Music Therapy For The Treatment Of Cisplatin Induced Tinnitus In Patients With rGCC: A Pilot Study
Primary Purpose
Relapsed Germ Cell Cancer, Cisplatin Induced Tinnitus
Status
Withdrawn
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Modified Heidelberg Model of Neuro-Music Therapy
Sponsored by
About this trial
This is an interventional supportive care trial for Relapsed Germ Cell Cancer focused on measuring relapsed germ cell cancer, cisplatin induced tinnitus, music therapy, germ cell cancer
Eligibility Criteria
Inclusion Criteria:
- ≥ 18 years old at the time of informed consent.
- English speaking.
- Ability to provide written informed consent and HIPAA authorization
- Confirmed diagnosis of CIT via a score on the TFI of 26 or greater.
- Personal history of rGCC.
- Previous exposure to cisplatin.
- Admitted to BMT service to undergo HDC-tBMR for the first time. (Because this is a feasibility study, a minimum number of MT sessions will not be required).
- Agrees not to receive music therapy outside of study.
Exclusion Criteria:
- Severe hearing impairment greater than 60 dB HL in the region of the center tinnitus frequency
- Patient's tinnitus can not be pitch matched.
- Clinical diagnosis of severe mental disorder or psychiatric or neurological disease such as psychosis, epilepsy, Parkinson's disease, dementia, alcohol or drug abuse.
Sites / Locations
- Indiana University Melvin & Bren Simon Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Modified Heidelberg Model of Neuro-Music Therapy (mHNMT)
Arm Description
The mHNMT for Tinnitus program was modified based on participant feedback of the original HNMT. This study will include 6 sessions, 2 sessions a week including the following interventions: resonance training, music relaxation, Intonation Training and session review/homework.
Outcomes
Primary Outcome Measures
Recruitment feasibility
The ability to enroll at least 50% of approached subjects.
Retention feasibility
The ability to successfully retain 60% of enrolled subjects.
Compliance and fidelity feasibility
The ability to deliver over 90% of planned intervention.
Secondary Outcome Measures
Effects of intervention on severity of Cisplatin Induced Tinnitus determined by scores on the Tinnitus Functional Index
The Tinnitus Functional Index (TFI) has eight subscales that address the intrusiveness of tinnitus, the sense of control the patient has, cognitive interference, sleep disturbance, auditory issues, relaxation issues, quality of life, and emotional distress. Minimum value is 1 and maximum value is 10. A higher score indicates worse tinnitus.
A mean score of 25 or less than 25 indicates relatively mild tinnitus and little or need for intervention. A mean score ranging from 25-50 indicates significant problems with tinnitus and a possible need for intervention. A mean score of 50 or greater indicates tinnitus severe enough to qualify for more aggressive intervention.
Effects of intervention on associated distress determined by scores on the Tinnitus Questionnaire
For each item, individuals indicate the level of agreement by answering; not true (score 0), partly true (score 1), or true (score 2). A three point scale limits its utility as an outcome measure. Total scores range from 0-82, with higher scores indicating more distressing tinnitus.
Effects of intervention on anxiety determined by scores on the Impact of Events Scale
A 22-item self-report measure that assesses subjective distress caused by traumatic events on a scale from 0-4, where 0 is not at all, and 4 is extremely. A higher score indicates increased anxiety.
Effects of intervention on depression determined by scores on Hospital Anxiety and Depression Scale
Each item on the questionnaire is scored from 0-3 and this means that a person can score between 0 and 21 for either anxiety or depression. The HADS uses a scale and therefore the data returned from the HADS is ordinal.
Effects of intervention on benefit findings determined by scores on The Benefit Finding Scale
Uses a 5-point Likert scoring method from 1 = Not at all to 5 = Extremely.
Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Adult Short Form
Use a 5-point Likert scale and employ 7-day recall. Higher scores indicate higher levels of fatigue. Scores are standardized (M = 50, SD = 10)
Number of hours asleep
Actiwatch Spectrum Pro watch. Sleep parameters will be computed using Actiware® software. The sleep parameters produced include total sleep time, sleep latency (minutes until sleep onset), sleep efficiency, frequency and duration of awakenings after sleep onset (WASO), and number of awakenings. These Sleep variables will be scored for each 24-hour period, and averages over the course of use will be computed for nighttime sleep alone and nighttime sleep plus daytime naps to be combined into epochs for assessment.
Number of times homework completed
This will be assessed each day of the intervention and captured using the Actiwatch Spectrum Pro and summed over the entire intervention period.
Audiometric evaluation
The Pure-tone hearing threshold audiometry (PTA) measures and classifies hearing loss into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). PTA will be measured in a soundproofing booth using an audiometer (SA 203, Entomed, Sweden), and include frequencies of 500, 1000, 2000, 3000, 4000, and 6000 Hz in both ears in accordance with the American National Standards Institute (ANSI) standard. The hearing threshold will be defined as the mean hearing threshold of the better ear on PTA tests at 500, 1000, 2000, and 4000 Hz. Hearing loss in this study will be defined as follows: <25 dB (normal hearing), ≥25 dB and <40 dB (mild hearing loss), and ≥40 dB (moderate-to-severe hearing loss).
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04402593
Brief Title
Music Therapy For The Treatment Of Cisplatin Induced Tinnitus In Patients With rGCC: A Pilot Study
Official Title
Music Therapy For The Treatment Of Cisplatin Induced Tinnitus In Patients With Relapsed Germ Cell Cancer (rGCC): A Pilot Study
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Due to staffing changes and no potential subjects at this time.
Study Start Date
September 2023 (Anticipated)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Indiana University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Pilot study evaluating the feasibility of recruitment, retention, and compliance to a modified Heidelberg Model of Neuro-Music Therapy (mHNMT) in patients with Cisplatin-induced Tinnitus and relapsed Germ Cell Cancer (rGCC).
Detailed Description
This is a prospective, interventional pilot study that plans to enroll 15 patients who are receiving salvage high dose chemo and bone marrow transplant for relapsed Germ cell Cancer (rGCC). Patients will be asked to go through a series of surveys and screening procedures to determine eligibility. Once enrolled, patients will receive music therapy while they are being treated either inpatient or outpatient for their standard of care treatments.
Primary Objective To evaluate the feasibility of recruitment, retention, and compliance to a mHNMT in patients with CIT and rGCC admitted to BMT service to undergo salvage high-dose chemotherapy with tandem bone marrow rescue.
Secondary Objectives To estimate the effects of mHNMT on severity of CIT, associated distress, anxiety, depression, fatigue, benefit findings, sleep, and audiometry measures and assess number of times homework completed.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsed Germ Cell Cancer, Cisplatin Induced Tinnitus
Keywords
relapsed germ cell cancer, cisplatin induced tinnitus, music therapy, germ cell cancer
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Study will enroll 15 subjects to a twice a week Music Therapy intervention (modified Heidelberg Model of Neuro-Music Therapy) for 3 weeks (6 sessions total).
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Modified Heidelberg Model of Neuro-Music Therapy (mHNMT)
Arm Type
Experimental
Arm Description
The mHNMT for Tinnitus program was modified based on participant feedback of the original HNMT. This study will include 6 sessions, 2 sessions a week including the following interventions: resonance training, music relaxation, Intonation Training and session review/homework.
Intervention Type
Behavioral
Intervention Name(s)
Modified Heidelberg Model of Neuro-Music Therapy
Intervention Description
6 sessions, 2 sessions a week including the following interventions: resonance training, music relaxation, Intonation Training and session review/homework.
Primary Outcome Measure Information:
Title
Recruitment feasibility
Description
The ability to enroll at least 50% of approached subjects.
Time Frame
30 days
Title
Retention feasibility
Description
The ability to successfully retain 60% of enrolled subjects.
Time Frame
from the start of intervention until last subject completes intervention (i.e. up to 2 years)
Title
Compliance and fidelity feasibility
Description
The ability to deliver over 90% of planned intervention.
Time Frame
from the start of intervention until last subject completes intervention (i.e. up to 2 years)
Secondary Outcome Measure Information:
Title
Effects of intervention on severity of Cisplatin Induced Tinnitus determined by scores on the Tinnitus Functional Index
Description
The Tinnitus Functional Index (TFI) has eight subscales that address the intrusiveness of tinnitus, the sense of control the patient has, cognitive interference, sleep disturbance, auditory issues, relaxation issues, quality of life, and emotional distress. Minimum value is 1 and maximum value is 10. A higher score indicates worse tinnitus.
A mean score of 25 or less than 25 indicates relatively mild tinnitus and little or need for intervention. A mean score ranging from 25-50 indicates significant problems with tinnitus and a possible need for intervention. A mean score of 50 or greater indicates tinnitus severe enough to qualify for more aggressive intervention.
Time Frame
Baseline, day +50, day +100, and day +270
Title
Effects of intervention on associated distress determined by scores on the Tinnitus Questionnaire
Description
For each item, individuals indicate the level of agreement by answering; not true (score 0), partly true (score 1), or true (score 2). A three point scale limits its utility as an outcome measure. Total scores range from 0-82, with higher scores indicating more distressing tinnitus.
Time Frame
Baseline, day +50, day +100, and day +270
Title
Effects of intervention on anxiety determined by scores on the Impact of Events Scale
Description
A 22-item self-report measure that assesses subjective distress caused by traumatic events on a scale from 0-4, where 0 is not at all, and 4 is extremely. A higher score indicates increased anxiety.
Time Frame
Baseline, day +50, day +100, and day +270
Title
Effects of intervention on depression determined by scores on Hospital Anxiety and Depression Scale
Description
Each item on the questionnaire is scored from 0-3 and this means that a person can score between 0 and 21 for either anxiety or depression. The HADS uses a scale and therefore the data returned from the HADS is ordinal.
Time Frame
Baseline, day +50, day +100, and day +270
Title
Effects of intervention on benefit findings determined by scores on The Benefit Finding Scale
Description
Uses a 5-point Likert scoring method from 1 = Not at all to 5 = Extremely.
Time Frame
Baseline, day +50, day +100, and day +270
Title
Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Adult Short Form
Description
Use a 5-point Likert scale and employ 7-day recall. Higher scores indicate higher levels of fatigue. Scores are standardized (M = 50, SD = 10)
Time Frame
Baseline, day +50, day +100, and day +270
Title
Number of hours asleep
Description
Actiwatch Spectrum Pro watch. Sleep parameters will be computed using Actiware® software. The sleep parameters produced include total sleep time, sleep latency (minutes until sleep onset), sleep efficiency, frequency and duration of awakenings after sleep onset (WASO), and number of awakenings. These Sleep variables will be scored for each 24-hour period, and averages over the course of use will be computed for nighttime sleep alone and nighttime sleep plus daytime naps to be combined into epochs for assessment.
Time Frame
Up to 3 weeks
Title
Number of times homework completed
Description
This will be assessed each day of the intervention and captured using the Actiwatch Spectrum Pro and summed over the entire intervention period.
Time Frame
Each day of intervention until study completion, about 3 weeks
Title
Audiometric evaluation
Description
The Pure-tone hearing threshold audiometry (PTA) measures and classifies hearing loss into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). PTA will be measured in a soundproofing booth using an audiometer (SA 203, Entomed, Sweden), and include frequencies of 500, 1000, 2000, 3000, 4000, and 6000 Hz in both ears in accordance with the American National Standards Institute (ANSI) standard. The hearing threshold will be defined as the mean hearing threshold of the better ear on PTA tests at 500, 1000, 2000, and 4000 Hz. Hearing loss in this study will be defined as follows: <25 dB (normal hearing), ≥25 dB and <40 dB (mild hearing loss), and ≥40 dB (moderate-to-severe hearing loss).
Time Frame
Baseline and day +270 (+/- 90 days)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
≥ 18 years old at the time of informed consent.
English speaking.
Ability to provide written informed consent and HIPAA authorization
Confirmed diagnosis of CIT via a score on the TFI of 26 or greater.
Personal history of rGCC.
Previous exposure to cisplatin.
Admitted to BMT service to undergo HDC-tBMR for the first time. (Because this is a feasibility study, a minimum number of MT sessions will not be required).
Agrees not to receive music therapy outside of study.
Exclusion Criteria:
Severe hearing impairment greater than 60 dB HL in the region of the center tinnitus frequency
Patient's tinnitus can not be pitch matched.
Clinical diagnosis of severe mental disorder or psychiatric or neurological disease such as psychosis, epilepsy, Parkinson's disease, dementia, alcohol or drug abuse.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Debra Burns, PhD
Organizational Affiliation
Indiana University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Indiana University Melvin & Bren Simon Cancer Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Music Therapy For The Treatment Of Cisplatin Induced Tinnitus In Patients With rGCC: A Pilot Study
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