C. Kriegler1, B. J. Debenham1,2, Y. M. Zhu1, M. Piva3, M. Bernardo3, A. Bylhouwer3, T. Karim3, G. Tucker Belliveau4, B. Merrick4, and M. Al Balushi1; 1University of Alberta, Edmonton, AB, Canada, 2Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada, 3Cross Cancer Institute, Edmonton, AB, Canada, 4University of Alberta, Faculty of Medicine and Dentistry, Edmonton, AB, Canada
Purpose/Objective(s): Procedural anxiety of cancer treatments may negatively impact patients and treatments. Environment modification with Virtual Reality (VR) is increasingly used across medicine to minimize procedural anxiety. We hypothesized that intrafraction VR use during external beam radiotherapy (EBRT) would improve radiotherapy experience and physiological measures of distress. Materials/
Methods: At our single institution between May – October 2023, adult patients receiving EBRT without contraindications to wearing a VR headset were eligible. Participants had heart rate recorded before and after EBRT and completed a post-EBRT survey for one treatment without intervention, and one using VR. Participants completed the Radiotherapy Experience Questionnaire (RTEQ) and additional questions regarding VR. Mean pre- and post-EBRT heart rate and RTEQ theme scores were compared between conditions using paired samples t-test. Results: Fifty-two participants completed the project. Between pre- and post-EBRT there was a significant decrease in heart rate with VR (80.35 bpm vs. 71.79 bpm; p < 0.0001*), but not in the control condition (78.90 bpm vs. 78.10 bpm; p = 0.44). Post-EBRT heart rate was significantly lower with VR than without (71.79 bpm vs. 78.10 bpm; p < 0.01*). RTEQ responses showed participants had significantly lower situational unease (1.46 vs. 2.02; p < 0.001*), a more beneficial situational response (1.55 vs. 2.12; p < 0.01*), and improved environment acceptance (1.30 vs. 1.60; p < 0.01*) when using VR. Most endorsed VR as comfortable (94%), improved treatment experience (86%), and would recommend its use to others (86%). Conclusion: We report the first evidence of impacts of intrafraction VR use during EBRT. Physiological measures of distress and patient perspectives suggest VR can minimize procedural anxiety, is well tolerated, and improves the overall treatment experience. VR should be considered as a tool for managing RT treatment anxiety. Further research should explore modifying this tool for patients unable to wear headsets and determining where the most clinically significant benefits can be found.
