Music Therapy and Music Intervention for NSCLC Patients Undergoing PET with Fear of Cancer Recurrence

Abstract

Background: Cancer and psychiatric symptoms are associated. Fear of cancer recurrence (FCR) is the most common psychological problem for cancer survivors. Pharmacological interventions can help, but also have major drawbacks. Music therapy and music interventions have been shown to be a safe and practical complementary treatment. Objective: This randomized, controlled trial aimed to investigate the effects of music therapy and music intervention in attenuating non-small cell lung cancer (NSCLC) patients' anxiety related to FCR. Methods: NSCLC patients with FCR were randomly allocated to a music therapy and intervention group (G1) and Control group (G2). Patients' anxiety was measured using the State-Trait Anxiety Inventory scores and heart rates. Primary outcome measure were PET scans. Secondary measures were salivary cortisol, salivary α-amylase levels and heart rate. Findings: Patients in G1 showed higher glucose metabolism of ¹⁸F-FDG in the superior frontal gyrus, anterior cingulate, superior temporal gyrus, and parahippocampal gyrus, compared to those in G2 (all P < .001). Heart rates and salivary α-amylase area under the curve (AUC) and relative variation (VAR) in G1 were significantly lower than those in G2 (all P < .05). State-Trait Anxiety Inventory scores and cortisol AUC in G1 were significantly lower than those in G2 (all P < .05). Conclusions: Music therapy and interventions can reduce anxiety and endocrinological responses and change glucose metabolism of ¹⁸F-FDG in fear-related brain regions.Trial registration: Registered retrospectively, ISRCTN Registry, www.isrctn.com, ISRCTN23276302Clinical Implications: Cancer treatment centers and physical examination centers should consider providing music therapy and intervention to the appropriate patients as a routine component of a comprehensive clinical care during medical examinations.

Keywords: anxiety; cancer survivor; fear of cancer recurrence FCR; music therapy intervention; non-small cell lung carcinoma NSCLC.

Figure 1.

Recruitment of NSCLC patients and healthy controls.

Figure 2.

Protocol for music (therapy) intervention and sample collection. Passive music intervention refers to the music intervention. Active music intervention refers to the music therapy intervention.

Figure 3.

PET comparisons between Groups 1 and 2. Patients in Group 1 showed lower glucose metabolism of F-FDG in the occipital lobe, left and right middle occipital gyrus (BA 18), left and right frontal lobe, and precentral gyrus (BA 4, BA 6) when compared to those in Group 2.

Figure 4.

Real-time monitoring of the anxiety and heart rates of NSCLC patients. (A) Except for at Time −30 (P = .90), there were significant differences in STAI scores between Group 1 and Group 2 (all P < .01, Figure 4A). (B) The STAI-score AUC in Group 1 was significantly lower than in Group 2 (P < .01). (C) There was no significant difference between the STAI-score VARs of Group 1 and Group 2 (P = .65). (D) Compared to Group 2, significant associations were detected at S3 (Time +30), S4 (Time +60), and S5 (Time +70) (all P < .01). (E) and (F) The heart-rate AUC (E) and VAR (F) in Group 1 were significantly lower than in Group 2 (all P < .01). *P < .01. All data are shown as the mean ± standard deviation.

Figure 5.

Relative variation of salivary cortisol and sAA levels. (A) and (D) The relative variations (VARs) of salivary cortisol (A) and sAA (D) were assessed. In Group 1, the salivary cortisol area under the curve (AUC) (B), sAA AUC (E), and sAA VAR (F) were significantly higher than those in Group 2 (all P < .05). (C) There was no difference between Group 1 and Group 2 in salivary cortisol VAR (P = .35). *P < .05. All data are shown as the mean ± standard deviation.