{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T15:06:42Z","timestamp":1758812802118,"version":"3.41.2"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We prospectively addressed whether patient characteristics, oncological outcomes, or metastatic risk impacted depression and anxiety in patients undergoing curative proton treatment for uveal melanoma (UM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed patient\u2010reported outcomes regarding anxiety (GAD\u20107) before and 2\u2009years after proton therapy and depression (PHQ\u20109) before, 1, and 2\u2009years after proton therapy. We performed descriptive statistics and used linear mixed effect modeling to analyze how the oncological outcome and baseline characteristics impacted anxiety and depression scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 130 (65 female) patients included, six developed metastatic disease and three died during the 2\u2010year follow\u2010up. The mean anxiety declined from 5.86 (SE\u00a0=\u00a00.56) at baseline to 3.74 (SE\u00a0=\u00a00.46) at 2\u2009years (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a02.11; SE\u00a0=\u00a00.6; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Depressive symptoms decreased moderately from 4.36 (SE\u00a0=\u00a00.37) at baseline to 3.67 (SE\u00a0=\u00a00.38) 2\u2009years later. Patients with unfavorable metastatic risk or disease progression had elevated anxiety and depression scores. Although female patients reported overall higher anxiety scores, both sexes recovered substantially and to a similar extent during the 2\u2010year follow\u2010up (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a02.35; SE 0.87; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.007 vs. <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a01.88; SE\u00a0=\u00a00.60; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.002). A trend for prolonged depressive symptoms was observed in patients living alone compared to patients living with family members 1 year after the treatment (<jats:italic>M<\/jats:italic>\u00a0=\u00a05.04 [SE\u00a0=\u00a00.85] vs. <jats:italic>M<\/jats:italic>\u00a0=\u00a03.73 [SE\u00a0=\u00a00.31], <jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a01.32; SE\u00a0=\u00a00.92; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.152). Patients with high baseline anxiety levels showed initially more severe depressive symptoms, which improved significantly during follow\u2010up (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a01.65; SE\u00a0=\u00a00.68; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Most patients undergoing proton therapy for UM experienced mild, transient depressive symptoms and anxiety. Patients with high pre\u2010treatment anxiety, unfavorable prognoses, and patients living alone may be more vulnerable to prolonged depressive symptoms. To these patients a more tailored support could be offered at an early stage of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1780","type":"journal-article","created":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T07:44:07Z","timestamp":1673682247000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Depression and anxiety in patients with uveal melanoma undergoing curative proton treatment\u2014A prospective study"],"prefix":"10.1002","volume":"6","author":[{"given":"Christopher","family":"Rabsahl","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Charit\u00e9 \u2013 Universit\u00e4tsmedizin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Boehmer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Charit\u00e9 \u2013 Universit\u00e4tsmedizin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Boeker","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Charit\u00e9 \u2013 Universit\u00e4tsmedizin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Gauger","sequence":"additional","affiliation":[{"name":"Statistical Consultant  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-3836","authenticated-orcid":false,"given":"Ute","family":"Goerling","sequence":"additional","affiliation":[{"name":"Department of Psycho\u2010Oncology CCCC, Charit\u00e9 \u2013 Universit\u00e4tsmedizin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0853-144X","authenticated-orcid":false,"given":"Johannes","family":"Gollrad","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Charit\u00e9 \u2013 Universit\u00e4tsmedizin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_11_2_1","DOI":"10.1016\/S0161\u20106420(03)00078\u20102"},{"doi-asserted-by":"publisher","key":"e_1_2_11_3_1","DOI":"10.1136\/bjo.86.3.333"},{"doi-asserted-by":"publisher","key":"e_1_2_11_4_1","DOI":"10.1167\/iovs.03\u20100538"},{"doi-asserted-by":"publisher","key":"e_1_2_11_5_1","DOI":"10.5858\/2010\u20100477\u2010OAR1"},{"doi-asserted-by":"publisher","key":"e_1_2_11_6_1","DOI":"10.1016\/j.ophtha.2007.06.012"},{"doi-asserted-by":"publisher","key":"e_1_2_11_7_1","DOI":"10.1016\/s0140\u20106736(96)90736\u20109"},{"doi-asserted-by":"publisher","key":"e_1_2_11_8_1","DOI":"10.1001\/archopht.119.7.969"},{"doi-asserted-by":"publisher","key":"e_1_2_11_9_1","DOI":"10.6004\/jnccn.2020.0007"},{"doi-asserted-by":"publisher","key":"e_1_2_11_10_1","DOI":"10.1016\/s0360\u20103016(01)01560\u20107"},{"doi-asserted-by":"publisher","key":"e_1_2_11_11_1","DOI":"10.1038\/eye.2000.233"},{"doi-asserted-by":"publisher","key":"e_1_2_11_12_1","DOI":"10.1046\/j.1600\u20100420.2003.0210.x"},{"doi-asserted-by":"publisher","key":"e_1_2_11_13_1","DOI":"10.1038\/eye.2016.188"},{"doi-asserted-by":"publisher","key":"e_1_2_11_14_1","DOI":"10.1001\/archopht.124.2.226"},{"doi-asserted-by":"publisher","key":"e_1_2_11_15_1","DOI":"10.21873\/anticanres.12562"},{"doi-asserted-by":"publisher","key":"e_1_2_11_16_1","DOI":"10.1001\/jamaophthalmol.2015.4343"},{"doi-asserted-by":"publisher","key":"e_1_2_11_17_1","DOI":"10.1684\/bdc.2011.1300"},{"doi-asserted-by":"publisher","key":"e_1_2_11_18_1","DOI":"10.1038\/s41433\u2010019\u20100440\u20100"},{"doi-asserted-by":"publisher","key":"e_1_2_11_19_1","DOI":"10.1046\/j.1525\u20101497.2001.016009606.x"},{"doi-asserted-by":"publisher","key":"e_1_2_11_20_1","DOI":"10.1001\/archinte.166.10.1092"},{"doi-asserted-by":"publisher","key":"e_1_2_11_21_1","DOI":"10.1016\/j.genhosppsych.2013.04.006"},{"doi-asserted-by":"publisher","key":"e_1_2_11_22_1","DOI":"10.1097\/MLR.0b013e318160d093"},{"doi-asserted-by":"publisher","key":"e_1_2_11_23_1","DOI":"10.1111\/aos.13823"},{"doi-asserted-by":"publisher","key":"e_1_2_11_24_1","DOI":"10.1186\/s13014\u2010021\u201001902\u20106"},{"doi-asserted-by":"publisher","key":"e_1_2_11_25_1","DOI":"10.1002\/pon.5514"},{"doi-asserted-by":"publisher","key":"e_1_2_11_26_1","DOI":"10.1002\/pon.4715"}],"container-title":["Cancer 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