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M. Melia, C.S. Moy, S.M. Reynolds, Collaborative Ocular Melanoma Study – Quality of Life Study (COMS–QOLS) Group; Quality of Life After I–125 Brachytherapy versus Enucleation for Choroidal Melanoma . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3378.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe health and vision–related quality of life following treatment for choroidal melanoma with I–125 brachytherapy or enucleation. Methods: Two hundred nine patients who were enrolling in the Collaborative Ocular Melanoma Study (COMS) clinical trial for medium–sized tumors gave informed consent to participate in an ancillary study of quality of life. Patients were interviewed by telephone by a trained interviewer prior to COMS randomization, at 6 months, and annual anniversaries of enrollment for up to 6 years. The questionnaire battery included the Medical Outcomes Study Short Form 36 (SF–36), the Activities of Daily Vision Scale (ADVS), the National Eye Institute Visual Function Questionnaire (NEI–VFQ), and the Hospital Anxiety and Depression Scale (HADS). Additional questions concerning satisfaction with appearance and concerns about cancer recurrence also were included. Results: There was a significant increase in level of reported difficulty for most vision–oriented activities, and in bodily and ocular pain, following either treatment. Enucleation patients tended to have larger decreases in visual function at 6 months than brachytherapy patients and to have stable visual function over follow–up, while brachytherapy patients had smaller decreases at 6 months followed by a slow decline in visual function over follow–up. Differences in visual functioning between the 2 treatments were relatively small, but significant differences favoring brachytherapy were observed for night driving for the first year of follow–up and peripheral vision for the first 2 years of follow–up. Anxiety levels in both treatment groups decreased significantly following treatment, but patients treated with brachytherapy who had symptoms of anxiety were less likely to have later resolution of symptoms than enucleation patients with symptoms of anxiety. This study was unable to assess impact of treatment on satisfaction with appearance and concerns about cancer recurrence during the first year of follow–up, but no treatment–related differences were found at 2 years or later follow–up times. Conclusions: Given that no significant differences in survival between enucleation and brachytherapy have been demonstrated, the COMS–QOLS results will help patients and their physicians make better–informed choices regarding treatment based on quality of life considerations.
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