Quality of life in the follow-up of uveal melanoma patients after enucleation in comparison to CyberKnife treatment

  • A. Klingenstein
  • C. Fürweger
  • A. K. Mühlhofer
  • S. F. Leicht
  • U. C. Schaller
  • A. Muacevic
  • B. Wowra
  • C. Hintschich
  • K. H. Eibl
Oncology

Abstract

Purpose

To compare quality of life (QoL) in patients with uveal melanoma after enucleation and stereotactic radiosurgery to that in an age-matched patient collective.

Methods

QoL was assessed in a cross-sectional survey and compared among 32 uveal melanoma patients after enucleation, 48 patients after stereotactic radiosurgery (CyberKnife®; Accuray® Incorporated, Sunnyvale, CA, USA), and an age-matched control group of 35 patients, using the SF-12 Health Survey. Statistical analysis was performed with Fisher’s exact test, Student’s t test, one-way ANOVA analysis, Wilcoxon rank-sum (Mann–Whitney test), and ordered logistic regression for multivariate analysis.

Results

There was no significant difference in QoL between patients treated by stereotactic radiosurgery and the age-matched control group. After enucleation, patients presented significantly lower values in Physical Functioning (PF), Role Physical (RP), and Role Emotional (RE) compared to the radiosurgery and control group. To control for the overall QoL lowering effect of visual loss, the QoL of the patients who underwent enucleation was compared with the QoL of patients suffering severe functional loss after CyberKnife radiosurgery in a subgroup analysis, which showed no statistically significant difference. The number of comorbidities had a significant impact on QoL in multivariate analysis.

Conclusions

Superior performance in PF, RP, and RE suggests that CyberKnife represents a suitable first-line therapy for uveal melanoma. In cases with painful amaurosis or vast tumor recurrence, enucleation can be performed with an acceptable QoL outcome.

Keywords

Quality of life SF-12 Health Survey Enucleation Stereotactic radiosurgery CyberKnife Uveal melanoma 

References

  1. 1.
    Singh AD, Topham A (2003) Incidence of uveal melanoma in the United States: 1973-1997. Ophthalmology 110:956–961CrossRefPubMedGoogle Scholar
  2. 2.
    Hu DN, Yu GP, McCormick SA, Schneider S, Finger PT (2005) Population-based incidence of uveal melanoma in various races and ethnic groups. Am J Ophthalmol 140(4):612–617PubMedGoogle Scholar
  3. 3.
    Gragoudas ES, Egan KM, Seddon JM, Walsh SM, Munzenrider JE (1992) Intraocular recurrence of uveal melanoma after proton beam irradiation. Ophthalmology 99:760–766CrossRefPubMedGoogle Scholar
  4. 4.
    Muacevic A, Nentwich M, Wowra B, Staerk S, Kampik A, Schaller U (2008) Development of a streamlined, non-invasive robotic radiosurgery method for treatment of uveal melanoma. Technol Cancer Res Treat 7(5):369–374CrossRefPubMedGoogle Scholar
  5. 5.
    Zorlu F, Selek U, Kiratli H (2009) Initial results of fractionated CyberKnife radiosurgery for uveal melanoma. J Neurooncol 94(1):111–117CrossRefPubMedGoogle Scholar
  6. 6.
    Diener-West M, Earle JD, Fine SL, Hawkins BS, Moy CS, Reynolds SM, Schachat AP, Straatsma BR, Collaborative Ocular Melanoma Study Group (2001) The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma, III: initial mortality findings. COMS Report No. 18. Arch Ophthalmol 119(7):969–982CrossRefPubMedGoogle Scholar
  7. 7.
    Collaborative Ocular Melanoma Study Group (2006) The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28. Arch Ophthalmol 124(12):1684–1693CrossRefGoogle Scholar
  8. 8.
    Foss AJE, Lamping DL, Schroter S, Hungerford J (2000) Development and validation of a patient based measure of outcome in ocular melanoma. Br J Ophthalmol 84:347–351CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Nentwich MM, Schebitz-Walter K, Hirneiss C, Hintschich C (2014) Dermis fat grafts as primary and secondary orbital implants. Orbit 33(1):33–38CrossRefPubMedGoogle Scholar
  10. 10.
    Meliá BM, Moy CS, McCaffrey L (1999) Quality of life in patients with choroidal melanoma: a pilot study. Ophthalmic Epidemiol 6:19–28CrossRefPubMedGoogle Scholar
  11. 11.
    Moy CD, Meliá MB (1999) The COMS quality of life assessment in the collaborative ocular melanoma study: design and methods. COMS-QOLS Report No. 1. COMS Quality of Life Study Group. Ophthalmic Epidemiol 6:5–17CrossRefGoogle Scholar
  12. 12.
    Raison CL, Miller AH (2003) Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry 54:283–294CrossRefPubMedGoogle Scholar
  13. 13.
    Brandberg Y, Kock E, Oskar 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 14:839–846CrossRefPubMedGoogle Scholar
  14. 14.
    Brandberg Y, Månsson-Brahme E, Rindborg U, Sjödén PO (1995) Psychological reactions in patients with malignant melanoma. Eur J Cancer 31:157–162CrossRefGoogle Scholar
  15. 15.
    Hjermstad MJ, Fayers PM, Bjørdal K, Kaasa S (1998) Health related quality of life in the general Norwegian population assessed by the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire: the QLQ-C30 (+3). J Clin Oncol 16:1188–1196PubMedGoogle Scholar
  16. 16.
    Chabert S, Velikay-Parel M, Zehetmayer M (2004) Influence of uveal melanoma therapy on patients’ quality of life: a psychological study. Acta Ophthalmol Scand 82:25–31CrossRefPubMedGoogle Scholar
  17. 17.
    Klingenstein A, Fürweger C, Nentwich MM, Schaller UC, Foerster PI, Wowra B, Muacevic A, Eibl KH (2013) Quality of life in the follow-up of uveal melanoma patients after CyberKnife treatment. Melanoma Res 23(6):481–488CrossRefPubMedGoogle Scholar
  18. 18.
    Ware JE, Kosinski M, Keller SD (1995) How to Score the SF-12 Physical and Mental Health Summary Scales, 2nd edn. The Health Institute, New England Medical Center, BostonGoogle Scholar
  19. 19.
    Desouky TF, Mora PA, Howell EA (2012) Measurement invariance of the SF-12 across European-American, Latina, and African-American postpartum women. Qual Life Res 22(5):1135–1144CrossRefPubMedGoogle Scholar
  20. 20.
    Amaro TAC, Yazigi L, Erwenne C (2010) Depression and quality of life during treatment of ocular bulb removal in individuals with uveal melanoma. Eur J Cancer Care 19:476–481CrossRefGoogle Scholar
  21. 21.
    Smith B, Bosniak SL, Lisman RD (1982) An autogenous kinetic dermis-fat orbital implant: an updated technique. Ophthalmology 89(9):1067–1071CrossRefPubMedGoogle Scholar
  22. 22.
    Archer DB, Amoaku WM, Gardiner TA (1991) Radiation retinopathy – clinical, histopathological, ultrastructural and experimental correlations. Eye 5:239–251CrossRefPubMedGoogle Scholar
  23. 23.
    Shields CL, Kaliki S, Furuta M, Fulco E, Alarcon C, Shields JA (2013) American Joint Committee on Cancer classification of posterior uveal melanoma (tumor size category) predicts prognosis in 7731 patients. Ophthalmology 120(10):2066–2071CrossRefPubMedGoogle Scholar
  24. 24.
    Kivelä T, Kujala E (2013) Prognostication in eye cancer: the latest tumor, node, metastasis classification and beyond. Eye 27:243–252CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Damato B (2000) Disease and “dis-ease” in patients with uveal melanoma. Br J Ophthalmol 84:343–344CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Melia M, Moy CS, Reynolds SM, Hayman JA, Murray TG, Hovland KR, Earle JD, Kurinij N, Dong LM, Miskala PH, Fountain C, Cella D, Mangione CM, Collaborative Ocular Melanoma Study-Quality of Life Study Group (2006) Quality of life after iodine 125 brachytherapy vs enucleation for choroidal melanoma: 5-year results from the Collaborative Ocular Melanoma Study: COMS QOLS Report No. 3. Arch Ophthalmol 124(2):226–238CrossRefPubMedGoogle Scholar
  27. 27.
    Cruickshanks KJ, Fryback DG, Nondahl DM, Robinson N, Keesey U, Dalton DS, Robertson DM, Chandra SR, Mieler WF, Zakov ZN, Custer PL, Del Priore LV, Albert DM (1999) Treatment choice and quality of life in patients with choroidal melanoma. Arch Ophthalmol 117:461–467CrossRefPubMedGoogle Scholar
  28. 28.
    Seregard S, Pelayes DE, Singh AD (2013) Radiation therapy: uveal tumors. Dev Ophthalmol 52:36–57CrossRefPubMedGoogle Scholar
  29. 29.
    Stewart AL, Ware JE (1992) Measuring Functioning and Well-Being: The Medical Outcome Study Approach. Duke University Press, DurhamGoogle Scholar
  30. 30.
    Sprangers MAG, Cull A, Groenvold M (1998) EORTC Quality of Life Study Group Guidelines for Developing Questionnaire Modules. EORTC, BrusselsGoogle Scholar
  31. 31.
    Thomé B, Dykes AK, Hallberg IR (2004) Quality of life in old people with and without cancer. Qual Life Res 13(6):1067–1080CrossRefPubMedGoogle Scholar
  32. 32.
    Furdova A, Sramka M, Chorvath M, Kralik G, Krasnik V, Krcova I, Waczulikova I (2014) Stereotactic radiosurgery in intraocular malignant melanoma--retrospective study. Neuro Endocrinol Lett 35(1):28–36PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • A. Klingenstein
    • 1
  • C. Fürweger
    • 2
  • A. K. Mühlhofer
    • 1
  • S. F. Leicht
    • 1
  • U. C. Schaller
    • 1
  • A. Muacevic
    • 2
  • B. Wowra
    • 2
  • C. Hintschich
    • 1
  • K. H. Eibl
    • 1
  1. 1.Department of Ophthalmology, Klinikum der Universität München Campus InnenstadtLudwig-Maximilians-UniversityMunichGermany
  2. 2.European CyberKnife® CenterMunichGermany

Personalised recommendations