Abstract
BACKGROUND: Primary central nervous system (CNS) tumors affect patients' psychological well-being and quality of life. Individualized approaches, such as Managing Cancer and Living Meaningfully (CALM), have shown potential in advanced cancers for improving these outcomes. AIMS: This study assessed the effects and feasibility of CALM delivered remotely to a diverse cohort of patients with a primary CNS tumor. METHODS: Patients completed 3-6 remote CALM sessions focusing on 4 interrelated domains. Depression, death anxiety, attachment style, and quality of life were assessed at study enrollment, 3-months, and 6-months into the intervention. RESULTS: Of the 19 patients enrolled, 15 (79% retention rate) completed the study. Most patients had a high-grade (47%) tumor, mainly diagnosed in the brain (60%). The median age was 44 years (range, 24-70). Feasibility was demonstrated through adherence to completing outcome questionnaires and a high level of patient satisfaction (100% found it worthwhile). Although no statistically significant changes were seen in depression, death anxiety, attachment anxiety, or quality of life (p > 0.05; g = -0.09 to 0.78) at any measured time, a clinically meaningful decrease in depression was observed at the 6-month point (mean difference = -3.36, p = 0.13) among spine tumor patients. CONCLUSIONS: This study demonstrated that delivering CALM via telehealth is feasible, as evidenced by high compliance, low attrition, and acceptability among patients diagnosed with CNS tumors. The findings indicated meaningful reductions in depressive symptoms among patients with spinal cord tumors. These preliminary positive findings justify further evaluation of the feasibility and effectiveness of CALM in a larger sample. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT04852302.