On-Table Virtual Reality to Reduce Anxiety/Distress during Radiotherapy Treatments: A Pilot Randomized Trial.

Abstract

We report the first randomized trial of a virtual reality (VR) headset used on-table during external beam radiotherapy treatments to reduce anxiety/distress during receipt of radiotherapy. A small pilot study was conducted among 10 patients, with VR randomized to start in the first week ('immediate VR') vs. second week ('delayed VR') of treatment. All patients (100%) in the immediate VR group had declines in measured distress scores after their first radiation treatment, compared to only 1 patient (16.7%) in the delayed VR group (P = .048), yet score declines generally did not meet the minimal clinically important difference threshold in the context of overall low distress scores at baseline. By day 5 of treatment, distress score changes were similar between immediate and delayed VR groups. Overall, 80% of patients in the study, including all patients with moderate or high level of baseline anxiety/distress, reported that on-table VR improved their radiotherapy experience and/or they would recommend VR to others. We propose that on-table VR is a readily-available, non-pharmacologic intervention that can be utilized to help reduce anxiety/distress associated with radiotherapy, and may be particularly helpful at the start of treatment among those with moderate/high baseline levels of anxiety/distress.