/strong><\/p>\n<ul>\n<li>FAC (5FU\/doxorubicin\/cyclophosphamide)<\/li>\n<\/ul>\n<p>+ Fluorouracil 500 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1, 4 ho\u1eb7c ng\u00e0y 1, 8<\/p>\n<p>+ Doxorubicin 50 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 500 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 6 chu k\u1ef3<\/strong><\/p>\n<ul>\n<li>4FAC (5FU\/doxorubicin\/cyclophosphamide) -&gt; 4P (paclitaxel).<\/li>\n<\/ul>\n<p>+ Fluorouracil 500 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Doxorubicin 50 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 500 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3. Theo sau<\/strong><\/p>\n<p>+ Paclitaxel 225 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1.<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3<\/strong><\/p>\n<ul>\n<li>4FAC (5FU\/doxorubicin\/cyclophosphamide) -&gt; 12 tu\u1ea7n paclitaxel<\/li>\n<\/ul>\n<p>+ Fluorouracil 500 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Doxorubicin 50 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 500 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3<\/strong><\/p>\n<p>+ Paclitaxel 80mg\/m<sup>2<\/sup>\/tu\u1ea7n, truy\u1ec1n t\u0129nh m\u1ea1ch 1 gi\u1edd, cho \u0111\u1ebfn 12 tu\u1ea7n.<\/p>\n<ul>\n<li>FEC (5FU\/epirubicin\/cyclophosphamide) chu k\u1ef3 3 tu\u1ea7n.<\/li>\n<\/ul>\n<p>+ Fluorouracil 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Epirubicin 90mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1 3FEC (5FU\/epirubicin\/cyclophosphamide) -&gt; 3D (docetaxel).<\/p>\n<p>+ Fluorouracil 500mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Epirubicin 100mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 500mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 3 chu k\u1ef3. Theo sau:<\/strong><\/p>\n<p>+ Docetaxel 100mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1.<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 3 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>4FEC (5FU\/epirubicin\/cyclophosphamide) -&gt; 4P (paclitaxel)<\/li>\n<\/ul>\n<p>+ Fluorouracil 500mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1,3<\/p>\n<p>+ Epirubicin 75mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 500mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3. Theo sau:<\/strong><\/p>\n<p>+ Paclitaxel 225 mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1.<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>4FEC (5FU\/epirubicin\/cyclophosphamide) -&gt; 8 tu\u1ea7n paclitaxel<\/li>\n<\/ul>\n<p>+ Fluorouracil 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Epirubicin 90mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 600mg\/m2, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1 Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3. Theo sau:<\/p>\n<p>+ Paclitaxel 100mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1.<\/p>\n<p><strong>Chu k\u1ef3 7 ng\u00e0y x 8 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>TAC (docetaxel\/doxorubicin\/cyclophosphamide) chu k\u1ef3 3 tu\u1ea7n. K\u00e8m G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t.<\/li>\n<\/ul>\n<p>+ Doxorubicin 50mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1<\/p>\n<p>+ Docetaxel 75mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1<\/p>\n<p>+ Cyclophosphamide 500mg\/m2, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y, \u0111i\u1ec1u tr\u1ecb 6 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>CAF (cyclophosphamide\/doxorubicin\/5FU)<\/li>\n<\/ul>\n<p>+ Cyclophosphamide 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>Doxorubicin 60mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1<\/p>\n<p>+ Fluorouracil 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 28 ng\u00e0y x 4 chu k\u1ef3<\/strong><\/p>\n<p>CMF (cyclophosphamide\/methotrexate\/5FU)<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0 D\u01b0\u1edbi 60 tu\u1ed5i.<\/strong><\/p>\n<p>+ Cyclophosphamide 100mg\/m<sup>2<\/sup>, u\u1ed1ng, ng\u00e0y 1-14<\/p>\n<p>+ Methotrexate 40mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1-8<\/p>\n<p>+ 5-fluorouracil 600mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1, 8<\/p>\n<p><strong>Chu k\u1ef3 28 ng\u00e0y, 6 chu k\u1ef3.<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0 Tr\u00ean 60 tu\u1ed5i.<\/strong><\/p>\n<p>+ Cyclophosphamide 100mg\/m<sup>2<\/sup>, u\u1ed1ng, ng\u00e0y 1-14<\/p>\n<p>+ Methotrexate 30mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1, 8<\/p>\n<p>+ 5-fluorouracil 400mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch, ng\u00e0y 1, 8<\/p>\n<p><strong>Chu k\u1ef3 28 ng\u00e0y, \u0111i\u1ec1u tr\u1ecb 6 \u0111\u1ee3t.<\/strong><\/p>\n<ul>\n<li>Paclitaxel + carboplatin h\u00e0ng tu\u1ea7n<\/li>\n<\/ul>\n<p>+ \u00a0Paclitaxel 80mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1,8,15<\/p>\n<p>+ Carboplatin AUC 6, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 4 chu k\u1ef3.<\/strong><\/p>\n<ul>\n<li>Docetaxel + carboplatin<\/li>\n<\/ul>\n<p>+ Docetaxel 75mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Carboplatin AUC 6, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1 Chu k\u1ef3 21 ng\u00e0y x 4-6 chu k\u1ef3.<\/p>\n<ul>\n<li>Paclitaxel \u0111\u01a1n thu\u1ea7n x 12 tu\u1ea7n<\/li>\n<\/ul>\n<p>+ Paclitaxel 80mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1 m\u1ed7i tu\u1ea7n x 12 tu\u1ea7n.<\/p>\n<ul>\n<li>B\u1ec7nh c\u00f2n t\u1ed3n t\u1ea1i tr\u00ean m\u00f4 b\u1ec7nh h\u1ecdc sau h\u00f3a tr\u1ecb t\u00e2n b\u1ed5 tr\u1ee3 c\u00f3 anthracyclin, taxane, alkyl h\u00f3a:<\/li>\n<\/ul>\n<p>+ Capecitabine 2.000-2500mg\/m<sup>2<\/sup>, u\u1ed1ng, ng\u00e0y 1-14, chu k\u1ef3 3 tu\u1ea7n x 6-8 chu k\u1ef3.<\/p>\n<h2><strong>2. Tr\u01b0\u1eddng h\u1ee3p HER2 d\u01b0\u01a1ng t\u00ednh <\/strong><\/h2>\n<p>S\u1eed d\u1ee5ng h\u00f3a ch\u1ea5t k\u1ebft h\u1ee3p kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng kh\u00e1ng HER2 nh\u01b0 trastuzumab pertuzumab, T-DM1 trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 v\u00fa c\u00f3 y\u1ebfu t\u1ed1 ph\u00e1t tri\u1ec3n bi\u1ec3u m\u00f4 HER2 d\u01b0\u01a1ng t\u00ednh.<\/p>\n<ul>\n<li>Trastuzumab (l\u1ecbch truy\u1ec1n h\u00e0ng tu\u1ea7n): Li\u1ec1u t\u1ea3i 4mg\/kg, truy\u1ec1n t\u0129nh m\u1ea1ch trong 90 ph\u00fat, chu k\u1ef3 1. Sau \u0111\u00f3 2mg\/kg, truy\u1ec1n t\u0129nh m\u1ea1ch trong kho\u1ea3ng 30 ph\u00fat (n\u1ebfu b\u1ec7nh nh\u00e2n dung n\u1ea1p t\u1ed1t v\u1edbi chu k\u1ef3 \u0111\u1ea7u ti\u00ean) h\u00e0ng tu\u1ea7n \u0111\u1ee7 1 n\u0103m.<\/li>\n<li>Trastuzumab (l\u1ecbch truy\u1ec1n m\u1ed7i 3 tu\u1ea7n): Li\u1ec1u t\u1ea3i 8mg\/kg, truy\u1ec1n t\u0129nh m\u1ea1ch trong 90 ph\u00fat chu k\u1ef3 1 theo sau b\u1edfi 6mg\/kg, truy\u1ec1n t\u0129nh m\u1ea1ch trong kho\u1ea3ng 30 ph\u00fat (n\u1ebfu b\u1ec7nh nh\u00e2n dung n\u1ea1p t\u1ed1t v\u1edbi chu k\u1ef3 \u0111\u1ea7u ti\u00ean) c\u00e1c chu k\u1ef3 ti\u1ebfp theo, chu k\u1ef3 21 ng\u00e0y \u0111\u1ee7 1 n\u0103m.<\/li>\n<li>Trastuzumab ti\u00eam d\u01b0\u1edbi da: li\u1ec1u c\u1ed1 \u0111\u1ecbnh l\u00e0 600mg kh\u00f4ng k\u1ec3 c\u00e2n n\u1eb7ng c\u1ee7a b\u1ec7nh nh\u00e2n, kh\u00f4ng c\u1ea7n li\u1ec1u t\u1ea3i, ti\u00eam trong kho\u1ea3ng 2-5 ph\u00fat, chu k\u1ef3 21 ng\u00e0y. D\u1ea1ng d\u00f9ng ti\u00eam d\u01b0\u1edbi da \u0111\u01b0\u1ee3c ph\u00ea chu\u1ea9n s\u1eed d\u1ee5ng trong c\u00e1c ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng t\u1ef1 nh\u01b0 d\u1ea1ng truy\u1ec1n t\u0129nh m\u1ea1ch.<\/li>\n<li>Pertuzumab: li\u1ec1u kh\u1edfi \u0111\u1ea7u 840mg, truy\u1ec1n t\u0129nh m\u1ea1ch trong 60 ph\u00fat \u0111\u1ed1i v\u1edbi chu k\u1ef3 1, ti\u1ebfp theo li\u1ec1u 420mg, truy\u1ec1n t\u0129nh m\u1ea1ch 30-60 ph\u00fat \u0111\u1ed1i v\u1edbi c\u00e1c chu k\u1ef3 ti\u1ebfp theo. Chu k\u1ef3 21 ng\u00e0y \u0111\u1ee7 1 n\u0103m. S\u1eed d\u1ee5ng chung v\u1edbi trastuzumab (Truy\u1ec1n t\u0129nh m\u1ea1ch ho\u1eb7c ti\u00eam d\u01b0\u1edbi da) v\u00e0 h\u00f3a tr\u1ecb.<\/li>\n<\/ul>\n<h4>2.1 C\u00e1c ph\u00e1c \u0111\u1ed3 \u01b0u ti\u00ean<\/h4>\n<ul>\n<li>4AC (doxorubicin\/cyclophosphamide) -&gt; 4P (paclitaxel) chu k\u1ef3 2 tu\u1ea7n + trastuzumab. K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t.<\/li>\n<li>4AC (doxorubicin\/cyclophosphamide) -&gt; 4P (paclitaxel) chu k\u1ef3 3 tu\u1ea7n + trastuzumab.<\/li>\n<li>4AC (doxorubicin\/cyclophosphamide) li\u1ec1u d\u00e0y -&gt; 12 tu\u1ea7n paclitaxel + trastuzumab. K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t khi d\u00f9ng AC li\u1ec1u d\u00e0y.<\/li>\n<li>4AC (doxorubicin\/cyclophosphamide) -&gt;12 tu\u1ea7n paclitaxel + trastuzumab.<\/li>\n<li>4AC (doxorubicin\/cyclophosphamide) -&gt; 4P (paclitaxel) + trastuzumab + pertuzumab<\/li>\n<li>4AC (doxorubicin\/cyclophosphamide) -&gt; 12 tu\u1ea7n paclitaxel + trastuzumab + pertuzumab<\/li>\n<\/ul>\n<ul>\n<li>Paclitaxel + trastuzumab<\/li>\n<li>TCH (docetaxel\/carboplatin\/trastuzumab). K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t.<\/li>\n<\/ul>\n<p>+ Doxetaxel 75mg\/m<sup>2<\/sup>, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p>+ Carboplatin AUC 6, truy\u1ec1n t\u0129nh m\u1ea1ch ng\u00e0y 1<\/p>\n<p><strong>Chu k\u1ef3 21 ng\u00e0y x 6 chu k\u1ef3. K\u1ebft h\u1ee3p v\u1edbi Trastuzumab<\/strong><\/p>\n<ul>\n<li>TCH (docetaxel\/carboplatin\/trastuzumab) + pertuzumab. K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t.<\/li>\n<\/ul>\n<p><strong>2.2 C\u00e1c ph\u00e1c \u0111\u1ed3 kh\u00e1c <\/strong><\/p>\n<ul>\n<li>AC (doxorubicin\/cyclophosphamide) -&gt; docetaxel + trastuzumab.<\/li>\n<li>AC (doxorubicin\/cyclophosphamide) -&gt;\u00a0 docetaxel + trastuzumab + pertuzumab.<\/li>\n<\/ul>\n<p>+ 4FAC (5FU\/doxorubicin\/cyclophosphamide) -&gt;\u00a0 4P + trastuzumab<\/p>\n<p>4FAC (5FU\/doxorubicin\/cyclophosphamide) -&gt; 12 tu\u1ea7n paclitaxel + trastuzumab<\/p>\n<p>+ 3FEC (5FU\/epirubicin\/cyclophosphamide) -&gt;3D + trastuzumab<\/p>\n<p>+ 4FEC (5FU\/epirubicin\/cyclophosphamide)-&gt; 4P + trastuzumab<\/p>\n<p>+ 4EC (epirubicin\/cyclophosphamide) -&gt; 4P + trastuzumab<\/p>\n<p>+ Docetaxel\/cyclophosphamide\/trastuzumab. K\u00e8m theo G-CSF d\u1ef1 ph\u00f2ng nguy\u00ean ph\u00e1t.<\/p>\n<p>+ C\u00e1c ph\u00e1c \u0111\u1ed3 c\u00f3 trastuzumab: th\u1eddi gian s\u1eed d\u1ee5ng trastuzumab chu\u1ea9n l\u00e0 1 n\u0103m.<\/p>\n<p>Tr\u01b0\u1eddng h\u1ee3p nguy c\u01a1 th\u1ea5p ho\u1eb7c b\u1ec7nh nh\u00e2n c\u00f3 \u0111i\u1ec1u ki\u1ec7n kinh t\u1ebf h\u1ea1n ch\u1ebf, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng trastuzumab v\u1edbi th\u1eddi gian ng\u1eafn h\u01a1n, t\u1ed1i thi\u1ec3u 9 tu\u1ea7n.<\/p>\n<p>+ Tr\u01b0\u1eddng h\u1ee3p \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb t\u00e2n b\u1ed5 tr\u1ee3 (v\u1edbi h\u00f3a tr\u1ecb \u0111\u1ee7 s\u1ed1 \u0111\u1ee3t v\u00e0 kh\u00e1ng HER2):<\/p>\n<ul>\n<li>Kh\u00f4ng c\u00f2n ung th\u01b0 tr\u00ean m\u00f4 b\u1ec7nh h\u1ecdc sau ph\u1eabu thu\u1eadt: trastuzumab (c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p pertuzumab ho\u1eb7c kh\u00f4ng) cho \u0111\u1ee7 1 n\u0103m.<\/li>\n<li>B\u1ec7nh c\u00f2n t\u1ed3n t\u1ea1i sau \u0111i\u1ec1u tr\u1ecb t\u00e2n b\u1ed5 tr\u1ee3: T-DM1 (trastuzumab-emtansine) x 14 \u0111\u1ee3t. T-DM1: li\u1ec1u 3,6mg\/kg chu k\u1ef3 21 ng\u00e0y cho \u0111\u1ebfn khi \u0111\u1ee7 14 chu k\u1ef3. Li\u1ec1u kh\u1edfi \u0111\u1ea7u truy\u1ec1n t\u0129nh m\u1ea1ch trong 90 ph\u00fat. C\u00e1c li\u1ec1u sau c\u00f3 th\u1ec3 truy\u1ec1n trong 30 ph\u00fat n\u00eau b\u1ec7nh nh\u00e2n dung n\u1ea1p t\u1ed1t v\u1edbi li\u1ec1u kh\u1edfi \u0111\u1ea7u. N\u1ebfu kh\u00f4ng dung n\u1ea1p ho\u1eb7c kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng T-DM1: trastuzumab (c\u00f3 th\u1ec3 k\u1ebft h\u1ee3p pertuzumab ho\u1eb7c kh\u00f4ng) cho \u0111\u1ee7 1 n\u0103m.<\/li>\n<\/ul>\n<p>Ngu\u1ed3n tham kh\u1ea3o: Ph\u00e1c \u0111\u1ed3 b\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ung th\u01b0 v\u00fa (UTV) l\u00e0 lo\u1ea1i ung th\u01b0 th\u01b0\u1eddng g\u1eb7p v\u00e0 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong h\u00e0ng \u0111\u1ea7u do ung th\u01b0 \u1edf ph\u1ee5 n\u1eef tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. M\u1ed7i n\u0103m n\u01b0\u1edbc ta c\u00f3 kho\u1ea3ng h\u01a1n 15.230 ph\u1ee5 n\u1eef m\u1edbi m\u1eafc v\u00e0 h\u01a1n 6.100 ng\u01b0\u1eddi t\u1eed vong do UTV. Ung th\u01b0 v\u00fa nam chi\u1ebfm kho\u1ea3ng [&hellip;]<\/p>\n","protected":false},"author":49,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[13,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa x\u00e2m nh\u1eadp: ho\u00e1 tr\u1ecb, b\u1ed5 tr\u1ee3, t\u00e2n b\u1ed5 tr\u1ee3 - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa x\u00e2m nh\u1eadp: ho\u00e1 tr\u1ecb, b\u1ed5 tr\u1ee3, t\u00e2n b\u1ed5 tr\u1ee3 g\u1ed3m c\u00e1c tr\u01b0\u1eddng h\u01a1p HER2 \u00e2m t\u00ednh, hER2 \u00e2m t\u00ednh, c\u00e1c ph\u00e1c \u0111\u1ed3 \u01b0u ti\u00ean\" \/>\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=\"\u0110i\u1ec1u tr\u1ecb ung th\u01b0 v\u00fa x\u00e2m nh\u1eadp: ho\u00e1 tr\u1ecb, b\u1ed5 tr\u1ee3, t\u00e2n b\u1ed5 tr\u1ee3 - 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