Intra-tumoral injection of E1B gene-deleted adenovirus combined with gemcitabine for unresectable pancreatic carcinoma: 19 cases analysis / 中华胰腺病杂志

ABSTRACT

Objective To evaluate the efficacy and tolerability of EUS-guided intra-tumoral injection of E1B gene-deleted adenovirus (H101) combined with intravenous gemcitabine for unresectable pancreatic carcinomas. Methods Nineteen patients with advanced adenocarcinoma of the pancreas who were not resectable and never to anti-cancer treatment were enrolled in this study. Each patient underwent two sessions of EUS-guided H101 intra-tumoral injection in combination with gemcitabine (i. v. , 1000 mg/m2, d3, 10, 17). The tumor size before and after H101 intra-tumoral injection were recorded for efficacy assessment. The changes of pain score and KPS, adverse effects and complication rates, survival were estimated. Results The tumor size decreased in twelve patients by5.3% ~ 69.7% , but the difference was not statistically significant (P =0.275). All of nineteen patients completed two cycles of combination treatment. Among them, 3 (15. 8% ) achieved partial response, 10 (52.6% ) had stable disease, and none had complete response. The mean pain score after injection was significantly lower than that before injection (3.1 ±1.7 vs. 3.9±1.6, P = 0.004). KPS after injection was significantly increased more than that before injection [ (68.4 ± 12.1)% vs. (61.1 ±9.9)%, P =0.003)]. There was no complication associated with the procedure. Major adverse effects associated with H101 injection were fever and diarrhea. The survival time was 2.5 to 10 months. Nine patients were still alive. Conclusions EUS-guided E1B gene-deleted adenovirus intra-tumral injection in unresectable pancreatic carcinomas is feasible and well tolerated in combination with intravenous gemcitabine, which can improve the quality of life and decrease the pain score.