en Radiation Biology Radiation Biology <div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:newspaper"><span style="text-kashida-space:50%"><span style="line-height:119%"><span style="font-family:Calibri"><span style="color:black"><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Background:</span></span></span></span></span></span> <span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">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. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Materials and Methods: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">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&ndash;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. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Results: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">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.</span></span></span></span></span></span></span></span></span></div> Hepatocellular carcinoma, radiation therapy, radiation-induced liver disease (RILD), traditional Chinese medicine, integrative oncology, liver toxicity. 997 1005 http://ijrr.com/browse.php?a_code=A-10-1-1608&slc_lang=en&sid=1 M. Zhao 7900319475328460034861 7900319475328460034861 No Hefei Preschool Education College, Hefei, Anhui, China H. Zhou 7900319475328460034862 7900319475328460034862 No Department of Infectious Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, China M. Shi 7900319475328460034863 7900319475328460034863 No Department of Infectious Disease, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, China J. Liu 7900319475328460034864 7900319475328460034864 No Hefei Preschool Education College, Hefei, Anhui, China S. Zhang 7900319475328460034865 7900319475328460034865 No Hefei Preschool Education College, Hefei, Anhui, China J. Zhang 7900319475328460034866 7900319475328460034866 No Hefei Preschool Education College, Hefei, Anhui, China X. Feng 7900319475328460034867 7900319475328460034867 No Hefei Preschool Education College, Hefei, Anhui, China G. Zhang guoliangzhang2022@163.com 7900319475328460034868 7900319475328460034868 No Hefei Preschool Education College, Hefei, Anhui, China