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Effects of non-pharmacological interventions on nutrition and immune status of nasopharyngeal carcinoma patients during chemoradiotherapy: a systematic review and meta-analysis protocol

Xia L, Hayashi N, Ota E, Qi L, Yan B

BMJ open, 2025

Abstract

Background: Nasopharyngeal carcinoma (NPC) presents significant nutritional challenges during concurrent chemoradiotherapy, adversely affecting treatment outcomes and quality of life. Non-pharmacological interventions may help improve nutritional and immune status, reduce complications and enhance overall well-being. However, evidence of their effectiveness is scattered and inconsistent, and no systematic review has yet synthesised the evidence on their effectiveness. This protocol outlines a systematic review and meta-analysis to evaluate the impact of non-pharmacological interventions on nutritional status, immune function and complications in NPC patients undergoing chemoradiotherapy. The findings may contribute to clinical recommendations and support evidence-based decision-making in the supportive care of NPC patients.

Methods: This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. A comprehensive search will be conducted in MEDLINE, PubMed, CINAHL, EMBASE, Cochrane Library, Web of Science, ProQuest, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wan Fang from November 2014 to November 2024. Search terms will include concepts related to NPC, nutrition, supplements, education, exercise, multimodal interventions and chemoradiotherapy. Only randomised controlled trials will be included. Two reviewers will independently screen studies, extract data and assess the risk of bias…

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