{"id":31854,"date":"2023-05-04T21:34:06","date_gmt":"2023-05-04T14:34:06","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31854"},"modified":"2023-05-04T21:34:06","modified_gmt":"2023-05-04T14:34:06","slug":"ung-thu-tuyen-giap-huong-dan-dieu-tri-theo-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/ung-thu-tuyen-giap-huong-dan-dieu-tri-theo-bo-y-te\/","title":{"rendered":"Ung th\u01b0 tuy\u1ebfn gi\u00e1p: H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb theo b\u1ed9 Y t\u1ebf"},"content":{"rendered":"<p>Ung th\u01b0 tuy\u1ebfn gi\u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf n\u1eef gi\u1edbi v\u00e0 \u0111ang ng\u00e0y c\u00e0ng t\u0103ng trong s\u1ed1 nam gi\u1edbi. \u0110i\u1ec1u tr\u1ecb ung th\u01b0 tuy\u1ebfn gi\u00e1p l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh l\u00e2u d\u00e0i t\u00f9y thu\u1ed9c v\u00e0o giai \u0111o\u1ea1n b\u1ec7nh, \u01b0u ti\u00ean c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 ph\u00e1c \u0111\u1ed3 c\u1ee7a b\u00e1c s\u0129. B\u00e0i vi\u1ebft sau \u0111\u00e2y s\u1ebd gi\u1edbi thi\u1ec7u v\u1ec1 h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ung th\u01b0 tuy\u1ebfn gi\u00e1p theo b\u1ed9 Y t\u1ebf.<\/p>\n<h2>1. \u0110\u1ea1i c\u01b0\u01a1ng v\u1ec1 ung th\u01b0 tuy\u1ebfn gi\u00e1p<\/h2>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/benh\/ung-thu-tuyen-giap-3195\/\">Ung th\u01b0 tuy\u1ebfn gi\u00e1p<\/a> x\u1ea3y ra khi c\u00e1c t\u1ebf b\u00e0o tuy\u1ebfn gi\u00e1p ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng v\u00e0 ph\u00e2n chia m\u1ea5t ki\u1ec3m so\u00e1t d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e0nh kh\u1ed1i u \u00e1c t\u00ednh. Tuy\u1ebfn gi\u00e1p l\u00e0 m\u1ed9t tuy\u1ebfn c\u00f3 h\u00ecnh con b\u01b0\u1edbm, n\u1eb1m \u1edf ph\u00eda tr\u01b0\u1edbc c\u1ed5 v\u00e0 l\u00e0 tuy\u1ebfn n\u1ed9i ti\u1ebft quan tr\u1ecdng nh\u1ea5t trong c\u01a1 th\u1ec3. V\u1eady n\u00ean c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 ph\u00e1t tri\u1ec3n trong tuy\u1ebfn gi\u00e1p c\u00f3 th\u1ec3 l\u00e0m r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng ti\u1ebft hormone c\u1ee7a tuy\u1ebfn gi\u00e1p d\u1eabn \u0111\u1ebfn c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1ec7t m\u1ecfi, thay \u0111\u1ed5i c\u00e2n n\u1eb7ng hay t\u00e2m tr\u1ea1ng th\u01b0\u1eddng xuy\u00ean thay \u0111\u1ed5i th\u1ea5t th\u01b0\u1eddng.<\/p>\n<p>Ung th\u01b0 tuy\u1ebfn gi\u00e1p l\u00e0 lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn. Theo GLOBOCAN 2020, ung th\u01b0 tuy\u1ebfn gi\u00e1p \u0111\u1ee9ng h\u00e0ng th\u1ee9 10 trong t\u1ed5ng s\u1ed1 c\u00e1c ca ung th\u01b0 \u1edf c\u1ea3 hai gi\u1edbi v\u1edbi kho\u1ea3ng 586.202 ca m\u1edbi m\u1eafc h\u00e0ng n\u0103m, \u0111\u1ee9ng th\u1ee9 5 trong s\u1ed1 c\u00e1c lo\u1ea1i ung th\u01b0 \u1edf n\u1eef gi\u1edbi v\u00e0 \u0111\u1ee9ng th\u1ee9 15 trong s\u1ed1 c\u00e1c lo\u1ea1i ung th\u01b0 \u1edf nam gi\u1edbi.<\/p>\n<p>Ung th\u01b0 tuy\u1ebfn gi\u00e1p chia l\u00e0m hai nh\u00f3m kh\u00e1c nhau v\u1ec1 l\u00e2m s\u00e0ng v\u00e0 ti\u00ean l\u01b0\u1ee3ng, \u0111\u00f3 l\u00e0 ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 bi\u1ec7t h\u00f3a v\u00e0 ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 kh\u00f4ng bi\u1ec7t h\u00f3a. Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 bi\u1ec7t h\u00f3a ti\u1ebfn tri\u1ec3n ch\u1eadm, ti\u00ean l\u01b0\u1ee3ng t\u1ed1t. Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 kh\u00f4ng bi\u1ec7t h\u00f3a ti\u1ebfn tri\u1ec3n nhanh, b\u1ec7nh nh\u00e2n th\u01b0\u1eddng \u0111\u1ebfn vi\u1ec7n khi kh\u1ed1i u v\u00e0 h\u1ea1ch \u0111\u00e3 x\u00e2m l\u1ea5n r\u1ed9ng, kh\u00f4ng c\u1eaft b\u1ecf \u0111\u01b0\u1ee3c, di c\u0103n xa s\u1edbm v\u00e0 ti\u00ean l\u01b0\u1ee3ng x\u1ea5u.<\/p>\n<figure id=\"attachment_31846\" aria-describedby=\"caption-attachment-31846\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-31846\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/20200526_155453_740159_fc.max-1800x1800-1-300x219.png\" alt=\"minh-hoa-ung-thu-tuyen-giap\" width=\"300\" height=\"219\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/20200526_155453_740159_fc.max-1800x1800-1-300x219.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/20200526_155453_740159_fc.max-1800x1800-1.png 640w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-31846\" class=\"wp-caption-text\">Ung th\u01b0 tuy\u1ebfn gi\u00e1p x\u1ea3y ra khi c\u00e1c t\u1ebf b\u00e0o tuy\u1ebfn gi\u00e1p ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng v\u00e0 ph\u00e2n chia m\u1ea5t ki\u1ec3m so\u00e1t<\/figcaption><\/figure>\n<h2>2. C\u00e1c y\u1ebfu t\u1ed1 l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc ung th\u01b0 tuy\u1ebfn gi\u00e1p<\/h2>\n<p>Hi\u1ec7n nay ng\u01b0\u1eddi ta ch\u01b0a t\u00ecm th\u1ea5y nguy\u00ean nh\u00e2n r\u00f5 r\u00e0ng trong c\u01a1 ch\u1ebf sinh b\u1ec7nh ung th\u01b0 tuy\u1ebfn gi\u00e1p. Tuy nhi\u00ean ng\u01b0\u1eddi ta th\u1ea5y c\u00f3 m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 sau l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng m\u1eafc ung th\u01b0 tuy\u1ebfn gi\u00e1p bao g\u1ed3m:<\/p>\n<ul>\n<li>Ti\u1ec1n s\u1eed x\u1ea1 tr\u1ecb v\u00f9ng c\u1ed5 tr\u01b0\u1edbc \u0111\u00f3<\/li>\n<li>V\u1ee5 th\u1ea3 bom nguy\u00ean t\u1eed c\u1ee7a M\u1ef9 \u1edf Hiroshima v\u00e0 Nagasaki (Nh\u1eadt B\u1ea3n) v\u00e0 sau v\u1ee5 n\u1ed5 nh\u00e0 m\u00e1y \u0111i\u1ec7n nguy\u00ean t\u1eed Chernobyl<\/li>\n<li>Ti\u1ec1n s\u1eed c\u00f3 m\u1eafc b\u1ec7nh u \u0111\u01a1n nh\u00e2n ho\u1eb7c \u0111a nh\u00e2n tr\u01b0\u1edbc \u0111\u00f3.<\/li>\n<li>\u0110\u1ed1i v\u1edbi ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 t\u1ee7y, c\u00f3 t\u00ednh ch\u1ea5t gia \u0111\u00ecnh v\u00e0 di truy\u1ec1n. Nh\u1eefng b\u1ec7nh nh\u00e2n ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 t\u1ee7y th\u01b0\u1eddng n\u1eb1m trong b\u1ec7nh c\u1ea3nh \u0111a u n\u1ed9i ti\u1ebft MEN 2. Y\u1ebfu t\u1ed1 di truy\u1ec1n v\u00e0 ngu\u1ed3n g\u1ed1c gen: RET, RAS, BRAF.<\/li>\n<\/ul>\n<h2>3. \u0110i\u1ec1u tr\u1ecb ung th\u01b0 tuy\u1ebfn gi\u00e1p<\/h2>\n<h3>3.1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/h3>\n<p>Ph\u1eabu thu\u1eadt c\u00f3 vai tr\u00f2 ch\u1ee7 \u0111\u1ea1o trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 tuy\u1ebfn gi\u00e1p. <a href=\"https:\/\/www.vinmec.com\/vi\/ung-buou-xa-tri\/thong-tin-suc-khoe\/lieu-phap-i-ot-phong-xa-radioiodine-cho-benh-ung-thu-tuyen-giap\/?link_type=related_posts\">I-131<\/a> c\u00f3 vai tr\u00f2 b\u1ed5 tr\u1ee3 v\u1edbi nh\u00f3m b\u1ec7nh nh\u00e2n ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 bi\u1ec7t ho\u00e1. Li\u1ec7u ph\u00e1p n\u1ed9i ti\u1ebft gi\u00fap ki\u1ec3m so\u00e1t b\u1ec7nh t\u1ed1t h\u01a1n. X\u1ea1 tr\u1ecb chi\u1ebfu ngo\u00e0i \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho lo\u1ea1i ung th\u01b0 kh\u00f4ng bi\u1ec7t h\u00f3a ho\u1eb7c lo\u1ea1i bi\u1ec7t h\u00f3a nh\u01b0ng \u1edf giai \u0111o\u1ea1n mu\u1ed9n kh\u00f4ng th\u1ec3 ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng h\u00f3a ch\u1ea5t v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00edch th\u01b0\u1eddng \u00e1p d\u1ee5ng \u1edf giai \u0111o\u1ea1n mu\u1ed9n v\u00e0 \u00edt hi\u1ec7u qu\u1ea3.<\/p>\n<h4>3.1.1. Ph\u1eabu thu\u1eadt<\/h4>\n<p><em>Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 bi\u1ec7t ho\u00e1 <\/em><\/p>\n<ul>\n<li>V\u1edbi u gi\u00e1p:<\/li>\n<\/ul>\n<p>+ Ch\u1ec9 \u0111\u1ecbnh c\u1eaft gi\u00e1p to\u00e0n b\u1ed9 trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p:<\/p>\n<p>\u25ca Ti\u1ec1n s\u1eed x\u1ea1 tr\u1ecb v\u00f9ng c\u1ed5<\/p>\n<p>\u25ca U giai \u0111o\u1ea1n T<sub>3,4<\/sub><\/p>\n<p>\u25ca C\u00f3 t\u1ed5n th\u01b0\u01a1ng th\u00f9y \u0111\u1ed1i b\u00ean<\/p>\n<p>\u25ca C\u00f3 di c\u0103n h\u1ea1ch c\u1ed5<\/p>\n<p>\u25ca C\u00f3 di c\u0103n xa<\/p>\n<p>\u25ca Ung th\u01b0 tuy\u1ebfn gi\u00e1p t\u00e1i ph\u00e1t<\/p>\n<ul>\n<li>Ngo\u00e0i nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ch\u1ec9 \u0111\u1ecbnh c\u1eaft gi\u00e1p to\u00e0n b\u1ed9 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh c\u1eaft th\u00f9y v\u00e0 eo gi\u00e1p.<\/li>\n<li>V\u1edbi h\u1ea1ch c\u1ed5:<\/li>\n<\/ul>\n<p>+ Nh\u00f3m cN0: V\u00e9t h\u1ea1ch c\u1ed5 nh\u00f3m VI d\u1ef1 ph\u00f2ng v\u1edbi u T3,T4.<\/p>\n<p>+ Nh\u00f3m cN1: V\u00e9t h\u1ea1ch c\u1ed5 nh\u00f3m h\u1ea1ch c\u00f3 b\u1eb1ng ch\u1ee9ng di c\u0103n.<\/p>\n<p><em>Ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 t\u1ee7y<\/em><\/p>\n<ul>\n<li>V\u1edbi u gi\u00e1p: Ch\u1ec9 \u0111\u1ecbnh c\u1eaft gi\u00e1p to\u00e0n b\u1ed9 cho t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p.<\/li>\n<li>V\u1edbi h\u1ea1ch c\u1ed5:<\/li>\n<\/ul>\n<p>+ Nh\u00f3m cN0: V\u00e9t h\u1ea1ch c\u1ed5 nh\u00f3m VI d\u1ef1 ph\u00f2ng. V\u00e9t h\u1ea1ch c\u1ea3nh d\u1ef1 ph\u00f2ng c\u00f2n \u0111ang tranh c\u00e3i.<\/p>\n<p>+ Nh\u00f3m cN1: V\u00e9t h\u1ea1ch c\u1ed5 nh\u00f3m h\u1ea1ch c\u00f3 b\u1eb1ng ch\u1ee9ng di c\u0103n.<\/p>\n<p><em>Ung th\u01b0 gi\u00e1p tr\u1ea1ng kh\u00f4ng bi\u1ec7t h\u00f3a:<\/em> ch\u1ec9 \u0111\u1ecbnh c\u1eaft gi\u00e1p to\u00e0n b\u1ed9 + v\u00e9t h\u1ea1ch c\u1ed5 tri\u1ec7t c\u0103n c\u00f2n kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt. Tuy nhi\u00ean th\u1ec3 m\u00f4 b\u1ec7nh h\u1ecdc n\u00e0y th\u01b0\u1eddng \u0111\u1ebfn vi\u1ec7n \u1edf giai \u0111o\u1ea1n mu\u1ed9n v\u00e0 kh\u00f4ng c\u00f2n kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt, n\u00ean th\u01b0\u1eddng ch\u1ec9 ph\u1eabu thu\u1eadt tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1edf kh\u00ed qu\u1ea3n hay m\u1edf th\u00f4ng d\u1ea1 d\u00e0y, sau \u0111\u00f3 ho\u00e1 x\u1ea1 tr\u1ecb.<\/p>\n<h4>3.1.2. \u0110i\u1ec1u tr\u1ecb <sup>131<\/sup>I (Radioactive iodine &#8211; RAI)<\/h4>\n<ul>\n<li>M\u1ee5c ti\u00eau: gi\u00fap gi\u1ea3m t\u1ef7 l\u1ec7 t\u00e1i ph\u00e1t \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n nguy c\u01a1 cao.<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh: d\u00e0nh cho c\u00e1c lo\u1ea1i ung th\u01b0 th\u1ec3 bi\u1ec7t h\u00f3a (nh\u00fa, nang) nguy c\u01a1 cao nh\u01b0 \u0111a \u1ed5, u T<sub>3<\/sub>, T<sub>4<\/sub>, di c\u0103n h\u1ea1ch, di c\u0103n xa v\u00e0 c\u00f3 n\u1ed3ng \u0111\u1ed9 Tg cao sau ph\u1eabu thu\u1eadt c\u1eaft gi\u00e1p to\u00e0n b\u1ed9. Tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb I-131, b\u1ec7nh nh\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 tuy\u1ebfn gi\u00e1p.<\/li>\n<\/ul>\n<h4>3.1.3 \u0110i\u1ec1u tr\u1ecb n\u1ed9i ti\u1ebft<\/h4>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb n\u1ed9i ti\u1ebft b\u1eb1ng levothyroxin sau ph\u1eabu thu\u1eadt \u0111\u1ec3 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 TSH, qua \u0111\u00f3 h\u1ea1n ch\u1ebf s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ebf b\u00e0o tuy\u1ebfn gi\u00e1p.<\/li>\n<li>V\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 nguy c\u01a1 t\u00e1i ph\u00e1t c\u00e1o n\u00ean duy tr\u00ec n\u1ed3ng \u0111\u1ed9 TSH d\u01b0\u1edbi 0,1mU\/L. C\u00f2n \u0111\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p nguy c\u01a1 th\u1ea5p th\u00ec n\u00ean duy tr\u00ec n\u1ed3ng \u0111\u1ed9 TSH t\u1eeb 0,1- gi\u1edbi h\u1ea1n d\u01b0\u1edbi c\u1ee7a gi\u00e1 tr\u1ecb tham chi\u1ebfu.<\/li>\n<\/ul>\n<h4>3.1.4. X\u1ea1 tr\u1ecb chi\u1ebfu ngo\u00e0i<\/h4>\n<ul>\n<li>Trong ung th\u01b0 tuy\u1ebfn gi\u00e1p bi\u1ec7t h\u00f3a ch\u1ec9 \u0111\u1ecbnh x\u1ea1 tr\u1ecb l\u00e0 r\u1ea5t h\u1ea1n ch\u1ebf b\u1edfi t\u1ebf b\u00e0o ung th\u01b0 c\u1ee7a th\u1ec3 n\u00e0y \u00edt nh\u1ea1y c\u1ea3m v\u1edbi x\u1ea1 tr\u1ecb. X\u1ea1 tr\u1ecb \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt, t\u1ea1i nh\u1eefng v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng kh\u00f4ng c\u1eaft b\u1ecf \u0111\u01b0\u1ee3c b\u1eb1ng ph\u1eabu thu\u1eadt.<\/li>\n<li>Trong ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 t\u1ee7y: X\u1ea1 tr\u1ecb b\u1ed5 tr\u1ee3 sau ph\u1eabu thu\u1eadt ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ee9ng minh c\u00f3 vai tr\u00f2 r\u00f5 r\u00e0ng trong \u0111i\u1ec1u tr\u1ecb. Tuy nhi\u00ean, x\u1ea1 tr\u1ecb \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng ph\u1eabu thu\u1eadt, t\u1ea1i nh\u1eefng v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng kh\u00f4ng c\u1eaft b\u1ecf \u0111\u01b0\u1ee3c b\u1eb1ng ph\u1eabu thu\u1eadt.<\/li>\n<li>Trong ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 kh\u00f4ng bi\u1ec7t h\u00f3a: X\u1ea1 tr\u1ecb sau ph\u1eabu thu\u1eadt l\u00e0 ch\u1ec9 \u0111\u1ecbnh g\u1ea7n nh\u01b0 b\u1eaft bu\u1ed9c v\u1edbi m\u1ee5c \u0111\u00edch ki\u1ec3m so\u00e1t t\u00e1i ph\u00e1t t\u1ea1i ch\u1ed7 v\u00e0 h\u1ec7 th\u1ed1ng h\u1ea1ch.<\/li>\n<\/ul>\n<h4>3.1.5. \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/h4>\n<p><em>H\u00f3a ch\u1ea5t<\/em><\/p>\n<p>H\u00f3a tr\u1ecb \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 kh\u00f4ng bi\u1ec7t h\u00f3a. C\u00e1c ph\u00e1c \u0111\u1ed3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u01b0\u1eddng c\u00f3 ch\u1ee9a <a href=\"https:\/\/vinmecdr.com\/thuoc\/doxorubicin\/\">doxorubicin<\/a>, paclitaxel, docetaxel, cisplatin, carboplatin. T\u00f9y v\u00e0o t\u00ecnh tr\u1ea1ng b\u1ec7nh ch\u00fang ta c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn ph\u00e1c \u0111\u1ed3 k\u1ebft h\u1ee3p ho\u1eb7c \u0111\u01a1n tr\u1ecb.<\/p>\n<p><em>\u0110i\u1ec1u tr\u1ecb \u0111\u00edch<\/em><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb \u0111\u00edch trong ung th\u01b0 tuy\u1ebfn gi\u00e1p c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n th\u1eddi gian s\u1ed1ng b\u1ec7nh, gi\u1ea3m nh\u1eb9 tri\u1ec7u ch\u1ee9ng v\u00e0 th\u01b0\u1eddng \u00e1p d\u1ee5ng \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n th\u1ea5t b\u1ea1i sau \u0111i\u1ec1u tr\u1ecb I-131, ho\u1eb7c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh.<\/p>\n<ul>\n<li>Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u00edch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ung th\u01b0 tuy\u1ebfn gi\u00e1p th\u1ec3 kh\u00f4ng bi\u1ec7t h\u00f3a: C\u00e1c thu\u1ed1c kh\u00e1ng BRAF nh\u01b0 dabrafenib\u066d v\u00e0 trametinib\u066d, thu\u1ed1c kh\u00e1ng NTRK l\u00e0 larotrectinib\u066d.<\/li>\n<li>Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u00edch \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ung th\u01b0 gi\u00e1p th\u1ec3 bi\u1ec7t h\u00f3a, th\u1ec3 t\u1ee7y l\u00e0 c\u00e1c thu\u1ed1c kh\u00e1ng TKI nh\u01b0 sorafenib, pazopanib, cabozatinib\u066d, sunitinib, axitinib\u066d, lenvatinib\u066d&#8230;<\/li>\n<\/ul>\n<h2>4. Theo d\u00f5i sau \u0111i\u1ec1u tr\u1ecb<\/h2>\n<ul>\n<li>\u00a0Kh\u00e1m l\u00e2m s\u00e0ng: ph\u00e1t hi\u1ec7n t\u00e1i ph\u00e1t u, h\u1ea1ch, c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a di c\u0103n xa<\/li>\n<li>C\u1eadn l\u00e2m s\u00e0ng:<\/li>\n<\/ul>\n<p>+ X\u00e9t nghi\u1ec7m FT4, TSH, Tg huy\u1ebft thanh<\/p>\n<p>+ \u0110\u1ed1i v\u1edbi th\u1ec3 t\u1ee7y, x\u00e9t nghi\u1ec7m calcitonin v\u00e0 CEA<\/p>\n<p>+ Ch\u1ee5p Xquang ph\u1ed5i ph\u00e1t hi\u1ec7n di c\u0103n<\/p>\n<p>+ Si\u00eau \u00e2m ph\u1ea7n m\u1ec1m v\u00f9ng c\u1ed5 v\u00e0 x\u1ea1 h\u00ecnh tuy\u1ebfn gi\u00e1p v\u1edbi <sup>131<\/sup>I<\/p>\n<p>+ Trong tr\u01b0\u1eddng h\u1ee3p v\u1edbi b\u1ec7nh nh\u00e2n Tg \u1edf m\u1ee9c cao &gt;10ng\/ml. X\u1ea1 h\u00ecnh tuy\u1ebfn gi\u00e1p, kh\u00e1m l\u00e2m s\u00e0ng, si\u00eau \u00e2m v\u00e0 CT scan kh\u00f4ng ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng t\u00e1i ph\u00e1t, di c\u0103n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ch\u1ee5p PET-CT v\u1edbi <sup>18<\/sup>F-FDG.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ung th\u01b0 tuy\u1ebfn gi\u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf n\u1eef gi\u1edbi v\u00e0 \u0111ang ng\u00e0y c\u00e0ng t\u0103ng trong s\u1ed1 nam gi\u1edbi. \u0110i\u1ec1u tr\u1ecb ung th\u01b0 tuy\u1ebfn gi\u00e1p l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh l\u00e2u d\u00e0i t\u00f9y thu\u1ed9c v\u00e0o giai \u0111o\u1ea1n b\u1ec7nh, \u01b0u ti\u00ean c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 ph\u00e1c \u0111\u1ed3 c\u1ee7a b\u00e1c s\u0129. [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ung th\u01b0 tuy\u1ebfn gi\u00e1p: H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb theo b\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb ung th\u01b0 tuy\u1ebfn gi\u00e1p l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh l\u00e2u d\u00e0i t\u00f9y thu\u1ed9c v\u00e0o giai \u0111o\u1ea1n b\u1ec7nh, \u01b0u ti\u00ean c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 ph\u00e1c \u0111\u1ed3 c\u1ee7a b\u00e1c s\u0129.\" \/>\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 tuy\u1ebfn gi\u00e1p: H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb theo b\u1ed9 Y t\u1ebf - 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