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Quality of life in patients with malignant choroidal melanoma after radiotherapy

  • Clinical Investigation
  • Published:
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Abstract

Background

Patient-orientated endpoints have attracted little attention in patients with malignant choroidal melanoma. This study was conducted to explore the long-term effects of malignant choroidal melanoma and radiotherapy on QOL by means of a differentiated and modular QOL approach, including global QOL, social support, and mental health, in comparison with sociodemographically matched healthy controls.

Methods

A random sample of 100 outpatients treated by radiotherapy were asked by mail to take part in a psychodiagnostic study [instruments: Short-Form 36 Health-Survey (SF-36), Symptom Checklist-90-Revised, German Social Support Questionnaire]. The same instruments were applied to a healthy control group, which was matched to patients with regard to age, gender, and vocational situation.

Results

93 patients (average age 61.2 years) responded at an average of 5.5 years (±3.7) after diagnosis. Visual acuity in the affected eye decreased considerably from diagnosis (0.49±0.30) to participation in the study (0.09±0.21). Compared with healthy controls, patients reported on average statistically significantly lower global QOL (SF-36), whereas social support and mental distress did not differ. Frequencies of clinically relevant mental distress were significantly higher in patients than in controls (35.5% vs. 16.1%). Mental distress was associated with poorer visual acuity, but not with the extent of loss of visual acuity or number of follow-up treatments.

Conclusion

Patients with choroidal melanoma suffer from low long-term global QOL, and every third patient suffers from relevant mental distress. Regular screening for mental distress should be implemented along with psychological counseling. Additional follow-up treatment does not seem to induce mental distress.

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References

  1. American Society of Clinical Oncology (1996) Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. J Clin Oncol 14:671–679

    PubMed  Google Scholar 

  2. Brandberg Y, Kock E, Iskar K, Af Trampe E, Seregard S (2000) Psychological reactions and quality of life in patients with posterior uveal melanoma treated with ruthenium plaque therapy or enucleation: a one year follow-up study. Eye 14:839–846

    CAS  PubMed  Google Scholar 

  3. Bullinger M, Kirchberger I (1998) SF-36. Fragebogen zum Gesundheitszustand. Hogrefe, Goettingen

  4. Cassileth BR, Lusk EJ, Strouse EJ, Miller DS, Brown LL, Cross PA, Tenaglia AN (1984) Psychosocial status in chronic illness: a comparative analysis of six diagnosis groups. N Engl J Med 311:506–511

    CAS  PubMed  Google Scholar 

  5. Collaborative Ocular Melanoma Study Group (2001) Collaborative Ocular Melanoma Study (COMS) randomized trial of I-125 brachytherapy for medium choroidal melanoma. I. Visual acuity after 3 years. COMS report No. 16. Ophthalmology 108:348–366

    Article  PubMed  Google Scholar 

  6. Collaborative Ocular Melanoma Study Group (2001) The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma. III. Initial mortality findings. Arch Ophthalmol 119:969–982

    PubMed  Google Scholar 

  7. Cruickshanks KJ, Fryback DG, Nondahl DM, Robinson N, Keesey U, Dalton DS, Robertson DM, Chandra SR, Mieler WF, Zakov ZN, Custer PL, DelPriore LV, Albert DM (1999) Treatment choice and quality of life in patients with choroidal melanoma. Arch Ophthalmol 117:461–467

    CAS  PubMed  Google Scholar 

  8. Derogatis LR (1992) SCL-90-R, administration, scoring and procedures manual-II for the r(evised) version and other instruments of the psychopathology rating scale series. Clinical Psychometric Research Inc.,Townson

  9. Derogatis LR, Morrow GR, Fetting J, Penman D, Piastsky S, Schmale AM, Henrichs M, Carnicke CLM (1983) The prevalence of psychiatric disorders among cancer patients. J Am Med Assoc 249:751–757

    Article  CAS  Google Scholar 

  10. Fawzy FI (1999) Psychosocial interventions for patients with cancer: what works and what doesn't. Eur J Cancer 35:1559–1564

    Article  CAS  PubMed  Google Scholar 

  11. Federici TJ, Meyer DR, Lininger LL (1999) Correlation of the vision-related functional impairment associated with blepharoptosis and the impact of blepharoptosis surgery. Ophthalmology 106:1705–1712

    CAS  PubMed  Google Scholar 

  12. Franke GH (1994) Testtheoretische Überprüfung des Fragebogens zur Sozialen Unterstützung. Z Med Psychol 4:168–177

    Google Scholar 

  13. Franke GH (2002) SCL-90-R. Die Symptom-Checkliste von Derogatis—Deutsche Version – Manual, 2. überarbeitete und neu normierte Auflage. Beltz-Testgesellschaft, Göttingen

  14. Franke GH, Heemann U, Kohnle M, Luetkes P, Maehner N, Reimer J (2000) Quality of life in patients before and after kidney transplantation. Psychol Health 14:1037–1049

    Google Scholar 

  15. Franke GH, Esser J, Reimer J, Maehner N (2002) Vision-targeted quality of life under different degrees of visual impairment. Rev Port Psicossom 4:39–49

    Google Scholar 

  16. Fydrich T, Sommer G, Menzel U, Höll C (1987) Fragebogen zur sozialen Unterstützung (Kurzform; SOZU-K-22). Z Klin Psychol 16:434–436

    Google Scholar 

  17. Glasgow RE, Hampson SE (1995) Recruiting older subjects for psychological studies of chronic disease: are community volunteer and clinic-based samples equivalent? Psychol Health 10:245–254

    Google Scholar 

  18. Grassi L, Rosti G (1996) Psychosocial morbidity and adjustment to illness among long-term cancer survivors. A six-year follow-up study. Psychosomatics 37:523–532

    CAS  PubMed  Google Scholar 

  19. Gutierrez P, Wilson MR, Johnson C, Gordon M, Cioffi GA, Ritch R, Sherwood M, Meng K, Mangione CM (1997) Influence of glaucomatous visual field loss on health-related quality of life. Arch Ophthalmol 115:777–784

    CAS  PubMed  Google Scholar 

  20. Hart PM, Chakravarthy U, Stevenson MR (1998) Questionnaire-based survey on the importance of quality of life measures in ophthalmologic practice. Eye 12:124–126

    PubMed  Google Scholar 

  21. House JS, Landis KR, Umberson D (1988) Social relationship and health. Science 241:540–545

    CAS  PubMed  Google Scholar 

  22. Klein R, Moss SE, Klein BEK, Gutierrez P, Mangione M (2001) The NEI-VFQ-25 in people with long-term type 1 diabetes mellitus. Arch Ophthalmol 119:733–740

    CAS  PubMed  Google Scholar 

  23. Lee PP, Whitcup SM, Hays RD, Spritzer K, Javitt J (1995) The relationship between visuall acuity and functioning and well-being among diabetics. Qual Life Res 4:319–323

    CAS  PubMed  Google Scholar 

  24. Lee PP, Spritzer K, Hays RD (1997) The impact of blurred vision on functioning and well-being. Ophthalmology 104:390–396

    CAS  PubMed  Google Scholar 

  25. Mangione CM, Phillips RS, Lawrence MG, Seddon JM, Orav EJ, Goldman L (1994) Improved visual function and attenuation of declines in health-related quality of life after cataract extraction. Arch Ophthalmol 112:1419–1425

    CAS  PubMed  Google Scholar 

  26. Mangione CM, Goldman L, Orav EJ, Marcantonio ER, Ludwig LE, Donaldson MC, Sugarbaker DJ, Poss R, Lee TH (1997) Health-related quality of life after elective surgery: measurement of longitudinal changes. J Gen Intern Med 12:686–697

    Article  CAS  PubMed  Google Scholar 

  27. Mangione CM, Lee PP, Pitts J, Gutierrez P, Berry S, Hays RD; for the NEI-VFQ Field Test Investigators (1998) Psychometric properties of the National Eye Visual Function Questionnaire (NEI-VFQ). Arch Ophthalmol 116:1496–1504

    CAS  PubMed  Google Scholar 

  28. Mangione CM, Gutierrez PR, Lowe G, Orav EJ, Seddon JM (1999) Influence of age-related maculopathy on visual functioning and health-related quality of life. Am J Ophthalmol 128:45–53

    Article  CAS  PubMed  Google Scholar 

  29. National Research Committee on Vision (1980) Recommended standard procedures for the clinical measurement and specification of visual acuity. Adv Ophthalmol 41:103–8

    PubMed  Google Scholar 

  30. Revicki DA, Osoba D, Fairclough D, Barofsky I, Berzon R, Leidy NK, Rothman M (2000) Recommendations on health related quality of life research to support labeling and promotional claims in the United States. Qual Life Res 9:887–900

    Article  CAS  PubMed  Google Scholar 

  31. Schueler AO, Bornfeld N (2000) Current therapy aspects of intraocular tumors. Ophthalmologe 97:207–222

    Article  PubMed  Google Scholar 

  32. Scott IU, Schein OD, West S, Bandeen-Roche K, Enger C, Folstein F (1994) Functional status and quality of life measurement among ophthalmic patients. Arch Ophthalmol 112:329–35

    CAS  PubMed  Google Scholar 

  33. Shields CL, Shields JA, Cater J, Gündüz K, Miyamoto C, Micaily B, Brady LW (2000) Plaque radiotherapy for uveal melanoma. Long-term outcome in 1106 consecutive patients. Arch Ophthalmol 118:1219–1228

    CAS  PubMed  Google Scholar 

  34. Simpson JSA, Carlson LE, Beck CA, Patten S (2002) Effects of a brief intervention on social support and psychiatric morbidity in breast cancer patients. Psycho-Oncology 11:282–294

    Article  Google Scholar 

  35. Wachtlin J, Bechrakis NE, Schueler AO, Helbig H, Bornfeld N, Foerster MH (2000) Phacoemulsification following treatment of choroidal melanoma. Graefes Arch Clin Exp Ophthalmol 238:942–948

    Article  CAS  PubMed  Google Scholar 

  36. Wandell PE, Lundstrom M, Brorsson B, Aberg H (1997) Quality of life among patients with glaucoma in Sweden. Acta Ophthalmol Scand 75:584–8

    CAS  PubMed  Google Scholar 

  37. Ware JE, Snow KK, Kosinski M, Gandek B (1993) SF-36 Health-survey manual and interpretation guide. Nimrod Press, Boston

  38. Wilson MR, Coleman AL, Yu F, Sasaki IF, Berlin K, Winters J, Lai A (1998) Functional status and well-being in patients with glaucoma as measured by the Medical Outcomes Study Short Form-36 Health Survey. Ophthalmology 105:2112–2116

    CAS  PubMed  Google Scholar 

  39. Wulsin LR, Jacobson AM, Rand LI (1991) Psychosocial correlates of mild visual loss. Psychosom Med 53:109–117

    CAS  PubMed  Google Scholar 

  40. Zabora JR (1998) Screening procedures for psychosocial distress. In: Holland JC (ed) Psychooncology. Oxford University Press, New York, pp 653–661

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Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany

    Jens Reimer & Michael Krausz

  2. Center for Ophthalmology, University of Essen, Hufelandstrasse 55, 45122 , Essen, Germany

    Joachim Esser, Anja Fleiss, Gerasimos Anastassiou & Norbert Bornfeld

  3. Department of Psychotherapy and Psychosomatic Medicine, University of Leipzig, Leipzig, Germany

    Aike Hessel

  4. Department of Rehabilitation Psychology, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany

    Gabriele Helga Franke

Authors
  1. Jens Reimer
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  2. Joachim Esser
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  3. Anja Fleiss
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  4. Aike Hessel
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  5. Gerasimos Anastassiou
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  6. Michael Krausz
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  8. Gabriele Helga Franke
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Correspondence to Joachim Esser.

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Reimer, J., Esser, J., Fleiss, A. et al. Quality of life in patients with malignant choroidal melanoma after radiotherapy. Graefe's Arch Clin Exp Ophthalmol 241, 371–377 (2003). https://doi.org/10.1007/s00417-003-0654-4

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  • DOI: https://doi.org/10.1007/s00417-003-0654-4

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