重组p53基因腺病毒注射液胸腔灌注治疗恶性胸水的临床疗效观察

目的观察重组p53基因腺病毒（rAd-p53）注射液胸腔灌注治疗恶性胸水的临床疗效。方法45例恶性胸水患者均行胸腔穿刺彻底引流后通过胸腔闭式引流管灌注rAd—p53，用量为1×1012VP×2支，4周后根据胸水量的变化进行疗效评价。结果45例患者中完全缓解（CR）20例，部分缓解（PR）19例，稳定（SD）4例，进展（PD）2例，总有效率达86．7％（39／45）。达到CR的20例病人中，有16例病人胸水在3个月内没有再出现。各肿瘤病种之间没有差异。所有患者主要副反应为自限性发热，体温在37．5℃～39．1℃之间，12h～24h后均可自行恢复正常。结论rAd-p53注射液胸腔灌注治疗恶性胸水的有效率高、疗效确切、副作用可以耐受，值得临床进一步应用观察。

Effects of recombinant adenovirus p53 injection on malignant pleural effusion

Objective To evaluate the effects of recombinant adenovirus p53 injection （rAd-p53,Gendicine） on malignant pleural effusion. Methods 2 × 10^12 VP of rAd-p53 was treated through intrathorakcic drain after malignant pleural effusion drain away for 45 cases. Therapeutic evaluation was carried out after 4 weeks according to the alteration of pleural effusion. Results Total effective rate was 86.7% （39/45）in 45 cases of malignant pleural effusion, included 20 cases in complete remission, 10 cases in partial remission, 4 cases in stable, and 2 cases in progress. 16 patients were norelapse after 3 months in 20 eases of complete remission. No difference in each kind of tumor patients. Side effects was self-limited fever between 37.5℃～39. 1℃. fadeaway after 12h～24h. Conclusion The rAd-p53 was effective and tolerant to treat patients with malignant pleural effusion.