内镜下瘤体内注射重组人5型腺病毒治疗晚期食管癌的临床疗效观察

Clinical Efficacy of Endoscopic Injection of Recombinant Human Adenovirus Type 5 for Advanced Esophageal Cancer

背景:重组人5型腺病毒是一种溶瘤性腺病毒,可选择性地在恶性肿瘤细胞内大量复制,裂解肿瘤细胞,从而造成肿瘤组织溶解坏死。目的:评价内镜下瘤体内注射重组人5型腺病毒治疗晚期食管癌的有效性和安全性。方法:选取2012年1月—2017年10月青岛市市立医院收治的晚期食管癌患者87例。根据不同治疗方式,分为单纯重组人5型腺病毒组(A组)、放化疗组(B组)和重组人5型腺病毒联合放化疗组(C组),比较三组临床疗效、生存率和不良反应发生率。结果:三组患者的临床病理特征相比差异均无统计学意义(P> 0. 05)。C组的治疗有效率、1年生存率、2年生存率、中位总生存期、中位无进展生存期均显著高于A组和B组(P <0. 05),而A组与B组上述指标相比无明显差异(P>0. 05)。A组不良反应发生率明显低于B组和C组(P <0. 05),而B组与C组相比无明显差异(P>0. 05)。结论:内镜下瘤体注射重组人5型腺病毒联合放化疗治疗晚期食管癌的效果显著,且未见不良反应发生率明显增加,是治疗晚期食管肿瘤的一个新途径。

Background:Recombinant human adenovirus type 5 is an oncolytic adenovirus,which can selectively replicate in tumor cells and lyse the tumor cells resulting in dissolution and necrosis of tumor tissues.Aims:To evaluate the efficacy and safety of endoscopic injection of recombinant human adenovirus type 5 in the treatment of advanced esophageal cancer.Methods:A total of 87 patients with advanced esophageal cancer from January 2012 to October 2017 at Qingdao Municipal Hospital were enrolled.According to the treatment performed,patients were divided into recombinant human adenovirus type 5 group(group A),radiation and chemotherapy group(group B)and recombinant human adenovirus type 5 combined with radiation and chemotherapy group(group C).The clinical efficacy,survival rate and adverse reaction rate were compared among the three groups.Results:No significant differences in clinicopathological features were found among the three group(P >0.05).The effective rate,1-year survival rate,2-year survival rate,median overall survival,median progression-free survival in groups C were significantly higher than those in group A and group B(P<0.05),and no significant differences in above-mentioned indices were found between group A and group B(P >0.05).Adverse reaction rate in group A was significantly decreased than that in group B and group C(P<0.05),however,no significant difference was found between group B and group C(P >0.05).Conclusions:The therapeutic effect of endoscopic injection of recombinant human adenovirus type 5 combined with radiation and chemotherapy for treatment of advanced esophageal cancer is remarkable,and is an important novel way for the treatment of advanced esophageal cancer,which does not increase obviously the incidence of adverse reactions.