重组人p53腺病毒注射液瘤内注射联合^(125)I粒子植入治疗肝细胞癌残余灶

Intratumoral injection of recombinant adenovirus p53 agent combined with ^(125)I seed interstitial brachytherapy in treatment of residue hepatocellular carcinoma

目的评价重组人p53腺病毒(rAd-p53)注射液瘤内注射联合125I粒子组织间植入对肝细胞癌(HCC)残余灶的治疗效果。方法 38例经过TACE及物理消融治疗后HCC患者,共发现肝癌残余灶69个。对17例30个病灶进行rAd-p53瘤内注射联合125I粒子植入治疗(联合治疗组);对21例39个病灶进行单纯125I粒子植入术(单纯125I粒子植入组)。对比观察两组患者肿瘤大小变化及不良反应。结果治疗后1、2和6个月,两组的有效率差异有统计学意义(P<0.05);两组间比较,完全缓解、部分缓解、稳定和进展差异无统计学意义。结论 rAd-p53瘤内注射联合125I粒子植入对HCC残余灶的短期治疗效果优于单纯125I粒子植入术。

Objective To evaluate the efficacy of intratumoral injection of recombinant human adenovirus mediated p53（rAd-p53） agent combined with 125I seed interstitial brachytherapy in the treatment of residue hepatocellular carcinoma（HCC） after TACE and ablation.Methods Totally 38 patients with 69 HCC residues were collected.Intratumoral injection of rAd-p53 combined with 125I seed interstitial brachytherapy was used to treat 30 HCC residues of 17 patients（combined treatment group）.125I seed interstitial brachytherapy was given to the 39 lesions of 21 patients（single 125I interstitial brachytherapy group）.The changes of tumor volume and the adverse effects were observed.Results There was statistical difference in the total effective rate between the two groups 1,2 and 6 months after operation.No difference of complete remission,partial remission,stable disease and progressive disease was detected between the two groups.Conclusion Using intratumoral injection of rAd-p53 combined with 125I seed interstitial brachytherapy,high curative effect can be obtained in the treatment of HCC residue after TACE and ablation.