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

Author(s)
Hope-Stone, Laura
Brown, Stephen L
Heimann, Heinrich
Damato, Bertil
Publication Date
2019-09
Abstract
<p><b>Background</b> 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.</p><p> <b>Methods</b> 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.</p><p> <b>Results</b> Patients treated by enucleation experienced greater functional problems at 6 months, which abated at 12 and 24 months (<i>P</i> = 0.020). PBR patients reported greater impairments of central and peripheral vision (<i>P</i> = 0.009) and reading difficulties (<i>P</i> = 0.002) over 24 months. Treatment modality did not influence difficulty in driving (<i>P</i> = 0.694), ocular irritation (<i>P</i> = 0.281), headaches (<i>P</i> = 0.640), appearance concerns (<i>P</i> = 0.187) or worry about recurrence (<i>P</i> = 0.899).</p><p> <b>Conclusions</b> 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.</p>
Citation
Eye, 33(9), p. 1478-1484
ISSN
1476-5454
0950-222X
Pubmed ID
30988421
Link
Publisher
Nature Publishing Group
Title
Comparison between patient-reported outcomes after enucleation and proton beam radiotherapy for uveal melanomas: a 2-year cohort study
Type of document
Journal Article
Entity Type
Publication

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