Please use this identifier to cite or link to this item: https://hdl.handle.net/1959.11/53829
Title: Comparison between patient-reported outcomes after enucleation and proton beam radiotherapy for uveal melanomas: a 2-year cohort study
Contributor(s): Hope-Stone, Laura (author); Brown, Stephen L  (author)orcid ; Heimann, Heinrich (author); Damato, Bertil (author)
Publication Date: 2019-09
Early Online Version: 2019-04-15
Open Access: Yes
DOI: 10.1038/s41433-019-0440-0Open Access Link
Handle Link: https://hdl.handle.net/1959.11/53829
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.

Publication Type: Journal Article
Source of Publication: Eye, 33(9), p. 1478-1484
Publisher: Nature Publishing Group
Place of Publication: United Kingdom
ISSN: 1476-5454
0950-222X
Fields of Research (FoR) 2020: 321201 Ophthalmology
Socio-Economic Objective (SEO) 2020: 200202 Evaluation of health outcomes
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Psychology

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