| ObjectiveThis study aimed to explore and evaluate the clinical efficacy and safety of endoscopic tumor injection of recombinant human type-5 adenovirus for patients with advanced gastrointestinal tumors.MethodsFrom August 12 2012 to July 8 2019,a total of 44 patients with advanced gastrointestinal carcinoma who received intratumoral injection of recombinant human type-5 adenovirus and/or chemotherapy at Qingdao Municipal Hospital were retrospectively enrolled.18 patients in the combination group were treated with recombinant human type-5 adenovirus combined with conventional chemotherapy,26 patients in the single group were treated with recombinant human type-5 adenovirus alone.The clinical characteristics of patients,short-term and long-term outcomes,quality of life and complication were compared in the two groups.The methods of t test,Chi-square test and Kaplan-Meier were performed for statistical analysis.Results1.The two groups of patients were comparable(P> 0.05).2.Disease control rate(DCR)and objective response rate(ORR)in the combination group were 83.33% and 66.67%,respectively,which were lower than those(DCR:61.54%,ORR:19.23%)in the single group,the difference on ORR was significant(P< 0.05).3.After treatment,the dysphagia score of combined group(1.87±0.64)and single group(2.32±0.75)were lower than those(3.47±0.92,3.48±0.96)before treatment(P<0.05),respectively.After 2 cycles of treatment,the Karnofsky scores of the combined group and the single group(82.22±5.48,78.85±7.11)were higher than those(77.22±5.75,75.38±5.08)before treatment(P <0.05).4.The levels of hemoglobin and serum albuminin in the combination group(99.44±8.28,35.49±3.86)were higher than those(73.39±9.06,28.36±4.18)before treatment,and the difference was significant(P <0.05).The levels of hemoglobin and serum albumin in the single group(87.81±5.91,32.09± 2.17)after treatment were not significant higher than those(80.73±8.74,29.12±4.22)before treatment(P> 0.05).5.The main complications of intratumoral injection of recombinant human type-5adenovirus were fever,flu-like symptoms,occasional nausea and vomiting,withoutsignificant liver and kidney dysfunction,and bone marrow transplantation.All complications were improved after related symptomatic treatment.6.Compared with the median survival(OS)and median progression-free survival(PFS)of the single group(9 months and 4 months),the OS and PFS of patients in the combined group(16.50 months and 7.75 months)prolonged 7.50 months and 3.75 months,respectively.Conclusion1.Endoscopic injection of recombinant human type-5 adenovirus therapy combined with conventional chemotherapy can effectively reduce tumor volume,prolong survival,selectively kill tumor cells by target multiple ways,activate systemic immunity,prevent and control tumor recurrence and metastasis.2.Endoscopic injection of recombinant human type-5 adenovirus therapy combined with conventional chemotherapy has a significant effect on patients with advanced gastrointestinal tumors,which provide new options for patients with advanced gastrointestinal cancer. |
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