Objective： To assess the safety and clinical antiangiogenic effect of recombinant adenovirus-p53 （rAd-p53） combined with hyperthermia plus or not plus radiotherapy in advanced cancer. Methods： Expression of Vascul...Objective： To assess the safety and clinical antiangiogenic effect of recombinant adenovirus-p53 （rAd-p53） combined with hyperthermia plus or not plus radiotherapy in advanced cancer. Methods： Expression of Vascular epithelial growth factor （VEGF） after intratumoral injection of rAd-p53 was assayed by immunohistochemistry （IHC） imaging. Forty-four patients with advanced cancer were enrolled into this clinical study. The patients were intratumorally injected with rAd-p53 （Gendicine） at a dose of 1×1012 vp once a week, with a total of 4-54 （mean 7.7） times. Total of 4-29 （mean 8.5） times of hyperthermia was given to the patients. Among the 44 patients, 30 patients were concurrently added with radiotherapy of a total dose 30-76 Gy/15-38 f/3-8 w （mean 58 Gy）. Results： Before and after intratumoral injection of rAd-p53, the VEGF IHC positive cell scores were 2.80 and 1.50, respectively （P=0.031）. The treatment of rAd-p53 combined with hyperthermia plus or not plus radiotherapy in advanced cancer achieved CR rate of 13.60% （6/44）, and PR rate of 29.6% （13/44）, and thus the effective rate was 43.2%. In addition to 6 patients with CR, 19 patients （19/38, 50.0%） had low density area （LDA） of more than 50% area on CT image within tumor indicating tumor tissue necrosis. Conclusions： Our data indicate that rAd-p53 inhibits VEGF expression and angiogenesis, and promotes tumor necrosis and shrinkage induced by hyperthermia plus or not plus radiotherapy in advanced cancer.展开更多
文摘Objective： To assess the safety and clinical antiangiogenic effect of recombinant adenovirus-p53 （rAd-p53） combined with hyperthermia plus or not plus radiotherapy in advanced cancer. Methods： Expression of Vascular epithelial growth factor （VEGF） after intratumoral injection of rAd-p53 was assayed by immunohistochemistry （IHC） imaging. Forty-four patients with advanced cancer were enrolled into this clinical study. The patients were intratumorally injected with rAd-p53 （Gendicine） at a dose of 1×1012 vp once a week, with a total of 4-54 （mean 7.7） times. Total of 4-29 （mean 8.5） times of hyperthermia was given to the patients. Among the 44 patients, 30 patients were concurrently added with radiotherapy of a total dose 30-76 Gy/15-38 f/3-8 w （mean 58 Gy）. Results： Before and after intratumoral injection of rAd-p53, the VEGF IHC positive cell scores were 2.80 and 1.50, respectively （P=0.031）. The treatment of rAd-p53 combined with hyperthermia plus or not plus radiotherapy in advanced cancer achieved CR rate of 13.60% （6/44）, and PR rate of 29.6% （13/44）, and thus the effective rate was 43.2%. In addition to 6 patients with CR, 19 patients （19/38, 50.0%） had low density area （LDA） of more than 50% area on CT image within tumor indicating tumor tissue necrosis. Conclusions： Our data indicate that rAd-p53 inhibits VEGF expression and angiogenesis, and promotes tumor necrosis and shrinkage induced by hyperthermia plus or not plus radiotherapy in advanced cancer.
