1008 - Virtual Reality (VR)-based Mindfulness Practice Improves Anxiety in Patients Preparing for Radiotherapy (RT)
Presenter(s)
M. Iocolano1, X. Han2, E. Xiong2, L. Chen2, C. Lai3, J. P. Plastaras3, J. Deleon2, J. Coleman2, K. A. Cengel1, S. J. Feigenberg1, J. D. Bradley4, M. J. LaRiviere3, and W. P. Levin1; 1Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 2University of Pennsylvania, Philadelphia, PA, 3Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, 4University of Pennsylvania/Abramson Cancer Center, Philadelphia, PA
Purpose/Objective(s): Cancer patients suffer from psychological distress, which can negatively impact treatment adherence and quality of life. To address this, we opened a pilot study to explore the feasibility of a VR platform that integrates mindfulness practices to provide an immersive relaxation experience for patients preparing for RT.
Materials/Methods: From 4/2024-2/2025, 25 patients (pts) age >=18 with ECOG <=2 were recruited by the adult thoracic radiation oncology team at the Hospital of the University of Pennsylvania to participate in a VR mindfulness program immediately prior to CT simulation. Exclusion criteria included prior RT and a medical history that would predict poor VR tolerance. The primary endpoint was feasibility, defined as 75% of pts completing 8 minutes of VR immersion. Immediately prior, baseline pre-test Hospital Anxiety and Depression Scale (scores and pre-test vs. immediate post-test State-Trait Anxiety Inventory 6 (STAI6) were obtained. Wilcoxon signed rank tests were performed. An alpha of 0.05 was used. Values are reported as mean +/- standard deviation unless otherwise specified.
Results: 25 pts were enrolled, median age 65, range 34-84, 56% male, 44% female. Median ECOG PS was 1, range 0-1. Primary diagnosis was lung cancer for 80%, lung metastasis for 12%, bone metastasis for 4%, and thymoma for 4%. Prior to the intervention, 68% of pts reported no experience with VR. Baseline scores were depression average 9.0 +/- 1.9 (borderline abnormal), median 9, range 6 (normal) to 14 (abnormal), anxiety average 11.1 +/- 2.6 (abnormal), median 11, range 5 (normal) to 15 (abnormal). 100% of pts completed the VR program. Pre- vs. post-test STAI6 scores revealed statistically significant improvements in all domains: “I am worried” 2.2 +/- 1.0 vs. 1.4 +/- 0.5, p=0.0004; “I am tense” 2.1 +/- 0.9 vs. 1.4 +/-0.9, p=0.004; “I feel upset” 1.7 +/- 0.7 vs. 1.2 +/- 0.5, p=0.001; “I am relaxed” 2.6 +/- 0.9 vs. 3.4 +/- 0.8, p=0.003; “I feel content” 2.6 +/- 0.9 vs. 3.3 +/- 0.7, p=0.007; “I feel calm” 2.8 +/- 0.9 vs. 3.5 +/- 0.7, p=0.002. The proportion of pts agreeing with the following statements were: “helped me cope with my cancer treatment” 52%, “distracted me from my cancer treatment” 56%, “lowered my stress level” 80%, “would use again” 92%, “would recommend to other pts” 88%.
Conclusion: In this pilot study, an unselected population of primarily older, VR-inexperienced lung cancer pts with borderline depression and abnormal anxiety at baseline saw statistically significant improvements across all anxiety-related domains. The primary endpoint of feasibility was met. A majority of pts reported that the intervention lowered their stress level and that they would both use the intervention again and recommend it to others, underscoring its potential as an important supportive tool in cancer treatment. Future studies are needed to test this program in a broader patient population. This feasibility study was IRB-approved and registered with ClinicalTrials.gov (NCT06318338).