UICC World Cancer Congress 2006

Objective: Discomfort and anxiety during radiotherapy can increase patient motion leading to decreased treatment accuracy. This systematic review was undertaken to evaluate the effectiveness of interventions for pain/anxiety during radiotherapy and interventional radiology procedures.

Methods: A systematic search was conducted using MEDLINE (1966- 2005) with MeSH headings/keywords for anxiety, pain, radiotherapy, and interventional radiology. (Last search: October, 2005). Included articles were randomized controlled trials of any intervention (i.e. pharmaceutical, complementary-alternative medicine (CAM)) for pain/anxiety in patients during radiotherapy/interventional radiology compared with no intervention, placebo, or active control. Changes in symptom scores in pain/anxiety was our primary outcome of interest.

Results: Twenty-six studies (8 no-intervention, 12 placebo, 6 active control) with 2051 total subjects were identified. Study size ranged from 16 – 313 (median: 54). Of the 4 radiotherapy studies included, all involved CAMs (1 hypnotherapy, 1 aromatherapy, 1 music therapy, 1 guided-imagery/relaxation). One of these studies (guided imagery) showed benefits in terms of pain. There were 22 radiology studies of which 13 tested pharmaceuticals and 9 CAMs. Radiological procedures included MRI (5), angiography (3), TRUS (2) and other (12), including 16 invasive procedures. Nine pharmacological and 6 CAM interventions showed benefits in decreasing pain/anxiety.

Conclusion: Literature on pain/anxiety interventions during radiotherapy is limited. Relaxation-therapies may decrease anxiety during radiology/radiotherapy. Evidence supports the benefit of pharmaceutical interventions for pain/anxiety for specific radiological procedures. Selection of common criteria for reporting pain/anxiety is valuable for future studies. Trials evaluating the use of pharmaceuticals and relaxation-therapies during radiotherapy, especially in the palliative setting are needed.