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目的评价重组人p53腺病毒注射液经肝动脉灌注治疗中、晚期肝癌的疗效。方法选择我院2008年~2014年临床诊断的无手术指征或拒绝手术治疗的原发性肝癌患者72例,分为选择性肝动脉栓塞化疗术(TACE)和重组人p53腺病毒注射液(r Ad-p53)联合栓塞化疗治疗,每组36例。两组均每隔28天进行一次治疗,4次为1疗程。于完成疗程后1月,根据临床表现、肝脏CT及肝功能检查等指标进行疗效评价。结果 TACE组患者病情缓解(CR+PR)18例(50%),肝脏肿瘤病灶无完全消失(CR),明显缩小或病灶数量减少(PR)18例(50%),病情稳定(SD)2例(5.6%),病情进展(PD)16例(44.4%);联合治疗组患者病情缓解(CR+PR)25例(69.4%),症状好转,一般状况改善,Karuafsky评分明显提高(P<0.05)。CR 2例(5.6%),PR 23例(63.8%),SD 2例(5.6%),PD 9例(25%);使用重组人p53腺病毒灌注治疗后不良反应轻微。结论应用重组人p53腺病毒注射液联合TACE治疗肝癌患者临床疗效优于单纯TACE治疗,值得在合适的肝癌患者中应用。
Objective To evaluate the efficacy of recombinant human p53 adenovirus injection in the treatment of advanced hepatocellular carcinoma by hepatic arterial infusion. Methods Seventy-two patients with primary hepatocellular carcinoma without surgical indication or surgical treatment were selected from 2008 to 2014 in our hospital. They were divided into two groups: selective hepatic artery chemoembolization (TACE) and recombinant human adenovirus p53 r Ad-p53) combined with embolization chemotherapy, 36 cases in each group. Two groups were treated once every 28 days, 4 times for a course of treatment. In January after completion of treatment, according to clinical manifestations, liver CT and liver function tests and other indicators of efficacy evaluation. Results Eighteen patients (50%) had complete remission (CR + PR) in TACE group, no complete disappearance of hepatic tumor lesion, 18 cases (50%) were significantly reduced or the number of lesions reduced (PR) (5.6%) and progression of disease (PD) 16 cases (44.4%). The CR + PR in 25 cases (69.4%) in the combined treatment group was improved, the symptoms improved, the general condition improved and the Karuafsky score was significantly improved (P < 0.05). 2 cases (5.6%) were CR, 23 cases (63.8%) were PR, 2 cases were SD (5.6%) and 9 cases were PD (25%). Adverse reaction was mild after perfusion with recombinant adenovirus p53. Conclusion The clinical efficacy of recombinant human p53 adenovirus injection combined with TACE in the treatment of liver cancer is superior to that of TACE alone and is worthy of application in patients with liver cancer.