目的 觀察動脈灌注多西他賽和表柔比星聯(lián)合靜脈輸入貝伐單抗治療乳腺癌術(shù)后胸壁復(fù)發(fā)的效果。方法 隨機(jī)選取2016年5月-2019年5月河北中石油中心醫(yī)院治療的乳腺癌術(shù)后胸壁復(fù)發(fā)患者60例，隨機(jī)分為2組。動脈灌注組（30例）：動脈灌注多西他賽、表柔比星聯(lián)合靜脈輸入貝伐單抗治療；靜脈化療組（30例）：靜脈輸入多西他賽、表柔比星、貝伐單抗治療。統(tǒng)計分析兩組患者的臨床療效、主要不良反應(yīng)發(fā)生情況和生命質(zhì)量評分情況。結(jié)果 治療后，動脈灌注組患者的總緩解率53.3%，顯著高于靜脈化療組的33.3%（P<0.05）。動脈灌注組患者中消化道反應(yīng)Ⅰ級6例，Ⅱ級5例，Ⅲ級1例，總發(fā)生率為40.0%；骨髓抑制Ⅰ級2例，Ⅱ級2例，Ⅲ級1例，總發(fā)生率為16.7%。靜脈化療組患者中消化道反應(yīng)Ⅰ級6例，Ⅱ級7例，Ⅲ級3例，Ⅳ級1例，總發(fā)生率為56.7%；骨髓抑制Ⅰ級4例，Ⅱ級3例，Ⅲ級1例，Ⅳ級1例，總發(fā)生率為30.0%。動脈灌注組患者的消化道反應(yīng)、骨髓抑制發(fā)生率均顯著低于靜脈化療組（P<0.05）。兩組患者治療后軀體、情感、認(rèn)知、角色、社會功能及整體生命質(zhì)量評分均顯著高于治療前（P<0.05），動脈灌注治療組患者的提升幅度顯著高于靜脈治療組（P<0.05）。結(jié)論 動脈灌注多西他賽、表柔比星聯(lián)合靜脈輸入貝伐單抗治療乳腺癌術(shù)后胸壁復(fù)發(fā)的效果優(yōu)于靜脈輸入多西他賽、表柔比星、貝伐單抗治療組。

Objective To observe the effect of intra-arterial infusion of docetaxel and epirubicin combined with intravenous infusion of bevacizumab in treatment of chest wall recurrence after breast cancer surgery. Methods 60 cases of patients with breast cancer recurrence after breast cancer surgery in Hebei Petro China Central Hospital from May 2016 to May 2019 were randomly selected and randomly divided into two groups. Arterial perfusion group (30 cases):intra-arterial perfusion with docetaxel and epirubicin combined with intravenous bevacizumab. Intravenous chemotherapy group (30 cases):intravenous infusion with docetaxel, epirubicin, and bevacizumab. The clinical efficacy, main adverse reactions, quality of life scores in two groups were analyzed. Results After treatment, the total remission rate in the arterial perfusion group was 53.3%, which was significantly higher than 33.3% of the intravenous chemotherapy group (P<0.05). In arterial perfusion group, gastrointestinal reactions were grade I in 6 cases, grade II in 5 cases, and grade III in 1 case, with a total incidence of 40.0%, myelosuppression was grade I in 2 cases, grade II in 2 cases and grade III in 1 case, with a total incidence of 16.7%. In the intravenous chemotherapy group, gastrointestinal reactions were 6 cases of grade I, 7 cases of grade II, 3 cases of grade III, and 1 case of grade Ⅳ, with a total incidence of 56.7%, myelosuppression was 4 cases of grade I, 3 cases of grade II, 1 case of grade III, and 1 case of grade IV, with a total incidence of 30.0%. The incidence of digestive tract reaction and myelosuppression in arterial perfusion group was significantly lower than that in intravenous chemotherapy group (P<0.05). The scores of physical, emotional, cognitive, role, social function and overall quality of life after treatment in two groups were significantly higher than those before treatment (P<0.05), the improvement of patients in arterial perfusion group was significantly higher than that in intravenous chemotherapy group (P<0.05). Conclusion The effect of intra-arterial infusion of docetaxel and epirubicin combined with intravenous injection of bevacizumab on chest wall recurrence after breast cancer surgery is better than that of intravenous infusion of docetaxel, epirubicin, and bevacizumab.

廊坊市科技支撐計劃項目（2015013002C）