CAJ | 학술논문

　　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2×1012 VP稀释入100 ml 0.9%氯化钠注射液行胸腔灌注；腹腔积液采用4×1012 VP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。
　　목적탐토중조인p53선병독재악성흉복강적액치료중적안전성화료효。방법회고성분석2007년10월-2012년4월아원34례접수중조인p53선병독흉、복강관주적종류환자병례자료。흉강적액채용2×1012 VP희석입100 ml 0.9%록화납주사액행흉강관주；복강적액채용4×1012 VP희석입500 ml 0.9%록화납주사액행복강관주。1차/5~7 d，련속사용3주。안조WHO료효평개표준급실체류평개표준(RECIST)진행료효평개，이상견불량반응평개표준(NCI CTCAE)4.0진행불량반응평개。결과34례중，5례완전완해(4례흉강적액화1례복강적액)，11례부분완해(8례흉강적액화3례복강적액)，객관유효솔위47.06%。총체불량반응경미，1~2급자한성발열19례，1급소화도출혈1례。결론인중조p53선병독강내관주치료흉복강악성적액료효교호，가작위만기종류환자적보조치료。
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 2×1012 VP diluted into 100 ml 0.9%NaCl while peritoneal effusion was treated by infusion of 4×1012 VP 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 rAd-p53 infusion is rather good on pleuroperitoneal effusion and can thus be used as an accessory therapy for advanced tumor patients.