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目的探讨局部晚期非小细胞肺癌患者采用支气管动脉灌注重组人p53腺病毒联合同期放化疗治疗的近期疗效及安全性。方法选取2011年10月至2013年10月间收治的106例局部晚期(Ⅲ期)非小细胞肺癌患者,按照抽签方式随机分为观察组和对照组,每组53例。观察组患者给予化疗(依托泊苷+顺铂)、放疗(60 Gy/30次)和支气管动脉灌注重组人p53腺病毒治疗,对照组患者给予化疗(依托泊苷+顺铂)和放疗(60 Gy/30次)。分析两组患者治疗疗效及不良反应。结果治疗后,观察组患者的有效率为71.7%,显著高于对照组的47.7%(P<0.05);观察组患者1年生存率为71.7%(38/53),无进展生存率为50.9%(27/53),对照组患者1年生存率为66.0%(35/53),无进展生存率45.3%(24/53),两组差异均无统计学意义(P>0.05)。治疗后,两组患者的癌胚抗原(CEA)水平均明显降低(P<0.05);与治疗后对照组比较,观察组患者CEA水平显著低于对照组(P<0.05);两组患者的糖链抗原199(CA199)、糖链抗原153(CA153)指标均低于治疗前,但差异均无统计学意义(P>0.05);两组患者不良反应发生率的差异无统计学意义(P>0.05)。结论局部晚期非小细胞肺癌采用支气管动脉灌注重组人p53腺病毒联合放化疗的近期疗效优于单纯放化疗,且不良反应发生率未增加。
Objective To investigate the short-term efficacy and safety of bronchial arterial infusion of recombinant human p53 adenovirus combined with concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer. Methods A total of 106 patients with locally advanced (stage Ⅲ) non-small cell lung cancer admitted from October 2011 to October 2013 were randomly divided into observation group and control group according to the way of drawing lots, with 53 cases in each group. Patients in the observation group were given chemotherapy (etoposide + cisplatin), radiation (60 Gy / 30 times) and bronchial artery infusion of recombinant human adenovirus p53, while those in the control group were given chemotherapy (etoposide + cisplatin) and radiotherapy Gy / 30 times). Analysis of two groups of patients treatment efficacy and adverse reactions. Results After treatment, the effective rate in the observation group was 71.7%, significantly higher than that in the control group (47.7%, P <0.05). The 1-year survival rate in the observation group was 71.7% (38/53) and the progression-free survival rate was 50.9 % (27/53). The 1-year survival rate was 66.0% (35/53) in the control group and 45.3% (24/53) in the progression-free survival group. There was no significant difference between the two groups (P> 0.05). After treatment, the level of carcinoembryonic antigen (CEA) was significantly decreased in both groups (P <0.05). Compared with the control group after treatment, CEA level in the observation group was significantly lower than that in the control group (P <0.05) The indexes of carbohydrate antigen 199 (CA199) and carbohydrate antigen 153 (CA153) were lower than those before treatment, but the differences were not statistically significant (P> 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusions The recent curative effect of local injection of recombinant human p53 adenovirus combined with radiotherapy and chemotherapy in patients with locally advanced non-small cell lung cancer is superior to radiotherapy and chemotherapy alone and the incidence of adverse reactions is not increased.