{"id":8014,"date":"2018-11-10T06:53:06","date_gmt":"2018-11-09T23:53:06","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/dieu-tri-ung-thu-phoi-khong-te-bao-nho-giai-doan-i-iii\/"},"modified":"2018-11-10T06:53:06","modified_gmt":"2018-11-09T23:53:06","slug":"dieu-tri-ung-thu-phoi-khong-te-bao-nho-giai-doan-i-iii","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/dieu-tri-ung-thu-phoi-khong-te-bao-nho-giai-doan-i-iii\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf, giai \u0111o\u1ea1n I-III"},"content":{"rendered":"<h2><strong>T\u1ed5ng quan v\u1ec1 ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf<\/strong><\/h2>\n<p>Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (UTPKTBN) chi\u1ebfm t\u1eeb <strong>85-90%<\/strong> t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i; ph\u1ea7n c\u00f2n l\u1ea1i 10-15% l\u00e0 ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf. S\u1ef1 kh\u00e1c bi\u1ec7t r\u00f5 r\u00e0ng n\u00e0y r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c c\u00e2n nh\u1eafc \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>B\u00e0i b\u00e1o n\u00e0y s\u1ebd b\u00e0n lu\u1eadn v\u1ec1 \u0111i\u1ec1u tr\u1ecb UTPKTBN khu tr\u00fa trong ng\u1ef1c (giai \u0111o\u1ea1n I, II v\u00e0 III). \u0110i\u1ec1u tr\u1ecb UTPKTBN \u0111\u00e3 di c\u0103n xa (giai \u0111o\u1ea1n IV) s\u1ebd \u0111\u01b0\u1ee3c b\u00e0n lu\u1eadn ri\u00eang. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1, tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ea9n \u0111o\u00e1n c\u1ee7a UTPKTBN c\u0169ng s\u1ebd \u0111\u01b0\u1ee3c b\u00e0n lu\u1eadn ri\u00eang.<\/p>\n<h2><strong>X\u00e1c \u0111\u1ecbnh giai \u0111o\u1ea1n c\u1ee7a UTPKTBN<\/strong><\/h2>\n<p>Khi \u0111\u00e3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 ph\u1ed5i, b\u01b0\u1edbc ti\u1ebfp theo l\u00e0 xem x\u00e9t k\u00edch th\u01b0\u1edbc t\u1ed5n th\u01b0\u01a1ng, x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c v\u1ecb tr\u00ed c\u1ee7a n\u00f3 v\u00e0 ph\u00e1t hi\u1ec7n tr\u01b0\u1eddng h\u1ee3p c\u00f3 di c\u0103n. Quy tr\u00ecnh n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 <strong>x\u00e1c \u0111\u1ecbnh giai \u0111o\u1ea1n<\/strong>. X\u00e1c \u0111\u1ecbnh giai \u0111o\u1ea1n c\u1ee7a ung th\u01b0 ph\u1ed5i c\u00f3 th\u1ec3 r\u1ea5t ph\u1ee9c t\u1ea1p v\u00ec nhi\u1ec1u \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a kh\u1ed1i u c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 c\u00f9ng l\u00fac. <strong>Giai \u0111o\u1ea1n c\u1ee7a UTPKTBN \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh d\u1ef1a v\u00e0o:<\/strong><\/p>\n<ul>\n<li>K\u00edch th\u01b0\u1edbc v\u00e0 v\u1ecb tr\u00ed c\u1ee7a kh\u1ed1i u.<\/li>\n<li>Kh\u1ed1i u c\u00f3 x\u00e2m nh\u1eadp h\u1ea1ch lympho v\u00e0 c\u00e1c m\u00f4 trong l\u1ed3ng ng\u1ef1c kh\u00f4ng.<\/li>\n<li>Kh\u1ed1i u c\u00f3 lan r\u1ed9ng\/di c\u0103n t\u1edbi c\u00e1c v\u1ecb tr\u00ed kh\u00e1c ngo\u00e0i l\u1ed3ng ng\u1ef1c (v\u00ed d\u1ee5: h\u1ea1ch lympho, tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn, n\u00e3o, gan, x\u01b0\u01a1ng\u2026).<\/li>\n<\/ul>\n<p><strong>Giai \u0111o\u1ea1n c\u1ee7a UTPKTBN \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 t\u1eeb I \u0111\u1ebfn IV.<\/strong>\u00a0T\u1eeb \u0111\u00f3 gi\u00fap d\u1ef1 \u0111o\u00e1n ti\u00ean l\u01b0\u1ee3ng v\u00e0 h\u01b0\u1edbng d\u1eabn l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p nh\u1ea5t. N\u00f3i chung, c\u00e1c giai \u0111o\u1ea1n I v\u00e0 II g\u1ee3i \u00fd r\u1eb1ng kh\u1ed1i u c\u00f2n nh\u1ecf v\u00e0 ch\u01b0a lan r\u1ed9ng ra xa; li\u00ean quan t\u1edbi ti\u00ean l\u01b0\u1ee3ng t\u1ed1t h\u01a1n. Ng\u01b0\u1ee3c l\u1ea1i, giai \u0111o\u1ea1n III v\u00e0 IV g\u1ee3i \u00fd r\u1eb1ng kh\u1ed1i u l\u1edbn h\u01a1n ho\u1eb7c \u0111\u00e3 c\u00f3 di c\u0103n, l\u00e0 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m li\u00ean quan t\u1edbi ti\u00ean l\u01b0\u1ee3ng x\u1ea5u h\u01a1n.<\/p>\n<ul>\n<li><strong>Giai \u0111o\u1ea1n I<\/strong>: Giai \u0111o\u1ea1n I ngh\u0129a l\u00e0 kh\u1ed1i u nh\u1ecf h\u01a1n ho\u1eb7c b\u1eb1ng 3 cm (kho\u1ea3ng 1.2 inch) theo \u0111\u01b0\u1eddng k\u00ednh l\u1edbn nh\u1ea5t v\u00e0 ch\u01b0a lan t\u1edbi b\u1ea5t c\u1ee9 m\u00f4 ho\u1eb7c h\u1ea1ch lympho n\u00e0o.<\/li>\n<\/ul>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\" wp-image-25508 aligncenter\" src=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/11\/ung-thu-phoi-te-bao-nho-1-300x229-1-20221010-090357.png\" alt=\"ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf 1\" width=\"314\" height=\"240\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><strong> H\u00ecnh 1: Ung th\u01b0 ph\u1ed5i giai \u0111o\u1ea1n I<\/strong><\/p>\n<ul>\n<li><strong>Giai \u0111o\u1ea1n II<\/strong>: Giai \u0111o\u1ea1n II ngh\u0129a l\u00e0 kh\u1ed1i u c\u00f3 k\u00edch th\u01b0\u1edbc t\u1eeb 3 \u0111\u1ebfn 7cm (kho\u1ea3ng 1.2 \u0111\u1ebfn 3 inch), \u0111\u00e3 lan t\u1edbi h\u1ea1ch lympho, x\u00e2m l\u1ea5n m\u00f4 xung quanh ph\u1ed5i ho\u1eb7c b\u1eaft \u0111\u1ea7u x\u00e2m l\u1ea5n v\u00e0o ph\u1ebf qu\u1ea3n l\u1edbn.<\/li>\n<\/ul>\n<p><img decoding=\"async\" class=\" wp-image-25509 aligncenter\" src=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/11\/ung-thu-phoi-te-bao-nho-2-300x255-1-20221010-090358.png\" alt=\"ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf 2\" width=\"307\" height=\"261\" \/><\/p>\n<p>&nbsp;<\/p>\n<p><strong>H\u00ecnh 2: Ung th\u01b0 ph\u1ed5i giai \u0111o\u1ea1n II<\/strong><\/p>\n<ul>\n<li><strong>Giai \u0111o\u1ea1n IIIA<\/strong>: Giai \u0111o\u1ea1n IIIA l\u00e0 khi kh\u1ed1i u l\u1edbn h\u01a1n 7cm (kho\u1ea3ng 3 inch), \u0111\u00e3 lan r\u1ed9ng t\u1edbi h\u1ea1ch lympho trong trung t\u00e2m l\u1ed3ng ng\u1ef1c (h\u1ea1ch trung th\u1ea5t), ho\u1eb7c lan t\u1edbi x\u01b0\u01a1ng s\u01b0\u1eddn, tim, m\u1ea1ch m\u00e1u l\u1edbn (nh\u01b0 \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 t\u0129nh m\u1ea1ch ph\u1ed5i), th\u1ef1c qu\u1ea3n ho\u1eb7c kh\u00ed qu\u1ea3n.<\/li>\n<\/ul>\n<p><img decoding=\"async\" class=\"size-medium wp-image-25503 aligncenter\" src=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/11\/dieu-tri-ung-thu-phoi-te-bao-nho-3-300x254-1-20221010-090358.png\" alt=\"\u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf 3\" width=\"300\" height=\"254\" \/><\/p>\n<p><strong>H\u00ecnh 3: Ung th\u01b0 ph\u1ed5i giai \u0111o\u1ea1n IIIA<\/strong><\/p>\n<ul>\n<li><strong>Giai \u0111o\u1ea1n IIIB<\/strong>: Giai \u0111o\u1ea1n IIIB \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 khi kh\u1ed1i u lan v\u00e0o h\u1ea1ch trung th\u1ea5t \u0111\u1ed1i b\u00ean (b\u00ean \u0111\u1ed1i di\u1ec7n v\u1edbi b\u00ean ph\u1ed5i c\u00f3 ung th\u01b0 ban \u0111\u1ea7u), ho\u1eb7c h\u1ea1ch lympho ph\u00eda tr\u00ean hay ph\u00eda sau x\u01b0\u01a1ng \u0111\u00f2n. Giai \u0111o\u1ea1n IIIB c\u0169ng bao g\u1ed3m c\u00e1c kh\u1ed1i u l\u1edbn lan t\u1edbi x\u01b0\u01a1ng s\u01b0\u1eddn, tim, c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn, th\u1ef1c qu\u1ea3n ho\u1eb7c kh\u00ed qu\u1ea3n v\u1edbi s\u1ef1 c\u00f3 m\u1eb7t h\u1ea1ch trung th\u1ea5t.<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-25506 aligncenter\" src=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/11\/dieu-tri-ung-thu-phoi-te-bao-nho-4-300x248-1-20221010-090358.png\" alt=\"\u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf 4\" width=\"323\" height=\"267\" \/><\/p>\n<p><strong> H\u00ecnh 4: Ung th\u01b0 ph\u1ed5i giai \u0111o\u1ea1n IIIB<\/strong><\/p>\n<ul>\n<li><strong>Giai \u0111o\u1ea1n IV<\/strong>: Giai \u0111o\u1ea1n IV l\u00e0 khi ung th\u01b0 \u0111\u00e3 di c\u0103n xa (nh\u01b0 di c\u0103n n\u00e3o, x\u01b0\u01a1ng, gan,\u2026) ho\u1eb7c di c\u0103n t\u1edbi ph\u00eda b\u00ean kia l\u1ed3ng ng\u1ef1c ho\u1eb7c t\u1edbi m\u00f4 n\u1eb1m ngo\u00e0i l\u1ed3ng ng\u1ef1c, ho\u1eb7c g\u00e2y ra \u201ctr\u00e0n d\u1ecbch \u00e1c t\u00ednh\u201d. S\u1ef1 tr\u00e0n d\u1ecbch \u00e1c t\u00ednh l\u00e0 t\u1eadp h\u1ee3p d\u1ecbch ch\u1ee9a t\u1ebf b\u00e0o ung th\u01b0 c\u00f3 th\u1ec3 t\u00edch t\u1ee5 gi\u1eefa ph\u1ed5i v\u00e0 th\u00e0nh trong c\u1ee7a ng\u1ef1c (tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i) ho\u1eb7c \u1edf kho\u1ea3ng tr\u1ed1ng xung quanh tim (tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim).<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-25507 aligncenter\" src=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/11\/dieu-tri-ung-thu-phoi-te-bao-nho-5-300x269-1-20221010-090359.png\" alt=\"\u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf 5\" width=\"325\" height=\"291\" \/><\/p>\n<p><strong>H\u00ecnh 5: Ung th\u01b0 ph\u1ed5i giai \u0111o\u1ea1n IV<\/strong><\/p>\n<p>Giai \u0111o\u1ea1n I-III trong UTPKTBN \u0111\u01b0\u1ee3c coi l\u00e0 ung th\u01b0 khu tr\u00fa, trong khi giai \u0111o\u1ea1n IV \u0111\u01b0\u1ee3c coi l\u00e0 ung th\u01b0 ti\u1ebfn tri\u1ec3n.<\/p>\n<pre><em><strong>Xem th\u00eam b\u00e0i\u00a0<a href=\"https:\/\/yhoccongdong.com\/thongtin\/dieu-tri-ung-thu-phoi-khong-te-bao-nho-utpktbn-theo-giai-doan\/\" target=\"_blank\" rel=\"noopener\">\u0110i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf theo giai \u0111o\u1ea1n<\/a><\/strong><\/em><\/pre>\n<h2><strong>T\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c ng\u1eebng h\u00fat thu\u1ed1c l\u00e1<\/strong><\/h2>\n<p>Nh\u1eefng ng\u01b0\u1eddi ti\u1ebfp t\u1ee5c h\u00fat thu\u1ed1c \u0111\u00e3 kh\u00f4ng c\u00f3 k\u1ebft qu\u1ea3 t\u1ed1t nh\u01b0 nh\u1eefng ng\u01b0\u1eddi ng\u1eebng (b\u1ecf) h\u00fat thu\u1ed1c. M\u1ed9t l\u00ed do \u0111\u01b0\u1ee3c \u0111\u01b0a ra l\u00e0 n\u1ebfu b\u1ec7nh nh\u00e2n v\u01b0\u1ee3t qua \u0111\u01b0\u1ee3c ung th\u01b0 ph\u1ed5i \u0111\u1ea7u ti\u00ean, nhi\u1ec1u kh\u1ea3 n\u0103ng h\u1ecd s\u1ebd b\u1ecb th\u00eam ung th\u01b0 ph\u1ed5i th\u1ee9 hai n\u1ebfu ti\u1ebfp t\u1ee5c h\u00fat thu\u1ed1c. Ngo\u00e0i ra, b\u1edfi v\u00ec \u0111i\u1ec1u tr\u1ecb b\u1eb1ng h\u00f3a tr\u1ecb, x\u1ea1 tr\u1ecb v\u00e0 ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 g\u00e2y th\u00eam t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i, n\u00ean vi\u1ec7c \u0111\u1ea3m b\u1ea3o ch\u1ee9c n\u0103ng ph\u1ed5i t\u1ed1t nh\u1ea5t c\u00f3 th\u1ec3 l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft. B\u1edfi v\u1eady, b\u1ec7nh nh\u00e2n n\u00ean ng\u1eebng h\u00fat thu\u1ed1c l\u00e1.<\/p>\n<p>\u0110\u00e2y c\u0169ng l\u00e0 m\u1ed9t c\u01a1 h\u1ed9i quan tr\u1ecdng \u0111\u1ec3 ng\u01b0\u1eddi nh\u00e0 v\u00e0 b\u1ea1n b\u00e8 b\u1ec7nh nh\u00e2n ng\u1eebng h\u00fat thu\u1ed1c. C\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 di truy\u1ec1n l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng m\u1eafc ung th\u01b0 ph\u1ed5i, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 y\u1ebfu t\u1ed1 di truy\u1ec1n n\u00e0y ho\u1eb7c khi nh\u1eefng ng\u01b0\u1eddi xung quanh h\u00fat thu\u1ed1c.<\/p>\n<h2><strong>\u0110i\u1ec1u tr\u1ecb giai \u0111o\u1ea1n I v\u00e0 II<\/strong><\/h2>\n<p><strong>Ph\u1eabu thu\u1eadt l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb nh\u01b0 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u ti\u00ean cho b\u1ec7nh nh\u00e2n UTPKTBN \u1edf giai \u0111o\u1ea1n I v\u00e0 II.<\/strong> X\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb cho b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n ph\u1eabu thu\u1eadt b\u1edfi b\u1ec7nh ph\u1ed5i n\u1eb7ng ho\u1eb7c c\u00f3 c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe \u0111i k\u00e8m kh\u00e1c. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u hi\u1ec7n nay \u0111ang c\u1ed1 g\u1eafng ki\u1ec3m \u0111\u1ecbnh xem li\u1ec7u tia x\u1ea1 c\u00f3 th\u1ec3 thay th\u1ebf ph\u1eabu thu\u1eadt cho c\u1ea3 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n ph\u1eabu thu\u1eadt.<\/p>\n<p>Trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, sau ph\u1eabu thu\u1eadt hay x\u1ea1 tr\u1ecb, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb th\u1ef1c hi\u1ec7n ti\u1ebfp h\u00f3a tr\u1ecb b\u1ed5 tr\u1ee3.<\/p>\n<h2><strong>Ph\u1eabu thu\u1eadt<\/strong><\/h2>\n<p>Ph\u1eabu thu\u1eadt lo\u1ea1i b\u1ecf ung th\u01b0 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u01b0\u1ee3c \u01b0a d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb UTPKTBN giai \u0111o\u1ea1n I v\u00e0 II. C\u00e1c ph\u01b0\u01a1ng \u00e1n trong ph\u1eabu thu\u1eadt ph\u1ee5 thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc v\u00e0 v\u1ecb tr\u00ed c\u1ee7a kh\u1ed1i u trong l\u1ed3ng ng\u1ef1c, v\u1edbi c\u00e1c lo\u1ea1i ph\u1eabu thu\u1eadt nh\u01b0:<\/p>\n<ul>\n<li><strong>C\u1eaft th\u00f9y ph\u1ed5i<\/strong>: lo\u1ea1i b\u1ecf m\u1ed9t th\u00f9y c\u1ee7a ph\u1ed5i (b\u00ecnh th\u01b0\u1eddng ph\u1ed5i ph\u1ea3i c\u00f3 3 th\u00f9y, ph\u1ed5i tr\u00e1i c\u00f3 2 th\u00f9y).<\/li>\n<li><strong>C\u1eaft m\u1ed9t ph\u1ea7n ph\u1ed5i ho\u1eb7c c\u1eaft h\u00ecnh ch\u00eam<\/strong>: c\u1ea3 2 th\u1ee7 thu\u1eadt n\u00e0y \u0111\u1ec1u c\u00f3 ngh\u0129a l\u00e0 c\u1eaft m\u1ed9t ph\u1ea7n c\u1ee7a ph\u1ed5i nh\u01b0ng kh\u00f4ng ph\u1ea3i c\u1ea3 th\u00f9y ph\u1ed5i. Ch\u00fang c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 m\u1ed9t kh\u1ed1i u nh\u1ecf h\u01a1n 2 cm. C\u00e1ch th\u1ee9c ph\u1eabu thu\u1eadt n\u00e0y hay d\u00f9ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 ch\u1ecbu \u0111\u1ef1ng ph\u1eabu thu\u1eadt c\u1eaft to\u00e0n b\u1ed9 th\u00f9y ph\u1ed5i th\u00f4ng th\u01b0\u1eddng. V\u00ed d\u1ee5 \u1edf tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n c\u00f3 l\u00e1 ph\u1ed5i kh\u00f4ng th\u1ef1c s\u1ef1 t\u1ed1t.<\/li>\n<li><strong>C\u1eaft to\u00e0n b\u1ed9 m\u1ed9t ph\u1ed5i<\/strong>: Ngh\u0129a l\u00e0 lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n ph\u1ed5i b\u1ecb \u1ea3nh h\u01b0\u1edfng. \u0110i\u1ec1u n\u00e0y th\u01b0\u1eddng c\u1ea7n thi\u1ebft trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p m\u00e0 c\u1eaft th\u00f9y ph\u1ed5i kh\u00f4ng th\u1ec3 lo\u1ea1i b\u1ecf ho\u00e0n to\u00e0n kh\u1ed1i u, nh\u01b0 trong tr\u01b0\u1eddng h\u1ee3p kh\u1ed1i u nguy\u00ean ph\u00e1t n\u1eb1m g\u1ea7n trung t\u00e2m l\u1ed3ng ng\u1ef1c. C\u1eaft to\u00e0n b\u1ed9 m\u1ed9t ph\u1ed5i \u0111\u00f2i h\u1ecfi ph\u1ed5i b\u00ean c\u00f2n l\u1ea1i ph\u1ea3i c\u00f3 ch\u1ee9c n\u0103ng th\u00f4ng kh\u00ed t\u1ed1t.<\/li>\n<\/ul>\n<p>Trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, m\u1ed9t ng\u01b0\u1eddi \u0111\u01b0\u1ee3c cho l\u00e0 m\u1eafc UTPKTBN giai \u0111o\u1ea1n I ho\u1eb7c II tr\u01b0\u1edbc m\u1ed5, nh\u01b0ng khi m\u1ed5 ra l\u1ea1i ph\u00e1t hi\u1ec7n b\u1ec7nh \u0111\u00e3 lan t\u1edbi c\u00e1c h\u1ea1ch b\u1ea1ch huy\u1ebft trung th\u1ea5t. N\u1ebfu \u0111i\u1ec1u n\u00e0y x\u1ea3y ra, b\u1ec7nh \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i l\u1ea1i th\u00e0nh giai \u0111o\u1ea1n III. \u0110\u00e2y c\u00f2n g\u1ecdi l\u00e0 up-staging (\u0111\u00e1nh gi\u00e1 giai \u0111o\u1ea1n b\u1ec7nh sau m\u1ed5 c\u0103n c\u1ee9 v\u00e0o k\u1ebft qu\u1ea3 gi\u1ea3i ph\u1eabu b\u1ec7nh l\u00fd). Ph\u00e2n \u0111\u1ed9 giai \u0111o\u1ea1n sau ph\u1eabu thu\u1eadt bao g\u1ed3m c\u1ea3 nh\u1eefng ph\u00e1t hi\u1ec7n t\u1eeb c\u00e1c m\u1eabu m\u00f4 d\u01b0\u1edbi k\u00ednh hi\u1ec3n vi, n\u00ean \u201cph\u00e2n \u0111\u1ed9 b\u1ec7nh h\u1ecdc\u201d ch\u00ednh x\u00e1c h\u01a1n so v\u1edbi \u201cph\u00e2n \u0111\u1ed9 l\u00e2m s\u00e0ng\u201d ch\u1ec9 d\u1ef1a v\u00e0o c\u00e1c d\u1ea5u hi\u1ec7u tr\u00ean ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh ri\u00eang bi\u1ec7t.<\/p>\n<h2><strong>X\u1ea1 tr\u1ecb<\/strong><\/h2>\n<p><strong>X\u1ea1 tr\u1ecb l\u00e0 vi\u1ec7c s\u1eed d\u1ee5ng tia X \u0111\u1ec3 ti\u00eau di\u1ec7t t\u1ebf b\u00e0o ung th\u01b0<\/strong>. X\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb cho b\u1ec7nh nh\u00e2n \u1edf giai \u0111o\u1ea1n I v\u00e0 II v\u1edbi c\u00e1c t\u00ecnh tr\u1ea1ng sau:<\/p>\n<ul>\n<li>Sau ph\u1eabu thu\u1eadt, x\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb cho b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ed1i u c\u00f2n s\u00f3t l\u1ea1i \u1edf di\u1ec7n\/m\u1eb7t c\u1eaft ph\u1eabu thu\u1eadt, ho\u1eb7c cho nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c cho r\u1eb1ng c\u00f3 nguy c\u01a1 cao b\u1ecb t\u00e1i ph\u00e1t t\u1ea1i ch\u1ed7. \u0110\u00e2y kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t \u0111i\u1ec1u tr\u1ecb c\u00f3 ti\u00eau chu\u1ea9n r\u00f5 r\u00e0ng, v\u00e0 n\u00f3 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1eb7t ra cho c\u00e1c b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 di c\u0103n h\u1ea1ch li\u00ean quan hay m\u1eb7t c\u1eaft ph\u1eabu thu\u1eadt \u00e2m t\u00ednh (t\u1ee9c kh\u00f4ng c\u00f3 ung th\u01b0 t\u1ea1i m\u1eb7t c\u1eaft d\u01b0\u1edbi k\u00ednh hi\u1ec3n vi), trong khi c\u00f3 v\u00e0i b\u1eb1ng ch\u1ee9ng cho r\u1eb1ng n\u00f3 c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i nhi\u1ec1u h\u01a1n.<\/li>\n<li>X\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi h\u00f3a tr\u1ecb, \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n ho\u1eb7c kh\u00f4ng mu\u1ed1n ph\u1eabu thu\u1eadt.<\/li>\n<\/ul>\n<p>X\u1ea1 tr\u1ecb th\u01b0\u1eddng nhanh g\u1ecdn v\u00e0 kh\u00f4ng g\u00e2y \u0111au \u0111\u1edbn, t\u01b0\u01a1ng t\u1ef1 nh\u01b0 khi ch\u1ee5p X-quang. X\u1ea1 tr\u1ecb th\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh trong 5 ng\u00e0y tr\u00ean 1 tu\u1ea7n, trong v\u00e0i tu\u1ea7n.<\/p>\n<p>M\u1ed9t k\u0129 thu\u1eadt kh\u00e1c c\u0169ng d\u00f9ng tia x\u1ea1, g\u1ecdi l\u00e0 x\u1ea1 tr\u1ecb l\u1eadp th\u1ec3 \u0111\u1ecbnh v\u1ecb to\u00e0n th\u00e2n (SBRT- stereotactic body radiation therapy) ho\u1eb7c stereotactic ablative body radiation (SABR), bao g\u1ed3m vi\u1ec7c \u0111\u01b0a nhi\u1ec1u tia x\u1ea1 h\u01a1n v\u00e0o m\u1ed9t di\u1ec7n nh\u1ecf h\u01a1n trong v\u00e0i ng\u00e0y li\u00ean t\u1ee5c \u0111i\u1ec1u tr\u1ecb (5 ho\u1eb7c \u00edt h\u01a1n). Nghi\u00ean c\u1ee9u v\u1ec1 SBRT \u0111\u01b0a ra k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb r\u1ea5t h\u1ee9a h\u1eb9n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 di c\u0103n h\u1ea1ch, gia t\u0103ng b\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p n\u00e0y nh\u01b0 m\u1ed9t li\u1ec7u ph\u00e1p thay th\u1ebf cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 v\u1ea5n \u0111\u1ec1 n\u1ed9i khoa nghi\u00eam tr\u1ecdng, khi\u1ebfn h\u1ecd kh\u00f4ng m\u1ed5 \u0111\u01b0\u1ee3c. Hi\u1ec7u qu\u1ea3 c\u1ee7a SBRT \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n m\u1ed5 nh\u01b0ng kh\u00f4ng mu\u1ed1n m\u1ed5 c\u0169ng \u0111ang \u0111\u01b0\u1ee3c quan t\u00e2m h\u01a1n. Hi\u1ec7u qu\u1ea3 l\u00e2u d\u00e0i v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 do SBRT so v\u1edbi ph\u1eabu thu\u1eadt th\u01b0\u1eddng v\u1eabn ch\u01b0a r\u00f5 r\u00e0ng.<\/p>\n<h2><strong>T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a x\u1ea1 tr\u1ecb<\/strong><\/h2>\n<p>X\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 trong su\u1ed1t qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. T\u00e1c d\u1ee5ng ph\u1ee5 th\u01b0\u1eddng ch\u1ea5m d\u1ee9t sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ed5 bi\u1ebfn nh\u1ea5t bao g\u1ed3m:<\/p>\n<ul>\n<li>Kh\u00f3 nu\u1ed1t g\u00e2y ra b\u1edfi s\u1ef1 s\u01b0ng n\u1ec1 v\u00e0 k\u00edch th\u00edch th\u1ef1c qu\u1ea3n (vi\u00eam th\u1ef1c qu\u1ea3n).<\/li>\n<li>S\u01b0ng n\u1ec1 v\u00e0 k\u00edch th\u00edch v\u00f9ng ph\u1ed5i l\u00e0nh xung quanh kh\u1ed1i u (vi\u00eam ph\u1ed5i).<\/li>\n<li>Ch\u00e1n \u0103n.<\/li>\n<li>K\u00edch th\u00edch da t\u1ea1i v\u1ecb tr\u00ed \u0111i\u1ec1u tr\u1ecb, tr\u00f4ng gi\u1ed1ng nh\u01b0 ch\u00e1y n\u1eafng \u1edf th\u00e0nh ng\u1ef1c.<\/li>\n<li>R\u1ee5ng l\u00f4ng \u1edf v\u00f9ng \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<h2><strong>H\u00f3a tr\u1ecb b\u1ed7 tr\u1ee3<\/strong><\/h2>\n<p>H\u00f3a tr\u1ecb l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb l\u00e0m t\u1ebf b\u00e0o ung th\u01b0 ch\u1eadm ho\u1eb7c ng\u1eebng ph\u00e1t tri\u1ec3n. K\u1ec3 c\u1ea3 khi kh\u1ed1i u \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf sau ph\u1eabu thu\u1eadt, c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 v\u1eabn c\u00f3 th\u1ec3 c\u00f2n t\u1ed3n t\u1ea1i trong c\u01a1 th\u1ec3, t\u0103ng nguy c\u01a1 t\u00e1i ph\u00e1t.<\/p>\n<p>H\u00f3a tr\u1ecb c\u00f3 th\u1ec3 lo\u1ea1i b\u1ecf c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 n\u00e0y v\u00e0 t\u0103ng c\u01a1 h\u1ed9i ch\u1eefa kh\u1ecfi b\u1ec7nh, nh\u01b0ng n\u00f3 ch\u1ec9 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 t\u00e1i ph\u00e1t \u0111\u1ee7 cao \u0111\u1ec3 c\u00e2n nh\u1eafc v\u1edbi c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a h\u00f3a tr\u1ecb. H\u00f3a tr\u1ecb sau ph\u1eabu thu\u1eadt g\u1ecdi l\u00e0 h\u00f3a tr\u1ecb b\u1ed5 tr\u1ee3. N\u00f3 \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb ch\u1ee7 y\u1ebfu \u1edf c\u00e1c b\u1ec7nh nh\u00e2n UTPKTBN giai \u0111o\u1ea1n II ho\u1eb7c III, ho\u1eb7c cho m\u1ed9t v\u00e0i (kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3) b\u1ec7nh nh\u00e2n giai \u0111o\u1ea1n IB. H\u00f3a tr\u1ecb b\u1ed5 tr\u1ee3 th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb cho giai \u0111o\u1ea1n IA, b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ed1i u nh\u1ecf h\u01a1n 3 cm v\u00e0 kh\u00f4ng c\u00f3 di c\u0103n h\u1ea1ch. C\u00e1c h\u01b0\u1edbng d\u1eabn chung n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c c\u00e1 nh\u00e2n h\u00f3a d\u1ef1a v\u00e0o c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a ung th\u01b0, s\u1ee9c kh\u1ecfe t\u1ed5ng tr\u1ea1ng v\u00e0 mong mu\u1ed1n c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p>H\u00f3a tr\u1ecb kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n h\u00e0ng ng\u00e0y m\u00e0 s\u1eed d\u1ee5ng theo t\u1eebng chu k\u00ec. M\u1ed7i chu k\u00ec h\u00f3a tr\u1ecb, th\u01b0\u1eddng l\u00e0 21 \u0111\u1ebfn 28 ng\u00e0y, l\u00e0 th\u1eddi gian \u0111\u1ec3 c\u01a1 th\u1ec3 ti\u1ebfp nh\u1eadn \u0111i\u1ec1u tr\u1ecb v\u00e0 h\u1ed3i ph\u1ee5c sau c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c. Thu\u1ed1c h\u00f3a tr\u1ecb th\u01b0\u1eddng bao g\u1ed3m s\u1ef1 k\u1ebft h\u1ee3p c\u1ee7a hai h\u00f3a ch\u1ea5t (th\u01b0\u1eddng g\u1ecdi l\u00e0 ph\u00e1c \u0111\u1ed3 h\u00f3a tr\u1ecb k\u00e9p). C\u00e1c ph\u1ed1i h\u1ee3p t\u1ed1t nh\u1ea5t \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u bao g\u1ed3m t\u00e1c nh\u00e2n cisplatin, m\u1eb7c d\u00f9 nguy c\u01a1 v\u1ec1 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 khi\u1ebfn cisplatin tr\u1edf n\u00ean k\u00e9m l\u00fd t\u01b0\u1edfng h\u01a1n so v\u1edbi carboplatin \u1edf nhi\u1ec1u b\u1ec7nh nh\u00e2n. H\u1ea7u h\u1ebft h\u00f3a ch\u1ea5t \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o b\u1eb1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch. Th\u00f4ng th\u01b0\u1eddng, h\u00f3a tr\u1ecb b\u1ed5 tr\u1ee3 cho UTPKTBN k\u00e9o d\u00e0i kho\u1ea3ng 3 th\u00e1ng.<\/p>\n<p>C\u00e1c b\u00e1c s\u0129 s\u1ebd t\u01b0 v\u1ea5n c\u1ee5 th\u1ec3 v\u1ec1 h\u00f3a ch\u1ea5t \u0111\u1eb7c hi\u1ec7u n\u00ean d\u00f9ng.<\/p>\n<h2><strong>T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a h\u00f3a tr\u1ecb<\/strong><\/h2>\n<p>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a h\u00f3a tr\u1ecb trong UTPKTBN bao g\u1ed3m:<\/p>\n<ul>\n<li>Gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u (t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng).<\/li>\n<li>S\u1ed1t gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u.<\/li>\n<li>Bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n.<\/li>\n<li>Thay \u0111\u1ed5i \u0111\u01b0\u1eddng ru\u1ed9t, c\u00f3 th\u1ec3 bao g\u1ed3m t\u00e1o b\u00f3n ho\u1eb7c ti\u00eau ch\u1ea3y.<\/li>\n<\/ul>\n<p>C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c c\u00f3 th\u1ec3 x\u1ea3y ra, v\u00e0 thay \u0111\u1ed5i t\u00f9y ph\u00e1c \u0111\u1ed3 h\u00f3a tr\u1ecb. May m\u1eafn l\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ed5 bi\u1ebfn c\u1ee7a h\u00f3a tr\u1ecb th\u01b0\u1eddng l\u00e0 t\u1ea1m th\u1eddi.<\/p>\n<h2><strong>\u0110i\u1ec1u tr\u1ecb giai \u0111o\u1ea1n III<\/strong><\/h2>\n<p>Hi\u1ec7n kh\u00f4ng c\u00f3 ph\u01b0\u01a1ng ph\u00e1p t\u1ed1t nh\u1ea5t n\u00e0o cho b\u1ec7nh nh\u00e2n UTPKTBN giai \u0111o\u1ea1n III. \u0110i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc v\u00e0 v\u1ecb tr\u00ed c\u1ee7a kh\u1ed1i u, h\u1ea1ch lympho li\u00ean quan, v\u00e0 vi\u1ec7c \u0111\u00e3 ph\u1eabu thu\u1eadt hay ch\u01b0a. Khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb n\u00ean \u0111\u01b0\u1ee3c c\u00e1 nh\u00e2n h\u00f3a \u0111\u01b0a ra b\u1edfi nh\u00f3m h\u1ed9i ch\u1ea9n ung th\u01b0 nhi\u1ec1u chuy\u00ean gia (Tumor board), v\u1edbi quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a kh\u1ed1i u, s\u1ee9c kh\u1ecfe t\u1ed5ng tr\u1ea1ng\/b\u1ec7nh \u0111i k\u00e8m v\u00e0 nhu c\u1ea7u c\u00e1 nh\u00e2n c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, .<\/p>\n<p>C\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng bao g\u1ed3m:<\/p>\n<ul>\n<li>X\u1ea1 tr\u1ecb (xem m\u1ee5c \u201cX\u1ea1 tr\u1ecb\u201d \u1edf tr\u00ean).<\/li>\n<li>H\u00f3a tr\u1ecb (xem m\u1ee5c \u201cH\u00f3a tr\u1ecb\u201d \u1edf tr\u00ean).<\/li>\n<li>Ph\u1eabu thu\u1eadt (xem m\u1ee5c \u201cPh\u1eabu thu\u1eadt\u201d \u1edf tr\u00ean).<\/li>\n<\/ul>\n<p>\u1ede nhi\u1ec1u b\u1ec7nh nh\u00e2n m\u1eafc UTPKTBN giai \u0111o\u1ea1n III, s\u1ef1 k\u1ebft h\u1ee3p h\u00f3a tr\u1ecb v\u00e0 x\u1ea1 tr\u1ecb th\u01b0\u1eddng l\u00e0 n\u1ec1n t\u1ea3ng c\u1ee7a \u0111i\u1ec1u tr\u1ecb. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng sau h\u00f3a tr\u1ecb b\u01b0\u1edbc \u0111\u1ea7u ho\u1eb7c h\u00f3a tr\u1ecb c\u00f9ng x\u1ea1 tr\u1ecb (g\u1ecdi l\u00e0 h\u00f3a-x\u1ea1 tr\u1ecb). H\u00f3a tr\u1ecb v\u00e0 x\u1ea1 tr\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng c\u00f9ng l\u00fac (g\u1ecdi l\u00e0 h\u00f3a x\u1ea1 tr\u1ecb \u0111\u1ed3ng th\u1eddi) ho\u1eb7c \u0111i\u1ec1u tr\u1ecb n\u00e0y n\u1ed1i ti\u1ebfp \u0111i\u1ec1u tr\u1ecb kia (g\u1ecdi l\u00e0 h\u00f3a x\u1ea1 tr\u1ecb tu\u1ea7n t\u1ef1). Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u \u0111\u1ea7u ti\u00ean, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi ch\u1ea9n \u0111o\u00e1n ban \u0111\u1ea7u kh\u00f4ng c\u00f3 nghi ng\u1edd di c\u0103n h\u1ea1ch v\u00e0 b\u1ec7nh \u0111\u01b0\u1ee3c cho l\u00e0 \u1edf giai \u0111o\u1ea1n I ho\u1eb7c II. N\u1ebfu m\u1ed5 r\u1ed3i m\u1edbi bi\u1ebft l\u00e0 giai \u0111o\u1ea1n III, ph\u1eabu thu\u1eadt s\u1ebd th\u01b0\u1eddng c\u00f3 h\u00f3a tr\u1ecb k\u00e8m theo (m\u1ed9t s\u1ed1 \u00edt ca c\u00f3 th\u1ec3 d\u00f9ng x\u1ea1 tr\u1ecb b\u1ed5 tr\u1ee3).<\/p>\n<p>Li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, lo\u1ea1i \u0111i\u1ec1u tr\u1ecb s\u1eed d\u1ee5ng h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 gi\u00fap l\u00e0m ch\u1eadm ho\u1eb7c d\u1eebng s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ung th\u01b0, l\u00e0 m\u1ed9t gi\u1ea3i ph\u00e1p m\u1edbi. M\u1ed9t thu\u1ed1c mi\u1ec5n d\u1ecbch c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc d\u00f9ng sau h\u00f3a x\u1ea1 tr\u1ecb \u0111\u1ed3ng th\u1eddi cho giai \u0111o\u1ea1n III c\u1ee7a UTPKTBN. C\u00e1c chuy\u00ean gia v\u1eabn \u0111ang ti\u1ebfp t\u1ee5c t\u00ecm hi\u1ec3u v\u1ec1 hi\u1ec7u qu\u1ea3 l\u00e2u d\u00e0i v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch \u1edf t\u00ecnh hu\u1ed1ng n\u00e0y.<\/p>\n<h2><strong>Kh\u1ed1i u \u0111\u1ec9nh ph\u1ed5i (Pancoast Tumors)<\/strong><\/h2>\n<p>Thu\u1eadt ng\u1eef Kh\u1ed1i u \u0111\u1ec9nh ph\u1ed5i n\u00f3i t\u1edbi UTPKTBN khu tr\u00fa \u1edf ph\u1ea7n cao nh\u1ea5t c\u1ee7a ph\u1ed5i, g\u1ecdi l\u00e0 \u0111\u1ec9nh ph\u1ed5i. Kh\u1ed1i u \u0111\u1ec9nh ph\u1ed5i c\u00f3 th\u1ec3 li\u00ean quan t\u1edbi c\u00e1c d\u00e2y th\u1ea7n kinh, g\u00e2y n\u00ean t\u1eadp h\u1ee3p c\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng Pancoast.<\/p>\n<p>\u0110\u1ea7u ti\u00ean, c\u00e1c tri\u1ec7u ch\u1ee9ng bao g\u1ed3m \u0111au vai v\u00e0 c\u00e1nh tay, y\u1ebfu kh\u1ed1i c\u01a1 b\u00e0n tay v\u00e0 \u0111\u1ecf b\u1eebng m\u1eb7t ho\u1eb7c t\u0103ng ti\u1ebft m\u1ed3 h\u00f4i m\u1ed9t b\u00ean m\u1eb7t. Khi kh\u1ed1i u ti\u1ebfn tri\u1ec3n, hi\u1ec7n t\u01b0\u1ee3ng \u0111\u1ecf b\u1eebng m\u1eb7t c\u00f3 th\u1ec3 bi\u1ebfn m\u1ea5t, m\u00ed m\u1eaft c\u00f3 th\u1ec3 b\u1ecb s\u1ee5p v\u00e0 n\u1eeda ng\u01b0\u1eddi b\u00ean li\u00ean quan c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 m\u1ed3 h\u00f4i.<\/p>\n<p>N\u1ebfu kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a di c\u0103n xa, \u0111i\u1ec1u tr\u1ecb kh\u1ed1i u Pancoast th\u01b0\u1eddng l\u00e0 k\u1ebft h\u1ee3p c\u1ee7a h\u00f3a tr\u1ecb v\u00e0 x\u1ea1 tr\u1ecb, c\u00f3 th\u1ec3 theo sau ph\u1eabu thu\u1eadt, mi\u1ec5n l\u00e0 kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a di c\u0103n xa.<\/p>\n<h2><strong>C\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng<\/strong><\/h2>\n<p>Ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i \u0111\u00f2i h\u1ecfi s\u1ef1 nghi\u00ean c\u1ee9u v\u00e0 ki\u1ec3m ch\u1ee9ng c\u00e1c \u0111i\u1ec1u tr\u1ecb t\u1ed1t h\u01a1n th\u00f4ng qua c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. Th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng l\u00e0 c\u00e1ch ki\u1ec3m so\u00e1t c\u1ea9n th\u1eadn \u0111\u1ec3 nghi\u00ean c\u1ee9u hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi ho\u1eb7c k\u1ebft h\u1ee3p m\u1edbi gi\u1eefa c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u00e3 bi\u1ebft. B\u1ea5t c\u1ee9 khi n\u00e0o c\u00f3 th\u1ec3, b\u1ec7nh nh\u00e2n m\u1eafc ung th\u01b0 ph\u1ed5i \u0111\u1ec1u n\u00ean \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch tham gia v\u00e0o c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng. \u0110\u1ec3 c\u00f3 th\u00eam th\u00f4ng tin v\u1ec1 c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, ho\u1eb7c \u0111\u1ecdc v\u1ec1 c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng t\u1ea1i:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.uptodate.com\/external-redirect.do?target_url=http%3A%2F%2Fwww.cancer.gov%2Fclinicaltrials%2F&amp;token=%2B4cBCd4hrat9fnIyIQ2cmIVgF64c9biG8ggfvS5L2PsMFrVJXXAY%2FwtuR87%2F56ie&amp;TOPIC_ID=876\" target=\"_blank\" rel=\"noopener\">cancer.gov\/clinicaltrials\/<\/a><\/li>\n<li><a href=\"https:\/\/www.uptodate.com\/external-redirect.do?target_url=http%3A%2F%2Fclinicaltrials.gov%2F&amp;token=YbJELcAW9G3aZfZrjTwglubdGkNLI6vF%2BUUqouKTYUezNDuyrLCVJ8CPUNOYDvHP&amp;TOPIC_ID=876\" target=\"_blank\" rel=\"noopener\">http:\/\/clinicaltrials.gov\/<\/a><\/li>\n<\/ul>\n<p>Video gi\u1ea3i quy\u1ebft c\u00e1c c\u00e2u h\u1ecfi ph\u1ed5 bi\u1ebfn v\u1ec1 c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng hi\u1ec7n c\u00f3 t\u1ea1i Hi\u1ec7p h\u1ed9i Ung th\u01b0 l\u00e2m s\u00e0ng Hoa K\u1ef3 (<a href=\"https:\/\/www.uptodate.com\/external-redirect.do?target_url=http%3A%2F%2Fwww.cancer.net%2Fpre-act&amp;token=%2B4cBCd4hrat9fnIyIQ2cmK40JXDUzuA7BM6%2Bqj4x5A3lYdMaHxx%2FwNpRx5dp3ug%2F&amp;TOPIC_ID=876\" target=\"_blank\" rel=\"noopener\">http:\/\/www.cancer.net\/pre-act<\/a>).<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p>UpToDate Patient education: Non-small cell lung cancer treatment; stage I to III cancer (Beyond the Basics)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (UTPKTBN) chi\u1ebfm t\u1eeb 85-90% t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i v\u00e0 \u0111i\u1ec1u n\u00e0y li\u00ean quan \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb.<\/p>\n","protected":false},"author":362,"featured_media":5018,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2460,2600],"tags":[2602,2603],"series":[1437],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf, giai \u0111o\u1ea1n I-III - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng<\/title>\n<meta name=\"description\" content=\"Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (UTPKTBN) chi\u1ebfm t\u1eeb 85-90% t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i v\u00e0 \u0111i\u1ec1u n\u00e0y li\u00ean quan \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/yhoccongdong.com\/ung-thu\/dieu-tri-ung-thu-phoi-khong-te-bao-nho-giai-doan-i-iii\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u0110i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf, giai \u0111o\u1ea1n I-III - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng\" \/>\n<meta property=\"og:description\" content=\"Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (UTPKTBN) chi\u1ebfm t\u1eeb 85-90% t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i v\u00e0 \u0111i\u1ec1u n\u00e0y li\u00ean quan \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/yhoccongdong.com\/ung-thu\/dieu-tri-ung-thu-phoi-khong-te-bao-nho-giai-doan-i-iii\/\" \/>\n<meta property=\"og:site_name\" content=\"D\u1ef1 \u00e1n Ung Th\u01b0\" \/>\n<meta property=\"article:author\" content=\"https:\/\/www.facebook.com\/tiendongmd\" \/>\n<meta property=\"article:published_time\" content=\"2018-11-09T23:53:06+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/11\/ung-thu-phoi-te-bao-nho-20221010-090401.png\" \/>\n\t<meta property=\"og:image:width\" content=\"660\" \/>\n\t<meta property=\"og:image:height\" content=\"330\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Ths.BS. 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