Adjuvant adenovirus-mediated delivery of herpes simplex virus thymidine kinase administration improves outcome of liver transplantation in patients with advanced hepatocellular carcinoma
Adjuvant adenovirus-mediated delivery of herpes simplex virus thymidine kinase administration improves outcome of liver transplantation in patients with advanced hepatocellular carcinoma
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辅助腺病毒介导的单纯疱疹病毒胸苷激酶给药可改善晚期肝细胞癌患者肝移植的结果
DOI：
10.1158/1078-0432.ccr-07-0499
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发表时间：
2007-10-01
影响因子：
11.5
通讯作者：
Ma, Ding
中科院分区：
文献类型：
--
作者：
Li, Ning;Zhou, Jianfeng;Ma, Ding
目的：晚期肝细胞癌（HCC）患者既往肝移植（LT）效果不佳已得到证实。腺罗斯介导的单纯疱疹病毒胸苷激酶（ADV-TK）治疗是一种既定的癌症辅助治疗，我们评估了其作为接受LT的HCC患者的辅助治疗的潜力。实验设计：45例肿瘤直径>5 cm的HCC患者参加了为期50个月的随访期。在这些患者中，22例仅接受LT治疗，23例接受LT联合ADV-TK治疗。结果：LT联合ADV-TK治疗组3年无复发生存率和总生存率分别为43.5%和69.6%;两个值均显著高于仅LT组（分别为9.1%和19.9%）。在非血管浸润亚组中，接受LT加ADV-TK的患者的总生存率为100%，无复发生存率为83.3%，显著高于接受LT only.Conclusions的患者：无论肝内巨大或弥漫性肿瘤，无血管浸润的HCC患者均可选择ILT，然后辅助ADV-TK治疗。我们建议，如果伴随ADV-TK治疗，基于肿瘤大小的当前ILT标准可能会扩大，因为预后改善。
Purpose: Previous poor results of liver transplantation (LT) have been confirmed in patients with advanced hepatocellular carcinoma (HCC). Adenovi rus- mediated delivery of herpes simplex virus thymidine kinase (ADV-TK) therapy is an established adjuvant treatment in cancer, and we evaluated its potential as an adjuvant treatment for HCC patients who underwent LT.Experimental Design: Forty-five HCC patients with tumors >5 cm in diameter participated in the study over a follow-up period of 50 months. Among these patients, 22 received LTonly, and 23 received LT combined with ADV-TK therapy. All HCC patients enrolled in this study had tumors >5 cm in diameter and no metastasis in lungs or bones was detected by computed tomography or magnetic resonance imaging scans.Results: The recurrence-free survival and the overall survival in the LT plus ADV-TK therapy group were 43.5% and 69.6%, respectively, at 3 years; both values were significantly higher than those in the LT-only group (9.1% and 19.9%, respectively). In the nonvascular invasion subgroup, overall survival was 100% and recurrence-free survival was 83.3% in the patients receiving LT plus ADV-TK, significantly higher than the patients receiving LTonly.Conclusions: HCC patients with no vascular invasion could be selected for ILT followed by adjuvant ADV-TK therapy, regardless of intrahepatic huge or diffuse tumor. We propose that the current criteria for ILT based on tumor size may be expanded if accompanied by ADV-TK therapy due to improved prognosis.