摘要
目的评价支气管动脉灌注今又生(重组人p53腺病毒注射液)联合EP方案同期放化疗治疗老年T4N0-2M0局部晚期非小细胞肺癌患者的近期疗效和不良反应。方法2010年1月-2012年12月经病理确诊、免疫组化检测p53蛋白表达突变型的老年(65岁≤年龄≤75岁)T4N0—2M0局部晚期NSCLC患者26例,行支气管动脉灌注今又生2次,每次4×10^12VPs,注射时间分别为化疗周期开始前3d。联合同期放化疗治疗,化疗为EP方案,顺铂:50mg/m^2,dl、8、29、36静脉滴注,足叶乙甙:50mg/m2,d1~5、d29~33静脉滴注。采取3D—CRT放疗,中位剂量为60Gy/30次,每周5次。结果随访率为100%。有效率76.9%(20/26),3级放射性食管炎4例(15.4%)、3级放射性肺炎3例(11.5%)。1年总生存率73.1%,1年无进展生存率57.7%。结论支气管动脉灌注今又生联合同期放化疗治疗老年T4N0—2M0局部晚期非小细胞肺癌取得较好近期疗效、不良反应可以耐受,值得推广。
Objective To evaluate the efficacy and safety of recombinant adeno- viral human p53 gene(rAd - p53) in combination with concurrent radio - chemothrepy in patients with Stage of T4N0 - 2 non - small cell lung cancer (NSCLC) in elderly. Methods From January 2010 to December 2012,26 patients received three - dimentional conformal radiotherapy of 60 Gy/30 fractions over 6 weeks and concurrent chemotherapy of cisplatin 50mg/m2 , dl, 8,29,36 and VP - 16 d1 - 5, d29 - 33 ivgtt, tAd - p53 was administered through bronchial artery infusion via a catheter access 3 days before once each chemotherapy at a dose level of 4 ×10^12 viral particles(VP). Patients were followed up, with safety evaluated by the National Cancer Institute's Common Toxicity Criteria and tumor response evaluated with thoracic CT scans performed 4 weeks after completion of treatment in accordance with response evaluation criteria in solid tumor (RECIST), re- spectively. Survival rates were analyzed by Kaplan- Meier method. Results All patients completed treatment and evaluation of toxicities and efficacy. The overall response rates was 76.9%. One - year overall survival rate was 73.1% ,and one- year progression- free survival rate was 57.7%. Grade 3 acute radia- tion esophagitis and radiation pneumonitis were observed in 15.4% and 11.5%, respectively. There were no serious adverse events except for self - limiting fever and transient influenza- like symptom was repo- ted. Conclusion Trans- catheter bronchial arterial infusion Gendicine combined with concurrent radio - chemothrepy in patients with stage of T4N0 - 2 non- small cell lung cancer in elderly is a safe, effective therapy.
出处
《中国煤炭工业医学杂志》
2013年第10期1586-1589,共4页
Chinese Journal of Coal Industry Medicine
基金
河北省卫生厅医学科学研究重点课题计划资助项目(2011-0196)
关键词
非小细胞肺癌
同期放化疗
重组人P53腺病毒注射液
支气管动脉灌注
老年人
Carcinoma, locally - advanced non - small cell lung/concurrent radio - chemothrepy
tAd - p53
Bronchial arterial infusion
Elderly