Supplementary Material for: Ultrasound verification of plaque brachytherapy placement in patients treated for primary uveal melanoma: a single-center experience

Introduction: 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. Methods: 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). Results: 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 is 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 87% (95% confidence interval: 81%-94%). Conclusions: We show improved local control utilizing ultrasound verification compared to historical controls who received TTT and brachytherapy without intraoperative ultrasound confirmation.

引言：准确的斑块定位是实现有效巩膜外斑块近距离放射治疗（episcleral plaque brachytherapy）的关键，可通过超声进行验证。本研究介绍了本中心用于斑块放置术中超声验证的操作方案，并报告了本中心针对原发性葡萄膜黑色素瘤（Uveal Melanoma, UM）患者的单中心局部复发数据，同时同步公布本中心原发性葡萄膜黑色素瘤患者的远处转移率。

方法：本研究纳入2017年5月至2022年3月期间于本机构就诊、诊断为脉络膜和/或睫状体葡萄膜黑色素瘤且接受斑块近距离放射治疗的所有患者。研究终点包括24个月局部无复发率（主要终点）与24个月转移率（次要终点），均采用Kaplan-Meier法（KM）进行估算。

结果：局部复发：共有176例患者符合研究纳入标准，中位随访时间为23.2个月。该队列的24个月无复发概率估算为99.1%（95%置信区间：0.974～1.00）。
远处复发：其中136例患者接受了至少1次随访监测扫描。本队列的24个月无转移生存概率为87%（95%置信区间：81%～94%）。

结论：与未接受术中超声验证、仅行经瞳孔温热疗法（Transpupillary Thermotherapy, TTT）联合近距离放射治疗的历史对照队列相比，本研究采用术中超声验证方案可获得更优的局部疾病控制效果。