Abstract
Simple SummaryChanges in the redox status and inflammation represent shared features among breast cancer, radiotherapy (RT)-related side effects, and mood disorders. Markers of peroxidation and inflammation are increased in patients with anxiety and depression, and their blockage could modulate these symptoms in cancer patients. The current literature about the role of psychotherapy with music intervention (PMI) in modulating anxiety, depression, and redox/inflammation status in breast cancer patients undergoing RT is still scant. To our knowledge, this is the first randomized trial showing PMI beneficial effects not only on anxiety and depression, but also on redox status. The results obtained highlight the potential of integrative therapies, specifically of PMI, as a valuable tool for the management of mood disorders in breast cancer patients undergoing RT. Findings concerning the redox status are promising and warrant further investigation.The aim of this study was to assess the effects of psychotherapy with music intervention (PMI) on anxiety, depression, redox status, and inflammation in breast cancer patients undergoing radiotherapy (RT). This monocentric randomized clinical trial recruited 60 patients who had a breast cancer operation and were undergoing postoperative RT. Eligible patients were randomized (1:1) in two groups: the control group (CG) received treatment as usual (n = 30), i.e., RT alone; the intervention group (PMI) received RT and psychotherapy with music intervention (n = 30), which was delivered in a group setting. Five patients were excluded after randomization. Assessments were performed at baseline (T0), at the end of RT (T1), and three months after the end of RT (T2). The main objectives of the study were the assessment of anxiety/depression, plasma glutathione (GSH), and thiobarbituric acid reactive substances (TBARS) in the two arms of the study. Our findings revealed a positive effect of PMI on anxiety, depression, resilience, and quality of life. Furthermore, a positive effect of PMI on redox status was found for the first time. Thus, in the PMI group, we found a significant increase of GSH (mean change 2.2 95%, CI 0.7 to 3.7) and a significant reduction of TBARS (mean change −1.1 95%, CI −1.8 to −0.3) at T2 vs. T0.
Highlights
Breast cancer is the most common malignancy in the female population and the second most common cancer across the globe
Our results are consistent with the widely acknowledged role of oxidative stress in the onset of mood disorders, but could shed light on the mechanisms underlying the effectiveness of psychotherapy with music intervention (PMI) in breast cancer patients undergoing RT
It is noteworthy that a decrease of thiobarbituric acid reactive substances (TBARS) and an increase of GSH emerged only in the PMI group patients, who showed an improvement in terms of anxiety, depression, and resilience
Summary
Breast cancer is the most common malignancy in the female population and the second most common cancer across the globe. In 2018, it was responsible for about two million cancers, accounting for the fifth leading cause of cancer deaths worldwide [1]. The CONCORD study reported that the five-year net survival for breast cancer has steadily increased to almost 80% in many countries [3]. Recent data indicate that radiotherapy (RT) provides a significant survival advantage to patients after breast conserving surgery, despite the related side effects and toxicity [4,5]. Increased cytokines release and oxidative stress could contribute to breast cancer recurrence and represent a key factor for a broader cluster of symptoms, including depression as well as pain, fatigue, and sleep disturbances [9,10]
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