title: A patient with a large intrathoracic malignant schwannoma who showed a complete clinical response to rAd-p53-combined with radiotherapy.
abstract: The prognosis of postoperatively recurred malignant schwannoma is poor and there is no effective treatment. We had a patient who was found to have a large intrathoracic tumor 1 year after surgery and could not tolerate an operation for the second time. We then decided to evaluate the synergistic effect of recombinant adenovirus-p53 (rAd-p53) combined with radiotherapy for the patient. rAd-p53 was injected intratumorally twice a week before radiotherapy, a total of 10 times, over a course of treatment. Radiotherapy then followed gene therapy at five fractions a week for 5 weeks, with a total dosage of 80.6 Gy/31f in the center part of the tumor and 62 Gy/31f in other locations. The pathological diagnosis of malignant schwannoma indicated that the p53 expression was strongly positive and vascular endothelial growth factor and Bcl-2 were positive before treatment on protein immunohistochemical staining. After treatment, the diameter of the tumor was noticeably reduced and the center part of the tumor presented as a fluid anechoic area and cavities on computed tomographic scanning. The result of the puncture biopsy showed that there were many fibronecrotic tissues and no significant tumor cells. The p53 expression was weakly positive, Vascular endothelial growth factor was negative, and Bcl-2 was weakly positive after treatment on protein immunohistochemical staining.
authors.affiliation: Departments of aThoracic Surgery bRadiation Oncology, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Keqiang
authors.initials: K
authors.lastname: Liu
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.forename: Huayong
authors.initials: H
authors.lastname: Jiang
authors.forename: Jingbo
authors.initials: J
authors.lastname: Ma
authors.forename: Jian
authors.initials: J
authors.lastname: Tan
authors.forename: Yingxin
authors.initials: Y
authors.lastname: Pei
authors.forename: Jianping
authors.initials: J
authors.lastname: Chen
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D015316:Genetic Therapy; D006801:Humans; D015552:Injections, Intralesional; D009442:Neurilemmoma / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D016159:Tumor Suppressor Protein p53 / Q000235:genetics* / Q000378:metabolism
chemical_list: D016159:Tumor Suppressor Protein p53