瘤内注射重组溶瘤病毒联合FOLFOX-4方案治疗晚期肝癌

目的观察和评价超声引导下瘤体内注射重组溶瘤病毒（H101）联合FOLFOX-4方案治疗晚期肝癌的疗效及安全性。方法：22例晚期原发性肝癌患者，采用超声引导下肝内瘤体内注射重组溶瘤病毒（H101）联合FOLFOX4方案进行治疗，分别以RECIST标准和NCICTC标准观察和评价其疗效和毒性。结果：共22例患者，有20例可以评价客观疗效，其中获得PR5例，SD7例，PD8例；患者的肿瘤进展时间（TTP）为1．2-6．1个月，中位，TTP 3．1个月。22例中，11例临床症状和KPS评分有明显改善，AFP阳性的17例患者中，有11例下降，5例明显下降（AFP下降超过原始基线的1／2）。22例患者均可评价毒性，主要不良反应为轻、中度的发热（45．6％），白细胞减少（44．5％）和腹泻（33．7％）。结论：本试验证实，瘤体内注射重组溶瘤病毒（H101）联合FOLFOX4方案治疗国人晚期原发性肝癌，疗效确切；较单纯全身化疗有更高的有效率；安全性高，不良反应较轻，患者易于耐受，值得进一步研究试用。

Intra-tumoral injection of E1B gene-deleted adenovirus combined with FOLFOX 4 for advanced hepatocellular carcinoma

Objective To determine the efficiency and safety of ultrasound-guided intra-tumoral injection of E1B gene-deleted adenovirus （H101） combined with FOLFOX 4 regimen （oxaliplatin and CF/5-FU） in recurrent, metastatic, or unresectable hepatocellular carcinoma. Methods 22 patients with advanced hepatocellular carcinoma were enrolled in this study after informed consent was obtained. Each patient underwent US-guided H101 intra-tumor injection and FOLFOX 4 treatment. The treatment response was evaluated using the RECIST criteria and~the toxicities using the American National Cancer Institute common toxicity criteria （NCLCTC）. Results Of 20 patients evaluated for treatment response, there were 5 patients with partial response, 7 with stable disease, 8 with disease progression. Time to tumor progression （TFP） ranged from 1.2 to 6.1 months with median of 3.1 months. Half of the 22 patients had obvious improvement in symptoms and Karnofsky performance status. Serum AFP levels decreased in 11/17 patients with 5 decreasing more than half of the baseline values. neurotoxicity （44.5%） and diarrhea （33.7%）. Conclusion The toxicities included Grade I-II fever （45.6%）,mild Intra-tumoral injection of H101 combined with FOLFOX 4 is a promising treatment regimen for advanced hepatocellular carcinoma with improved tumor necrosis rate, safety and low toxicity.