重组人P53腺病毒注射液联合局部热疗与化疗治疗晚期胰腺癌的效果观察
|
摘要
目的探讨重组人P53腺病毒注射液联合局部热疗与化疗治疗晚期胰腺癌的效果。方法回顾性分析我院肿瘤科2006年7月~2012年7月收治的晚期胰腺癌患者48例,患者均有中到大量腹水,根据治疗方法不同分为研究组和对照组,研究组23例患者接受基因治疗,同时联合吉西他滨+顺铂化疗,局部热疗。对照组25例患者接受吉西他滨+顺铂全身化疗。比较两组疗效。结果研究组的疾病控制率为78.26%,对照组为32.00%,两组的疾病控制率比较,差异有统计学意义(P<0.05)。研究组的疼痛缓解率为83.33%,对照组为25.00%,两组的疼痛缓解率比较,差异有统计学意义(P<0.05)。研究组Ⅲ~Ⅳ度骨髓抑制发生率为21.74%,对照组为24.00%,两组的Ⅲ~Ⅳ度骨髓抑制率比较,差异无统计学意义(P>0.05)。结论重组人P53腺病毒注射液联合局部热疗与化疗治疗晚期胰腺癌可取得较高的疾病控制率,同时可有效缓解疼痛,提高患者的生活质量,且未增加骨髓毒性。
Objective To explore the effect of Recombinant Human P53 Adenovirus Injection combined with regional heperthermia and chemotherapy treating advanced pancreatic cancer.Methods Forty-eight patients with advanced pancreatic cancer treated by department of oncology in our hospital from July 2006 to July 2012 were retrospectively analyzed.Patients had moderate to massive ascites.These patients were divided into research group and control group according to different treatment methods.The research group:23 patients received gene therapy,Gemcitabine and Cisplatin chemotherapy,local hyperthermia.Control group:25 patients received Gemcitabine and Cisplatin systemic chemotherapy alone.The effect between two groups was compared.Results The disease control rate was 78.26% in research group and it was 32.00% in control group,and the difference between the two groups was statistically significant(P<0.05).The pain relief rate was 83.33% in the study group and it was 25.00% in control group and the difference was statistically significant between the two groups(P<0.05).The incidence rate of Ⅲ~Ⅳ myelosuppression was 21.74% in research group,and in was 24.00% in control group,and there was no statistical difference between the two groups(P>0.05).Conclusion Recombinant Human P53 Adenovirus Injection combined with regional heperthermia and chemotherapy treating advanced pancreatic cancer can obtain higher disease control rate,effectively relief the pain,improve patients′quality of life,and without increasing bone marrow toxicity.
Objective To explore the effect of Recombinant Human P53 Adenovirus Injection combined with regional heperthermia and chemotherapy treating advanced pancreatic cancer.Methods Forty-eight patients with advanced pancreatic cancer treated by department of oncology in our hospital from July 2006 to July 2012 were retrospectively analyzed.Patients had moderate to massive ascites.These patients were divided into research group and control group according to different treatment methods.The research group:23 patients received gene therapy,Gemcitabine and Cisplatin chemotherapy,local hyperthermia.Control group:25 patients received Gemcitabine and Cisplatin systemic chemotherapy alone.The effect between two groups was compared.Results The disease control rate was 78.26% in research group and it was 32.00% in control group,and the difference between the two groups was statistically significant(P<0.05).The pain relief rate was 83.33% in the study group and it was 25.00% in control group and the difference was statistically significant between the two groups(P<0.05).The incidence rate of Ⅲ~Ⅳ myelosuppression was 21.74% in research group,and in was 24.00% in control group,and there was no statistical difference between the two groups(P>0.05).Conclusion Recombinant Human P53 Adenovirus Injection combined with regional heperthermia and chemotherapy treating advanced pancreatic cancer can obtain higher disease control rate,effectively relief the pain,improve patients′quality of life,and without increasing bone marrow toxicity.
引文
[1]Malvezzi M,Bertuccio P,Levi F,et al.European cancer mortality predictions for the year 2014[J].Ann Oncol,2014,25(8):1650-1656.
[2]Jemal A,Murray T,Samuels A,et al.Cancer Statistics,2003[J].CA Cancer Clin,2003,53(1):5-26.
[3]De Witt J,Yu M,Al-Haddad MA,et al.Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA[J].Gastrointest Endosc,2010,71(2):260-265.
[4]Yonemori K,Okusaka T,Ueno H,et al.the efficacy of 5-fluorouracil(5-FU)plus cisplatin therapy for controlling malignant ascites in advanced pancreatic cancer patients[J].Hepatogastroenterology,2007,54(80):2383-2386.
[5]汤钊猷.现代肿瘤学[M].2版.上海:上海医科大学出版社,2000:132-134.
[6]Li D,Xie K,Wolff R,et al.Pancreatic cancer[J].Lancet,2004,363(9414):1049-1057
[7]Chen W,Zheng R,Zuo T,et al.National cancer incidence and mortality in China,2012[J].Chin J Cancer Res,2016,28(1):1-11.
[8]金懋林.消化道恶性肿瘤化学治疗[M].北京:北京大学医学出版社,2008:342-343.
[9]张珊文,肖绍文,刘长清,等.头颈部鳞癌基因治疗结合放射治疗的临床研究[J].中华肿瘤杂志,2005,27(7):426-428.
[10]Yang ZX,Wang D,Wang G,et al.Clinical study o ecombinant adenovirus-p53 combined with fractionated stereotactic radiotherapy for hepatocellular carcinoma[J].J Cancer ResClin Oncol,2010,136:625-630.
[11]Nishizaki M,Meyn RE,Levy LB,et al.Synergistic inhibition of human lung cancer cell growth by adenovirus-mediated wild-type p53 gene transfer in combination with docetaxel and radiation therapeutics in vitro and in vivo[J].Clin Cancer Res,2001,7(9):2887-2897.
[12]王晓东,刘学政.肿瘤热疗机制及临床应用研究进展[J].辽宁医学院学报,2011,32(4):373-374.
[13]周继.实用肿瘤内科学[M].2版.北京:人民卫生出版社,2006:163-164.
[14]李海金,董良,陈亚男,等.恶性腹腔积液体外高频深部热疗联合腹腔化疗的临床观察[J].中华肿瘤防治杂志,2011,18(19):1559-1562.
[15]李灿宇,张自森,薛长年,等.热灌注顺铂治疗晚期卵巢癌恶性腹腔积液的临床疗效[J].中国老年学杂志,2012,32(17):3656-3658.
[16]Esquivel J,Sticca R,Sugarbaker P,et al.Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin:a consensus Statement[J].Ann Surg Oncol,2007,14(1):128-133.
[17]殷蔚伯.肿瘤放射治疗学[M].北京:中国协和医科大学出版社,2002:23-24.
[2]Jemal A,Murray T,Samuels A,et al.Cancer Statistics,2003[J].CA Cancer Clin,2003,53(1):5-26.
[3]De Witt J,Yu M,Al-Haddad MA,et al.Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA[J].Gastrointest Endosc,2010,71(2):260-265.
[4]Yonemori K,Okusaka T,Ueno H,et al.the efficacy of 5-fluorouracil(5-FU)plus cisplatin therapy for controlling malignant ascites in advanced pancreatic cancer patients[J].Hepatogastroenterology,2007,54(80):2383-2386.
[5]汤钊猷.现代肿瘤学[M].2版.上海:上海医科大学出版社,2000:132-134.
[6]Li D,Xie K,Wolff R,et al.Pancreatic cancer[J].Lancet,2004,363(9414):1049-1057
[7]Chen W,Zheng R,Zuo T,et al.National cancer incidence and mortality in China,2012[J].Chin J Cancer Res,2016,28(1):1-11.
[8]金懋林.消化道恶性肿瘤化学治疗[M].北京:北京大学医学出版社,2008:342-343.
[9]张珊文,肖绍文,刘长清,等.头颈部鳞癌基因治疗结合放射治疗的临床研究[J].中华肿瘤杂志,2005,27(7):426-428.
[10]Yang ZX,Wang D,Wang G,et al.Clinical study o ecombinant adenovirus-p53 combined with fractionated stereotactic radiotherapy for hepatocellular carcinoma[J].J Cancer ResClin Oncol,2010,136:625-630.
[11]Nishizaki M,Meyn RE,Levy LB,et al.Synergistic inhibition of human lung cancer cell growth by adenovirus-mediated wild-type p53 gene transfer in combination with docetaxel and radiation therapeutics in vitro and in vivo[J].Clin Cancer Res,2001,7(9):2887-2897.
[12]王晓东,刘学政.肿瘤热疗机制及临床应用研究进展[J].辽宁医学院学报,2011,32(4):373-374.
[13]周继.实用肿瘤内科学[M].2版.北京:人民卫生出版社,2006:163-164.
[14]李海金,董良,陈亚男,等.恶性腹腔积液体外高频深部热疗联合腹腔化疗的临床观察[J].中华肿瘤防治杂志,2011,18(19):1559-1562.
[15]李灿宇,张自森,薛长年,等.热灌注顺铂治疗晚期卵巢癌恶性腹腔积液的临床疗效[J].中国老年学杂志,2012,32(17):3656-3658.
[16]Esquivel J,Sticca R,Sugarbaker P,et al.Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin:a consensus Statement[J].Ann Surg Oncol,2007,14(1):128-133.
[17]殷蔚伯.肿瘤放射治疗学[M].北京:中国协和医科大学出版社,2002:23-24.