Kansarka Maqaarka iyo UVB Phototherapy

Waa maxay khatarta kansarka maqaarka ee UVB phototherapy?

Si ka duwan shucaaca ultraviolet ee iftiinka qoraxda ee dabiiciga ah iyo laambadaha maqaarka la isku qurxiyo, tobanaan sano oo loo isticmaalo maqaarka ayaa muujiyay in UVB/UVB-Narrowband phototherapy (kaas oo UVA si weyn looga reebay) khatar weyn uma aha kansarka maqaarka;
oo ay ku jiraan kansarka unugyada basal-ka (BCC), kansarka unugyada squamous cell (SCC) iyo melanoma malignant maqaarka (CMM).

Si aad u taageerto bayaankan, fadlan tixgeli
Qodobbada daraasadda ee soo socda, iyo doodda soo socota:

Daraasad kooxeed dib-u-eegis ah oo la daabacay Diseembar 2023 ayaa loo yeedhay
Dhacdooyinka iyo astaanta kansarka maqaarka ee bukaannada ka dib ultraviolet phototherapy oo aan lahayn psoralens ayaa soo gabagabeeyay:

 

 

"Guud ahaan, 3506 bukaan oo lagu daweeyey broadband-ultraviolet-B, cidhiidhi-UVB iyo/ama isku-dhafka UVAB ayaa lagu qiimeeyay celcelis ahaan dabagal 7.3 sano ah oo lagu soo gabagabeeyey ma jirto khatar dheeraad ah oo melanoma ah iyo kansarka keratinocyte waxaa laga helay sawir-qaade"

Daraasad cusub oo xiiso leh oo la daabacay Abriil 2023 ayaa muujisay "Dadka qaba vitiligo waxay leeyihiin khatar aad u yar oo ah kansarka maqaarka ee melanoma iyo non-melanoma labadaba marka loo eego dadweynaha."
Waxaa kaloo lagu sheegay in "Marka la eego welwelka laga qabo in daawaynta qaar ee vitiligo, sida daaweynta sawir-qaadista ee dheer, ay kordhin karto khatarta kansarka maqaarka, hoos u dhaca la muujiyay ee kansarka maqaarku waa inuu u xaqiijiyaa labadaba dadka qaba vitiligo iyo dhakhaatiirta maareynaya xaaladda."

A Daraasad cusub oo la daabacay Agoosto 2022 ka Vancouver (Dhacdooyinka kansarka maqaarka ee bukaanka canbaarta leh ee lagu daweeyay ultraviolet phototherapy) waxay ku soo gabagabaysay:

 

"Guud ahaan, marka laga reebo bukaanada leh taariikhda qaadashada daawaynta difaaca jirka, ma jirin khatar kordhaysa oo ah melanoma, kansarka unugyada squamous cell, ama kansarka unugyada basal cell ee bukaanada helaya ultraviolet phototherapy, oo ay ku jiraan UVB cidhiidhi ah, Broadband UVB, iyo UVA iyo Broadband. UVB, oo tan ku taageeraysa sidii daawaynta aan kansarka lahayn ee bukaannada qaba cambaarta atopic.

"Dib u eegis lagu sameeyo daraasadaha ku saabsan UVB, labadaba cidhiidhiga ah iyo kuwa ballaadhan, ma muujinayaan khatarta sii kordheysa ee kansarka maqaarka ee nonmelanoma ama melanoma."

Si aad u akhrido daraasadda oo dhan, raac xidhiidhkan:

Daawaynta cudurka psoriasis iyo halista xumaanta.

Patel RV1, Clark LN, Lebwohl M, Weinberg JM.

"Daraasaddan ballaaran, oo la socota ilaa 22 sano laga bilaabo daawaynta koowaad ee NB-UVB, ma aanan helin wax xiriir ah oo u dhexeeya daaweynta NB-UVB iyo BCC, SCC ama kansarka maqaarka melanoma." 

Si aad u akhrido daraasadda oo dhan, raac xidhiidhkan:
Dhacdooyinka kansarka maqaarka ee 3867 bukaan oo lagu daweeyey Narrow-Band UVB Phototherapy
Maqal RMKer ACRaxiim KFFerguson JDawe RS.

"Ma jirto khatar kordhaysa oo kansarka maqaarka ah ayaa lagu caddeeyey afarta daraasadood ee si gaar ah u qiimeynaya khatarta kansarka ee NB-UVB."

Si aad u akhrido daraasadda oo dhan, raac xidhiidhkan:
Khatarta kansarka naasaha ah ee daaweynta psoralen UV-A iyo daawaynta UV-B ee cidhiidhiga ah ee cudurka psoriasis ee daba-dheeraada: dib-u-eegis suugaaneed habaysan.

Archier E1, Devaux S, Castela E, Gallini A, Aubin F, Le Maître M.

"Ma jirin farqi weyn oo u dhexeeya nbUVB iyo kooxaha kantaroolka. Markaa, nbUVB phototherapy iyadoo la adeegsanayo nalalka TL-01 waxay u muuqataa inay tahay hab daawayn badbaado leh oo loogu talagalay bukaannada qaba sawir-qaadista maqaarka III-V."

Si aad u akhrido daraasadda oo dhan, raac xidhiidhkan:
Ma jiraan wax caddaynaya khatarta kansarka maqaarka ee korodhay ee Kuuriyaanka leh sawir-qaadista maqaarka III-V oo lagu daweeyay daawaynta sawir-qaadista UVB cidhiidhi ah.

Jo SJ1, Kwon HH, Choi MR, Youn JI.

“Dr. Lebwohl ayaa yidhi. "Ugu yaraan ilaa hadda, waxay u muuqataa in UVB-ga ciriiriga ah uusan wax ku biirin kansarka maqaarka. Si kastaba ha ahaatee, bukaanada u nugul kansarka, waxaan ka taxadarnaa isticmaalka daawaynta sawir-qaadista."

Si aad u akhrido daraasadda oo dhan, raac xidhiidhkan:
Daaweynta psoriasis ee caadiga ah
saamaynta Fursadaha bukaannada uu ku dhaco kansarka maqaarka maqaarka Times May-2017

"Sidaa darteed, daraasadda hadda jirta ma bixinayso caddaynta khatarta kansarka maqaarka ee sii kordheysa ee bukaannada lagu daaweeyey labadaba Broadband ama UVB phototherapy" 


Si aad u akhrido daraasadda oo dhan, raac xidhiidhkan:
Ma jirto wax caddaynaya khatarta kansarka maqaarka ee korodhka ah ee bukaanka psoriasis ee lagu daaweeyay baladh-baanad ama cidhiidhi UVB phototherapy: daraasad dib-u-eegis ah oo ugu horreysa.

Weischer M1, Blum A, Eberhard F, Röcken M, Berneburg M.

"(UVB-Narrowband) Daawaynta sawirku waa badbaado oo fudud in la sameeyo. Inkasta oo dhibaatooyinka ay ka mid yihiin gubashada qorraxda, ma aragno kansar maqaarka ah, melanoma ama non-melanoma. Vitiligo waxay u badan tahay inay difaac u tahay melanoma. 

Fikrado cusub, daawaynta vitiligo - Pearl Grimes - Maqaarka Times Agoosto-2016

"In kasta oo walaac laga qabo awoodda kansarka ee shucaaca ultraviolet, cilmi-baarisyada intooda badani ma aysan helin khatarta sii kordheysa ee kansarka maqaarka ee non-melanoma ama melanoma ee bukaanada lagu daaweeyey ultraviolet B (broadband iyo narrowband) iyo ultraviolet A1 phototherapy."

Si aad u akhrido daraasadda oo dhan, raac xidhiidhkan:
Dhinaca mugdiga ah ee iftiinka: Daawaynta sawir-qaadista.

Valejo Coelho MM1, Apetato M2.

Dood

Shucaaca ultraviolet (UVR) ee ka yimaada iftiinka qorraxda ee dabiiciga ah
"waxaa loo arkaa sababta ugu weyn
Induction ee kansarka maqaarka"

UVR waxa loo qaybiyaa:

UVA
320-400nm
Mawjadaha haraggu

UVB
280-320nm
Hirarka hirarka gubanaya

UVC
100-280nm
Waxaa sifeeyay jawiga dhulka

UVB UVA
Sidaa darteed, ujeeddooyinka dooddan, UVR=UVA+UVB.

Mawjadaha kala duwan ee iftiinka iftiinka wuxuu keenaa saameyno kala duwan oo bayooloji ah oo maqaarka aadanaha ah. Mawjadaha dhaadheer ee UVA waxay galaan maqaarka, halka UVB ay galaan oo keliya epidermis.

Waxaa jira saddex nooc oo waaweyn oo kansarka maqaarka ah:

BCC

kansarka unugyada hoose ee basalaka

SCC

kansarka unugyada jirka

CMM

melanoma malignant maqaarka

BCC iyo SCC waa la isu geeyey sidii kansarrada maqaarka ee aan melanoma ahayn (NMSC), waxayna ku xiran yihiin qiyaasta nolosha ee UVB. Meelaha maqaarka ee la siiyay qiyaaso badan oo nolosha ah ee UVR ayaa ah kuwa ugu nugul, sida madaxa, qoorta, laabta, iyo gacmaha hore. NMSC si diyaar ah ayaa loo daweyn karaa haddii goor hore la ogaado.
Kansarka maqaarka iyo UVB Phototherapy
Halka UVB ay mas'uul ka tahay gubashada maqaarka (erythema) iyo NMSC, waa is-khilaafsan sidoo kale mawjadaha mawjadaha ka sameeya Vitamin D maqaarka waana kan ugu waxtarka badan ee daaweynta cudurrada maqaarka ee kala duwan.

Si loo yareeyo erythema iyo NMSC iyada oo wali la bixinayo daaweynta cudurrada maqaarka ee waxtarka leh, UVB-Narrowband (311nm peak, /01) waxaa sameeyay Philips Lighting 1980-meeyadii oo hadda waxay xukumaan daaweynta sawir-qaadista ee adduunka oo dhan. Wixii macluumaad dheeraad ah eeg: Fahamka Narrowband UVB Phototherapy.

Melanoma waa kansarka maqaarka ee ugu khatarta badan maadaama ay ku faafi karto kansarka meelaha kale ee jirka. "Waxay u badan tahay in arrimo isbiirsaday, oo ay ku jiraan arrimaha deegaanka iyo hiddaha, ay keenaan melanoma. Weli, dhakhaatiirtu waxay aaminsan yihiin soo-gaadhista shucaaca ultraviolet (UV) ee ka yimaada qorraxda iyo nalalka maqaarka iyo sariiraha ayaa ah sababta ugu weyn ee melanoma."17

Iftiinka UV ma keeno dhammaan melanoma, gaar ahaan kuwa ku dhaca meelaha jidhkaaga ka mid ah ee aan helin iftiinka qorraxda. Tani waxay muujinaysaa in arrimo kale ay gacan ka geysan karaan halista melanoma. Melanoma waxaa sababi kara UVA iyo UVB labadaba, laakiin waxaa jira caddayn ah in UVA laga yaabo inay door weyn ka ciyaaraan.3

Khatarta melanoma waxaa ka mid ah: moles (melanocytic nevi), nooca maqaarka (shakhsiyaadka maqaarkoodu yahay mid aad uga khatar badan kuwa madawga leh), iyo gubasho soo noqnoqda, gaar ahaan caruurnimada. "Soo-gaadhista joogtada ah ee iftiinka qoraxda ee xooggan ayaa si xoog leh ula xidhiidha horumarinta melanoma marka loo eego soo-gaadhista joogtada ah ee maalin kasta. " 6

Haddana in la sharaxo waa xaqiiqda "Melanoma waxay ku badan tahay dadka qaba shaqooyinka gudaha marka loo eego dadka helaya soo-gaadhista UV-ga deegaanka ee badan (beeraleyda, kalluumaysatada, iwm.)."

Inta badan suugaanta sayniska ee kansarka maqaarka waxay la xiriirtaa saamaynta iftiinka qoraxda ee dabiiciga ah (UVR, oo ka kooban inta badan UVA, oo leh boqolkiiba hoos u dhaca UVB marka loolka korodho),

Laakiin ka waran marka kaliya UVB la isticmaalo (oo UVA laga saaray), sida daaweynta UVB/UVB-Narrowband phototherapy?

In kasta oo xaqiiqda ah in waxqabadka waxqabadka ee NMSC uu ku dhawaad ​​​​dhammaan yahay xadka UVB, daraasadaha kore waxay muujinayaan in UVB/UVB-Narrowband phototherapy maaha arrin halis weyn u ah kansarka maqaarka; oo ay ku jiraan kansarka unugyada basal-ka (BCC), kansarka unugyada squamous cell (SCC) iyo melanoma malignant maqaarka (CMM).

Maqnaanshaha UVA ee khatarta ah waxay u badan tahay inay door ka ciyaaraan, iyo "Guud ahaan, waxaa jira cadaymo muujinaya in fitamiin D uu door ka qaadan karo kansarka maqaarka ee nonmelanoma (NMSC) iyo ka hortagga melanoma, in kasta oo ilaa hadda aysan jirin caddayn toos ah oo muujinaysa saameyn difaac ah." 14,15 "Daraasado dhowr ah ayaa soo jeediyay in fitamiin D-ga uu ka ciyaaro door difaac ah oo ah noocyo kala duwan oo malignancies gudaha ah. Marka la eego kansarka maqaarka, cudurrada faafa iyo shaybaarka waxay soo jeedinayaan in fitamiin D iyo dheef-shiid kiimikaad ay yeelan karaan saameyn isku mid ah oo difaac ah.. " 13

Si wax looga qabto welwelka NMSC ee UVB ay keentay, sababtoo ah waxay ku xiran tahay qiyaasta isugeynta nolosha, gaar ahaan shakhsiyaadka maqaarka cadaaladda ah, waa macquul in laga saaro daawaynta meelaha maqaarka ee aan u baahnayn daawaynta oo lahaa UVR badan inta uu nool yahay bukaanka. iyo sidoo kale in laga ilaaliyo meelahaas UVR dheeraad ah iftiinka dabiiciga ah. Kuwa leh taariikhda iyo/ama taariikhda qoyska ee kansarka maqaarka waa inay la tashadaan dhakhtarkooda ka hor intaysan qaadan daaweynta UV. Waa inay sidoo kale sameeyaan "baaritaanka maqaarka" ugu yaraan sannadkii si loo ogaado kansarka maqaarka; sida qof kasta oo uu ku dhaco iftiinka ultraviolet, ha ahaato daawaynta UV-ga caafimaadka, qalabka maqaarka lagu qurxiyo, ama iftiinka qorraxda dabiiciga ah.

Intaa waxaa dheer, UVR ka soo baxa iftiinka qorraxda ee dabiiciga ah ayaa inta badan laga helaa qofka korkiisa (tusaale qorraxdu waxay ka soo iftiimaysaa korka wejiga, dhegaha iyo garbaha), halka jidh buuxa Daawaynta UVB had iyo jeer waa laga bixiyaa dhinaca (bukaanku caadi ahaan waxay u taagan yihiin daawaynta qalab toosan), sidaa darteed waxaa jira xoogaa soo-gaadhis joomatari ah oo hoos u dhigaya meelaha ugu halista badan ee maqaarka. Marxaladda "nadiifinta" ee hore ee UVB waxay caadi ahaan ku lug leedahay qiyaasaha sawir qaade ee UVB oo sii kordhaya dhowr bilood, oo ay ku xigto daawaynta "dayactirka" muddada dheer ee qiyaasaha iyo inta jeer ee la dhimay.

Qorraxda Jirka oo buuxa
Qalabka jirka oo buuxa
UVB phototherapy uma baahna in bukaanku helo gubasho, iyo UVB qiyaaso ka yar inta ugu badan ayaa waxtar u leh dayactirka muddada dheer "Unugyada Guriga ee Ultraviolet B ma yihiin ikhtiyaar macquul ah oo loogu talagalay daawaynta joogtada ah ama dayactirka cudurrada maqaarka ee ka jawaaba sawirka?” ,18 iyo in la ilaaliyo ku filnaanta Vitamin D. 09,11,12

Dhammaan aaladaha SolRx UVB-Narrowband waxay u hoggaansamaan Caafimaadka Kanada “La’aanta Vitamin-D” sida "tusmaynta isticmaalka", taas oo macnaheedu yahay in la go'aamiyay inay badbaado iyo waxtar leh, oo sidaas si sharci ah loogu suuq gayn karo ujeedadaas gudaha Kanada. 10

Ku saabsan Bogga Hore daaweynta sawir-qaadista, habka caajiska dabiiciga ah ee qaadashada daawaynta iyo dabeecadda bini'aadamka waxay ku hagaysaa bukaan-socodka inuu qaato oo keliya qaddarka UVB ee lagama maarmaanka u ah inuu ilaaliyo maqaar cad ama u dhow. Bukaannada sawir-qaadista ee guriga waxay caadi ahaan noqdaan khabiir ku saabsan inta ay le'eg tahay UVB inay qaataan iyo goorta, iyada oo ka yar, qiyaaso badan oo soo noqnoqda ay door bidaan dad badan.

Daaweynta sawir-qaadista ee guriga ayaa sidoo kale ka dhigaysa mid yar in daawaynta la seego oo daawaynta xigta ay keento gubasho aan loo baahnayn. Si aad u ogaato, "Ultraviolet B phototherapy ee guriga ayaa si la mid ah waxtar u leh daaweynta cudurka psoriasis sida ultraviolet B phototherapy ee goobta bukaan-socodka oo ka tarjumaysa khataro dheeraad ah oo badbaado ah marka la eego goobta ay ka hortagayso shucaaca aan la qorin ee suurtogalka ah. Intaa waxaa dheer, daaweynta gurigu waxay keenaysaa culays hoose, si fiican ayaa loo mahadiyaa, waxayna ku siinaysaa horumar la mid ah tayada nolosha. Bukaannada intooda badan waxay yiraahdeen waxay door bidaan daawaynta ultraviolet B mustaqbalka ee guriga marka loo eego daaweynta sawir-qaadista ee goobta bukaan-socodka." 16

Nidaamyada Solarc waxay soo dhaweynayaan talo kasta oo lagu hagaajinayo maqaalkan macluumaadka dadweynaha.

FIIRO GAAR AH

Waa muhiim in UVB iyo UVB-Narrowband phototherapy aan lagu jahwareerin PUVA (psoralen + UVA light), sida "doorka daaweynta PUVA ee kansarka maqaarka ee dadka qaba cudurka psoriasis ayaa si cad loo muujiyay" [Khatarta kansarka naasaha leh ee PUVA iyo nbUVB ee xuubka psoriasis ee dabadheeraada_ dib u eegista suugaanta habaysan 2012] PUVA sidaas darteed inta badan waxay ku kooban tahay 200 ilaa 300 daaweyn iyo kaliya kiisaska ugu daran ee ku guuldareystay UVB ama UVB-Narrowband phototherapy.   

Tixraacyo:

1 Brenner, Michaela, iyo Vincent J. Maqalka. "Doorka Ilaalinta ee Melanin ee ka dhanka ah waxyeelada UV ee Maqaarka Aadanaha. " Kiimikada sawir-qaadista iyo sawir-qaadista, vol. 84, maya. 3, 2007, bogga 539–549., doi:10.1111/j.1751-1097.2007.00226.x.

2 “Kansarka Maqaarka/Xarunta Melanoma: Calaamadaha, Daawaynta, Calaamadaha, Noocyada, Sababaha, iyo Baaritaanada. WebMD

3 Setlow, RB, iyo al. "Mawjadaha dhaadheer ee wax ku oolka leh ee kicinta melanoma ee xun.Talaabooyinka Akademiyada Qaranka ee Sayniska, vol. 90, maya. 14, 1993, bogga 6666–6670., doi:10.1073/pnas.90.14.6666.

4 Berneburg, Mark, iyo Lena Krieger. "Kulliyada 1000 ee Qiimaynta Melanoma Induction by Ultraviolet A laakiin maaha shucaaca ultraviolet B wuxuu u baahan yahay midabka melanin." F1000 - Dib-u-eegistii asaagga ee daabacaadda ka dib ee suugaanta noole, 2012, doi:10.3410/f.717952967.793458514.

5 Brenner, Michaela, iyo Vincent J. Maqalka. "Doorka Ilaalinta ee Melanin ee ka dhanka ah waxyeelada UV ee Maqaarka Aadanaha. " Kiimikada sawir-qaadista iyo sawir-qaadista, vol. 84, maya. 3, 2007, bogga 539–549., doi:10.1111/j.1751-1097.2007.00226.x.

6 Rhodes, A.Arrimaha Khatarta Melanoma. " AIM ee Melanoma, Fitzpatrick's Dermatology ee Daawada Guud

7 Juzeniene, Asta, iyo Johan Moan. "Saamaynta Faa'iidada leh ee Shucaaca UV Marka laga reebo Soo saarista Vitamin D. " Dermato-Endocrinology, vol. 4, maya. 2, 2012, bogga 109-117., doi:10.4161/derm.20013.

8 Maverakis, Emanual, iyo al. "Iftiin, oo ay ku jiraan Ultraviolet. " Machadka Qaranka ee Caafimaadka, Meey 2010, doi:10.1016/j.jaut.2009.11.011.

9 Maraykanka, Congress, Barnaamijka Sunta Qaranka. "Broad-SpectrumUltraviolet (UV) shucaac iyo UVA, iyo UVB, iyo UVC.Balaadhan-Spectrum Ultraviolet (UV) shucaac iyo UVA, iyo UVB, iyo UVC, Shirkadda Qorshaynta iyo Maaraynta Tignoolajiyada, 2000.

10 "Macluumaad Sharci." Hal qayb oo ka mid ah Solarc Systems Inc.,

11 Bogh, Mkb, iyo al. "Narrowband Ultraviolet B Saddex jeer todobaadkii ayaa aad uga waxtar badan daawaynta yaraanta Vitamin D in ka badan 1600IU Vitamin D3 ee afka ah maalintii: Tijaabo Caafimaad oo Randomized. " Joornaaliistaha joornaalka ee Ingiriiska, vol. 167, maya. 3, 2012, bogga 625–630., doi:10.1111/j.1365-2133.2012.11069.x.

12 Ala-Houhala, Mj, iyo al. "Isbarbardhigga Soo-gaadhista Ultraviolet B ee cidhiidhiga ah iyo Beddelka Fitamiin D ee Afka ee Serum 25-Hydroxyvitamin D.Joornaaliistaha joornaalka ee Ingiriiska, vol. 167, maya. 1, 2012, bogga 160–164., doi:10.1111/j.1365-2133.2012.10990.x

13 Tang, Jean Y., iyo al. "Faytamiin D ee Kansarka Cutaneous: Qaybta I.Machadka Qaranka ee Caafimaadka, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

14 Tang, Jean Y., iyo al. "Faytamiin D ee Kansarka Cutaneous: Qaybta II.Machadka Qaranka ee Caafimaadka, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

15 Navarrete-Dechent, Cristián, iyo al. "Ku-wareejinta Faytamiin-D-ku-xidhka borotiinka iyo 25-Hydroxyvitamin D Lacag-ururinta ee Bukaannada qaba Melanoma: Daraasad- Xakamaynta Kiis."Wargeyska Agaasinka Agaasinka Agaasinka Mareykanka, vol. 77, maya. 3, 2017, bogga 575–577., doi:10.1016/j.jaad.2017.03.035.

16 Koek, M. BG, iyo al. "Guriga iyo Bukaan-socodka Ultraviolet B Phototherapy oo loogu talagalay Cudurka psoriasis Fudud ilaa Daran: Xarunta Badan ee Pragmatic (Daraasadda PLUTO).” Bmj, vol. 338, maya. may07 2, Luulyo 2009, doi:10.1136/bmj.b1542.

17 https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

18 Unugyada Guriga ee Ultraviolet B ma yihiin ikhtiyaar macquul ah oo loogu talagalay daawaynta joogtada ah ama dayactirka cudurrada maqaarka ee ka jawaaba sawirka?"