Leggiero Nicole M, Armstrong Terri S, Gilbert Mark R, King Amanda L
Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Neurooncol Pract. 2020 Mar 28;7(5):477-489. doi: 10.1093/nop/npaa012. eCollection 2020 Oct.
Primary brain tumors (PBTs) remain incurable, with a typically poor prognosis and significant symptom burden for patients. Virtual reality (VR) can potentially alleviate some of the negative aspects of illness by allowing individuals to escape to environments where they can experience more positive thoughts and emotions. Given promising findings for VR use in other clinical populations, there is increasing interest to use VR for symptomatic improvement in oncology patients. The purpose of this review was to analyze the literature of VR-related interventions for symptom management in adult PBT and other solid-tumor patients, which will guide development of future VR interventions in these populations.
A systematic search of EMBASE, PubMed, Scopus, and Web of Science was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with predefined eligibility criteria. Thirteen studies met the inclusion criteria and were selected for review.
Findings showed promising evidence that VR can improve anxiety for solid-tumor patients, with mixed results reported for pain, distress, depression, and mood. There was significant heterogeneity in methodological approaches across the literature and the majority of studies were underpowered and lacked rigorous study designs. Qualitative findings demonstrated a high degree of participant satisfaction with VR use, with very few adverse side effects reported.
Findings from this review suggest that VR can be used as an innovative delivery system for targeted interventions to improve symptoms in PBTs and other solid-tumor patient populations, though additional well-designed clinical trials are needed to better establish its efficacy.
原发性脑肿瘤(PBTs)仍然无法治愈,患者的预后通常很差,症状负担很重。虚拟现实(VR)可以让个体置身于能体验到更积极思想和情绪的环境中,从而有可能减轻疾病的一些负面影响。鉴于VR在其他临床人群中的应用取得了有前景的研究结果,人们越来越有兴趣将VR用于改善肿瘤患者的症状。本综述的目的是分析有关VR相关干预措施用于成年PBT患者和其他实体瘤患者症状管理的文献,这将为未来针对这些人群的VR干预措施的开发提供指导。
按照PRISMA(系统评价和Meta分析的首选报告项目)指南及预定义的纳入标准,对EMBASE、PubMed、Scopus和Web of Science进行了系统检索。13项研究符合纳入标准并被选入综述。
研究结果显示有证据表明VR可以改善实体瘤患者的焦虑情绪,而关于疼痛、痛苦、抑郁和情绪的结果则喜忧参半。整个文献中的方法学方法存在显著异质性,大多数研究的样本量不足且缺乏严谨的研究设计。定性研究结果表明,参与者对VR的使用满意度很高,报告的不良副作用很少。
本综述的研究结果表明,VR可以作为一种创新的干预措施实施系统,用于改善PBT患者和其他实体瘤患者群体的症状,不过还需要更多设计良好的临床试验来更好地确定其疗效。