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

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.

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.

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.

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.

CTRI/2023/02/049409 (Registered prospectively on 02/02/2023).