Objective: To evaluate the impact of key lifestyle factors on liver function in patients with liver cancer receiving radiotherapy, integrating both conventional clinical evidence and Traditional Chinese Medicine (TCM) perspectives.


Methods: A systematic review of literature published between January 2000 and March 2024 was conducted using PubMed, CNKI, Wanfang, Web of Science, and Scopus. Inclusion criteria focused on studies assessing the effect of lifestyle factors such as stress, diet, sleep, and exercise on liver function in the context of liver cancer and radiotherapy.


Results: A total of 47 studies were included (18 RCTs, 22 observational studies, 7 systematic reviews). Emotional stress was significantly associated with worsened liver function during radiotherapy (OR = 2.87; 95% CI: 2.14–3.84; p < 0.001). High-fat diets increased the risk of hepatic steatosis and impaired liver function (RR = 1.94; 95% CI: 1.67–2.25; p < 0.001), while plant-based diets were protective (OR = 0.68; 95% CI: 0.57–0.81; p < 0.001). Poor sleep quality correlated with liver enzyme elevation (r = 0.62; 95% CI: 0.54–0.69; p < 0.001). Moderate exercise, including TCM-based practices like Tai Chi, was linked to improved liver function and reduced radiation-induced toxicity (SMD = 0.82; 95% CI: 0.67–0.97; p < 0.001).


Conclusion: Lifestyle factors significantly influence liver function in liver cancer patients undergoing radiotherapy. Interventions targeting emotional regulation, diet optimization, sleep hygiene, and physical activity—especially when aligned with TCM principles—may enhance hepatic resilience and therapeutic outcomes. These insights support integrative, lifestyle-centered care in oncology settings.