Impact of adjuvant ocular interventions on the quality of life of patients with uveal melanoma after proton beam therapy

Abstract

Introduction Proton beam therapy is an established primary treatment for patients with non-metastasized uveal melanoma. Adjuvant local interventions, like intravitreal injections or surgery, were shown to improve long-term eye preservation; however, their impact on the patient’s quality of life (QOL) remains unknown. Methods In a post-radiotherapeutic follow-up, we prospectively collected data on QOL, visual acuity, and interventional adjuvant procedures. QOL was measured with QOL-C30 and QLQ-OPT30 questionnaires at baseline, and at three and twelve months after proton therapy. Patients were grouped by the type of adjuvant treatment. Impact on QOL was analyzed by comparing changes in mean score values and visual acuity for different interventional subgroups, with generalized linear mixed models and Wilcoxon signed-rank tests. Results We received 108 (100%) and 95 (88.0%) questionnaires at three and twelve months post-therapy, respectively. Adjuvant interventions included: observation (n=61, 56.5%), intravitreal injections (n=17, 15.7%), and an intraocular surgical procedure (n=30, 27.8%). In the latter group, several QOL items significantly declined after the 3 month adjuvant interval, but they partially recovered at the 12-month follow-up. In all adjuvant-intervention groups, global QOL scores returned to baseline levels at 12 months. Conclusion Post-treatment adjuvant interventions had no long-lasting effects on QOL in patients with uveal melanoma.