Grimes Joseph M, Zhou Henry, Dal Col Alexis K, Gershkovich Alexandra, Bogomolny Dmitry, Marr Brian P
Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY, USA.
Ocul Oncol Pathol. 2023 Aug;9(1-2):17-24. doi: 10.1159/000529836. Epub 2023 Mar 14.
Proper plaque positioning is essential for effective episcleral plaque brachytherapy and can be verified using ultrasound. In this study, we show our center's protocol for intraoperative ultrasound verification of plaque placement and present our single-center local recurrence data in patients with primary UM involving the choroid and/or ciliary body. We also indicate our center's distance metastasis rate for patients presenting with primary UM.
All patients who presented to our institution with UM of the choroid and/or ciliary body between May 2017 and March 2022 and treated with plaque brachytherapy were enrolled. Endpoints include the 24-month local recurrence-free rate (primary) and 24-month metastasis rate (secondary), both estimated using the Kaplan-Meier method (KM).
Local Recurrence: 176 patients met the study criteria with median follow-up of 23.2 months. The 24-month recurrence-free probability for this cohort was estimated at 99.1% (95% confidence interval: 0.974-1.00). Metastatic Recurrence: 136 of these patients underwent at least one follow-up surveillance scan. The 24-month metastasis-free survival probability in our cohort was estimated at 87% (95% confidence interval: 81-94%).
We show improved local control utilizing ultrasound verification compared to historical controls who received TTT and brachytherapy without intraoperative ultrasound confirmation.
合适的斑块定位对于有效的巩膜外斑块近距离放射治疗至关重要,并且可以通过超声进行验证。在本研究中,我们展示了我们中心用于术中超声验证斑块放置的方案,并呈现了我们单中心原发性脉络膜黑色素瘤(UM)累及脉络膜和/或睫状体患者的局部复发数据。我们还指出了我们中心原发性UM患者的远处转移率。
纳入2017年5月至2022年3月期间就诊于我们机构、患有脉络膜和/或睫状体UM并接受斑块近距离放射治疗的所有患者。终点包括24个月局部无复发生存率(主要终点)和24个月转移率(次要终点),均使用Kaplan-Meier方法(KM)进行估计。
局部复发:176例患者符合研究标准,中位随访时间为23.2个月。该队列的24个月无复发生存概率估计为99.1%(95%置信区间:0.974 - 1.00)。转移复发:这些患者中有136例接受了至少一次随访监测扫描。我们队列的24个月无转移生存概率估计为87%(95%置信区间:81 - 94%)。
与未进行术中超声确认而接受TTT及近距离放射治疗的历史对照相比,我们通过超声验证显示出更好的局部控制效果。