On Patient Experience and Anxiety During Treatment With Magnetic Resonance–Guided Radiation Therapy

Abstract

Purpose: To assess patient experience and anxiety during MR-guided radiotherapy (MRgRT) on a 1.5 Tesla (T) MR-Linac when offered calming video content. Methods and Materials: A single center study was conducted within the Multi-OutcoMe EvaluatioN of radiation Therapy Using the MR-Linac (MOMENTUM) cohort. Patients were offered to watch calming video content on a video monitor during treatment. Questionnaires were used to assess patient experience (MRL-PE) and anxiety (State Trait Anxiety Inventory, STAI) at first treatment fraction (M1) and at third, fourth or fifth treatment fraction (M2). Paired T-tests were used to test for significant differences, and effect sizes (ES) to determine the importance of the difference. Results: Between November 2021 and November 2022, 66 patients were included. The majority was male (n=59, 89%). MRgRT was most frequently delivered to prostate cancer (n=45, 68%) followed by a lesion in the pancreas (n=8, 12%). At M1 and M2, 24/59 patients (41%) preferred to watch calming video content. One patient was not able to look at the video-monitor comfortably at first fraction. Patient experience was generally favorable or neutral; tingling sensations were reported by 17% of patients. Anxiety levels were high (16%), moderate (18%) or low to none (67%) prior to M1. STAI-scores were 33 (SD 9) prior to M1 and 29 (SD 7) after M1 (ES 0.7, p<0.001). STAI-scores were 32 (SD 9) prior to M2 and 31 (SD 8) (ES 0.4, p=0.009). Conclusions: Patients were able to comfortably view the video monitor during MRgRT. Consequently, this set up could be used for future applications, such as biofeedback. A sizeable minority of patients preferred to watch calming video's, which distracted them during treatment. Although the patient's experience was overall excellent, anxiety was reported. Anxiety levels were highest prior to treatment, which decreased after treatment.