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Five-element music therapy reduces anxiety and depression and improves sleep quality in cancer patients undergoing chemotherapy

This meta-analysis of 20 RCTs (1588 patients) found that five-element music therapy (FEMT) significantly reduced anxiety (SAS MD=-7.16, 95% CI -9.56 to -4.67; HAMA MD=-5.19) and depression (SDS MD=-7.07; HAMD MD=-5.89) scores compared to control. FEMT also improved sleep quality as measured by PSQI (MD=-2.52, 95% CI -2.89 to -2.16). However, the certainty of evidence was low to very low due to methodological limitations.

Last updated: Aug 11, 2026•0 RCTs•1 Meta-analyses•📖 Read as article →

Evidence Score

Evidence Score63/100
Human RCT☆☆☆☆☆
Meta-analysis★★★☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Effects of five-element music therapy on chemotherapy patients with cancer: A systematic review and meta-analysis of randomized controlled trials.

observational

Sun T, Zhao R, Shan X, Zhu Y, Zhang Y, Zheng Y · Complementary therapies in medicine (2026)

Participants: N/A
Duration: N/A
Intervention: Five-element music therapy (FEMT) added to standard care or compared with control music interventions
Outcome: Anxiety (SAS, HAMA), depression (SDS, HAMD), sleep quality (PSQI), quality of life (QLQ-C30), immune function (CD3+, CD4+), inflammatory markers (SOD, NO)
Effect Size: SAS MD=-7.16; HAMA MD=-5.19; SDS MD=-7.07; HAMD MD=-5.89; PSQI MD=-2.52; QLQ-C30 overall health MD=9.27
Population: Cancer patients undergoing chemotherapy

Result:

PubMed: 42551573DOI: 10.1016/j.ctim.2026.103411

Mechanism Graph

FEMT may modulate emotional state through auditory stimulation and relaxation responses
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Reduction in anxiety and depression may lead to improved sleep quality
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Improved emotional state and sleep may enhance quality of life
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FEMT may also modulate immune function (increased CD3+, CD4+) and reduce oxidative stress (increased SOD, decreased NO)

Limitations

  • ⚠Methodological quality of included studies was generally low, with most outcomes graded as low or very low certainty evidence
  • ⚠Generalizability outside of China remains unclear due to limited number, characteristics, and methodological quality of studies

Frequently Asked Questions

What is five-element music therapy?▼

Five-element music therapy is a traditional Chinese medicine-based intervention that uses music corresponding to the five elements (wood, fire, earth, metal, water) to harmonize emotions and improve health.

How effective is five-element music therapy for sleep in chemotherapy patients?▼

The meta-analysis found a significant improvement in sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI), with a mean difference of -2.52 points (95% CI -2.89 to -2.16), indicating better sleep.

What are the limitations of this evidence?▼

The evidence is limited by low methodological quality of the included RCTs, potential risk of bias, and the fact that most studies were conducted in China, so generalizability to other populations is uncertain.

Should cancer patients undergoing chemotherapy use five-element music therapy?▼

While the therapy shows potential benefits for anxiety, depression, and sleep, patients should discuss with their healthcare providers, as the evidence quality is low and more high-quality international trials are needed.

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References

  1. 1.Sun T, Zhao R, Shan X, Zhu Y, Zhang Y, Zheng Y. "Effects of five-element music therapy on chemotherapy patients with cancer: A systematic review and meta-analysis of randomized controlled trials.." Complementary therapies in medicine, 2026. PMID: 42551573 DOI: 10.1016/j.ctim.2026.103411
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.