Improvement of anxiety in adolescent cancer patients with music therapy treatment

Objective: This randomized controlled trial aimed to evaluate the efficacy of structured music therapy interventions in alleviating anxiety symptoms among adolescent cancer patients through dual neuroendocrine and psychological mechanisms, specifically by modulating serotonin metabolism and enhancing stress adaptation capacities. Methods: Thirty-eight adolescents (aged 12–19 years) diagnosed with cancer-related anxiety disorders were randomly assigned to either a music therapy group (n = 19) receiving biweekly 50-min sessions (24 sessions over 12 weeks) combined with standard care or a control group (n = 19) receiving standard care alone. The multimodal assessment protocol included 1) biochemical markers (serum 5-HT and salivary cortisol levels), 2) standardized psychological instruments (Beck Anxiety Inventory [BAI] and Daily Hassles Questionnaire [DHQ]), and 3) semi-structured clinical interviews. Outcome measures were collected at baseline, post-intervention, and 4-week follow-up. Results: The music therapy group demonstrated significant neuroendocrine improvements compared to controls, with a 28.6% mean increase in 5-HT levels (95% CI 18.4–38.8%, p = 0.007) and a 34.1% reduction in cortisol concentrations (95% CI 25.3–42.9%, p = 0.003) post-intervention. Psychological assessments revealed clinically meaningful reductions in BAI scores and DHQ stress frequency scores. Treatment effects remained stable at follow-up (p > 0.05 for time interaction). No significant changes were observed in control group parameters across measurement periods. Conclusion: Systematic music therapy induces durable anxiolytic effects in adolescent oncology patients through coordinated neurobiological and psychological pathways, suggesting its potential as an adjuvant therapy in pediatric psycho-oncology. The dual modulation of serotoninergic activity and hypothalamic-pituitary-adrenal axis regulation provides mechanistic insights for non-pharmacological anxiety management.