JMIR Publications

ABSTRACT

Background:

Immersive virtual reality represents a novel technology recently employed to address anxiety, depression, pain, cognitive function, and self-efficacy in patients with gastrointestinal cancers. However, the efficacy of immersive virtual reality interventions in adult patients remains contentious and has yet to be evaluated within systematic reviews.

Objective:

This systematic review and meta-analysis aimed to evaluate the effects of immersive virtual reality as an intervention for gastrointestinal cancer patients and identifying factors influencing its therapeutic outcomes.

Methods:

We conducted a comprehensive search of 12 electronic databases, 2 trial registries and citation searches from inception to 15 August 2025. Randomized controlled trials comparing immersive virtual reality with routine care in adult gastrointestinal cancer patients were included. Data were extracted independently by two reviewers. Meta-analyses were performed using RevMan 5.4.1. The Cochrane risk-of-bias tool version 2 were used to examine the certainty of evidence.

Results:

14 randomised controlled trials involving 1,014 participants from 7 different countries were included. Immersive Virtual Reality interventions significantly reduced anxiety (SMD: –0.54; 95% CI: –0.90 to –0.19; P = 0.001), depression (MD: –2.49; 95% CI: –4.20 to –0.78), pain (SMD: –0.93; 95% CI: –1.39 to –0.48; P = 0.001), and improved knowledge (MD: 1.21; 95% CI: 0.77–1.64; P < 0.001), cognitive function (MD: 3.19; 95% CI: 1.96–4.41; P < 0.001), self-efficacy (MD: 18.24; 95% CI: 14.57–21.92; P < 0.001), systolic blood pressure (MD: –2.44; 95% CI: –4.73 to –0.15; P = 0.004), diastolic blood pressure (MD: –3.78; 95% CI: –6.83 to –0.72; P = 0.02), and length of hospital stay (MD: –4.11; 95% CI: –7.93 to –0.29; P = 0.04). Immersive virtual reality also showed a non-significant trend in reducing complications (RR: 0.60; 95% CI: 0.34–1.06; P = 0.08). Subgroup analyses revealed that interventions lasting ≥20 minutes administered during treatment were most effective for anxiety reduction. No significant publication bias was detected.

Conclusions:

Immersive virtual reality is an effective non-pharmacological intervention for improving psychological distress, pain, knowledge, cognitive function, self-efficacy, hemodynamic stability, and length of stay in gastrointestinal cancer patients. Future trials on a large scale with follow-up assessments are needed. Clinical Trial: The protocol was registered on PROSPERO (Registration number: CRD420251113000).