2738 - Applying Virtual Reality in Patient Education at a Proton Center to Improve Treatment Precision and Patient Experience: A Randomized Controlled Trial Protocol

Purpose/Objective(s): Radiotherapy-related anxiety often reduces compliance and increases setup uncertainty, which is critical in proton therapy due to sharp dose gradients. Educational interventions using visual aids improve positioning reproducibility. Virtual reality (VR) provides immersive visualization of workflows; randomized trials have demonstrated that VR-based education reduces anxiety [1]. Furthermore, VR tools have shown potential to improve objective setup accuracy in general radiotherapy settings [2]. However, the effectiveness of VR-assisted education in proton therapy remains unclear. This trial evaluates whether VR-assisted education improves psychological readiness and objective setup precision. Correlation between patient-reported anxiety scores and daily 3D translational/rotational setup errors will be analyzed.

Materials/Methods: Trial design: This is a prospective, randomized (1:1), non-blinded, two-arm clinical trial (N=100) at a medical center. Planned intervention: The intervention group receives standard education plus a 10-minute interactive VR-based simulation. This novel module allows patients to virtually experience the proton gantry's rotational movement, the auditory environment of the treatment room, and the immobilization process (e.g., mask fitting). For pediatric patients (ages 12-17), legal guardians participate in the VR session to enhance emotional support. Major eligibility: Patients =12 years receiving first-course proton therapy; excluded if requiring sedation or having severe motion sickness. Randomization and Blinding: Stratified randomization (age, education, site) is used. A single-blind design ensures radiation oncologists and technologists remain unaware of assignments during CBCT review and error recording. Statistical methods: Based on an effect size of 0.41 from prior data [1], a sample of 100 provides >90% power (a=0.05) considering a 20% dropout rate. The primary endpoint is the change in patient-reported anxiety (HADS and SAS scales) pre- and post-education. The secondary endpoint is setup precision, quantified by 3D translational and rotational vectors derived from daily CBCT. Current status: The trial is active and recruiting; 11 patients have been enrolled to date. Trial registration: CMUH113-REC3-178.

Results: TBD

Conclusion: TBD