内镜下注射重组人5型腺病毒联合化疗对中晚期食管癌和胃癌的初步疗效探讨  

An investigation on the preliminary curative effect of combining human recombinant adenovirus type 5 with chemotherapy against middle or late stage esophageal cancer and gastric cancer

作　　者：吕舒 李俊垚[2] 张然 崔艳欣[3] 姜相君[3] LV Shu;LI Jun-yao;ZHANG Ran;CUI Yan-xin;JIANG Xiang-jun(Taishan Medical University,Taian,Shandong,271000;Emergency Department,Qingdao Municipal Hospital,Qingdao,Shandong,266000;Department of Gastroenterology II, Qingdao Municipal Hospital, Qingdao, Shandong, 266000)

机构地区：[1]泰山医学院,山东泰安271000 [2]青岛市市立医院急诊科,山东青岛266000 [3]青岛市市立医院消化内二科,山东青岛266000

出　　处：《临床普外科电子杂志》2019年第1期15-21,共7页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨内镜下注射重组人5型腺病毒联合化疗对中晚期食管癌和胃癌的初步疗效。方法回顾性收集青岛市市立医院2012年9月至2017年10月符合纳入标准的患者128例,依据不同的治疗方法分为3组,单独行内镜下注射重组人5型腺病毒治疗的中晚期食管癌和胃癌患者42例(A组),行内镜下注射重组人5型腺病毒联合化疗的中晚期食管癌和胃癌患者46例(B组),单独行化疗的中晚期食管癌和胃癌40例(C组)。2个疗程后比较三组患者的临床疗效、毒副反应。结果 A、B、C三组有效率分别为25.0%、56.5%、26.7%,(P<0.05),其中A组食管癌、胃癌的有效率分别为42.1%、8.7%,(P<0.05),B组的食管癌、胃癌的有效率分别为74.1%、40.0%,(P<0.05)。三组发热发生率分别为:73.8%、69.6%、15.0%,(P<0.05);恶心、呕吐发生率分别为:11.9%、19.6%、60.0%,(P<0.05);骨髓抑制发生率分别为:2.4%、10.8%、40.0%,(P<0.05)。结论内镜下瘤体注射腺病毒联合化疗能有效提高中晚期食管癌和胃癌患者的临床疗效,并减轻化疗的毒副反应。且食管癌患者效果比胃癌好。内镜下注射重组人5型腺病毒联合化疗对中晚期食管癌和胃癌的治疗提供更多选择。Objective To investigate the preliminary curative effect of combining human recombinant adenovirus type 5 with chemotherapy against middle or late stage esophageal cancer and gastric cancer.Methods Retrospectively Collected one hundred and twenty-eight patients who met the inclusion criteria from September 2012 to October 2017 in Qingdao Municipal Hospital.The patients were divided into three groups according to different treatment methods.Forty-two patients were accepted human recombinant adenovirus type 5 local injections by endoscope(Group A).Forty-six patients were accepted human recombinant adenovirus type 5 local injections combined chemotherapy(Group B),Forty patients were received concurrent chemotherapy alone(Group C).After two courses,the clinical effi cacy,toxic side effects of the three groups were compared.Results The effective rates were 23.8%,56.5%,26.7%respectively,(P<0.05).The effective rates of esophageal cancer and gastric cancer in group A were 42.1%and 8.7%respectively,(P<0.05);The effective rates of esophageal cancer and gastric cancer in group B were 76.1%and 40.0%respectively,(P<0.05).During the treatment,the incidence rates of fever were 73.8%,69.6%,15.0%respectively,(P<0.05);The incidence rates of nausea and vomiting were 11.9%,19.6%,60.0%respectively,(P<0.05);The incidence rates of bone marrow suppression were 2.4%,10.8%,40.0%respectively,(P<0.05).Conclusion Endoscopic intratumor injection combined with chemotherapy can effectively improve the clinical efficacy of patients with middle or late stage esophageal cancer and gastric cancer,reduce toxicity of chemotherapy,the treatment is safe and effective,and the treatment of esophageal cancer is better.Endoscopic injection of human recombinant adenovirus type 5 combined with chemotherapy which provides more choice for the treatment of middle or late stage esophageal cancer and gastric cancer.

关 键 词：重组人5型腺病毒 溶瘤病毒治疗 食管癌 胃癌 

分 类 号：R735.1[医药卫生—肿瘤]