重组人p53腺病毒联合化疗治疗颈部转移癌的临床疗效观察

The Clinical Observation of Recombinant Adenovirus p53 Injection Combined with Chemotherapy in the Treatment of Neck Metastatic Carcinoma

目的:观察重组人p53(rAd-p53)腺病毒配合化疗治疗颈部转移性癌的疗效及毒性反应。方法:选择2009年7月-2012年3月在本院接受今又生与化疗联合治疗的患者26例,均经病理组织学或细胞学确诊为颈部转移性癌。近期疗效评价参照实体肿瘤客观疗效评定标准,用B超测量治疗前后肿瘤大小变化;患者生活质量采用KPS评分标准。结果:本组病例在接受治疗后4周进行疗效评价:其中完全缓解(CR)9例,部分缓解(PR)12例,病情稳定(SD)2例,病情进展(PD)3例,总有效率(CR+PR)为80.8%(21/26),疾病控制率(CR+PR+SD)为88.5%(23/26);21例患者的生活质量(QOL)得到改善,2例QOL稳定,3例QOL下降。rAd-p53最常见的不良反应为发热,多为自限性低热(37.3～38.3℃),患者均能耐受。结论:使用rAd-p53局部注射与DF(氟尿嘧啶、顺铂)化疗联合应用方法治疗颈部转移性癌显示较好的疗效,临床使用安全,不良反应轻。

Objective： To evaluate the efficacy and toxicity of recombinant adenovirus p53 injection （ rAd-p53 or gendicine ） combined with chemotherapy in the treatment of neck metastatic ： 26 patients which had been treated by gendicine in our department from July 2009 to March 2012 were selected, they were confirmed to be the neck metastatic carcinoma by the histologically or cytologically. The changing of the tumor Size was measured by type-B ultrasound before and after each treatment, then the curative effect was judged with response evaluation criteria in solid tumors （ RECIST ） . The quality of patients＇ life was evaluated by Karnofsky performance score （ KPS ） . Result： All the 26 patients had received efficacy evaluation after four weeks＇ treatment , there were 9 cases of complete remission （ CR ）, 12 cases achieved partial remission （ PR ）, 2 cases of stable disease （ SD ）, 3 cases of progressive disease （ PD ）, that is, the total effective rate （ CR＋PR ） was 80.8% （ 21/26 ） and disease control rate （ CR＋PR＋SD ） was 88.5% （ 23/26 ） . The quality of life was improved on 21 cases, stabled on 2 cases, and decreased On 3 cases. The fever was the common adverse reaction of gendicine, mostly it was self limited low fever （ 37.3-38.3 ~C ）, so the patients were able to tolerate. Conclusion： It is demonstrated that the use of gendicine combined with ＂DF＂ chemotherapy is effective and safe for neck metastatic carcinoma and the adverse reaction is mild.