范宇飞　秦苑　李定纲

[摘要]目的 探讨重组人P53腺病毒注射液联合局部热疗与化疗治疗晚期胰腺癌的效果。方法 回顾性分析我院肿瘤科2006年7月～2012年7月收治的晚期胰腺癌患者48例，患者均有中到大量腹水，根据治疗方法不同分为研究组和对照组，研究组23例患者接受基因治疗，同时联合吉西他滨+顺铂化疗，局部热疗。对照组25例患者接受吉西他滨+顺铂全身化疗。比较两组疗效。结果 研究组的疾病控制率为78.26%，对照组为32.00%，两组的疾病控制率比较，差异有统计学意义（P<0.05）。研究组的疼痛缓解率为83.33%，对照组为25.00%，两组的疼痛缓解率比较，差异有统计学意义（P<0.05）。研究组Ⅲ～Ⅳ度骨髓抑制发生率为21.74%，对照组为24.00%，两组的Ⅲ～Ⅳ度骨髓抑制率比较，差异无统计学意义（P>0.05）。结论 重组人P53腺病毒注射液联合局部热疗与化疗治疗晚期胰腺癌可取得较高的疾病控制率，同时可有效缓解疼痛，提高患者的生活质量，且未增加骨髓毒性。

[关键词]晚期胰腺癌；重组人P53腺病毒注射液；局部热疗；化疗

[中图分类号] R735.9 [文献标识码] A [文章编号] 1674-4721（2017）05（a）-0084-03

[Abstract]Objective To explore the effect of Recombinant Human P53 Adenovirus Injection combined with regional heperthermia and chemotherapy treating advanced pancreatic cancer.Methods Forty-eight patients with advanced pancreatic cancer treated by department of oncology in our hospital from July 2006 to July 2012 were retrospectively analyzed.Patients had moderate to massive ascites.These patients were divided into research group and control group according to different treatment methods.The research group：23 patients received gene therapy，Gemcitabine and Cisplatin chemotherapy，local hyperthermia.Control group：25 patients received Gemcitabine and Cisplatin systemic chemotherapy alone.The effect between two groups was compared.Results The disease control rate was 78.26% in research group and it was 32.00% in control group，and the difference between the two groups was statistically significant （P<0.05）.The pain relief rate was 83.33% in the study group and it was 25.00% in control group and the difference was statistically significant between the two groups （P<0.05）.The incidence rate of Ⅲ～Ⅳ myelosuppression was 21.74% in research group，and in was 24.00% in control group，and there was no statistical difference between the two groups （P>0.05）.Conclusion Recombinant Human P53 Adenovirus Injection combined with regional heperthermia and chemotherapy treating advanced pancreatic cancer can obtain higher disease control rate，effectively relief the pain，improve patients′ quality of life，and without increasing bone marrow toxicity.

[Key words]Advanced pancreatic cancer；Recombinant Human P53 Adenovirus Injection；Regional heperthermia；Chemotherapy

胰腺癌的病因與发病机制至今未明，临床资料分析表明，可能是多种因素长期共同作用的结果，与大量吸烟、饮酒、饮咖啡者，糖尿病患者，慢性胰腺炎等可能有关。最近的研究发现，胰腺癌是男性继肺癌、结直肠癌、前列腺癌之后第四大的恶性肿瘤[1]。胰腺癌是目前最难治疗肿瘤之一，号称“癌中之王”，也是目前常见恶性肿瘤中预后极差的肿瘤之一[2]。胰腺癌患者的死亡率最高，仅有13%～15%的患者有可能行胰十二指肠切除术，术后中位生存期为13.3个月，94%的患者 5年内死亡，75%的患者生存期≤1年，仅有6%的患者生存期可能>5年，大部分伴有腹水的晚期患者中位生存期为63～81 d[3-4]。……