经动脉灌注rAd-p53联合TAE治疗中晚期肝癌的疗效观察  

Intra-arterial infusion of rAd-p53 combined with transcatheter arterial embolization for middle-late stage hepatocellular carcinoma: observation of its therapeutic efficacy

作　　者：刘丽[1] 卲天朋 杨涛[1] 曹建民[1] 卢光明[1] 许健[1] 

机构地区：[1]南京军区南京总医院医学影像科,210002

出　　处：《介入放射学杂志》2016年第3期210-213,共4页Journal of Interventional Radiology

摘　　要：目的 探讨经动脉灌注重组人p53腺病毒注射液联合碘化油栓塞治疗中晚期肝癌的安全性及有效性。方法 回顾性分析2012年5月至2015年6月采用经肿瘤供血动脉灌注重组人p53腺病毒注射液联合碘化油栓塞治疗的31例中晚期原发性肝癌患者的临床资料。所有入组患者均为无法行外科手术治疗的中晚期肝癌患者。患者介入术程顺利,术后采用改良实体瘤评价标准（mRECIST）评价临床疗效。采用SPSS 18.0软件进行统计分析。结果 31例患者共进行76次（平均每例2.4次）介入治疗。随访3-36个月,术后3、6、12个月完全缓解率（CR）均为0,部分缓解率分别为58.1%、38.7%、29%,总有效率分别为58.1%、38.7%、29%;6个月、1年及2年的总生存率分别为77.4%、58.1%、19.3%;6个月、1年及2年的无进展生存率分别为38.7%、25.8%、12.9%。全组患者均未见急性肝衰竭、肝脓肿、肺栓塞等严重并发症,术后87.1%患者出现发热。结论 采用经动脉灌注重组人p53腺病毒注射液联合TAE治疗中晚期肝癌具有良好的安全性和有效性,为中晚期肝癌提供了一种新的治疗选择。Objective To evaluate the safety and efficacy of intra-arterial infusion of recombinant adenovirus p53 combined with transcatheter arterial embolization （TAE） using iodized oil as embolie agent in treating middle-late stage hepatocellular carcinoma （HCC）. Methods A total of 31 patients with middle-late stage HCC, who were admitted to authors＇ hospital during the period from May 2012 to June 2015, were enrolled in this study. Intra-arterial infusion of recombinant adenovirus p53 combined with TAE using iodized oil as embolic agent was carried out in all patients. The clinical data were retrospectively analyzed. All patients suffered from inoperable advanced HCC. Successful interventional procedure was accomplished in all patients. After the treatment, the clinical efficacy was evaluated with solid tumors evaluation criteria （mRECIST）, and SPSS 18.0 software was used to make the statistical analysis. Results A total of 76 times of interventional procedure were performed in 31 patients （average of 2.4 times）. The patients were followed up for 3-36 months. At 3, 6 and 12 months after the treatment, the complete response rates were all 0%, while the partial response rates were 58.1%, 38.7% and 29.0% respectively. The total effective rates were 58.1%, 38.7% and 29.0% respectively. The 6-month, one-year and two-year overall survival rates were 77.4%, 58.1% and 19.3% respectively. The 6-month, one-year and two-year progress-free survival rates were 38.7%, 25.8% and 12.9% respectively. No severe complications such as hepatic failure, liver abscess, pulmonary embolism, etc. occurred. Postoperative fever was observed in 87.1% of patients. Conclusion For the treatment of middle-late stage HCC, intra-arterial infusion of recombinant adenovirus p53 combined with TAE using iodized oil as embolic agent is quite safe and effective. This technique provides a new treatment option for patients with advanced HCC.

关 键 词：重组人P53腺病毒注射液 中晚期肝癌 经动脉栓塞术 疗效评估 

分 类 号：R735.7[医药卫生—肿瘤]