RESEARCH

Scientific research investigation seeks to establish facts, answer questions, or collect information about a topic. There are many types of research attempting to find better ways to prevent, diagnose and treat cancer, including eye cancers.

Two important types of research studies are retrospective and prospective studies. Retrospective studies look at data relating to past events while prospective studies focus on the future. Another important type of research is a clinical trial that tests how well a medical treatment or intervention works. For example, a clinical trial may see if one type of treatment, or combination of treatments, is more effective than another. You can learn more about clinical trials for all types of cancer at the National Institutes of Health.

The Collaborative Ocular Melanoma Study (COMS) is designed to evaluate which treatment alternative, enucleation or radiation plaque therapy, better prolongs life. In addition, if the two alternative treatments were found to provide similar expectations of survival, the study wanted to determine which treatment offers the patient the longer cancer-free life and the better prognosis for vision overall.

Of the 1,317 patients who participated in the COMS Medium-Size Choroidal Melanoma Trial, 660 patients were assigned to receive radiation plaque therapy and 657 were enucleated. The two treatment alternatives were found equally effective. The COMS Large Choroidal Melanoma Trial enrolled 1,003 patients. Of these, 506 patients were randomized to standard enucleation and 497 to pre-enucleation radiotherapy followed by enucleation. No statistically significant difference was noted for either treatment outcome based on the selected treatment of pre-enucleation radiotherapy followed by enucleation or enucleation alone.

In addition to the two randomized trials, a number of pilot studies and ancillary studies have been conducted by COMS investigators. In the absence of a survival outcome difference between treatments, along with the known decrease in visual function associated with plaque therapy, patient psychological and physical well-being become increasingly more pivotal to making treatment decisions.

The COMS Medium-Tumor Trial Quality of Life Study (QOLS) was designed to measure the impact of disease and its treatment on quality of life, and compare how the quality life differs for enucleated and plaque patients. Patients are interviewed at selected intervals during follow-up visits to assess health status, visual function, anxiety and depression. Quality of life data is pending from the COMS and remains the major outcome variable yet to be reported. You can find a complete list of COMS publications at their website.

If you are interested in reading research articles about eye cancer, a good resource is the National Library of Medicine.