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

Hope-Stone, Laura, Brown, Stephen L ORCID: 0000-0002-6142-0995, Heimann, Heinrich and Damato, Bertil (2019) Comparison between patient-reported outcomes after enucleation and proton beam radiotherapy for uveal melanomas: a 2-year cohort study. EYE, 33 (9). pp. 1478-1484.

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Official URL: http://dx.doi.org/10.1038/s41433-019-0440-0

Abstract

<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.

Item Type:	Article
Uncontrolled Keywords:	Humans, Melanoma, Uveal Neoplasms, Neoplasm Recurrence, Local, Prognosis, Treatment Outcome, Eye Enucleation, Cohort Studies, Depth Perception, Visual Acuity, Quality of Life, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male, Proton Therapy, Surveys and Questionnaires, Patient Reported Outcome Measures
Depositing User:	Symplectic Admin
Date Deposited:	14 May 2019 15:33
Last Modified:	19 Jan 2023 00:45
DOI:	10.1038/s41433-019-0440-0
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3041298