Patients with advanced cancer in palliative or end-of-life care contexts experience multiple symptoms that impair quality of life. Music therapy is used as a complementary intervention; however, the effectiveness of multiple-session interventions remains insufficiently evaluated.
To assess the effect of multiple-session music therapy interventions on symptom management, quality of life and emotional well-being in adults with advanced cancer in palliative or end-of-life care contexts.
This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Literature searches were conducted in PubMed, EMBASE and the Cochrane Library for studies published between 2010 and 2024. Eligible studies included controlled trials involving adults with advanced cancer receiving music therapy interventions of at least two sessions. Primary outcomes included symptom management, quality of life and emotional well-being, assessed using validated instruments. Two independent reviewers conducted study selection and quality assessment. Owing to methodological heterogeneity, a narrative synthesis was performed.
Six controlled trials involving 438 participants across five countries were included. Sample sizes ranged from 31 to 104 participants, with mean ages between 53.8 and 66.9 years. All studies reported significant reductions in anxiety. Improvements in quality of life were observed in spiritual well-being (p=0.04) and ego-integrity (p<0.01) domains, whereas global quality of life showed no significant changes. Significant pain reduction was reported in patients undergoing chemotherapy at days 1 (p=0.005) and 5 (p=0.004) post-treatment. Sleep quality improved significantly (p=0.006 to p=0.012). Only half of the included studies demonstrated high methodological quality.
This systematic review suggests that music therapy shows promise as a complementary intervention for adults with advanced cancer in palliative or end-of-life care contexts, particularly for anxiety reduction and specific emotional well-being domains. Larger, methodologically rigorous randomised controlled trials using standardised protocols are needed to strengthen the evidence base.
Trial Registration
PROSPERO CRD42024613493