重组人p53腺病毒腔内灌注治疗胸腹腔恶性积液34例疗效观察  

Clinical observation of intra-cavity rAd-p53 infusion in 34 patients with malignant pleuroperitoneal effusion

作　　者：张欣[1] 胡毅[1] 汪进良[1] 张素洁[1] 陶海涛[1] 孙京[1] 吴柏寿[1] 

机构地区：[1]解放军总医院肿瘤综合治疗科,北京100853

出　　处：《解放军医学院学报》2013年第7期671-672,692,共3页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金面上项目(30540027)~~

摘　　要：目的探讨重组人p53腺病毒在恶性胸腹腔积液治疗中的安全性和疗效。方法回顾性分析2007年10月-2012年4月我院34例接受重组人p53腺病毒胸、腹腔灌注的肿瘤患者病例资料。胸腔积液采用2×10^12VP稀释入100 ml 0.9%氯化钠注射液行胸腔灌注;腹腔积液采用4×10^12VP稀释入500 ml 0.9%氯化钠注射液行腹腔灌注。1次/5-7 d,连续使用3周。按照WHO疗效评价标准及实体瘤评价标准（RECIST）进行疗效评价,以常见不良反应评价标准（NCI CTCAE）4.0进行不良反应评价。结果 34例中,5例完全缓解（4例胸腔积液和1例腹腔积液）,11例部分缓解（8例胸腔积液和3例腹腔积液）,客观有效率为47.06%。总体不良反应轻微,1-2级自限性发热19例,1级消化道出血1例。结论人重组p53腺病毒腔内灌注治疗胸腹腔恶性积液疗效较好,可作为晚期肿瘤患者的辅助治疗。Objective To study the safety and effect of rAd-p53 in patients with malignant pleuroperitoneal effusion.Methods Clinical data about 34 tumor patients treated with intra-cavity rAd-p53 infusion in our hospital from October 2007 to April 2012 were retrospectively analyzed.Pleural effusion was treated by infusion of 2×10^12VP diluted into 100 ml 0.9% NaCl while peritoneal effusion was treated by infusion of 4×10^12VP diluted into 500 ml 0.9% NaCl,once 5-7 days for 3 weeks.Their therapeutic effects were assessed according to the WHO criteria and RECIST,respectively.Adverse reactions were assessed according to the NCI CTCAE 4.0.Results Of the 34 patients,5（4 with pleural effusion and 1 with peritoneal effusion） were completely improved,and 11（8 pleural effusion and 3 peritoneal effusion） were partially improved with an overall effective rate of 47.06%.The adverse reactions were mild with grade 1-2 self-limited fever occurred in 19 patients and grade 1 gastric bleeding occurred in 1 patient.Conclusion The effect of rAdp53 infusion is rather good on pleuroperitoneal effusion and can thus be used as an accessory therapy for advanced tumor patients.

关 键 词：重组人P53腺病毒 腔内灌注 胸腔积液 恶性 腹腔积液 恶性 

分 类 号：R73-36[医药卫生—肿瘤]