重组人p53腺病毒注射液联合顺铂胸腹腔内注射治疗恶性胸腹水疗效观察

Clinical study of combined application of recombinant human adenovirus p53 injected into thoracic cavity and abdominal cavity with cisplatin therapy in treating malignant thoracic cavity and abdomen cavity effusion

目的观察胸腹腔内注射重组人p53腺病毒注射液联合顺铂治疗恶性胸腹水的疗效。方法选择住院治疗的42例恶性胸腹水患者,随机分为两组,每组21例。观察组先将胸腹水经穿刺放液尽量引流后,胸腔内灌注重组人p53腺病毒注射液2×1012VP,腹腔内灌注重组人p53腺病毒注射液4×1012VP,灌注后帮助患者改变体位,24 h后再注入顺铂40 mg/m2,每周重复1次,4次为一疗程。对照组只应用顺铂。观察患者接受治疗后的临床症状评分、生活质量、卡氏评分及不良反应等的变化,同时记录生存期。结果观察组疾病控制率(CR+PR+SD)为85.7%(18/21),对照组为57.1%(12/21)(P<0.05)。观察组生存质量卡氏评分提高率为76.2%(16/21),对照组为38.1%(8/21)(P<0.05)。结论胸腹腔内注射重组人p53腺病毒注射液联合顺铂治疗恶性胸腹水的临床疗效好,具有重要的临床价值,不良反应轻微。

Objective To evaluate the clinical value of combined application of recombinant human adenovirus p53 injected into thoracic cavity and abdominal cavity with cisplatin therapy in treating malignant thoracic cavity and abdomen cavity effusion. Methods Forty-two patients with malignant thoracic or abdomen cavity effusion in this hospital from Janurary 2010 to December 2012 were included in this study. The patients were divided into two groups： for observation group （n =21 ） , recombinant 2 x 1012 VP hu- man adenovirus p53 injected into thoracic cavity, recombinant 4 x 1012 VP human adenovirus p53 injected into abdominal cavity after outflow effusion by puncture. Patients were demanded to change their position after injection, 40 mg/m2 cisplatin injection was per- formed after 24 hours. ＇The injection was repeated once every week and 4 times was a therapy period. For control group （ n = 21 ） , only cisplatin was used. The clinical grading, quality of life, Kashi grading, and untoward reactions were observed and recorded for all pa- tients. Survival period was recorded at the same time. Results The efficiency rate of therapy（ CR ＋ PR ＋ SD） for observation group was 85.7% （18/21）, while that for control group was 57.1% （ 12/21 ） （P 〈 0.05 ）. The increase in Kashi grading of living quality was 76.2% （ 16/21 ） , while that for control group was 38.1% （ 8/21 ） （P 〈 0.05 ）. Conclusions Combined application of recombinant human adenovirus p53 injected into thoracic cavity and abdominal cavity with cisplatin therapy in treating malignant thoracic cavity and abdomen cavity effusion shows great clinical value with mild untoward reaction.