重组人p53腺病毒经肝动脉灌注化疗治疗中晚期肝癌临床疗效观察

doi:10.3969/j.issn.1672-5069.2015.02.005

实用肝脏病杂志 ›› 2015, Vol. 18 ›› Issue (3): 237-240.doi: 10.3969/j.issn.1672-5069.2015.02.005

重组人p53腺病毒经肝动脉灌注化疗治疗中晚期肝癌临床疗效观察

崔红利, 杨均, 肖潇, 颜綦先, 尹昕茹, 杨洋, 刘卉, 张艳梅, 赖姝婕, 魏艳玲, 刘念, 王军, 陈东风

400042 重庆市第三军医大学野战外科研究所大坪医院消化内科

收稿日期:2015-03-07 出版日期:2015-05-10 发布日期:2016-02-19
通讯作者: 通讯作者陈东风,E-mail:chendf1981@126.com E-mail:2465517206@qq.com
作者简介:崔红利,主治医师。主要研究方向：慢性肝病及消化道肿瘤诊治。E-mail:2465517206@qq.com

Clinical evaluation of recombinant adenovirus p53 therapy in combination with transcatheter arterial chemoembolization for patients with primary liver cancer

Cui Hongli, Yang Jun, Xiao Xiao, et al.

Department of Gastroenterology,Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042,China

Received:2015-03-07 Online:2015-05-10 Published:2016-02-19

摘要/Abstract

摘要： 目的评价重组人p53腺病毒注射液经肝动脉灌注治疗中、晚期肝癌的疗效。方法选择我院2008年~2014年临床诊断的无手术指征或拒绝手术治疗的原发性肝癌患者72例,分为选择性肝动脉栓塞化疗术（TACE）和重组人p53腺病毒注射液（rAd-p53）联合栓塞化疗治疗,每组36例。两组均每隔28天进行一次治疗,4次为1疗程。于完成疗程后1月,根据临床表现、肝脏CT及肝功能检查等指标进行疗效评价。结果 TACE组患者病情缓解(CR+PR) 18例（50%）,肝脏肿瘤病灶无完全消失（CR）,明显缩小或病灶数量减少（PR）18例（50%）,病情稳定（SD）2例（5.6%）,病情进展（PD）16例（44.4%）;联合治疗组患者病情缓解（CR+PR）25例（69.4%）,症状好转,一般状况改善,Karuafsky评分明显提高（P<0.05）。CR 2例（5.6%）,PR 23例（63.8%）,SD 2例（5.6%）,PD 9例（25%）;使用重组人p53腺病毒灌注治疗后不良反应轻微。结论应用重组人p53腺病毒注射液联合TACE治疗肝癌患者临床疗效优于单纯TACE治疗,值得在合适的肝癌患者中应用。

关键词: 肝癌, 基因治疗, p53, 腺病毒, 经肝动脉栓塞化疗术

Abstract: Objective To determine the effect of recombinant adenovirus p53 （rAd-p53） therapy in combination with transcatheter hepatic arterial themoembolization（TACE） for patients with primary liver cancer （PLC）. Methods A total of 72 patients with advanced PLC were enrolled in this study from Jan. 2008 to Dec. 2014. Patients were divided into TACE group （mitomycin 8 mg,epirubicin 5 mg/m²,oxaliplatin 30 mg/m²,n=36） and p53 treatment group （rAd-p53,mitomycin 8 mg,epirubicin 5mg/m²,oxaliplatin 30 mg/m²,n=36）. The procedure was repeated once every 28 days for 4 times as a course. The therapeutic effects were evaluated according to the clinical symptoms,CT scans and liver functions. Results In TACE group,the total effective rate（CR+PR） was 50% including no complete response （CR） and partial response（PR） of 50%,stable disease （SD） was 5.6%,and progressive disease（PD） was 44.4%;In p53 treatment group,the total effective rate was 69.4%,including CR of 5.6%,PR of 63.8%,SD of 5.6%,and PD of 25%;The Karnofsky performance score in p53 treatment group was improved better than in TACE group（P<0.05）;The adverse effects in rAd-p53-treated patients was transient and self-limited fever. Conclusion The rAd-p53 therapy in combination with TACE is effective for patients with advanced PLC.

Key words: Primary liver cancer, Gene therapy, p53, Adenovirus, Transcatheter arterial chemoembolization

崔红利, 杨均, 肖潇, 颜綦先, 尹昕茹, 杨洋, 刘卉, 张艳梅, 赖姝婕, 魏艳玲, 刘念, 王军, 陈东风. 重组人p53腺病毒经肝动脉灌注化疗治疗中晚期肝癌临床疗效观察[J]. 实用肝脏病杂志, 2015, 18(3): 237-240.

Cui Hongli, Yang Jun, Xiao Xiao, et al.. Clinical evaluation of recombinant adenovirus p53 therapy in combination with transcatheter arterial chemoembolization for patients with primary liver cancer[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2015, 18(3): 237-240.

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重组人p53腺病毒经肝动脉灌注化疗治疗中晚期肝癌临床疗效观察

Clinical evaluation of recombinant adenovirus p53 therapy in combination with transcatheter arterial chemoembolization for patients with primary liver cancer

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