Effect of music therapy and relaxation visualization intervention on mask anxiety in head and neck cancer patients undergoing radiotherapy-a randomized controlled trial

Journal

Supportive Care in Cancer

Year

2025

Abstract

PURPOSE: Head and neck cancer (HNC) patients undergoing radiation therapy (RT) often experience mask anxiety due to the use of thermoplastic masks for immobilization. This study evaluated the effectiveness of a combined music therapy and relaxation-visualization intervention in reducing mask anxiety among HNC patients receiving RT at a tertiary care super-specialty oncology hospital in central India. METHODS: A total of 216 HNC patients scheduled for RT were randomized into either the intervention group (N = 108) or the control group (N = 108). Mask anxiety was assessed using a modified distress thermometer (MDT) at baseline and after five RT sessions. Participants in the intervention group listened to pre-recorded soft instrumental, non-lyrical music and practiced a guided relaxation-visualization technique during their first five RT sessions. The control group received standard medical care. RESULTS: Of the enrolled participants, 208 were included in the final statistical analysis (intervention group: N = 100; control group: N = 108). At the end of five RT sessions, the intervention group showed a statistically significant reduction in mask anxiety scores [median (IQR): 2 (2)] compared to the control group [median (IQR): 6 (1)], with p < 0.001. No adverse events were reported. However, four participants discontinued the intervention, citing distracting thoughts and difficulty concentrating. CONCLUSION: The findings support the potential of music therapy combined with relaxation-visualization as an effective non-pharmacological intervention to alleviate mask anxiety in HNC patients undergoing RT. Integrating such complementary strategies into routine oncology practice may enhance emotional well-being, promote treatment adherence, and improve overall treatment outcomes. Further large-scale validation is warranted. REGISTRATION NUMBER OF THE CLINICAL TRIAL: CTRI/2023/02/049409 (Registered prospectively on 02/02/2023).

Music and Health Institute Terms

Anxiety; Cancer; Hospital Setting; Music in Combination with Other Techniques; Music Therapy; Noninvasive Procedures; Radiation Therapy; Receptive Music Methods

Indexed Terms

Elderly; Anxiety; Head and Neck Neoplasms; Masks; Relaxation Therapy; Head and neck cancer; India; Mask anxiety; Radiotherapy; Relaxation-visualization

Study Type

Randomized Controlled Trial; Quantitative Methods

Document Type

Article

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