Between hope and uncertainty: the elusive evidence on hyperbaric oxygen therapy and radiotherapy

HBOT shows promising activity in mitigating late RT toxicities, particularly in pelvic toxicities, while evidence in other anatomical sites remains conflicting. Its hypothesized radiosensitizing role is largely speculative. Given the heterogeneity and low evidence level of existing studies, well-designed prospective trials are needed to clarify patient selection, optimal HBOT parameters, and its potential integration with RT.