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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。
Objective To investigate the short-term efficacy of recombinant human p53 adenovirus (rAd-p53) in the treatment of spinal metastases. Methods June 2006 In August 2009, 18 patients with primary spinal metastases from squamous cell carcinoma of the lung were treated with percutaneous injections of rAd-p53 combined with radiotherapy and radiotherapy alone. The therapeutic effect was evaluated by comparing the tumor volumes before and after treatment The tumor necrosis rates of the two groups were observed. The expression of P53 protein in the cancer tissue and the level of anti-p53 gene adenovirus in serum were detected. Results The efficacy of the combination therapy group was 66.7%, which was higher than that of the radiotherapy alone group (27.8%), the difference was statistically significant (P <0.05). The combined treatment group showed obvious necrosis of tumor cells, positive expression of P53 protein and strong positive anti-p53 gene adenovirus antibody in serum. Conclusions rAd-p53 gene therapy can inhibit tumor growth. Radiotherapy combined with radiotherapy can make up for the deficiency of single radiotherapy, improve radiosensitivity and effectively treat spinal metastases.