Background: Radiotherapy has become an important therapeutic option for hepatocellular carcinoma (HCC). However, treatment-related liver injury, including radiation-induced liver disease (RILD), continues to limit its use, especially in patients with compromised hepatic reserve. This review examined whether lifestyle-related factors and supportive interventions based on Traditional Chinese Medicine (TCM) are associated with liver function outcomes in patients with liver cancer receiving radiotherapy. Materials and Methods: A systematic search was performed in PubMed, Web of Science, Scopus, CNKI, and Wanfang to identify relevant publications from January 2000 to March 2024. Studies were considered eligible if they involved adults with primary liver cancer treated with radiotherapy and reported outcomes related to hepatic function, RILD, Child–Pugh or ALBI changes, quality of life, or treatment tolerance. The reviewed evidence included clinical studies using stereotactic body radiotherapy (SBRT) or other external-beam radiotherapy techniques, as well as experimental irradiation models. Radiation reporting varied across studies; experimental models included 15 Gy liver irradiation and 4 Gy whole-body irradiation, while clinical SBRT schedules were not consistently described. In this review, TCM-based supportive care referred to herbal medicine, acupuncture-related therapy, moxibustion, TCM-guided dietary approaches, Tai Chi, and Qigong. Results: Eleven studies fulfilled the eligibility criteria. The available evidence indicated that radiotherapy may contribute to hepatic metabolic disturbance, oxidative stress, inflammatory responses, and deterioration of liver function. Supportive lifestyle measures, including regular physical activity, healthier dietary patterns, stress management, and sleep improvement, together with selected TCM-based approaches, appeared to support hepatic resilience and improve treatment tolerance. |
