重组人p53腺病毒治疗脊柱转移瘤的近期疗效观察

目的探讨重组人p53腺病毒（recombinant human p53 adenovirus,rAd-p53）在脊柱转移瘤的治疗中的近期疗效。方法 2006年6月2009年8月,以经皮注射rAd-p53联合放疗及单独放疗方法治疗肺鳞状细胞癌来源脊柱转移瘤患者各18例,通过比较两组治疗前后的肿瘤体积变化评价疗效,观察两组治疗后肿瘤细胞坏死率情况,检测P53蛋白在癌组织中的表达以及血清中抗特异p53基因腺病毒抗体水平。结果联合治疗组疗效评定有效率为66.7%,高于单独放疗组的27.8%,差异有统计学意义（P〈0.05）。联合治疗组可见明显肿瘤细胞坏死、P53蛋白表达阳性及血清中抗特异p53基因腺病毒抗体水平强阳性。结论 rAd-p53基因治疗能抑制肿瘤生长,联合放疗可弥补单一放疗的不足,提高放疗的敏感性,有效治疗脊柱转移瘤。

Clinical Efficacy of Recombinant Human p53 Adenovirus on the Treatment of Metastatic Spinal Tumors

Objective To investigate the clinical efficacy of recombinant human p53 adenovirus （rAd-p53） in the treatment of metastatic spinal tumor. Methods From June 2006 to August 2009, 36 cases of metastatic spinal tumors were treated with the percutaneous injection of rAd-p53 combined with radiotherapy （n=18） or radiotherapy alone （n=18）, respectively. Thirty-six cases were observed before and after treatment including the change of the tumors, the tumor cell necrosis rate, P53 protein in cancer tissue, and serum anti-p53 adenovirus-specific antibody levels. Results The effect rate of combination therapy group was 66.7%, showing significantly higher than that of radiotherapy group （27.8%, P0.05）. Tumor cell necrosis in combination therapy group was predominant. P53 protein expression was positive and anti-p53 adenovirus-specific antibody level was strong positive in combinant therapy group. Conclusion The rAd-p53 gene therapy can inhibit tumor growth and is an effective treatment for spinal metastases, and combination therapy can make up for lack of a single radiation to improve sensitivity to radiotherapy.