Lifestyle interventions delivered during radiotherapy may improve selected patient-centered and treatment-related toxicity outcomes, with exercise comprising the largest body of evidence, but heterogeneity across studies limits conclusions regarding optimal approaches.
Key Findings
Results
Exercise interventions were most consistently associated with improvements in fatigue and functional capacity during radiotherapy, whereas effects on quality of life were less consistent.
Exercise interventions were evaluated in 12 of the 23 included RCTs, making them the most studied lifestyle intervention type during RT.
Breast, head and neck, and prostate cancers were the most frequently represented cancer types across exercise studies.
QoL, fatigue, and functional capacity were the most commonly assessed outcomes across all included studies.
Effects on QoL from exercise interventions were described as 'less consistent' compared to fatigue and functional capacity outcomes.
Results
Nutritional interventions showed favorable findings for nutritional status and treatment-related toxicity during radiotherapy.
Nutritional interventions were evaluated in five of the 23 included RCTs.
Two additional studies evaluated combined exercise-and-nutrition interventions.
Two studies evaluated combined nutrition-and-psychological interventions.
Favorable findings were reported specifically for nutritional status and treatment-related toxicity outcomes.
Results
Psychological, combined, and multimodal interventions showed favorable findings for selected quality of life, fatigue, nutritional, and psychological outcomes.
Only one RCT evaluated a purely psychological intervention during RT.
One study evaluated a multimodal intervention comprising all three components (exercise, nutrition, and psychological).
Two studies evaluated combined nutrition-and-psychological interventions.
Favorable findings were identified across selected outcomes but the limited number of studies restricts generalizability.
Methods
Twenty-three randomized controlled trials were included in this scoping review of lifestyle interventions delivered during radiotherapy.
PubMed and Web of Science were searched for RCTs published from April 2016 to April 2026.
Eligible studies included adults who received exercise, nutritional, psychological, combined, or multimodal lifestyle interventions during their RT treatment.
Study characteristics, intervention details, and outcomes were charted and narratively synthesized.
Breast, head and neck, and prostate cancers were most frequently represented cancer populations.
Results
Key evidence gaps identified include heterogeneous intervention protocols and outcome assessments, limited evidence for non-exercise interventions, and underrepresentation of several cancer populations.
Heterogeneity across studies was identified as a major limitation preventing conclusions regarding optimal intervention approaches.
Non-exercise interventions such as nutritional and psychological approaches were substantially underrepresented compared to exercise.
Several cancer populations beyond breast, head and neck, and prostate cancers were underrepresented in the evidence base.
The authors called for 'further RT-specific studies using standardized intervention programs and comparable outcome measures' to inform supportive-care delivery.
Conclusions
Lifestyle interventions delivered concurrently during radiotherapy may improve selected patient-centered and treatment-related toxicity outcomes.
The review specifically focused on interventions delivered during RT treatment, not before or after.
Patient-centered outcomes included quality of life, fatigue, functional capacity, and psychological outcomes.
Treatment-related toxicity outcomes were also assessed across multiple intervention types.
The authors concluded that evidence supports a role for lifestyle interventions as part of supportive-care delivery during RT.
What This Means
This research reviewed 23 clinical trials that tested lifestyle changes—such as exercise, dietary support, and psychological support—in cancer patients undergoing radiation therapy (radiotherapy). The researchers searched scientific databases for studies published over a 10-year period and found that exercise was by far the most studied approach, appearing in about half of the trials, while nutritional and psychological interventions were studied much less frequently. The cancers most often studied were breast, head and neck, and prostate cancers.
The findings suggest that exercise during radiotherapy most reliably helps reduce fatigue and improve physical functioning, though its effects on overall quality of life were more variable across studies. Nutritional support appeared helpful for maintaining nutritional status and reducing side effects from treatment. Psychological interventions and programs combining multiple lifestyle approaches also showed some benefits across quality of life, fatigue, and psychological wellbeing measures, though these were studied in far fewer trials.
This research matters because radiotherapy can cause significant side effects that reduce patients' quality of life, and identifying supportive strategies that can be used alongside treatment is clinically important. However, the studies used very different types of interventions and measured outcomes in different ways, making it difficult to identify the single best approach. The authors highlight a need for more standardized research, particularly for non-exercise interventions and cancer types beyond those most commonly studied, to better guide how supportive care is delivered to patients undergoing radiotherapy.
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Stergioula A, Antiochou-Plexida M, Giannoutsou M, Gotsopoulou E, Karavopoulou S, Kitsou I, et al.. (2026). Lifestyle Interventions During Radiotherapy: A Scoping Review of Their Effects on Toxicity and Patient-Centered Outcomes.. Medical sciences (Basel, Switzerland). https://doi.org/10.3390/medsci14040501