重组人p53腺病毒注射液联合放疗治疗鼻咽鳞癌的临床观察  

Clinical observations of recombinant adenovirus-p53 combined with radiotherapy on nasopharyngeal squamous carcinoma

作　　者：王晓红[1] 王建功[1] 张静[1] 胡万宁[1] 张瑞娟[1] 

机构地区：[1]河北省唐山市人民医院,河北唐山063000

出　　处：《现代中西医结合杂志》2012年第9期924-925,934,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的评价重组人p53腺病毒(rAd-p53)注射液结合放疗治疗鼻咽鳞癌的疗效及安全性。方法 50例鼻咽鳞癌患者随机分成基因治疗+放疗(GTRT)组24例和单纯放疗(RT)组26例。2组放疗剂量和方法相同。rAd-p53注射液用法:每周1次,每次1×1012VP(病毒颗粒),共9～10次。常规放疗加三维适形放射治疗方案:每次2Gy,每周5次,共7周。观察肿瘤变化和不良反应,并以CT评价疗效。结果 8周后GTRT组完全缓解(CR)9例(38%),部分缓解(PR)13例(54%),稳定(SD)2例(8%),有效率92%;RT组CR 3例(12%),PR 13例(50%),SD 7例(27%),PD 3例(12%),有效率62%;2组有效率比较有显著性差异(P<0.01)。RT组1 a生存17例(71%),2 a生存16例(67%),3 a生存13例(54%);GTRT组1 a生存20例(91%),2 a生存19例(86%),3 a生存17例(77%);2组生存率相比具有显著性差异(P<0.01)。GTRT组除了6例出现一时性发热外,未发现其他不良反应。结论 rAd-p53结合放疗治疗鼻咽鳞癌是安全而有效的。Objective It is to evaluate the effect and safety of recombinant adenovirus- p53 （rAd -p53 ） injection combined with radiotherapy in treatment of squamous nasopharyngeal carcinoma （ NPC）. Methods Fifty patients with NPC were divided into 2 groups ： Gendicine injection combined with radiotherapy was used for treatment of 24 cases in GTRT group. Single radiotherapy was used for treatment of 26 cases in RT group. Usage of Gendicine： 1 ＊ 1012 viral particles （VP） , once a week, average 9 to 10 times; Regimen for radiotherapy： 2Gy/F, 5 times a week for 7 weeks. The change of tumor volume and the adverse effects were observed, and curative effect was evaluated by CT examination. Results Among the GTRT patients, CR was achieved in 4 cases （38%） , PR in 6 cases （54%） and SD in 2 cases （8%） , effective rate was 92%. Among the RT patients, CR was achieved in 3 cases （12%）, PR in 13 cases （50%）, and SD in 7 eases （27%）, PD in 3 cases （ 12% ） , effective rate was 62%. There was significant difference in effective rate between both group （ P 〈 0.01 ）. 1 - , 2 - , 3 -year survival rate was 71% , 67% and 54% respectively in RT group, and was 91% , 86% and 77% respectively in GTRT group. There was significant difference in survival rate between both groups （ P 〈 0.01 ）. All 24 patients has no adverse effect when received Gendieine, except transient fever. Conclusion Treatment with intratumoral injection of rAdp53 plus radiotherapy on NPC is safe and effective.

关 键 词：重组人P53腺病毒 放疗 鼻咽癌 

分 类 号：R739.63[医药卫生—肿瘤]