Abstract
Background: Music intervention (MI) is a promising complementary therapy for alleviating psychological distress in patients with cancer undergoing radiotherapy. This systematic review and meta-analysis assessed the efficacy of MI in reducing anxiety, depression, and fatigue in these patients. Methods: A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and the International Clinical Trials Registry Platform from inception to 9 January 2025. We included randomized controlled trials (RCTs) and cohort studies investigating MI's impact on psychological outcomes in patients with cancer receiving radiotherapy in this review. The study quality was appraised using the Cochrane Risk of Bias 2.0 for RCTs and the ROBINS-I tool for cohort studies. A meta-analysis was performed using a random-effects model in Review Manager 5.4. Results: A total of 13 studies (11 RCTs and 2 cohort studies) with 1073 participants were included. The pooled analysis revealed a significant reduction in anxiety (mean difference [MD]: -3.53, 95% confidence interval [CI]: -5.98 to -1.07, p = 0.003), a non-significant effect on depression (MD: -1.12, 95% CI: -3.25 to 1.01, p = 0.29), and a significant improvement in fatigue (MD: -15.88, 95% CI: -28.19 to -3.57, p = 0.01). A subgroup analysis based on intervention type indicated that music medicine (MM) was more effective in reducing anxiety compared to music therapy (MT). Conclusions: The findings of this study suggest that MI, particularly MM, may be beneficial in alleviating anxiety and fatigue in patients with cancer undergoing radiotherapy, but its impact on depression remains inconclusive. Future studies should employ standardized methodologies and rigorous RCT designs to validate these findings.