Objective To establish the evidence-based treatment strategy for an advanced lung cancer case with spinal metastasis, regarding the patient’s condition and treatment expectations. Methods According to PICO principles, questions in the patient’s treatment were converted into a search strategy. The literature searching was performed in several databases. In accordance with the five evidence grading standards in evidence-based medicine, the best clinical evidence was interpreted to guide the treatment decisions. Results A total of 148 papers were detected and screened, of which 4 systematic reviews or meta-analyses were included finally. Four issues that patients concerned, including restoring spinal cord function (walking and sphincter function), local pain control, long-term survival, and treatment complications, were all supported by grade-1 evidence. The patient finally chose surgical decompression, which was of a higher complication risk, but better possibility of restoring nerve function, significant pain relief, and improved long-term survival. The patient obtained fully recovery and regained walking function after surgery. Conclusion The evidence-based treatment is able to provide reasonable treatment options for lung cancer patients with spinal metastasis. Decompression surgery for patients with walking dysfunction should be carried out as soon as possible, in order to early restore spinal marrow function, relieve pain and improve long-term survival. But both doctors and patients should fully acquaint themselves with the higher risk of surgical complications.
目的 評估非小細胞肺癌患者中癌癥相關性乏力的發生情況及其與患者臨床病理特征和生存期之間的相互關系。 方法 應用簡明疲勞量表中文版評估2008年12月－2009年12月間收治的72例初治肺癌患者，入組患者均完成根治性手術及術后生存隨訪。 結果 72例早期非小細胞肺癌患者中，無乏力9例（12.5%），輕度乏力48例（66.7%），中度乏力15例（20.8%），重度乏力0例（0%），乏力總體發生率為87.5%。乏力指數與患者的年齡、性別、吸煙史均無相關性，與患者的體力狀況評分（ECOG PS）、TNM分期呈正相關，與中位生存期呈負相關，均有統計學意義（P＜0.05）。 結論 癌癥相關性乏力作為非小細胞肺癌患者中普遍存在的一種癥狀，不僅能夠反映患者當時的主觀感受和生活狀況，還可能是判斷患者術后病理分期及最終總生存期的預測因素。