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随着科学技术的飞速发展 ,现代诊疗技术包括设备和药物 ,不断地更新和充实 ,有力地推动了医疗思想的变革。就临床肿瘤学而论 ,几乎每 10年就有一次重要刷新出现。旧有的 ,经过几十年临床锤炼的经典模式 ,包括一个疗法的指导准则 ,都失去了它固有的权威 ,不再被奉为不可动摇的圭臬。这正是自然规律的真理精髓 :推陈出新 ,不断前进。近年来循证医学的强调 ,反映了人们需要把惯用的顺理成章的不自觉的临床行为 ,变为目靶清楚 ,定位精到 ,证据确凿的有效行为。为此 ,人们不仅要参考经典 ,因为它有深厚的历史底蕴 ;更要不断探索实践 ,因为它才是前进的动力。把握证据和着眼临床实效 ,这是匡正医疗行为的两条并行的行进轨道。传统与反传统 ,经典与离经叛道 ,这其实是两千多年来医学科学发展的主线。本文作者在这一医疗思想不断变革的大背景下 ,围绕喉癌治疗原则和方法 ,结合文献 ,进行了评析 ,提出了自己的看法。设题准确 ,观点鲜明 ,文字犀利 ,富於挑战精神 ,是本刊《癌症论坛》的好文章。我们欢迎这种学术争鸣 ,并且希望引起广泛讨论 ,以达到共同提高的目的。
With the rapid development of science and technology, modern diagnostic and therapeutic technologies, including equipment and drugs, are continuously updated and enriched, effectively promoting the revolution in medical thinking. In the case of clinical oncology, there is an important refreshment almost every 10 years. Old, classic models after decades of clinical practice, including a therapeutic guideline, have lost their inherent authority and are no longer regarded as unshakeable. This is the essence of the truth of nature’s laws: to push forward new ideas and keep moving forward. The emphasis of evidence-based medicine in recent years reflects that people need to turn their usual unconscious clinical behaviors into clear-cut objectives, well-targeted, and evidence-confirmed effective behavior. For this reason, people should not only refer to the classic because it has a deep historical heritage; it is also necessary to constantly explore the practice because it is the driving force for progress. Grasping evidence and focusing on clinical effectiveness, this is the two parallel marching tracks of Yongzheng’s medical practice. Tradition and anti-tradition, classic and deviant, this is actually the main line of medical science development for more than two thousand years. The author of this article under the background of the continuous transformation of this medical ideology, based on the principles and methods of treatment of laryngeal cancer, combined with the literature, made an analysis and put forward his own views. The accurate title, clear point of view, sharp text, and full of challenging spirit are good articles in the “Cancer Forum”. We welcome this kind of academic contention and hope that it will lead to extensive discussions in order to achieve common goals.