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目的:对比导航系统辅助三维(3D)打印模板联合引导下n 125I粒子治疗恶性肿瘤的术前、术后计划差异，验证光学导航辅助下的粒子植入计划完成质量。n 方法:回顾性纳入2018年12月至2019年11月于北京大学第三医院接受导航系统辅助3D打印模板引导下粒子植入治疗的肿瘤患者共20例(男10例，女10例，中位年龄60.5岁)，植入部位为头颈部8例、胸壁1例、盆腔9例、椎旁和(或)腹膜后2例，中位处方剂量150 Gy。对比术前、术后计划中的粒子数、针数、相关剂量学参数等。剂量学参数包括靶区90%大体肿瘤靶区(GTV)所接受的处方剂量(n D90)、GTV分别接受100%、150%、200%处方剂量的体积百分比(n V100、n V150、n V200)、GTV接受的最小边缘剂量(MPD)、适形指数(CI)、靶区外体积指数(EI)、均匀性指数(HI)以及2 cmn 3范围脊髓接受剂量(n D2 cmn 3)。采用配对n t检验及Wilcoxon符号秩检验分析数据。n 结果:术后使用针数与术前计划一致[均为12 (9，19)根]；术后实际粒子数较术前计划多，但差异无统计学意义[51(35，68)和49(35，63)颗；n z＝1.859，n P>0.05]。术后计划的MPD较术前计划高，差异有统计学意义[(80.52±14.89)和(67.22±20.56) Gy；n t＝-3.769，n P＝0.001]；其余剂量学参数差异均无统计学意义(n t值：-0.533，-0.423，n z值：-0.849～1.416，均n P>0.05)。术后剂量质量评价为优者17例(17/20)，为良者2例(2/20)，为中者1例(1/20)。n 结论:联合模式引导对植入计划的完成质量良好，术后实际靶区剂量可达到术前预计划的要求。“,”Objective:To compare the difference of preoperative and postoperative plans of navigation-assisted three-dimensional (3D)-printing template combined with CT-guided radioactive n 125I seeds implantation for malignant tumors, and verify preliminarily the plan quality of optical navigation-assisted seeds implantation.n Methods:From December 2018 to November 2019, a total of 20 patients (10 males, 10 females, median age: 60.5 years) with malignant tumors received navigation-assisted 3D-printing template combined with CT-guided radioactive n 125I seeds implantation in Peking University Third Hospital. Eight cases were implanted in the head and neck, 1 case in the chest wall, 9 cases in the pelvis and 2 cases in the paravertebral and/or retroperitoneal region. The median prescription dose was 150 Gy. The data in the preoperative and postoperative plans was compared, including seeds number, needles number, and some dosimetry parameters. Dosimetry parameters including dose delivered to 90% gross tumor volume (GTV) (n D90), percentage of GTV received 100%, 150%, and 200% of the prescribed dose (n V100, n V150, n V200), minimum peripheral dose (MPD), conformal index (CI), external index (EI), homogeneity index (HI) of target volume, and 2 cmn 3 range of spinal cord receiving dose (n D2 cmn 3). Paired n t test and Wilcoxon signed rank test were used to analyze the data.n Results:The needles number of preoperative and postoperative plans was the same (both 12 (9, 19)), and the seeds number of postoperative plan was more than preoperative plan with no significant difference (51(35, 68) n vs 49(35, 63); n z=1.859, n P>0.05). The MPD of postoperative plans was higher than preoperative plans ((80.52±14.89)n vs (67.22±20.56) Gy, n t=-3.769, n P=0.001). There were no significant differences in other dosimetry parameters between the two plans (n t values: -0.533, -0.423, n z values: from -0.849 to 1.416, all n P>0.05). Postoperative dose quality assessment was excellent in 17 cases (17/20), good in 2 cases (2/20) and middle in 1 case (1/20).n Conclusions:The quality of the implantation is good under the guidance of combined mode. The actual target dose after operation can meet the requirements of preoperative planning.