Virtual Reality for Symptom Management During Outpatient Chemotherapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Patients receiving outpatient chemotherapy frequently experience anxiety, pain, and reduced quality of life (QOL). Virtual reality (VR) has been proposed as a supportive nonpharmacological intervention; however, its effectiveness in this setting remains uncertain. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the effectiveness of VR interventions among patients undergoing outpatient chemotherapy. Eligible studies compared VR with standard care or non-VR control conditions and reported outcomes related to anxiety, pain, psychological distress, or QOL. Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated for continuous outcomes. Results: Ten RCTs involving 937 patients were included in the study. It was found that VR significantly reduced anxiety compared with control conditions (MD = 8.66, 95% CI [4.87, 12.45], I² = 84.2%). Sensitivity analysis demonstrated a smaller but still significant effect (MD = 6.06, 95% CI [3.81, 8.32], I² = 24.8%). Conversely, VR was not associated with a significant reduction in pain (MD = 1.55, 95% CI [-4.05, 7.16], I² = 96.9%) or a significant improvement in QOL (MD = 0.15, 95% CI [-0.47, 0.77], I² = 0%). The certainty of evidence was low for QOL and very low for anxiety and pain. Conclusions: VR appears beneficial for reducing anxiety during outpatient chemotherapy, but evidence for improvements in pain and QOL remains insufficient. Therefore, further high-quality trials are warranted.