1例晚期胃癌患者的循证治疗

Evidence-Based Treatment for 1 Case with Advanced Gastric Cancer Patients

摘要: 目的：采用循证医学方法为1例晚期胃癌患者制定诊治方案。方法：根据临床问题检索MEDLINE、ACP Journal Club、中国知网，并利用搜索引擎——谷歌学术搜索在互联网所获取的文献进行归纳分析。结果：共获得有关晚期胃癌姑息手术和新辅助化疗时机的系统评价6篇，临床对照研究病例756例。以上证据表明：晚期胃癌行新辅助化疗的根治性手术率及生存率优于姑息手术组。结合客观证据及患者意愿，为患者实施了两个疗程的奥沙利铂+希罗达(Cape + OX)化疗方案，结合化疗前后病灶的影像学变化，成功实施了手术，无手术后并发症发生。结论：循征医学方法对疑难病例的治疗有一定的指导作用。

Abstract: Objective: To make the diagnosis and treatment for advanced gastric cancer patients using evi-dence-based medicine method. Methods: Retrievalling MEDLINE, ACP Journal Club, Chinese How-Net according to the clinical question, and then searching and summarizing the literature in Internet using the search engines—Google academic search. Results: 6 systematic reviews about advanced gastric cancer palliative operation and neoadjuvant chemotherapy time and 756 cases of controlled clinical study were obtained. The above evidence approved that it was superior to palliative operation group in the radical surgery and survival rates. Combining the objective evidence and the patients’ willingness, patients were treated with two courses of chemotherapy options with oxaliplatin plus capecitabine (Cape + OX) regimen. The operation was performed successfully without complications combining with the change of focus images before and after chemotherapy. Conclusion: The evidence-based medicine method was useful for the treatment of difficult patients.