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郑女士66岁,因腰背酸痛十多年,加重半年,于1996年9月到某中医大学第一附属医院(A医院)就诊。经A医院的MRI核磁共振检查,被怀疑为骨转移瘤并须放射性治疗止痛。某肿瘤医院(B医院)医师根据病史、临床表现、体征、全身ECT骨扫描,结合A医院的MRI,也诊断郑某患骨转移瘤,但未找到原发病灶这并不能说明诊断错误,正如《肿瘤学》所述:骨骼原发灶不明的转移瘤的发生率可达1/3,这类转移瘤的原发灶难于寻找,甚至尸解也有不少病例找不到原发病灶。虽未发现原发肿瘤,但郑某请求医师给予放疗止痛治疗。医师告诉患者家属:给予患者止痛性放疗的姑息治疗,这是合乎治疗原则的;《肿瘤放射治疗学》也认为:“骨转移的放射治疗止痛作用又快、又好,同时也有延长生存期的作用。”患者及其家属同意做放疗,但未签《放疗同意书》。
At the age of 66, Ms. Cheng is suffering from back pain for more than ten years and exacerbated for six months. She went to the First Affiliated Hospital of a Chinese University of Traditional Chinese Medicine (A Hospital) in September 1996. A hospital by MRI, was suspected of bone metastases and radiotherapy to be painkillers. A tumor hospital (B Hospital) doctors according to history, clinical manifestations, signs, systemic ECT bone scan, combined with the MRI of A hospital, Zheng also diagnosed bone metastases, but did not find the primary lesion this does not explain the diagnostic error, just as “Oncology” said: the incidence of bone metastases unknown primary metastasis up to 1/3, the primary tumor of these metastases is difficult to find, and even autopsy, there are many cases can not find the primary lesion. Although no primary tumor was found, Zheng asked the physician to give radiotherapy and pain treatment. The physician told the patient’s family: Palliative treatment given to patients with pain-relieving radiotherapy, which is in line with the principle of treatment; “Cancer Radiation Therapeutics” also believes: "Radiotherapy of bone metastases pain relief role fast, good, but also prolong survival The role of patients and their families agreed to do radiotherapy, but did not sign the consent of radiotherapy.