作者Pardice (一直走下去)
看板medstudent
标题[申覆] 医学(三) 37
时间Thu Aug 5 01:58:27 2010
一位53岁男性有体重减轻及贫血的情形，经大肠镜检查後，发现降结肠处有一2×1公
分大的肿瘤，切片证实为腺癌，其他检查发现单一肝转移（3×3公分位於segment 7），
但无局部组织侵犯、腹膜及淋巴结转移。下列治疗何者最为适当？
(A)手术切除大肠病灶，再合并术後化学治疗
(B)同步化学与放射治疗
(C)手术切除大肠肿瘤与肝转移病灶，再合并术後化学治疗
(D)手术切除大肠肿瘤，再合并经导管动脉化学栓塞肝肿瘤
TREATMENT Most metastatic carcinomas respond
poorly to all forms of
treatment, which is usually only palliative. Rarely a single, large
metastasis can be removed surgically. Systemic chemotherapy may slow tumor
growth and reduce symptoms, but it does not alter the prognosis.
Chemoembolization, intrahepatic chemotherapy, and alcohol or radiofrequency
ablation may provide palliation.
参考资料：
Kasper, Dennis L.; Braunwald, Eugene; Fauci, Anthony. Harrison's Principles
of Internal Medicine (16th edition).
Blacklick, OH, USA: McGraw-Hill Professional Book Group, 2006. p 536.
Copyright c 2006. McGraw-Hill Professional Book Group. All rights reserved.
申覆理由：根据课文所述，肝转移对於任何治疗均只有palliative之疗效，且
chemoembolization可以提供palliation之效果。
建议改成C、D均给分。
这题这样不知道可不可以凹到...
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1F：→ solomonK:单一肝转移 08/05 08:21
2F：推 ckyuzi:你的这段感觉会自己打枪= = 08/05 22:10