Comparison between patient-reported outcomes after enucleation and proton beam radiotherapy for uveal melanomas: a 2-year cohort study

Abstract

Background Uveal melanomas affect 2-8 per million Europeans each year. Approximately 35%, are treated by enucleation. Proton beam radiotherapy (PBR) can be an eye-conserving alternative to enucleation for patients who wish to retain the eye. Both treatments have adverse effects, and it is difficult for clinicians and patients to make fully informed choices between them because the relative effects of enucleation and PBR on patient-reported outcomes are unknown. Methods We compared differential effects of enucleation and PBR on patient-reported outcomes on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Ophthalmological module (EORTC QLQ-OPT30) in a consecutive sample of 115 treated patients~6, 12 and 24 months after diagnosis. Pre-treatment demographic variables, unrelated health problems, vision in the fellow eye, tumour characteristics and prognosis for metastatic disease were statistically controlled. Results Patients treated by enucleation experienced greater functional problems at 6 months, which abated at 12 and 24 months (P = 0.020). PBR patients reported greater impairments of central and peripheral vision (P = 0.009) and reading difficulties (P = 0.002) over 24 months. Treatment modality did not influence difficulty in driving (P = 0.694), ocular irritation (P = 0.281), headaches (P = 0.640), appearance concerns (P = 0.187) or worry about recurrence (P = 0.899). Conclusions When making treatment decisions, it is important that patients and clinicians consider long-standing difficulties of visual impairment associated with PBR and temporary 6-month difficulties in activities related to depth perception associated with enucleation.

Quality of life and treatment-related burden during ocular proton therapy: a prospective trial of 131 patients with uveal melanoma

“…First, previous studies included different treatment strategies; second, data acquisition was inhomogeneous, with respect to the follow-up strategy; and third, some selected different questionnaires. For example, Hope-Stone et al did not report QLQ-C30 data, but showed similar results regarding "ocular irritation" and "worry about recurrence" at 6 months after treatment [13,14]. However, in that study, no pre-treatment assessment data were available to evaluate treatment-related changes over time.…”

“…Summary tables including all correlation heatmaps, final multiple linear regression models and figures on marginal means are provided as an attachment to this article (Additional files 1, 2, 3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22.…”

“…The QOL of patients after UM treatment has been investigated in numerous studies over the past few years, and different treatment methods have been compared [7][8][9][10][11][12][13][14][15]. However, studies on the pre-treatment QOL, with a focus on the treatment procedure, are rare.…”

Clinical Outcomes after International Referral of Uveal Melanoma Patients for Proton Therapy

“…Proton therapy is increasingly available for the treatment of uveal melanomas and is a valuable alternative for enucleation. Proton therapy offers good local tumour control, eye preservation and for some patients, even visual acuity preservation, which is important for functioning and quality of life [ 48 ]. Future studies should aim to further improve visual outcomes and reduce side effects.…”

Two 11-Years Periods Statistics and Trends of Enucleation and Evisceration

“…Proton beam radiotherapy might be an option in contrast to enucleation in patients who don’t agree to enucleation. 21 Regardless of revolutionary enucleation treatment, the quantity of patients who create metastases and end lethally is still as high as half. 22 There stays a worry that if choroidal dangerous melanoma is little and undiscovered in light of its size, it might make the tumor metastasize and the patient will kick the bucket sooner contrasted with if the tumor is bigger and conclusion and treatment quicker.…”