问题 单项选择题

男性,14岁,左股骨下端骨肉瘤,胸片未见异常,最佳的治疗方案是

A.根治性切除+术后大剂量化疗
B.根治性切除+术后放疗
C.术前大剂量化疗+根治性切除+术后大剂量化疗
D.术前放疗+根治性切除+术后放疗
E.术前大剂量化疗和放疗+肿瘤刮除+术后大剂量化疗和放疗

答案

参考答案:C

解析:[考点] 恶性骨肿瘤
[分析] 骨肉瘤是最常见的恶性骨肿瘤,好发于青少年,好发部位是膝关节上下及肱骨近端的干骺端。骨肉瘤肺转移发生率极高。既往虽行根治性切除术,但5年存活率不高。近年来由于早期诊断和化疗的迅速发展,对本例属于G2T1-2M0的患者,术前大剂量化疗,然后根据肿瘤浸润范围作根治性切除,术后继续大剂量化疗。如已有肺转移,属G2T1-2M1者,除上述治疗外,还可行手术切除转移灶,5年存活率提高至50%以上。

单项选择题

Lying in the sun on a rock, the cougar(美洲狮) saw Jeb and his son, Tom, before they saw it. Jeb put his bag down quickly and pulled his jacket open with both hands, making himself look big to the cougar. It worked. The cougar hesitated, ready to attack Jeb, but ready to forget the whole thing, too.

Jeb took off his jacket, grasped Tom and held him across his body, making a cross. Now the cougar’ s enemy looked even bigger, and it rose up, ready to move away, but unfortunately Tom got scared and struggled free of Jeb.

"Tom, No !" shouted his father.

But Tom broke and ran and that’ s the last thing you do with a cougar. The second Tom broke free, Jeb threw himself on the cougar, just as it jumped from the rock. They hit each other in mid-air and both fell. The cougar was on Jeb in a flash, forgetting about Tom, which was what Jeb wanted. Cougars are not as big as most people think and a determined man stands a chance, even with just his fists. As the cougar’s claws got into his left shoulder, Jeb swung his fist at its eyes and hit hard. The animal howled(吼叫)and put its head back. Jeb followed up with his other fist. Then out of the comer of his eye, Jeb saw Tom. The boy was running back to help his father.

"Knife, Tom," shouted Jeb.

The boy ran to his father’ s bag, while Jeb started shouting as well as hitting, to keep the cou-gar’s attention away from Tom. Tom got the knife and ran over to Jeb. The cougar was moving its head in and out, trying to find a way through the wall. Jeb was making out of his arms. Tom swung with the knife, into the cougar’ s back. It howled horribly and ran off into the mountains.

How did Jeb try to hold the cougar’ s attention()

A. By keeping shouting and hitting.

B. By making a wall out of his arms.

C. By throwing himself on the cougar.

D. By swinging his fists at the cougar’ s eyes.

单项选择题 A1/A2型题