2878 - Using Virtual Reality Technology to Improve Patient Anxiety and Reduce Opioids Use during HDR Brachytherapy Procedure for Patients with Gynecological Cancer

S. Samanta¹, A. Z. Kesaria¹, E. Baker², H. Kelly³, R. L. Crownover⁴, F. Mahmoudabadi⁵, and G. D. Lewis⁶; ¹Department of Radiation Oncology, UAMS Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, ²University of Arkansas for medical Sciences, Little Rock, AR, ³University of Arkansas for Medical Sciences, Little Rock, AR, ⁴Mays Cancer Center, UT Health San Antonio, San Antonio, TX, ⁵University of Arkansas for Medical Sciences, Littel Rock, AR, ⁶The University of Texas Medical Branch, Galveston, TX

Purpose/Objective(s): Brachytherapy using HDR plays a crucial role in treatment of gynecological cancer undergoing radiation therapy. This pilot study examines the use of Virtual Reality (VR) distraction for subjects undergoing HDR brachytherapy and its effects on their satisfaction, mental wellness, procedural anxiety, pain, and the need for analgesics or anxiolytics. We hypothesize that incorporating VR distraction into the brachytherapy treatment workflow will improve patient’s satisfaction, reduce procedural anxiety and pain and reduce the need for analgesics or anxiolytics. Materials/

Methods: From December 2022 to November 2023, 7 patients have been enrolled so far, each requiring a minimum of 4 sessions of HDR brachytherapy. Hybrid applicators without any needles were used during this procedure and all patients received oral oxycodone 30 mins prior to the procedure. All patients were awake during the procedure. Further oxycodone was given as PRN during treatment or during removal of devices. Each patient underwent 2 sessions with VR and 2 sessions without. Each patient was also asked to fill out a questionnaire before and after each HDR brachytherapy session, that included satisfaction score, pain score, anxiety score among other details. Data including AE events were recorded post treatment for all sessions.
Results: With an accrual goal of 20 patients, 7 women, ages 29 to 81, participated in the study. Six of the subjects were White and 1 Subject was Black or African American. All 7 subjects attempted to use virtual reality during brachytherapy at least once, contributing to a total of 12 sessions with virtual reality, which were compared to 13 complete sessions without virtual reality. The preliminary results show the following.

1. Subjects reported lower average pre-procedural pain prior to VR sessions.
2. Subjects reported lower average procedural pain during VR sessions.
3. Subjects reported about the same pre-procedural anxiety with or without VR sessions
4. Subjects reported a high satisfaction score and would like to use the VR again

Conclusion: These preliminary results suggest a potential reduction in procedural pain with the inclusion of VR sessions during HDR brachytherapy. However, there was no observed change in the need for anxiety medications among these initially enrolled patients. All subjects reported high satisfaction score and would like to use VR again. While many subjects reported it was their first time engaging with VR device, in future, we plan to incorporate a longer demo session and modify questionnaire to improve the subject’s familiarity with the technology.