目的 观察动脉灌注多西他赛和表柔比星联合静脉输入贝伐单抗治疗乳腺癌术后胸壁复发的效果。方法 随机选取2016年5月-2019年5月河北中石油中心医院治疗的乳腺癌术后胸壁复发患者60例，随机分为2组。动脉灌注组（30例）：动脉灌注多西他赛、表柔比星联合静脉输入贝伐单抗治疗；静脉化疗组（30例）：静脉输入多西他赛、表柔比星、贝伐单抗治疗。统计分析两组患者的临床疗效、主要不良反应发生情况和生命质量评分情况。结果 治疗后，动脉灌注组患者的总缓解率53.3%，显著高于静脉化疗组的33.3%（P<0.05）。动脉灌注组患者中消化道反应Ⅰ级6例，Ⅱ级5例，Ⅲ级1例，总发生率为40.0%；骨髓抑制Ⅰ级2例，Ⅱ级2例，Ⅲ级1例，总发生率为16.7%。静脉化疗组患者中消化道反应Ⅰ级6例，Ⅱ级7例，Ⅲ级3例，Ⅳ级1例，总发生率为56.7%；骨髓抑制Ⅰ级4例，Ⅱ级3例，Ⅲ级1例，Ⅳ级1例，总发生率为30.0%。动脉灌注组患者的消化道反应、骨髓抑制发生率均显著低于静脉化疗组（P<0.05）。两组患者治疗后躯体、情感、认知、角色、社会功能及整体生命质量评分均显著高于治疗前（P<0.05），动脉灌注治疗组患者的提升幅度显著高于静脉治疗组（P<0.05）。结论 动脉灌注多西他赛、表柔比星联合静脉输入贝伐单抗治疗乳腺癌术后胸壁复发的效果优于静脉输入多西他赛、表柔比星、贝伐单抗治疗组。

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.

廊坊市科技支撑计划项目（2015013002C）