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目的借助循证医学方法为1例Ⅲ期复发性卵巢癌患者制定治疗方案。方法针对该患者的临床问题,遵循循证临床实践的PICO原则,查找并评价当前与复发性卵巢癌治疗相关的最佳临床证据。结果现有证据表明:对于铂类耐药的复发性卵巢癌患者,倾向于药物治疗模式。查找临床指南、大型随机对照试验和基于随机对照试验的系统评价或Meta分析研究,并结合医生临床经验及患者意愿,我们为该患者选用伊立替康+多柔比星脂质体介入化疗的方案。经过3个周期的化疗,病情获得部分缓解,医疗组拟继续进行6～8个周期的化疗,目前仍在随访中。结论采用循证治疗方法,为铂类耐药的复发性卵巢癌患者确定合理的治疗方案,不仅可有效提高治疗效果,同时有利于引导医患双方共同承担医疗不确定性的风险。
Objective To develop a treatment regimen for 1 case of stage Ⅲ recurrent ovarian cancer by evidence-based medicine. Methods According to the patients’ clinical problems, follow the PICO principle of evidence-based clinical practice to find out and evaluate the current best clinical evidence of relapse-related ovarian cancer. Results The available evidence suggests that for platinum-resistant patients with recurrent ovarian cancer, there is a trend towards pharmacotherapy modalities. Finding out clinical guidelines, large randomized controlled trials, and systematic reviews or meta-analyzes based on randomized controlled trials, combined with the clinical experience of the physician and the wishes of the patients, we selected the option of irinotecan + doxorubicin liposomal intervention for this patient . After 3 cycles of chemotherapy, the condition was partially relieved, and the medical team intends to continue the chemotherapy for 6 to 8 cycles, which is still under follow-up. Conclusions The evidence-based treatment method for platinum-resistant recurrent ovarian cancer patients to determine a reasonable treatment program, not only can effectively improve the treatment effect, but also conducive to guide both doctors and patients to share the risk of medical uncertainty.