肿瘤扩散转移之后，还有期盼很久存活吗？看完这篇就清楚了
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">谢伯伯结肠癌术后3年余，复查<span style="color: black;">发掘</span>肝寡转移3个病灶，于是到<strong style="color: blue;">桃源县中医医院肿瘤血液科</strong>就诊，在综合治疗稳定后，会诊<span style="color: black;">思虑</span>手术切除有难度，谢伯伯<span style="color: black;">亦</span>不愿意手术，<span style="color: black;">经过</span>沟通，<strong style="color: blue;">科<span style="color: black;">专家</span>李程</strong>远<span style="color: black;">选取</span>为谢伯伯实施肝脏冷冻消融术。<span style="color: black;">全部</span>手术过程，舒适<span style="color: black;">没</span>痛，小小针眼，<span style="color: black;">处理</span>了<span style="color: black;">病人</span>大大的问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">肿瘤<span style="color: black;">已然</span>转移了，还有机会<span style="color: black;">长时间</span><span style="color: black;">存活</span>吗？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">首要</span>我们来学习下什么是寡转移？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">以前的认识：只要<span style="color: black;">发掘</span>一个部位的远处转移病灶，<span style="color: black;">那样</span>就<span style="color: black;">能够</span>宣布这个病人属于晚期癌症。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">此刻</span>的认识：<span style="color: black;">倘若</span>是有远处转移，属于寡转移，有些<span style="color: black;">病人</span><span style="color: black;">能够</span>实现<span style="color: black;">长时间</span><span style="color: black;">存活</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">定义：寡转移最初<span style="color: black;">指的是</span>单个器官孤立转移性病灶，随着医学技术发展，寡转移定义<span style="color: black;">已然</span>延伸为局限在个别器官内有限的转移病灶。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">日前</span>认为：转移的器官数目＜3 个，转移的肿瘤病灶数目＜5 个，<span style="color: black;">每一个</span>病灶的<span style="color: black;">体积</span>＜3 cm等。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肠癌寡转移<span style="color: black;">怎样</span>治疗？ </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一般</span>以局部联合全身治疗为主，局部治疗<span style="color: black;">包含</span>手术、放疗和消融治疗，全身系统治疗<span style="color: black;">包含</span>化疗、靶向治疗、免疫治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗目的：积极<span style="color: black;">掌控</span>肿瘤，延长<span style="color: black;">存活</span>期和<span style="color: black;">加强</span>生活质量，<span style="color: black;">乃至</span>实现临床治愈。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">局部治疗：</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">1、手术治疗</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术依然是寡转移<span style="color: black;">病人</span>有效切除原发肿瘤和局部转移病灶的<span style="color: black;">办法</span>之一，但需充分<span style="color: black;">评定</span>转移病灶的数量和部位。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">2、放射治疗</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对</span><span style="color: black;">没</span>法手术的寡转移<span style="color: black;">病人</span>，放疗治疗是<span style="color: black;">日前</span>最常用的局部治疗手段。<span style="color: black;">尤其</span>随着<span style="color: black;">精细</span>影像技术的进步，SBRT <span style="color: black;">精细</span>放疗实现高精度、高剂量治疗肿瘤病灶。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">3、消融治疗</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">消融治疗是在 CT 引导下将消融针<span style="color: black;">精细</span>置入肿瘤病灶内，<span style="color: black;">经过</span>热或冷效应使肿瘤坏死的局部治疗<span style="color: black;">办法</span>，疗效与外科手术相当，<span style="color: black;">拥有</span>创伤小、可重复性强的特点。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">全身治疗：</strong><span style="color: black;">包含</span>化疗，靶向，免疫治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">举例1：局部治疗冷冻消融过程</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、术前腹部CT，确定入针位置</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q8.itc.cn/q_70/images03/20240414/d8a8f88e826e498b88b60364f8775652.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/q_70/images03/20240414/d99fe85d678349e7afa1aa20f0447993.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、消毒，局部<span style="color: black;">麻木</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/q_70/images03/20240414/721f9d23af2144dd9388e05e3af5600d.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q8.itc.cn/q_70/images03/20240414/0b3a1193a46f41c0814c527593d5244b.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3、CT引导下穿刺定位，确定肿瘤位置</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/q_70/images03/20240414/5b92705436cd4d36a8a3f928350693cb.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/q_70/images03/20240414/285cd3e9fa174c41ad1f8d4fc0f843c9.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4、治疗：先“冻”后“融”，彻底摧毁肿瘤细胞</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（<span style="color: black;">全部</span>过程中CT全程监测，计算机全程<span style="color: black;">精细</span>监控）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q8.itc.cn/q_70/images03/20240414/ec83b1615f214c79a45ea1a33caf3bfd.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q7.itc.cn/q_70/images03/20240414/46116864291e408d93c40440ad9df0f9.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">5、治疗结束，回到病房</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q0.itc.cn/q_70/images03/20240414/870a1105cf6d4fcf929a4e1146e3eb7b.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q5.itc.cn/q_70/images03/20240414/fe052f76b17243c08c30bd0263c41873.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">6、结合全身治疗，半年后随访，<span style="color: black;">加强</span>CT<span style="color: black;">检测</span>三个病灶均缩小，<span style="color: black;">没</span>病灶强化。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">举例2：放疗（SBRT）</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">直线加速器</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/q_70/images03/20240414/980323e102394545ba6ee3196e60d707.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">呼气</span>门控技术</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4DCT扫描</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q2.itc.cn/q_70/images03/20240414/e7a54e1b429a4afba14997ca7924cf43.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q5.itc.cn/q_70/images03/20240414/ddf0b8e4e325477794db0c737c910c92.png" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此呢</span>，不管是<span style="color: black;">同期</span>性寡转移，还是异时性寡转移，虽然是肿瘤扩散了，但千万不要绝望，随着医疗技术的<span style="color: black;">持续</span><span style="color: black;">提高</span>，<span style="color: black;">病人</span>经过<span style="color: black;">恰当</span>的治疗后还是有<span style="color: black;">期盼</span><span style="color: black;">得到</span><span style="color: black;">长时间</span>，高质量的<span style="color: black;">存活</span>。</p>
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