不可切除和复发的头颈癌患者，以四组不同的剂量（15、30、6
0 和120 μg DNA/cm3 肿瘤）进行瘤体注射，未发现明显的毒性作用；评估的6例
患者中，4例肿瘤得到控制，1例部分缩小，1例有较小的改变。Kirn等［24］用在
p53功能丧失的肿瘤细胞中选择性复制的E1B缺失的5型腺病毒（ONYX-015），对复
发的、放化学治疗难以控制的21例头颈癌患者进行Ⅱ期临床试验，每天肿瘤内注射
ONYX-015（1010PFU），连续5天，每3周重复治疗一次，13例患者可以评估，其中
2例肿瘤缩小50%以上，2例完全消退，5例肿瘤稳定持续6～12周，3例症状（咬颌和
语言）得到改善，1例治疗前后无改变。以上结果均表明E1A基因对晚期头颈部肿瘤
的治疗是有效的。
　　目前大多数基因治疗的策略是基于肿瘤局部注射，该途径安全、简捷、易于观
察疗效。因此，头颈肿瘤应是E1A基因临床应用首选的肿瘤。E1A基因不仅局部注射
Ⅰ、Ⅱ期临床试验均取得了肯定的疗效，而且静脉注射在动物模型也取得了较好的
治疗效果，未见明显的毒副作用。因此，E1A基因通过多种途径，作用于不同的基
因，不仅可以治疗不可手术的和复发的头颈癌，而且对远处转移的头颈癌也可获得
同样的治疗效果。所以，E1A基因在头颈肿瘤治疗中的应用前景可能是光明的。
　　近年来，随着分子生物学技术的发展，基因治疗的研究在医学领域越来越活跃
。相信E1A基因的临床应用将有可能推动肿瘤的综合治疗，进一步改善患者的生存
质量，提高患者的生存率。
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