河北医科大学学报
河北醫科大學學報
하북의과대학학보
JOURNAL OF HEBEI MEDICAL UNIVERSITY
2014年
7期
793-796
,共4页
癌,非小细胞肺%肿瘤抑制蛋白质p53%放化疗,辅助
癌,非小細胞肺%腫瘤抑製蛋白質p53%放化療,輔助
암,비소세포폐%종류억제단백질p53%방화료,보조
carcinoma,non-small-cell lung%tumor suppressor protein p53%chemoradiotherapy,adjuvant
目的：评价支气管动脉灌注重组人p53腺病毒注射液联合同期放化疗治疗局部晚期非小细胞肺癌（ non-small cell lung carcinoma ，NSCLC）的近期疗效和不良反应。方法病理确诊、免疫组织化学检测p53蛋白表达突变型的Ⅲ期NSCLC 患者47例，行支气管动脉灌注重组人p53腺病毒注射液2次，依据肿瘤大小每次（2~6）×1012病毒颗粒，注射时间为每周期化疗开始前3d；同期放化疗治疗，三维适形放疗中位剂量为60Gy/30次，化疗为足叶乙甙+顺铂（EP）方案，顺铂50mg/m2，第1、8、29、36天静脉滴注，足叶乙甙50mg/m2，第1~5天、第29~33天静脉滴注。结果随访率为100.0%。有效率76.6%，3级放射性食管炎7例（14.9%），3级放射性肺炎5例（10.6%）。随访1年以上者局部控制率为82.9%（29/35），1年总生存率72.3%，1年无进展生存率51.1%。结论支气管动脉灌注重组人p53腺病毒注射液联合同期放化疗治疗局部晚期NSCLC近期疗效较好，不良反应可以耐受。
目的：評價支氣管動脈灌註重組人p53腺病毒註射液聯閤同期放化療治療跼部晚期非小細胞肺癌（ non-small cell lung carcinoma ，NSCLC）的近期療效和不良反應。方法病理確診、免疫組織化學檢測p53蛋白錶達突變型的Ⅲ期NSCLC 患者47例，行支氣管動脈灌註重組人p53腺病毒註射液2次，依據腫瘤大小每次（2~6）×1012病毒顆粒，註射時間為每週期化療開始前3d；同期放化療治療，三維適形放療中位劑量為60Gy/30次，化療為足葉乙甙+順鉑（EP）方案，順鉑50mg/m2，第1、8、29、36天靜脈滴註，足葉乙甙50mg/m2，第1~5天、第29~33天靜脈滴註。結果隨訪率為100.0%。有效率76.6%，3級放射性食管炎7例（14.9%），3級放射性肺炎5例（10.6%）。隨訪1年以上者跼部控製率為82.9%（29/35），1年總生存率72.3%，1年無進展生存率51.1%。結論支氣管動脈灌註重組人p53腺病毒註射液聯閤同期放化療治療跼部晚期NSCLC近期療效較好，不良反應可以耐受。
목적：평개지기관동맥관주중조인p53선병독주사액연합동기방화료치료국부만기비소세포폐암（ non-small cell lung carcinoma ，NSCLC）적근기료효화불량반응。방법병리학진、면역조직화학검측p53단백표체돌변형적Ⅲ기NSCLC 환자47례，행지기관동맥관주중조인p53선병독주사액2차，의거종류대소매차（2~6）×1012병독과립，주사시간위매주기화료개시전3d；동기방화료치료，삼유괄형방료중위제량위60Gy/30차，화료위족협을대+순박（EP）방안，순박50mg/m2，제1、8、29、36천정맥적주，족협을대50mg/m2，제1~5천、제29~33천정맥적주。결과수방솔위100.0%。유효솔76.6%，3급방사성식관염7례（14.9%），3급방사성폐염5례（10.6%）。수방1년이상자국부공제솔위82.9%（29/35），1년총생존솔72.3%，1년무진전생존솔51.1%。결론지기관동맥관주중조인p53선병독주사액연합동기방화료치료국부만기NSCLC근기료효교호，불량반응가이내수。
Objective To evaluate the efficacy and safety of recombinant adeno-viral human p53 gene( rAd-p53 ) in combination with concurrent radio-chemotherapy in patients with unresectable stage Ⅲ non-small cell lung cancer( NSCLC). Methods Forty-seven patients with P53 protein mutant NSCLC Ⅲ were diagnosed through pathology,immunohistochemistry. All patients were treated by recombinant human p53 adenovirus injection twice through bronchial artery infusion before concurrent radio-chemotherapy 3 days,which based on tumor size every( 2 -6 )× 1012 VPs( viral particles ). Concurrent radio-chemotherapy was performed,and the average dose was 60Gy/30 fractions. EP chemotherapy was used,cisplatin was given by intravenous drip 50mg/m2 at 1,8,29 and 36 days. VP-16 was given by intravenous drip 50mg/m2 at 1 -5 and 29 -33 days. Results All patients completed treatment and evaluation of toxicities and efficacy. The overall response rates were 76. 6%. Seven patients had 3 level esophagitis( 14 . 9%),five patients had 3 level radiation pneumonitis( 10 . 6% ). Local control rate was 82. 9%(29/35)in the patients followed-up of more than 1 year. One-year overall survival rate was 72 . 3%,and one-year progression-free survival rate was 51 . 1%. Conclusion Trans-catheter bronchial arterial infusion rAd-p53 combined with concurrent radio-chemotherapy in patients with unresectable stage Ⅲ non-small cell lung cancer is a safe,effective therapy.
