Randomized Trial Assessing Fatigue in Women with Breast ́s or Gynecology ́s Cancer During Radiation Therapy

Abstract

BACKGROUND: Fatigue is a frequent side effect of radiotherapy, and may interfere with self-esteem, social activities, and quality of life. The authors investigated the influence of music therapy (MT) on the reduction of fatigue in women with breast or gynecological malignant neoplasia during radiotherapy. OBJETIVE: To study the influence of music therapy in reduction of Fatigue related to cancer in patients with breast’s or gynecology’s cancer, during the radiotherapy treatment. METHODS: This is a randomized controled study (Control Group - CG e Musictherapy Group - MTG) to assess fatigue, quality of life using the Functional Assessment of Cancer Therapy (FACT-F and FACT – G) version 4 and symptoms of depression using Beck Depression Inventory (BDI) in women undergoing radiotherapy in three distinct moments (during the first and the last week of radiotherapy, and on the week of the intermediary phase). Women allocated in MTG, in addition to the scales described above, answered the Music therapy Questionary (MQ), and the Subjective Impression of the Subject’s Questionary in last meeting. Music Therapy sessions were individual and lasted an average of 40 minutes. Music therapeutic techniques used were Musical Audition (MA) and Therapeutic Musical Audition (TMA). RESULTS: In the analysis between groups, Functional Assesment of Cancer Therapy: Fatigue (FACIT-F) demonstrated significance related to Trial Outcome Index (TOI) (p=0,011), Functional Assesment of Cancer Therapy – Geral (FACT-G) (p=0,001) FACIT-F (p=0,005) areas to the MGT compared to CG. In comparisson made inside the same group results pointed a significant worsening for women. FACT-F results were significant regarding Trial Outcome Index (TOI), synthesis of the Physical and functional well-being areas of FACT-F (p = 0.011), FACT-G (p = 0.005), FACT-F (p = 0.001) for MTG compared with CG. The depressive symptoms were reduced to the minimum levels in the MTG (p = 0,005) with risk reduction of 74% (RR = 0,26 e CI 95% 0,10 - 0,70). Music Therapy Questionnaire showed that 59,3% of the patients didn’t know what music therapy was, and 53,7% thought that Music Therapy was a relaxing activity. In the end of the process, based on Subjective Impression of the Subject’s Questionnaire 98,1% of the women afirmated that Music Therapy made difference in their lives, 96,2% reported a positive perception of music therapy, 75,5% noticed less fatigue and 84,9% reported less stress. CONCLUSIONS: Individual MT sessions are effective to reduce fatigue related to cancer and symptoms of depression, as well as to improve quality of life for women with breast or gynecological cancer undergoing radiotherapy. KEY-WORD: Fatigue, Quality of Life, Breast Cancer, Gynecological Cancer, Radiotherapy, Music therapy