An Investigation On The Preliminary Curative Effect Of Combining Human Recombinant Adenovirus Type5 With Radiation And Chemotherapy Against Middle Or Late Stage Esophageal Cancer And Gastric Cancer

Objective:By observing the preliminary curative effect and safety of endoscopic injection of recombinant human adenovirus type 5 combined with radiotherapy and chemotherapy for middle and advanced esophageal cancer and gastric cancer,and following up the survival period,To investigate the clinical significanc of combining human recombinant adenov-irus type 5 with radiation and chemotherapyagainst middle or late stage esophageal cancer and gastric cancer.Methods:107 patients who met the inclusion criteria and exclusion criteria from April 2013 to April 2018 in Qingdao Municipal Hospital were enrolled.The patients were divided into three groups randomly.6 cases were eliminated in group A.29 patients were accepted human recombinant adenovirus type 5 local injections by endoscope（Group A）.36 patients were accepted human recombinant adenovirus type 5 local injections combined radiation and chemotherapy（Group B）,36 were received concurrent radiation and chem.-.otherapyalone（Group C）.The patients of gastric cancer were treated tegafur combined with oxaliplatin.The patients of esophageal cancer were treated radiation combined with DDP and 5-FU.The patients were given endoscopic intratumor injection of 5×1011vp-1.5×1012human recombinant adenovirus type 5.21 days is a courses.One month after two courses,the clinical efficacy,toxic side effects were compared.The the survival period（OS）of the three groups were followed up.Results:The effective rates were 31.0%,63.9%,30.6%respectively,(P_AB<0.05,P_AC<0.05).The effective rates of esophageal cancer and gastric cancer in group A were 37.5%and 23.1%respectively,（P>0.05）;The effective rates of esophageal cancer and gastric cancer in group B were 80.0%and 43.8%respectively,（P<0.05）.The effective rates of group B was higher than that of group A and C(P_AB<0.05,P_AC<0.05).There was no significant difference in the effective rates of gastric cancer among the three groups（P>0.05）.After treatment.During the treatment,the incidence rates of fever were 73.8%,69.6%,15.0%respectively,(P_AC<0.05,P_BC<0.05);The incidence rates of nausea and vomiting were 11.9%,19.6%,60.0%respectively,(P_AB<0.05,P_AC<0.05);The incidence rates of bone marrow suppression were 2.4%,10.8%,40.0%respectively,(P_AB<0.05,P_AC<0.05).The incidence rates of abnormal liver functionwere 6.9%,13.8%,13.8%,（P>0.05）.The median survival time was 16.0 months,29.0 months and 17.5 months,respectively.The 1-year survival rate was 68.9%,91.7%,72.2%respectively,（P>0.05）,and the 2-year survival rate was 37.9%,61.1%,36.1%,respectively(P_BC<0.05).The KM survival curve of group B was statist-ically significant compared with that of group A and group C,(P_AB<0.05,P_BC<0.05).The survival rate of group B was significantly higher than that of group A and group C.Conclusion:Endoscopic intratumor injection combined with radiation and chemotherapy can effectively improve the clinical efficacy of patients with middle or late stage esophageal cancer and gastric cancer,Combined with radiotherapy and chemotherapy has better efficacy in the treatment of esophageal cancer.Endoscopic injection of adenovirus into the tumor combined with radiotherapy and chemotherapy significantly improved the median survival and longterm survival of the patients.Endoscopic injection of human recombinant adenovirus type 5 combined with radiation and chemotherapyt is safe and effective,Which can provide more options for the treatment of advanced esophageal and gastric canc-er,which have some practical significances in antitumor therapy.