Purpose. To assess neurocognitive function (NCF), psychosocial outcome, health-related quality of life (HRQoL), and long-term effects of immune-related adverse events (irAE) on metastatic melanoma survivors treated with ipilimumab (IPI). Methods. Melanoma survivors were identified within two study populations (), at a single-center university hospital, and defined as patients who were disease-free for at least 2 years after initiating IPI. Data were collected using 4 patient-reported outcome measures, computerized NCF testing, and a semistructured interview at the start and 1-year follow-up. Results. Out of 18 eligible survivors, 17 were recruited (5F/12M); median age is 57 years (range 33-86); and median time since initiating IPI was 5.6 years (range 2.1-9.3). The clinical interview revealed that survivors suffered from cancer-related emotional distress such as fear of recurrence (), existential problems (), survivor guilt (), and posttraumatic stress disorder (). The mean EORTC QLQ-C30 Global Score was not significantly different from the European mean of the healthy population. Nine survivors reported anxiety and/or depression (Hospitalization Depression Scale) during the survey. Seven survivors (41%) reported fatigue (Fatigue Severity Scale). Seven patients (41%) had impairment in NCF; only three out of seven survivors had impairment in subjective cognition (Cognitive Failure Questionnaire). Anxiety, depression, fatigue, and neurocognitive symptoms remained stable at the 1-year follow-up. All cases of skin toxicity (), hepatitis (), colitis (), and sarcoidosis () resolved without impact on HRQoL. Three survivors experienced hypophysitis; all suffered from persistent fatigue and cognitive complaints 5 years after onset. One survivor who experienced a Guillain-Barré-like syndrome suffered from persisting depression, fatigue, and impairment in NCF. Conclusion. A majority of melanoma survivors treated with IPI continue to suffer from emotional distress and impairment in NCF. Timely detection in order to offer tailored care is imperative, with special attention for survivors with a history of neuroendocrine or neurological irAE. The trial is registered with B.U.N. 143201421920.

中文翻译：

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接受 Ipilimumab 治疗的第一代转移性黑色素瘤幸存者的神经认知功能、心理社会结果和与健康相关的生活质量。

目的。评估神经认知功能 (NCF)、心理社会结果、健康相关生活质量 (HRQoL) 和免疫相关不良事件 (irAE) 对接受易普利姆玛 (IPI) 治疗的转移性黑色素瘤幸存者的长期影响。方法。在两个研究人群中确定了黑色素瘤幸存者（)，在单中心大学医院，定义为在开始 IPI 后至少 2 年无病的患者。使用 4 项患者报告的结果测量、计算机化的 NCF 测试以及开始时的半结构化访谈和 1 年的随访收集数据。结果。在 18 名符合条件的幸存者中，招募了 17 名（5F/12M）；中位年龄为 57 岁（范围 33-86）；自启动 IPI 以来的中位时间为 5.6 年（范围 2.1-9.3）。临床访谈显示，幸存者遭受与癌症相关的情绪困扰，例如害怕复发（),存在问题 (),幸存者内疚 ()和创伤后应激障碍 (）。平均 EORTC QLQ-C30 全球评分与欧洲健康人群的平均值没有显着差异。九名幸存者在调查期间报告了焦虑和/或抑郁（住院抑郁量表）。七名幸存者 (41%) 报告了疲劳（疲劳严重程度量表）。7 名患者 (41%) 的 NCF 受损；只有七分之三的幸存者有主观认知障碍（认知失败问卷）。在 1 年的随访中，焦虑、抑郁、疲劳和神经认知症状保持稳定。所有皮肤毒性病例（),肝炎 (),结肠炎 ()和结节病 ()在不影响 HRQoL 的情况下得到解决。三名幸存者出现垂体炎；所有患者在发病 5 年后都出现持续的疲劳和认知问题。一名经历过格林-巴利样综合征的幸存者患有持续的抑郁、疲劳和 NCF 损伤。结论。大多数接受 IPI 治疗的黑色素瘤幸存者继续遭受情绪困扰和 NCF 损伤。及时检测以提供量身定制的护理是必不可少的，特别注意有神经内分泌或神经 irAE 病史的幸存者。该试验已在 BUN 143201421920 注册。