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Arezu Haghighi, Bao han Allison Le, Daniel Yadegari, Jonathan W Kim, Jesse L Berry; Quality of Life Outcomes Following Eye Physics Brachytherapy Plaques for the Treatment of Choroidal Melanoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3631. doi: https://doi.org/.
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To compare quality of life outcomes of computer-modeled Eye Physics (EP) plaque brachytherapy to Collaborative Ocular Melanoma Study (COMS) plaques for treatment of choroidal melanoma. This study utilizes the Ophthalmic Oncology Group of the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC-QLQ-OPT30) designed for patients with uveal melanoma and including domains such as symptomatology, functional outcome, and psychological factors. EP plaques are patient-customized, deliver less radiation to healthy tissue, and have thinner profiles. We thus hypothesize that quality of life following EP plaques is comparable if not superior to standard COMS brachytherapy.
This is a prospective, non-randomized study of 58 patients with choroidal melanoma treated with EP plaques at the University of Southern California between the years 2007-2017. Patients were recruited using electronic medical record databases and surveyed using the EORTC-QLQ-OPT30 in person, electronically, or via telephone. Patient responses were graded on a scale of 1-4. Average responses and percentage with significant symptoms (scores of 3-4) were recorded. A direct comparison was made to COMS brachytherapy outcomes from the original EORTC-QLQ-OPT30 study by Brandberg et al.
The most prevalent adverse impact on quality of life with EP plaques were psychological with 43.1-50% of patients exhibiting significant symptoms—worries about future health, losing the eye, and tumor recurrence locally or systemically. Less than 17.2% of patients reported significant symptoms in each question of the ocular irritation domain (excluding dry eyes). Only 5.2% of patients reported significant dissatisfaction with cosmetic results. Mean score in all vision-related domains was 1.8; scores <1.5 were deemed to have limited relevance by the original Brandberg study. Overall quality of life outcomes were similar between EP and COMS plaques (cumulative mean score 54.57 vs 50.13, respectively).
Quality of life after EP plaques is comparable to standard plaque brachytherapy. EP plaques offer particularly good outcomes in the ocular irritation and cosmesis domains. Further work is underway to stratify quality of life with EP plaques by patient characteristics (age, time to treatment, and complications) and compare to more recent data collected for COMS plaques.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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