| BackgroundRetinoblastoma(RB)is the most common intraocular malignant tumor that occurs in children.As modern medicine techniques have advanced,the survival rate is higher than 95%,and most patients can live to old age.However,the concept of‘cure'has changed from simple extinction of cancer to a more complex meaning of‘restoration of health',in which‘health'is not limited to physical health but also includes mental health,social functioning,and so on.RB can influence RB patients in both physical and psychological aspects,affecting the quality of life(Qo L).There are no studies on the Qo L of adult RB survivors in China.PurposeTo assess the Qo L in adult survivors of unilateral RB in China and to further analyze the predictors of Qo L.MethodsThis is a cross-sectional study which was performed in the ophthalmology department of our hospital between April 2018 and October 2019.Enrolment was offered to all adult survivors of unilateral RB who were treated by enucleation.A total of 66 RB survivors were enrolled;66 noncancer healthy adults who accompanied other patients(not RB)during the same period served as a control group.The researchers collected demographic and clinical data,and they used standardized questionnaires to assess the Qo L.Finally,multi-factor stepwise linear regression models were used to analyze predictors of Qo L.ResultsA total of 66 RB survivors(57.0%female)and 66 healthy adults(66.7%female)were aged 27.9±7.6 and 29.2±8.4 at the time of the study,respectively.There was no significant difference in demography between groups.On the HAD(a)subscale,RB survivors scored lower than the control group[4.00(2.00-6.00)v 5.00(2.75-8.25);p=0.045],9(14.1%)adult survivors of unilateral RB and 18(27.3%)healthy subjects were with anxiety.Age at diagnosis(?=0.210)and fear(?=0.549)were the factors influencing HAD(a)scores.RB survivors were more likely to worry about their facial appearance[1.59(1.27-2.16)v 0.36(0.09-1.18);p<0.001].And there were significant differences in the three domains,including cognitive emotion(CA),behavior(B)and projection(P),with 68.7%satisfaction rate in RB survivors and 95.5%in the control group(p<0.001).Gender(?=0.313)was the influencing factor for appearance concern(F=6.743,p=0.012,R~2=0.084),with female survivors reporting 64.7%satisfaction with their appearance compared to 73.3%for male survivors.In the assessment of fear,9(14.1%)adult survivors had psychological dysfunction.In addition,female patients had more fear of diseases and were more likely to worry about being affected by diseases[28.50(23.75-35.00)v 26.00(17.50-29.25);p=0.031].8(23.5%)female survivors and only 1(3.3%)male survivor had psychological dysfunction(p=0.021).RB survivors scored higher on the physical functioning(PF)[100.00(95.00-100.00)v 95.00(90.00-100.00);p=0.001],bodily pain(BP)[100.00(72.00-100.00)v 74.00(69.50-100.00);p=0.011]and role-emotional(RE)[100.00(66.67-100.00)v 66.67(0.002);p=0.002]subscales than the control group.Mental health is the main predictor of the Qo L,while chemotherapy,marital status,age at diagnosis,and residence status can also affect the Qo L.There was no correlation between appearance concern,radiotherapy and the Qo L.ConclusionsUnilateral RB survivors experience a relatively good overall Qo L,and they do not have psychological disorder.Mental health is the main predictor of Qo L.Females may need more specific psychosocial care. |
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