rAd-p53联合化学药物治疗晚期口腔癌的临床研究  

Clinical evaluation on rad-p53 combined with chemotherapy for advanced oral carcinoma

作　　者：李一[1] 李龙江[1] 王莉娟[2] 黄元丁[1] 韩波[1] 

机构地区：[1]四川大学口腔疾病研究国家重点实验室,成都610041 [2]四川大学华西保健医院口腔科

出　　处：《北京口腔医学》2009年第2期94-97,共4页Beijing Journal of Stomatology

摘　　要：目的探讨采用选择性动脉灌注,进行p53基因联合化疗冶疗晚期头颈癌的临床疗效及其安全性。方法将2003至2005年间收治的56名晚期口腔癌患者随机分为3组,通过选择性动脉灌注给予rAd-p53联合化疗(Ⅰ组),单纯rAd-p53基因治疗(Ⅱ组)及单纯化疗(Ⅲ组),评价各组疗效,并检测治疗前后wt-p53、Bax以及Bcl-2的蛋白表达水平。结果Ⅰ组的完全有效率、总体存活率明显高于Ⅱ、Ⅲ两组,但Ⅱ、Ⅲ两组的治疗结果并没有明显差异。最常见的副作用是暂时性流感样症状和骨髓抑制。与治疗前相比,Ⅰ、Ⅱ组患者治疗后wt-p53蛋白免疫活性升高,Bax免疫染色呈阳性,而Bcl-2降低。结论选择性动脉灌注可提高rAd-p53基因治疗疗效,rAd-p53基因治疗联合化疗可有效提高晚期口腔癌患者的生存率。Objective To evaluate the safety and therapeutic effects of selective intraarterial rAd-p53 infusion combined with chemotherapy for advanced oral carcinoma. Methods Fifty-six patients with advanced oral carcinoma underwent unilateral or bilateral retrograde selective catheterization of external carotid artery, rAd-p53 combined with chemotherapeutic agents was administrated to group Ⅰ （20 patients ）, tAd-p53 to group Ⅱ （16 patients ）, and chemotherapeutic agents to group Ⅲ （20 patients ）. The therapeutic response of primary tumor and metastatic lesion was evaluated by clinical examination and morphological measurement. Meanwhile, wt-p53, Bax and Bcl-2 were examined by immunohistoehemistry before and after treatment. Results The complete response rate （40%） of group I was higher than that （25% and 25%, respectively ） of group Ⅱ and group m （P〈 0. 05 ）. The therapeutic effects were not found significantly different between group Ⅱ and Ⅲ （ P 〉 0. 05 ）. Forty-seven patients experienced some sort of side effects, which was mostly transient flu-like symptom, suppression of marrow or both. The transactivation of Bax and inactivation of Bcl-2 were only observed in group Ⅰ and Ⅱ. Conclusion Routine chemotherapy combined with rAd-p53 infusion can increase the curative effect and decrease the toxic implication of chemotherapy

关 键 词：口腔癌 基因治疗 化疗 动脉灌注 

分 类 号：R739.81[医药卫生—肿瘤]