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目的探讨重组人p53腺病毒注射液联合顺铂(DDP)腹腔热灌注化疗治疗伴恶性腹腔积液的晚期胰腺癌患者的疗效。方法对80例伴恶性腹腔积液的晚期胰腺癌患者,抽出腹腔积液后行腹腔热灌注化疗,共分二组,每组40例。DDP组:DDP60mg腹腔热灌注化疗,隔日1次,共3次。p53联合DDP组:腹腔内先注入p53注射液4×1012 VP,再注入DDP60mg腹腔热灌注化疗,隔日1次,共3次。观察近期疗效、生活质量及毒副作用。结果 80例患者均进行客观疗效及安全性评价。p53联合DDP组有效率(RR)、疾病控制率(DCR)分别为52.5%和85.0%,与DDP组相比有效率和疾病控制率均明显提高,差异有统计学意义(P<0.05)。p53联合DDP组患者生活质量(QOL)改善者占80%,较DDP组明显提高(P<0.05)。其临床症状明显改善,治疗相关毒副作用不明显。结论重组人p53腺病毒注射液联合顺铂(DDP)腹腔热灌注化疗是晚期胰腺癌治疗的一种有效方法。
Objective To investigate the efficacy of recombinant human adenovirus p53 combined with cisplatin (DDP) intraperitoneal hyperthermic perfusion chemotherapy in the treatment of advanced pancreatic cancer patients with malignant ascites. Methods 80 cases of patients with advanced pancreatic cancer with malignant ascites were treated with intraperitoneal hyperthermic perfusion chemotherapy after peritoneal effusion, divided into two groups, 40 cases in each group. DDP group: DDP60mg intraperitoneal hot infusion chemotherapy, every other day, a total of 3 times. In the combination of p53 and DDP group, p53 injection (4 × 1012 VP) was injected intraperitoneally first, followed by intraperitoneal hyperthermic perfusion chemotherapy with DDP60mg once a day for 3 times. Observation of short-term efficacy, quality of life and side effects. Results 80 patients were objective and efficacy evaluation. The effective rate (RR) and disease control rate (DCR) of p53 combined with DDP group were 52.5% and 85.0%, respectively. Compared with DDP group, the effective rate and disease control rate were significantly increased, the difference was statistically significant (P <0.05). The improvement of QOL in patients with p53 combined with DDP group was 80%, which was significantly higher than that of DDP group (P <0.05). The clinical symptoms were significantly improved, treatment-related side effects are not obvious. Conclusion Recombinant human p53 adenovirus injection combined with cisplatin (DDP) intraperitoneal hyperthermic perfusion chemotherapy is an effective method for the treatment of advanced pancreatic cancer.