Survival benefit of concurrent beta-blocker use in cancer patients treated with radiotherapy: A systematic review and meta-analysis.

BACKGROUND

Both preclinical and retrospective studies have implicated β-adrenergic signaling in cancer progression, leading to interest in β-blockers (BBs) as adjunctive anticancer agents. There is evidence that they may enhance the sensitivity of cancer cells to radiotherapy and other conventional therapies. We conducted a systematic review and meta-analysis to explore the radiosensitizing effects of BBs.

METHODS

PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, the China biology medicine database, Wan fang Data, and the VIP database were searched for articles in both English and Chinese from the establishment of the databases to September 8, 2025, to identify studies comparing outcomes according to beta-blocker use (yes vs no) in patients with solid tumors treated with radiotherapy. The primary endpoint was overall Survival (OS), Secondary objectives included 1, 2, 5-Year Survival, disease-free survival, distant metastasis-free survival, locoregional progression-free survival and progression-free survival (PFS).

RESULTS

8 studies (3165 patients), including 7 retrospective cohort studies and 1 randomized controlled trial, were analyzed. The most common cancer was non-small cell lung cancer (n = 5). BB use was associated with significantly improved OS (hazard ratio [HR] 0.73, 95% confidence interval: 0.64-0.83). Benefits were also observed for disease-free survival (HR 0.69) and Distant Metastasis-Free Survival (HR 0.62), indicating reduced recurrence and metastasis.

CONCLUSION

In this meta-analysis, the use of BBs during or around radiotherapy may be associated with longer OS in cancer patients, suggesting that it may enhance the efficacy of radiotherapy and provide a survival benefit. Alternatively, the effect of β-blockers on survival may shift from a nonspecific effect to an intriguing cancer-specific effect over time. Beta-blockers are an intriguing option to explore in prospective studies of patients with solid tumors undergoing radiotherapy.