Quality of life: fractionated stereotactic radiotherapy versus enucleation treatment in uveal melanoma patients

Abstract

Purpose: To report the quality of life and visual functioning in uveal melanoma patients treated with enucleation or fractionated stereotactic radiation therapy (fSRT).Methods: Uveal melanoma (UM) patients treated with fSRT (n = 65) or enucleation (n = 48) participated in this prospective study. Questionnaires to measure anxiety (State-Trait Anxiety Inventory), subjective distress (Impact of Event Scale) and quality of life (EORTC-QLQ-C30 and National Eye Institute Visual Function Questionnaire (VFQ-25)) were obtained before treatment and 2, 6, 12, 24, 36 and 48 months after treatment.Results: Less peripheral vision was observed until 3 years (p = 0.026) posttreatment in enucleated patients compared to irradiated patients. From 2 months until 3 years posttreatment irradiated patients increase in role functioning-score (p = 0.005), while enucleated patients decrease in score (p = 0.012). Regardless of their treatment, for all patients we measured a reduction in physical functioning (p = 0.035), insomnia (p < 0.001) and in state anxiety from pretreatment until 2 years posttreatment (p < 0.001). An increase in pain overall (p = 0.023) and in emotional functioning is observed 1 year posttreatment (p < 0.001). At baseline, patients with metastases (independent of their treatment) have more subjective distress (p = 0.037) than patients without metastases. The mean 'global health score' overall, without effect of time, was 76.4 (SD: 13.6).Conclusion: Enucleated patients had more difficulty working or performing household tasks 2 months posttreatment compared to irradiated patients. Enucleated patients had diminished peripheral vision until 3 years compared to irradiated patients. Overall quality of life is not significantly different between both treatment groups.

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

“…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.…”

“…They observed a significant decline in the subscale "social functioning", but anxiety symptoms improved one month after treatment, and global QOL remained stable. Van Beek et al compared QOL outcomes in 113 patients treated with either stereotactic radiotherapy or enucleation [10]. Two months after treatment, the stereotactic radiotherapy group demonstrated improved "role functioning" and "emotional functioning", compared to the pre-treatment assessment.…”

Local tumour control and radiation side effects for fractionated stereotactic photon beam radiotherapy compared to proton beam radiotherapy in uveal melanoma

“…The same counts for UM treated with PBR, where 7.7% of the eyes were enucleated after 5 years [15]. As the local control in UM patients is high regardless of treatment, the emphasis must lie on limiting the ocular morbidity for patients' quality of life [37]. Moreover, knowledge on the occurrence of complications can help caregivers to apply personalized treatment.…”

<p>Screening for Predictive Parameters Requiring Psycho-Oncological Intervention via the National Comprehensive Cancer Network Distress Thermometer in the Follow-Up of Uveal Melanoma Patients</p>

“…There is a current trend in the literature that emphasizes the need for psychooncological support focusing on patients' quality of life (QoL) apart from successful medical treatment in uveal melanoma patients. [1][2][3][4] Importantly, the effects of the treatment on the patients' QoL should be taken into consideration. 5 As uveal melanoma is a rare disease with a prevalence of 1-9/ 100.000, 6 data on patients' QoL are limited and to our knowledge, the NCCN distress thermometer has not yet been evaluated for uveal melanoma patients outside of our research.…”