RBTT-03. USE OF VIRTUAL REALITY ENVIRONMENTS TO IMPROVE SELF-REPORTED DISTRESS, MOOD DISTURBANCE AND OVERALL SYMPTOM BURDEN USING CORRELATIVE STRESS BIOMARKERS IN PRIMARY BRAIN TUMOR (PBT) PATIENTS

Abstract

Abstract Approximately 20% of PBT patients experience moderate-severe distress at the time of neuroimaging & diagnostic evaluation, which can adversely impact their psychological health and ability to tolerate oncologic therapies. Virtual reality (VR) technology is increasingly being utilized in clinical populations with demonstrated improvement in self-reported pain, anxiety, and distress, though little is known about the biological pathways involved. We hypothesize that VR can improve distress through a combination of distraction and promotion of the relaxation response, both of which could blunt activity of physiological stress pathways. The purpose of this study is to assess the effect of VR breathing and relaxation scenarios on self-reported acute and long-term distress incorporating correlative stress biomarkers, as well as assessing long-term effects on mood disturbance and overall symptom burden. This is a phase 2 experimental pre-post design with a sample size of 100 PBT patients, stratified into low and high distress groups. Self-reported measures include the Distress Thermometer, PROMIS Anxiety and Depression Short Forms, and the MD Anderson Symptom Inventory Brain Tumor instrument. Correlative stress biomarkers include salivary cortisol and dehydroepiandrosterone-sulfate (DHEA-S), representing hypothalamic-pituitary-adrenal (HPA) axis activity, and salivary alpha amylase (sAA) and heart rate, representing activity of the sympathetic-adrenal-medullary (SAM) system. Baseline and post-intervention assessments will be taken surrounding a 5 to 10 minute VR experience in clinic, with repeat assessments 1 week later and at the next clinic appointment. Anticipated outcomes include a decrease in self-reported acute and remote distress with correlative decrease in stress biomarkers, as well as improvement of mood disturbance and overall symptom burden. VR has the potential to help PBT patients improve self-management of their psychological symptoms, potentially enhancing their tolerance of oncologic therapies and overall quality of life. Additionally, the benefits of this intervention may have broad applicability to other cancer patient populations.