[申覆] 醫學(三) 37
一位53歲男性有體重減輕及貧血的情形，經大腸鏡檢查後，發現降結腸處有一2×1公
分大的腫瘤，切片證實為腺癌，其他檢查發現單一肝轉移（3×3公分位於segment 7），
但無局部組織侵犯、腹膜及淋巴結轉移。下列治療何者最為適當？
(A)手術切除大腸病灶，再合併術後化學治療
(B)同步化學與放射治療
(C)手術切除大腸腫瘤與肝轉移病灶，再合併術後化學治療
(D)手術切除大腸腫瘤，再合併經導管動脈化學栓塞肝腫瘤
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.
參考資料：
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：根據課文所述，肝轉移對於任何治療均只有palliative之療效，且
chemoembolization可以提供palliation之效果。
建議改成C、D均給分。
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