Efficacy and safety of superficial radiotherapy in the treatment of cutaneous warts: A meta-analysis.

ObjectiveTo systematically evaluate clinical evidence concerning the efficacy and safety of superficial radiotherapy in the treatment of cutaneous warts.MethodsEight major international clinical literature databases were queried according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for superficial radiotherapy studies published prior to 9 August 2025. Randomized controlled trials, prospective/retrospective controlled studies, and case series with sample sizes ≥10 were included. The primary outcome was the cure rate, whereas secondary outcomes included recurrence rate and adverse reactions. Risk or odds ratio with 95% confidence interval were pooled using random-effects or fixed-effects models as appropriate. Heterogeneity was assessed using the I2 statistic. Subgroup analysis was performed based on monotherapy versus combination therapy. Publication bias was evaluated using funnel plots and Egger's test, and the Grading of Recommendations Assessment, Development and Evaluation system was applied to assess the quality of evidence.ResultsThe overall cure rate for cutaneous warts using superficial radiotherapy was 81% (95% confidence interval: 0.76-0.85, p < 0.05), whereas the recurrence rate was 14% (95% confidence interval: 0.10-0.18, p < 0.05). For superficial radiotherapy monotherapy, the cure rate was 76% (95% confidence interval: 0.69-0.83, p < 0.05), and recurrence rate was 21% (95% confidence interval: 0.04-0.38, p < 0.05). Compared with superficial radiotherapy monotherapy, combination therapy was associated with a higher cure rate (odds ratio = 4.08, 95% C confidence interval: 2.43-6.83, p < 0.05) and lower recurrence rate (odds ratio = 0.23, 95% confidence interval: 0.08-0.65, p < 0.05).ConclusionsSuperficial radiotherapy monotherapy is an effective treatment for cutaneous warts, associated with low recurrence rates and infrequent adverse reactions. Combination therapy is associated with a higher cure rate and a lower recurrence rate than superficial radiotherapy monotherapy. Further studies comparing combination and superficial radiotherapy monotherapy are necessary for a more rigorous evaluation of the long-term recurrence rates associated with these therapies. The study was retrospectively registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (Registration Number: INPLASY202650102).