Objective To study the role of real-time optimization of 125 I seed implantation in the treatment of gliomas .Meth-ods 38 cases were enrolled in this retrospective study .21 cases with 24 lesions involved from September 1st 2013 to September 30th 2015 were only performed preoperative planning and postoperative verification .17 cases with 21 lesions involved were addi-tional performed real-timeoptimization during the operation .D90, mPD, V90, V100, V150, V200, CI, EI, and HI were recor-ded.D90 and mPD were compared between preoperative planning and postoperative verification .V90, V100, V150, V200, CI, EI, and HI were compared with the inter-group postoperative verification .Paired t test was used to compare the difference within group .Independent sample test was used to compare the difference between groups .Results There was no difference in D 90 and mPD between preplan and postplan of group A , but were difference of group B.There were differences in V90, V100, V150, CI, EI, and HI of postplan between group A and group B but no difference in V 150 and V200.Conclusion Real-time optimization during operation could insure the good measure of preoperative planning to guarantee the reasonable distribution of postoperative dose and is of great value in the brachytherapy of brain tumors .%目的 探讨术中实时剂量学优化在125 I放射性粒子植入治疗脑胶质瘤手术中价值.方法 对8例患有恶性脑胶质瘤并行125 I放射性粒子植入治疗的患者进行回顾性分析,术前计划和术后计划的验证,还要在术中进行了实时剂量学优化,对比分析两组病例剂量学评价指标的差异.记录两组患者术前及术后DVH图所示D90、mPD、PD、V90、V100、V150、V200、CI、EI、HI,比较组内术前及术后计划D90和mPD差异,同时对组间术后计划PD、V90、V100、V150、V200、CI、EI、HI进行比较,了解有无差别.其中,组内差异采用的统计学方法为配对t检验,组间差异的统计学方法采用独立样本t检验.结果 A组手术前后D90和mPD差异有统计学意义.B组手术前后D90和mPD差异无统计学意义.两组手术后V90、V100、CI、EI和HI差异有统计学意义.两组手术后PD、V150和V200差异无统计学意义.结论 术中实时剂量学优化能够保证术前计划相对准确的实施,从而确保术后剂量学分布的更加合理.
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