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针对原发性脑肿瘤患者的痛苦和焦虑症状的虚拟现实干预的可行性:2 期临床试验的中期分析。

Feasibility of a virtual reality intervention targeting distress and anxiety symptoms in patients with primary brain tumors: Interim analysis of a phase 2 clinical trial.

机构信息

Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA.

Office of Patient-Centered Outcomes Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Road, Bethesda, MD, 20892, USA.

出版信息

J Neurooncol. 2023 Mar;162(1):137-145. doi: 10.1007/s11060-023-04271-0. Epub 2023 Mar 8.

Abstract

PURPOSE

Cancer patients experience distress and anxiety when undergoing imaging studies to monitor disease status, yet these symptoms are not always appropriately identified or well-managed. This interim analysis of a phase 2 clinical trial explored feasibility and acceptability of a virtual reality relaxation (VR) intervention for primary brain tumor (PBT) patients at the time of clinical evaluation.

METHODS

English speaking, adult PBT patients with previous reports of distress and upcoming neuroimaging were recruited between March of 2021 and March 2022. A brief VR session was done within 2 weeks prior to neuroimaging with patient-reported outcomes (PROs) collected before and immediately post-intervention. Self-directed VR use over the next 1 month was encouraged with additional PROs assessments at 1 and 4 weeks. Feasibility metrics included enrollment, eligibility, attrition, and device-related adverse effects with satisfaction measured with qualitative phone interviews.

RESULTS

Fifty-five patients were approached via email, 40 (73%) responded and 20 (50%) enrolled (9 declines, 11 screen fails). 65% of participants were ≤ 50 years, 50% were male, 90% were White/non-Hispanic, 85% had good KPS (≥ 90), and most were on active treatment. All patients completed the VR intervention, PROs questionnaires, weekly check-ins, and qualitative interview. Most (90%) reported frequent VR use and high satisfaction and only 7 mild AEs were recorded (headache, dizziness, nausea, neck pain).

CONCLUSION

This interim analysis supports feasibility and acceptability of a novel VR intervention to target psychological symptoms for PBT patients. Trial enrollment will continue to assess for intervention efficacy.

TRIAL REGISTRATION

NCT04301089 registered on 3/9/2020.

摘要

目的

癌症患者在进行影像学检查以监测疾病状况时会感到痛苦和焦虑,但这些症状并不总是得到适当的识别或良好的管理。这项 2 期临床试验的中期分析探讨了虚拟现实放松(VR)干预在临床评估时对原发性脑肿瘤(PBT)患者的可行性和可接受性。

方法

招募了 2021 年 3 月至 2022 年 3 月期间有过痛苦报告和即将进行神经影像学检查的英语母语、成年 PBT 患者。在神经影像学检查前 2 周内进行简短的 VR 治疗,在干预前后收集患者报告的结果(PROs)。鼓励患者在接下来的 1 个月内自行使用 VR,并在第 1 和第 4 周进行额外的 PROs 评估。可行性指标包括入组、合格性、流失率和与设备相关的不良反应,满意度通过电话访谈进行定性评估。

结果

通过电子邮件联系了 55 名患者,40 名(73%)做出回应,20 名(50%)入组(9 人拒绝,11 人筛查不合格)。65%的参与者年龄≤50 岁,50%为男性,90%为白种人/非西班牙裔,85%的 KPS(≥90)良好,大多数正在接受积极治疗。所有患者都完成了 VR 干预、PROs 问卷、每周检查和定性访谈。大多数患者(90%)报告频繁使用 VR 且满意度高,仅记录到 7 例轻度不良反应(头痛、头晕、恶心、颈部疼痛)。

结论

这项中期分析支持针对 PBT 患者心理症状的新型 VR 干预措施的可行性和可接受性。试验入组将继续评估干预的效果。

试验注册

NCT04301089 于 2020 年 3 月 9 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/469b/10049941/5311ad433bd3/11060_2023_4271_Fig1_HTML.jpg

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