Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Study question
Can structured telehealth music therapy provide long-term anxiety relief for cancer survivors that is not worse than standard cognitive behavioral therapy (CBT)?
Design and methods
- Comparative effectiveness randomized trial in 300 cancer survivors with anxiety.
- Participants: English- or Spanish-speaking, majority female and White, with 19% Hispanic.
- Intervention: Seven weekly telehealth sessions of either:
- Music therapy
- CBT (first-line standard)
- Coprimary endpoints: Change in Hospital Anxiety and Depression Scale (HADS) anxiety scores at weeks 8 and 26.
- Noninferiority margin: 0.35 SD (corresponding to ~1.7 HADS points, the minimal clinically important difference).
- Secondary outcomes: Fatigue, depression, insomnia, pain, cognitive dysfunction, and health-related quality of life.
Key results
- Week 8 mean HADS anxiety change:
- Music therapy: −3.12 (95% CI −3.59 to −2.65)
- CBT: −2.97 (95% CI −3.45 to −2.50)
- Between-group difference: −0.15 (95% CI −0.78 to 0.49), meeting noninferiority criteria.
- Week 26 mean HADS anxiety change:
- Music therapy: −3.31 (95% CI −3.78 to −2.85)
- CBT: −3.00 (95% CI −3.47 to −2.53)
- Between-group difference: −0.31 (95% CI −0.95 to 0.32), also within noninferiority bounds.
- Both groups achieved anxiety reductions greater than the predefined minimal clinically important difference.
- Secondary outcomes improved similarly in both arms.
Clinical interpretation
Telehealth-delivered music therapy is not inferior to CBT for reducing anxiety in cancer survivors, with benefits sustained to at least 26 weeks and comparable improvement in related symptoms and quality of life domains. This supports music therapy as a viable, evidence-based alternative for patients who lack access to or prefer not to engage in CBT.