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ASCO：局部晚期不可切除胰腺癌临床实践指南

2016-07-24 MedSci MedSci原创

局部晚期不可切除胰腺癌
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为了给肿瘤医生提供基于证据的局部晚期不可切除胰腺癌的治疗建议，美国临床肿瘤协会召集了由肿瘤医学、放射肿瘤学、肿瘤外科学、胃肠病学、胰腺护理专家组成的专家小组对2002年1月到2015年6月的文献进行了系统回顾。共有26篇随机对照试验符合回顾标准。 指南建议要点如下： ◆应进行胸部、腹部、盆腔多相CT扫描。 ◆应评估基线状态和合并症。 ◆护理目标，患者偏好，精神状态，支持系统

为了给肿瘤医生提供基于证据的局部晚期不可切除胰腺癌的治疗建议，美国临床肿瘤协会召集了由肿瘤医学、放射肿瘤学、肿瘤外科学、胃肠病学、胰腺护理专家组成的专家小组对2002年1月到2015年6月的文献进行了系统回顾。共有26篇随机对照试验符合回顾标准。

指南建议要点如下：

◆应进行胸部、腹部、盆腔多相CT扫描。

◆应评估基线状态和合并症。

◆护理目标，患者偏好，精神状态，支持系统和症状应该做作为治疗的决策指导。

◆首次就诊时就应开始姑息治疗。

◆全身化疗(6个月)结合养生对大多数患者是推荐的(有些患者应先进行放疗)。没有明确的证据表明哪种养生的方法是由于其他方法的。

◆肿瘤转移后基于吉西他滨的治疗方法(如氟尿嘧啶、亚叶酸、伊立替康，奥沙利铂+吉西他滨+纳米白蛋白结合型紫杉醇)尚未在局部晚期不可切除胰腺癌中进行随机临床试验。

◆若在化疗中出现局部疾病进展，而无转移，东部肿瘤协作组体能状态≤ 2，可考虑行放疗或立体定向放疗。

◆若6个月化疗结束后，疾病稳定但毒性作用太大，可行放疗。若疾病进展可参考ASCO转移性胰腺癌治疗指南。每3-4月进行一次随访。

原始出处：

Edward P. Balaban, Pamela B. Mangu, Alok A. Khorana, et al,Locally Advanced, Unresectable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline,JCO August 1, 2016 vol. 34 no. 22 2654-2668


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  1. 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channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2017-01-24 lvliquan

    #实践指南#

    0

  2. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2016-12-18 quxin068

    #ASC#

    0

  3. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2017-04-28 yhy100208

    #局部晚期#

    0

  4. 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encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405695, encodeId=223014056951e, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571954, encodeId=f12b15e1954c8, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2016-07-25 yanjie6253_56072842

    #临床实践#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2031007, encodeId=d71c203100e91, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Jan 24 21:14:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938616, encodeId=fe28193861682, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Dec 18 07:14:00 CST 2016, time=2016-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650711, encodeId=481d1650e117c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Fri Apr 28 11:14:00 CST 2017, time=2017-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323639, encodeId=d44d132363980, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405695, encodeId=223014056951e, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571954, encodeId=f12b15e1954c8, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2016-07-25 chg122

    #局部#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2031007, encodeId=d71c203100e91, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Jan 24 21:14:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938616, encodeId=fe28193861682, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Dec 18 07:14:00 CST 2016, time=2016-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650711, encodeId=481d1650e117c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Fri Apr 28 11:14:00 CST 2017, time=2017-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323639, encodeId=d44d132363980, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405695, encodeId=223014056951e, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571954, encodeId=f12b15e1954c8, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2016-07-25 仁医06

    #临床实践指南#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2031007, encodeId=d71c203100e91, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Jan 24 21:14:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938616, encodeId=fe28193861682, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Dec 18 07:14:00 CST 2016, time=2016-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650711, encodeId=481d1650e117c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Fri Apr 28 11:14:00 CST 2017, time=2017-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323639, encodeId=d44d132363980, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405695, encodeId=223014056951e, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571954, encodeId=f12b15e1954c8, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2016-07-24 oo902

    讲的很全面

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2031007, encodeId=d71c203100e91, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Jan 24 21:14:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938616, encodeId=fe28193861682, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Dec 18 07:14:00 CST 2016, time=2016-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650711, encodeId=481d1650e117c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Fri Apr 28 11:14:00 CST 2017, time=2017-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323639, encodeId=d44d132363980, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405695, encodeId=223014056951e, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571954, encodeId=f12b15e1954c8, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2016-07-24 huangwukui

    好的，但是感觉证据等级可能不是太高

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2031007, encodeId=d71c203100e91, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Jan 24 21:14:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938616, encodeId=fe28193861682, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Dec 18 07:14:00 CST 2016, time=2016-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650711, encodeId=481d1650e117c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Fri Apr 28 11:14:00 CST 2017, time=2017-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323639, encodeId=d44d132363980, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405695, encodeId=223014056951e, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571954, encodeId=f12b15e1954c8, content=<a href='/topic/show?id=413922e74cd' target=_blank style='color:#2F92EE;'>#临床实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2016-07-24 1dd8c52fm63(暂无匿称)

    学习学习！

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=2031007, encodeId=d71c203100e91, content=<a href='/topic/show?id=5df2460e269' target=_blank style='color:#2F92EE;'>#实践指南#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46072, encryptionId=5df2460e269, topicName=实践指南)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=796422, createdName=lvliquan, createdTime=Tue Jan 24 21:14:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938616, encodeId=fe28193861682, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Dec 18 07:14:00 CST 2016, time=2016-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650711, encodeId=481d1650e117c, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Fri Apr 28 11:14:00 CST 2017, time=2017-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1323639, encodeId=d44d132363980, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, 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channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22774, encryptionId=413922e74cd, topicName=临床实践指南)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Mon Jul 25 15:14:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94491, encodeId=2b5694491cd, content=讲的很全面, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=a37a1710612, createdName=oo902, createdTime=Sun Jul 24 17:19:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94465, encodeId=94f494465f5, content=好的，但是感觉证据等级可能不是太高, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90ea1614944, createdName=huangwukui, createdTime=Sun Jul 24 10:22:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94447, encodeId=00519444e02, content=学习学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:40:00 CST 2016, time=2016-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94440, encodeId=ee9094440d0, content=难治的疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sun Jul 24 07:07:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2016-07-24 深海的鱼

    难治的疾病

    0

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