Quality of life in patients with malignant choroidal melanoma after radiotherapy.
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.


CONCLUSIONS
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.
Reimer
Jens
J
Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany.
Esser
Joachim
J
Fleiss
Anja
A
Hessel
Aike
A
Anastassiou
Gerasimos
G
Krausz
Michael
M
Bornfeld
Norbert
N
Franke
Gabriele Helga
GH
D000203:Activities of Daily Living; D001007:Anxiety / Q000523:psychology; D002830:Choroid Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D003863:Depression / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008545:Melanoma / Q000523:psychology* / Q000532:radiotherapy*; D008603:Mental Health; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014792:Visual Acuity