CAJ | 학술논문

背景与目的:肿瘤抑制基因p53是目前研究最为广泛和系统的抑癌基因之一,p53基因突变或缺失导致肿瘤的形成.本研究评价重组人p53腺病毒注射液(rAd-p53)导入野生型p53基因抑癌基凼治疗同时联合顺铂治疗肺癌所致胸腔积液的临床疗效和毒副反应.方法:将35例肺癌合并胸腔积液患者随机分为联合组和单药组两组.所有患者应用长春瑞滨25 mg/m~2静脉点滴,第1、8天,每3周重复一次.前述治疗基础上,联合组胸腔内灌入rAd-p53 1×10~(12) VP和顺铂注射液40 ms/m~2;单药组胸腔内灌入顺铂注射液40 ms/m~2,每周重复一次,连用4次后观察疗效.结果:联合组和单药组的有效率分别为82.35%和50.00%(P<0.05);联合组和单药组的一般状况改善率分别为64.70%和33.33%(P<0.05);两组患者主要不良反应为发热、胸痛、消化道反应及白细胞减少.联合组发热的发生率高于单药组(P<0.05),主要为自限性发热,36 h后自行恢复正常.结论:重组人p53腺病毒注射液联合顺铂治疗肺癌所致胸腔积液疗效确切,且毒副反应较低,值得临床推广应用.
배경여목적:종류억제기인p53시목전연구최위엄범화계통적억암기인지일,p53기인돌변혹결실도치종류적형성.본연구평개중조인p53선병독주사액(rAd-p53)도입야생형p53기인억암기당치료동시연합순박치료폐암소치흉강적액적림상료효화독부반응.방법:장35례폐암합병흉강적액환자수궤분위연합조화단약조량조.소유환자응용장춘서빈25 mg/m~2정맥점적,제1、8천,매3주중복일차.전술치료기출상,연합조흉강내관입rAd-p53 1×10~(12) VP화순박주사액40 ms/m~2;단약조흉강내관입순박주사액40 ms/m~2,매주중복일차,련용4차후관찰료효.결과:연합조화단약조적유효솔분별위82.35%화50.00%(P<0.05);연합조화단약조적일반상황개선솔분별위64.70%화33.33%(P<0.05);량조환자주요불량반응위발열、흉통、소화도반응급백세포감소.연합조발열적발생솔고우단약조(P<0.05),주요위자한성발열,36 h후자행회복정상.결론:중조인p53선병독주사액연합순박치료폐암소치흉강적액료효학절,차독부반응교저,치득림상추엄응용.
Background and Objective:p53 gene is one of cancer suppressor genes and its mutation and deletion induces almost all human cancers.This study was to evaluate the clinical efficacy and toxicity of recombinant human Ad-p53 injection(rAd-p53)combined with cisplatin in treatment of malignant pleural effusion induced by lung cancer. Methods: A total of 35 cases of malignant pleural effusion were randomly divided into the combined group (n=17) and the single-agent group(n=18). On the basis of systemic treatment(vinorelbine 25 mg/m~2,Days 1-8,every 3 weeks),the combined group were given intracavitary administration of rAd-p53(1 × 10~(12)VP) and cisplatin(40 mg/m~2)once a week for 4 weeks.The single-agent group were given the same intracavitary administration as the combined group but without rAd-p53 therapy.Results:The total effective rates in the combined group and the single-agent group were 82.35%and 50.00% (P<0.05),respectively.The total modification rates in the combined group and the single-agent group were 64.70%and 33.33%(P<0.05),respectively.Thetoxicities in the two groups were fever, stethalgia, nausea/vomiting and leukopenia.The toxic reaction in combined group was mainly self-limited fever(P<0.05),which disappeared automatically after 36 h.Conclusions:rAd-P53 and cisplatin is safe and effective for malignant pleural effusion induced by lung cancer.It is worthy of application in clinical treatment.