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目的 分析立体定向放射外科 (SRS)诱导放射性脑水肿的危险因素。方法 回顾性分析接受X刀治疗且有完整影像学随访资料的病人 6 7例 ,分成两组 :水肿组 (2 2例 )、对照组 (4 7例 ) ,采用单因素分析 (χ2 或Wilcoxon秩和检验 )和logistic回归分析方法分析年龄、性别、肿瘤体积、最大剂量、边缘剂量、肿瘤位置、靶点数目、10Gy剂量覆盖的体积及随访时间对治疗后脑水肿的影响。结果 单因素分析提示肿瘤体积、10Gy等剂量线所包括的体积和最大剂量在两组间有差异显著性 (P <0 0 1) ;多因素分析表明边缘治疗剂量对X刀诱导脑水肿的贡献最大 (OR =1 73 ) ,其次为肿瘤体积 (OR =1 11)。结论 在SRS诱导脑水肿的诸多因素中 ,边缘剂量和肿瘤体积是相对重要的危险因素。
Objective To analyze the risk factors of radiation induced brain edema induced by stereotactic radiosurgery (SRS). Methods Sixty-seven patients with X-knife and complete follow-up imaging were retrospectively divided into two groups: edema group (22 cases) and control group (47 cases), and univariate analysis (χ2 or Wilcoxon rank And test) and logistic regression analysis were used to analyze the effect of age, gender, tumor volume, maximum dose, marginal dose, tumor location, target number, volume covered by 10Gy dose and follow-up time on brain edema after treatment. Results The univariate analysis showed that the volume and the maximum dose of the 10Gy iso-dose line were significantly different between the two groups (P <0.01). Multivariate analysis showed that the contribution of marginal dose to X-knife induced cerebral edema (OR = 1 73), followed by tumor volume (OR = 11 1). Conclusion Among the many factors that cause brain edema in SRS, the marginal dose and tumor volume are relatively important risk factors.