葡萄球菌肠毒素瘤体内注射并放疗治疗复发性颈部淋巴结转移癌的临床研究

Clinical study on intratumoral injection with staphyloentero-toxin plus radiotherapy in the patients with recurrent metastatic carcinoma of the cervical lymph nodes

目的：了解葡萄球菌肠毒素瘤体内注射配合放疗治疗复发性颈部淋巴结转移癌临床使用价值。方法：65例患者分为治疗组与对照组,治疗组采用葡萄球菌肠毒素瘤体内注射配合肌肉注射联合放射治疗;对照组仅行放射治疗,两组照射剂量均为DT50-70GY/6-7周,观察其疗效、不良反应等。结果：治疗结束后,治疗组33例中CR 15例,PR 15例,反应率（RR）为90.9%（30/33）,NC 3例,PD 0例。而对照组32例中CR 7例,PR 15例,反应率（RR）为68.8%（22/32）,NC10例,PD 0例（P〈0.05）。治疗结束3月后复查,结果亦相同。远期生存率,治疗组1,2,3年分别为66.7%（22/33）、48.5%（16/33）、45.5（15/33）;对照组则分别为59.4%（19/32）、46.9%（15/32）、40.1%（13/32）。另外对患者的生存质量及体重也有明显的改善作用（P〈0.05）。结论：葡萄球菌肠毒素瘤体内注射联合肌肉注射,可使颈部转移瘤体内该药物浓度增高,配合放射治疗、增强了对肿瘤细胞的直接杀伤作用,具有较高的肿瘤消退率并且改善了患者的生存质量,但对远期1,2,3年生存率无统计学意义（P〉0.05）。

Objective： To evaluate the effect of Staphyloentero-toxin （SE） intratumoral injection plus radiotherapy in the treatment of recurrent metastatic carcinoma of the cervical lymph nodes. Methods： A total of 65 patients with recurrent metastatic carcinoma of the cervical lymph nodes were divided into two groups randomly： the test and the control. The test group were treated with SE intratumoral injection and intramuscular plus radiotherapy. The control group was treated with radiotherapy only. Results： SE intratumoral injection and intramuscular plus radiotherapy was beneficial to the recurrent metastases carcinoma of the cervical lymph nodes control rate. The two groups control rates wereCR 45.5%（15/33）, 21. 9%（7/32）, PR 45.5% （15/33）, 46.9% （15/32）, RR 90.9%, 68.8% respectively （P〈0. 05）. The test group 1, 2, 3year overall survival rate（OSR） were 66. 7%（22/33）, 48.5%. （16/33）, 45.5（15/33）, the control group 1, 2, 3 year OSR were 59.4%（19/32）, 46.9% （15-32）, 49.1% （13/32）, and could improved the test groups＇ quality of life （P〈0.05）. Conclusion： SE intratumoral injection and intramuscular plus radiotherapy is beneficial to the recurrent metastatic carcinoma of the cervical lymph nodes control rate. It may improve the quality of life in the patients. Intratumoral injection with SE is a simple, safe, and effective alternative for the treatment of recurrent metastases carcinoma of the cervical lymph nodes.