University of California San Francisco, San Francisco, California, USA; University of Liverpool, Liverpool, United Kingdom.
University of Liverpool, Liverpool, United Kingdom.
Am J Ophthalmol. 2018 Sep;193:230-251. doi: 10.1016/j.ajo.2018.03.015. Epub 2018 Mar 17.
To test the hypothesis that patients treated with radiotherapy for choroidal melanoma enjoy better quality of life (QoL) than patients who have undergone enucleation.
In this nonrandomized study, patients with choroidal melanoma treated at the Royal Liverpool University Hospital, Liverpool, UK, were invited to complete QoL questionnaires approximately 6 months postoperatively and then on each anniversary of their primary treatment. These instruments consisted of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-OPT30 questionnaire, Hospital Anxiety & Depression Scale, and the Functional Assessment of Cancer Treatment questionnaire. Patient-reported outcomes were correlated with demographics, ocular treatment, social factors, presenting tumor and ocular status, self-reported general health, marital status, and employment status.
The 1596 patients were treated with radiotherapy (72.3%) or enucleation (27.7%). Enucleation was associated with male sex (χ, P = .004), older age (t test, P < .001), larger tumor diameter (t test, P < .001), monosomy 3 (χ, P < .001), depression (linear regression, 95% confidence interval [CI], .17 to 1.01), and reduced physical and functional well-being (linear regression, 95% CI, -1.14 to -0.12 and -1.96 to -0.47), respectively. Poor QoL was attributed to the ocular disease by 21% and 20% of enucleated and irradiated patients, respectively (χ, P = .938).
Patient-reported outcomes and QoL were worse in patients who had undergone primary enucleation for choroidal melanoma. These outcomes may partly have been caused by factors predisposing to enucleation rather than enucleation itself, because enucleated patients tended to be older, with more advanced disease at presentation, and a worse prognosis for survival. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
检验以下假说，即接受放射治疗的脉络膜黑色素瘤患者比接受眼球摘除术的患者生活质量（QoL）更好。
在这项非随机研究中，英国利物浦皇家大学医院治疗的脉络膜黑色素瘤患者被邀请在术后大约 6 个月以及在其主要治疗后的每个周年日填写 QoL 问卷。这些工具包括欧洲癌症研究与治疗组织（EORTC）QLQ-OPT30 问卷、医院焦虑与抑郁量表和癌症治疗功能评估问卷。患者报告的结果与人口统计学、眼部治疗、社会因素、初诊时的肿瘤和眼部状况、自我报告的总体健康状况、婚姻状况和就业状况相关联。
1596 例患者分别接受了放射治疗（72.3%）或眼球摘除术（27.7%）。眼球摘除术与男性（χ²，P=0.004）、年龄较大（t 检验，P<0.001）、肿瘤直径较大（t 检验，P<0.001）、单体型 3（χ²，P<0.001）、抑郁（线性回归，95%置信区间[CI]，0.17 至 1.01）以及身体和功能健康状况较差（线性回归，95%CI，-1.14 至-0.12 和-1.96 至-0.47）相关。21%和 20%的眼球摘除和放射治疗患者分别将较差的 QoL 归因于眼部疾病（χ²，P=0.938）。
对于脉络膜黑色素瘤，接受初次眼球摘除术的患者的患者报告结果和 QoL 较差。这些结果可能部分归因于导致眼球摘除的因素，而不是眼球摘除本身，因为眼球摘除患者的年龄较大，初诊时疾病更严重，生存预后更差。注：本文的发表由美国眼科学会赞助。
