p53基因联合腹腔热灌注化疗治疗精囊腺癌术后腹腔转移的探讨及文献复习

Discussion of using hyperthermic peritoneal perfusion chemotherapy and p53 gene therapy for the recurrence patient of primary adenocarcinoma of the seminal vesicles with greater omentum metastasis

目的:探讨精囊腺癌生物治疗的疗效及相关文献复习。方法:1例患者在使用腹腔热灌注化疗联合rAd-p53基因(今又生)治疗前已进行手术及放疗,并于治疗后1年腹腔复发转移,再次给予手术切除及CIK(细胞因子诱导杀伤),随后序贯给予腹腔热灌注化疗和rAd-p53基因静脉输注及腹腔灌注。结果:治疗5个月后复查全身PET/CT未发现新病灶,不良反应轻微。结论:精囊腺癌目前主要的治疗方法是手术和放射治疗,没有标准的全身治疗方案,患者易复发,腹腔局部热灌注化疗有可能使腹腔局部复发的患者得到控制,在一定程度上改善患者的预后。

Objective：To explore the efficacy of biotherapy in seminal vesicle carcinoma and correlative study review. Methods：The patient was male with age of 41 years. He was diagnosed as adenocarcinoma of left seminal vesicles in 2004. He was treated with laparoscopic left seminal vesielerectomy and post operation radiotherapy to the tumor bed including prostate, right seminal vesicles base of bladder with around space of fat tissue, and the total dose of 60Gy/27f was delivered using three dimensional eonformal radiation techniques. Before this admission, the soft tissue mass with size of 5cm in his pelvis was found by PET/CT scan. The pathological diagnoses after pelvis operation were metastasis of greater omentum and fat node of sigmoid colon mesentery. After giving operation resection and Cytokine-induced killer therapy（ CIK）, 6 cycles of hyperthermic peritoneal perfusion chemotherapy（ CHPP chemotherapy） were given by turns with gemcitabine 1.2g/per time and cisplatin 40mg/per time every week following rAd-p53 gene therapy with 2 × 10^12VP/per week of intravenous drip 8 weeks, 1.0 × 10^12VP/per week of intraperitoneal infusion 2 weeks and 2 × 10^12VP/per week of intraperitoneal infusion 4 weeks. Results ： Five months after the treatments, no recurrence and metastasis was found by PET/CT scan. Conclusion：Primary seminal vesicle carcinoma is kind of a rare malignant tumor and there is still no standard care for this tumor, especially for the recurrence and metastasis patient. The effect of traditional treatment for this disease is dissatisfied. CHPP combines with gene therapy might be a suitable treatment for such as recurrence disease with greater omentum metastasis.