Nutritional and Lifestyle Interventions for Prostate Cancer Patients Undergoing Radiotherapy: A Systematic Review.

[BACKGROUND] Radiotherapy for prostate cancer often leads to gastrointestinal toxicity, weight gain, fatigue, and reduced quality of life. Nutrition and lifestyle interventions are increasingly used in cancer care, yet evidence specific to men receiving radiotherapy remains limited.

[METHODS] We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library to June 2025 for studies evaluating nutrition and lifestyle interventions in adults undergoing radiotherapy for prostate cancer. Study quality was assessed using the Cochrane Risk of Bias tool, Newcastle-Ottawa Scale, and ROBINS-I.

[RESULTS] Nineteen studies were included. In radiotherapy-specific trials, individualized nutrition interventions showed potential to attenuate weight gain and manage gastrointestinal symptoms, while restrictive dietary modifications alleviated bowel complaints but were associated with declines in energy intake and nutritional status. Tomato-juice supplementation increased lycopene levels without consistent clinical benefit. In mixed-modality cohorts, dietary modifications were associated with meaningful weight loss and favorable changes in triglycerides, HDL, and HbA1c. Comprehensive lifestyle programs improved psychological distress, urinary symptoms, and quality of life.

[CONCLUSIONS] Nutrition and lifestyle interventions show promising signals for improving weight control, symptoms, metabolic profiles, and quality of life during radiotherapy. Given the heterogeneity of evidence, more robust, radiotherapy-specific randomized trials with standardized endpoints are needed to confirm efficacy.