# Effects of Ozone Therapy on Adverse Events and Inflammatory Markers in Patients With Hepatocellular Carcinoma Undergoing Interventional Therapy

## TL;DR

This study investigated whether ozone therapy could reduce adverse events and inflammation in patients with liver cancer undergoing treatment, but found no significant benefits.

## Contribution

The study is one of the first to evaluate ozone therapy as an adjunct in hepatocellular carcinoma interventional therapy.

## Key findings

- Ozone therapy did not significantly reduce treatment-related adverse events compared to the control group.
- No significant differences were observed in inflammatory biomarker levels between the ozone and control cohorts post-treatment.
- Higher AFP and ALT/AST ratio were independently associated with increased risk of adverse events.

## Abstract

There has been very limited investigation regarding reduced interventional therapy–related adverse events in patients with hepatocellular carcinoma (HCC). This study was aimed at evaluating the effect of ozone therapy as an adjunctive treatment on inflammation markers and adverse events in patients with HCC receiving interventional therapy.

Three hundred and forty-two patients with HCC undergoing interventional therapy were enrolled from December 2020 to June 2023, of which 221 patients received rectal ozone insufflation therapy (ozone cohort), and the other 121 patients did not receive ozone therapy (control cohort). The information on treatment-related adverse events (TRAEs) was retrieved and analyzed.

In the study, most clinical characteristics between the ozone and control cohorts showed no significant differences. In the ozone cohort, 122 patients (55.2%) reported TRAEs of any grade, compared with 67 (55.4%) patients in the control cohort (p > 0.05). In terms of specific TRAE incidence, no distinctiveness was found in incidence of other TRAEs. Furthermore, multivariate logistic regression revealed that higher levels of AFP (OR, 1.82; 95% CI, 1.13–2.94; p = 0.014) and ALT/AST ratio (OR, 2.02; 95% CI, 1.04–3.91; p = 0.037) were independently correlated with increased risk of total TRAEs. Based on similar levels of laboratory parameters with patients with HCC before treatment, there were no significant differences in these biomarker levels posttreatment between the ozone and control cohorts.

Ozone therapy did not significantly decrease the incidence of adverse events or mitigate the increase in inflammatory markers. Further research with a larger sample size is warranted.