Objective:Toassessthesafetyandclinicalantiangiogeniceffectofrecombinantadenovirus-p53(rAd-p53)combinedwithhyperthermiaplusornotplusradiotherapyinadvancedcancer.Methods:ExpressionofVascularepithelialgrowthfactor(VEGF)afterintratumoralinjectionofrAd-p53wasassayedbyimmunohistochemistry(IHC)imaging.Forty-fourpatientswithadvancedcancerwereenrolledintothisclinicalstudy.ThepatientswereintratumorallyinjectedwithrAd-p53(Gendicine)atadoseof1×1012vponceaweek,withatotalof4-54(mean7.7)times.Totalof4-29(mean8.5)timesofhyperthermiawasgiventothepatients.Amongthe44patients,30patientswereconcurrentlyaddedwithradiotherapyofatotaldose30-76Gy/15-38f/3-8w(mean58Gy).Results:BeforeandafterintratumoralinjectionofrAd-p53,theVEGFIHCpositivecellscoreswere2.80and1.50,respectively(P=0.031).ThetreatmentofrAd-p53combinedwithhyperthermiaplusornotplusradiotherapyinadvancedcancerachievedCRrateof13.60%(6/44),andPRrateof29.6%(13/44),andthustheeffectiveratewas43.2%.Inadditionto6patientswithCR,19patients(19/38,50.0%)hadlowdensityarea(LDA)ofmorethan50%areaonCTimagewithintumorindicatingtumortissuenecrosis.Conclusions:OurdataindicatethatrAd-p53inhibitsVEGFexpressionandangiogenesis,andpromotestumornecrosisandshrinkageinducedbyhyperthermiaplusornotplusradiotherapyinadvancedcancer.