影响前庭神经鞘瘤放射外科治疗计划的梯度指数的因素研究

目的探索影响前庭神经鞘瘤(VS)放射外科计划梯度指数(GI)的因素。方法收集上海伽玛医院神经外科2020年1月—2021年9月收治的所有VS患者的治疗计划。根据因素对GI的影响是患者固有特性决定的还是治疗计划决定的分为两大类，再对上述因素和GI的关系进行统计分析研究。结果研究共纳入309例患者的治疗计划，患者固有特性决定的因素中，肿瘤最大直径、肿瘤体积和GI的相关性有统计意义；而对治疗计划决定的因素的单因素分析发现，各计划参数与GI的相关性均有统计意义；综合患者因素和计划因素的多因素分析发现，病灶最大直径、是否有手术史和覆盖指数的相关性有统计意义。结论VS治疗计划中，GI同时受到患者固有因素和治疗计划本身因素的双重影响，病灶大小和既往手术史对于GI的影响可能最大。

ObjectiveTo explore the factors influencing the gradient index(GI) of radiosurgical planning for vestibular schwannoma（VS）. MethodsThe treatment plans of all VS patients in Department of Neurosurgery, Shanghai Gamma Hospital from January 2020 to September 2021 were collected. There were two main categories based on whether the influence of factors on the GI was determined by the inherent characteristics of the patient or by the treatment plan. The relationship between the above factors and the GI was statistically analyzed and studied. ResultsA total of 309 patients were included in the study. Among the factors determined by the inherent characteristics of patients, the correlation between the maximum tumor diameter, tumor volume and GI was statistically significant. While the univariate analysis of the factors determined by the treatment plan found that the correlation between each planning parameter and the GI was statistically significant. Multivariate analysis combining inherent and treatment plan factors found statistically significant associations between maximum lesion diameter, previous surgical history, and coverage index. ConclusionsThe GI in the treatment plan of VS is affected by both the inherent factors of the patient and the treatment plan. The size of the lesion and the history of previous surgery may have the main influence on the GI.