Volume 24 Issue 4
Apr.  2026
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Article Navigation >  Chinese Journal of General Practice  > 2026  >  24(4): 569-573
YANG Xinyao, CUI Lei, LIU Xue, ZHANG Like, HOU Lili. Evidence Summary for management of symptom clusters of gastrointestinal adverse reactions caused by radiotherapy and chemotherapy for lung cancer[J]. Chinese Journal of General Practice, 2026, 24(4): 569-573. doi: 10.16766/j.cnki.issn.1674-4152.004441
Citation: YANG Xinyao, CUI Lei, LIU Xue, ZHANG Like, HOU Lili. Evidence Summary for management of symptom clusters of gastrointestinal adverse reactions caused by radiotherapy and chemotherapy for lung cancer[J]. Chinese Journal of General Practice, 2026, 24(4): 569-573. doi: 10.16766/j.cnki.issn.1674-4152.004441
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Evidence Summary for management of symptom clusters of gastrointestinal adverse reactions caused by radiotherapy and chemotherapy for lung cancer

doi: 10.16766/j.cnki.issn.1674-4152.004441
  • 1.

    Nursing School, Shanghai Jiao Tong University, Shanghai 200025, China

Funds:

 82272919

  • Received Date: 2025-08-19
    Abstract
  •   Objective  To search and summarize the best evidence for assessing and managing gastrointestinal adverse reactions caused by radiotherapy and chemotherapy for lung cancer, and support evidence-based practice.  Methods  Systematically searched each database and guideline networks for management evidence of gastrointestinal adverse reactions caused by radio- and chemotherapy for lung cancer. The search timeline was from database establishment to August 2024. Two trained researchers performed literature screening, quality evaluation, evidence extraction, and integration independently.  Results  Twenty-eight articles were included, including 5 meta-analyses, 2 systematic reviews, 4 evidence summaries, 8 expert consensuses, 5 guidelines, and 4 clinical decisions. One hundred and six recommendations in three dimensions of assessment, prevention, treatment, and intervention were summarized, involving seven themes of oral mucositis, radiation esophagitis, anorexia, nausea and vomiting, chemo- and radiotherapy-associated diarrhea/constipation, and malnutrition.  Conclusion  Tumor teams should fully consider the individual differences of patients and provide appropriate evidence-based interventions.

     

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    • References(49)
  • [1]
    HAN B, ZHENG R, ZENG H, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1): 47-53.
    [2]
    WAHLANG J B, LAISHRAM P D, BRAHMA D K, et al. Adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital[J]. Ther Adv Drug Saf, 2017, 8(2): 61-66. doi: 10.1177/2042098616672572
    [3]
    DICENSO A, BAYLEY L, HAYNES R B. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009, 12(4): 99-101.
    [4]
    BROUWERS M C, KHO M E, BROWMAN G P, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care[J]. CMAJ, 2010, 182(18): E839-E842. doi: 10.1503/cmaj.090449
    [5]
    MCARTHUR A, KLUGAROVA J, YAN H, et al. Chapter 4: Systematic reviews of text and opinion[EB/OL]. JBI Manual for Evidence Synthesis, 2020. https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fjbi.global%2Fsites%2Fdefault%2Ffiles%2F2023-09%2F2.Checklist_Textual_Evidence_Opinion.docx&wdOrigin=BROWSELINK.
    [6]
    AROMATARIS E, FERNANDEZ R, GODFREY C M, et al. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach[J]. Int J Evid Based Healthc, 2015, 13(3): 132-140. doi: 10.1097/XEB.0000000000000055
    [7]
    FOSTER M J, SHURTZ S. Making the critical appraisal for summaries of evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence[J]. J Med Libr Assoc, 2013, 101(3): 192-198. doi: 10.3163/1536-5050.101.3.008
    [8]
    邢唯杰, 胡雁, 周英凤, 等. 推动证据向临床转化(六)证据总结的制作与撰写[J]. 护士进修杂志, 2020, 35(12): 1129-1132.

    XING W J, HU Y, ZHOU Y F, et al. Promoting the transformation of evidence into clinical practice: making and writing evidence summary[J]. Journal of Nurses Training, 2020, 35(12): 1129-1132.
    [9]
    The JBI Levels of Evidence and Grades of Recommendation Working Party. JBI levels of evidence 2014[EB/OL]. [2024-09-30]. https://jbi.global/sites/default/files/2020-07/Supporting_Doc_JBI_Levels_of_Evidence.pdf.
    [10]
    王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11): 964-967.

    WANG C Q, HU Y. JBI evidence pre-classification and evidence recommendation level system (2014 edition)[J]. Journal of Nurses Training, 2015, 30(11): 964-967.
    [11]
    BRIAN G CZITO M, CHRISTOPHER G WILLETT M. Overview of gastrointestinal toxicity of radiation therapy[EB/OL]. (2024-05-13)[2024-08-09]. http://www.uptodate.zd.hggfdd.top/contents/zh-Hans/overview-of-gastrointestinal-toxicity-of-radiation-therapy.
    [12]
    SUNEEL KAMATH M, KANIKA G NAIR M. Clinical presentation and risk factors for chemotherapy-associated diarrhea, constipation, and intestinal perforation[EB/OL]. (2024-05-30)[2024-08-09]. http://www.uptodate.zd.hggfdd.top/contents/clinical-presentation-and-risk-factors-for-chemotherapy-associated-diarrhea-constipation-and-intestinal-perforation.
    [13]
    CHARLES L LOPRINZI M, AMINAH JATOI M. Management of cancer anorexia/cachexia[EB/OL]. (2024-04-16)[2024-08-09]. https://sso.uptodate.com/contents/zh-Hans/management-of-cancer-anorexia-cachexia.
    [14]
    CAROLE MACARON M, SUNEEL KAMATH M. Management of acute chemotherapy-related diarrhea[EB/OL]. (2024-08-20)[2024-09-19]. http://www.uptodate.zd.hggfdd.top/contents/zh-Hans/management-of-acute-chemotherapy-related-diarrhea?
    [15]
    中国抗癌协会肿瘤护理专业委员会. 《中国癌症症状管理实践指南》: 厌食[J]. 护理研究, 2019, 33(15): 2549-2556.

    Oncology Nursing Committee of Chinese Anti-Cancer Association. China cancer symptom management practice guidelines: anorexia[J]. Chinese Nursing Research, 2019, 33(15): 2549-2556.
    [16]
    ROCK C L, THOMSON C A, SULLIVAN K R, et al. American Cancer Society nutrition and physical activity guideline for cancer survivors[J]. CA Cancer J Clin, 2022, 72(3): 230-262.
    [17]
    HESKETH P J, KRIS M G, BASCH E, et al. Antiemetics: ASCO guideline update[J]. J Clin Oncol, 2020, 38(24): 2782-2797. doi: 10.1200/JCO.20.01296
    [18]
    CANCER CARE ALBERTA A H S. Clinical Practice Guideline, Endorsement of the 2020 American Society of Clinical Oncology' s Guideline for Antiemetics. [EB/OL]. (2024-06-01)[2024-08-30]. https://www.albertahealthservices.ca/assets/info/hp/cancer/if-hp-cancer-guide-supp011-nausea-vomiting.pdf.
    [19]
    NCCN Antiemesis Panel Members. NCCN Clinical Practice Guidelines in Oncology: Antiemesis, Version1. 2024[EB/OL]. (2023-12-13)[2024-08-14]. https://nccn.medlive.cn/guide/detail/514.
    [20]
    中国抗癌协会肿瘤营养专业委员会, 中华医学会肠外肠内营养学分会. 肺癌患者的营养治疗专家共识[J]. 肿瘤代谢与营养电子杂志, 2023, 10(3): 336-341.

    Chinese Society of Nutritional Oncology, Chinese Society of Parenteral and Enteral Nutrition. Expert consensus on nutritional therapy for patients with lung cancer[J]. Electronic Journal of Metabolism and Nutrition of Cancer, 2023, 10(3): 336-341.
    [21]
    上海市抗癌协会癌症康复与姑息治疗专业委员会, 上海市抗癌协会肿瘤药物临床研究专业委员会, 中国老年保健协会肿瘤防治与临床研究管理专业委员会, 等. 抗肿瘤治疗所致恶心呕吐全程管理上海专家共识(2024年版)[J]. 中国癌症杂志, 2024, 34(1): 104-134.

    Shanghai Anti-Cancer Association Cancer Rehabilitation and Palliative Care Committee, Shanghai Anti-Cancer Association Clinical Research Committee on Cancer Drugs, Cancer Prevention and Clinical Research Committee of Chinese Aging Well Association, et al. Shanghai expert consensus on the whole-course management of nausea and vomiting caused by anti-tumor therapy (2024 edition)[J]. China Oncology, 2024, 34(1): 104-134.
    [22]
    中国抗癌协会肿瘤营养专业委员会, 全国卫生产业企业管理协会医学营养产业分会, 浙江省医学会肿瘤营养与治疗学分会. 肿瘤患者食欲下降的营养诊疗专家共识[J]. 肿瘤代谢与营养电子杂志, 2022, 9(3): 312-319.

    Chinese Society of Nutritional Oncology, Medical Nutrition Industry Branch of National Association of Health Industry and Enterprise Management, Zhejiang Society of Oncology Nutrition and Therapy. Expert consensus on nutritional diagnosis and treatment for cancer patients with decreased appetite[J]. Electronic Journal of Metabolism and Nutrition of Cancer, 2022, 9(3): 312-319.
    [23]
    李涛, 吕家华, 郎锦义, 等. 恶性肿瘤放疗患者营养治疗专家共识[J]. 肿瘤代谢与营养电子杂志, 2018, 5(4): 358-365.

    LI T, LYU J H, LANG J Y, et al. Expert consensus on nutritional therapy for cancer patients undergoing radiotherapy[J]. Electronic Journal of Metabolism and Nutrition of Cancer, 2018, 5(4): 358-365.
    [24]
    中国抗癌协会肿瘤临床化疗专业委员会, 中国抗癌协会肿瘤支持治疗专业委员会. 中国肿瘤药物治疗相关恶心呕吐防治专家共识(2022年版)[J]. 中华医学杂志, 2022, 102(39): 3080-3094.

    China Anti-Cancer Association Committee of Clinical Chemotherapy, China Anti-Cancer Association Committee of Supportive Care. Chinese expert consensus on the prevention and management of anti-tumor drug related nausea and vomiting (2022 edition)[J]. National Medical Journal of China, 2022, 102(39): 3080-3094.
    [25]
    李梅, 陈军, 杨梅, 等. 老年肺癌护理中国专家共识(2022版)[J]. 中国肺癌杂志, 2023, 26(3): 177-192.

    Lung Cancer Specialty Committee of Chinese Elderly Health Care Association, Enhanced Recovery after Surgery Specialty Committee of Tianjin Medical and Health Association. Consensus of Chinese experts on nursing of lung cancer in the elderly (2022 edition)[J]. Chinese Journal of Lung Cancer, 2023, 26(3): 177-192.
    [26]
    FEYER P C, MARANZANO E, MOLASSIOTIS A, et al. Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009[J]. Supp Care Cancer, 2011, 19: S5-S14.
    [27]
    杨从容, 王军, 袁双虎. 放射性食管炎的预防与治疗临床实践指南[J]. 中华肿瘤防治杂志, 2023, 30(6): 324-332.

    YANG C R, WANG J, YUAN S H. Clinical practice guideline for the prevention and treatment of radiation esophagitis[J]. Chinese Journal of Oncology Prevention and Treatment, 2023, 30(6): 324-332.
    [28]
    李野, 唐玲, 徐京巾, 等. 中医护理适宜技术缓解化疗相关恶心呕吐的最佳证据总结[J]. 中国实用护理杂志, 2023, 39(34): 2681-2687.

    LI Y, TANG L, XU J J, et al. Summary of the best evidence on appropriate techniques of traditional Chinese medicine nursing for alleviating chemotherapy-related nausea and vomiting[J]. Chinese Journal of Practical Nursing, 2023, 39(34): 2681-2687.
    [29]
    张兴瑜, 李永红, 陈菊, 等. 肿瘤患者放化疗致口腔黏膜炎非药物预防与管理的最佳证据总结[J]. 临床护理杂志, 2022, 21(6): 61-66.

    ZHANG X Y, LI Y H, CHEN J, et al. Summary of the best evidence on non-pharmacological prevention and management of chemoradiotherapy-induced oral mucositis in cancer patients[J]. Journal of Clinical Nursing, 2022, 21(6): 61-66.
    [30]
    丁娟, 刘晁含, 严玉娇, 等. 癌症患者化疗相关性便秘的最佳证据总结[J]. 中华现代护理杂志, 2020, 26(12): 1550-1554.

    DING J, LIU Z H, YAN Y J, et al. Summary of the best evidence for chemotherapy-related constipation in cancer patients[J]. Chinese Journal of Modern Nursing, 2020, 26(12): 1550-1554.
    [31]
    姚小云, 陈红宇, 胡君娥, 等. 癌症患者化疗相关性便秘评估与管理最佳证据总结[J]. 护理学报, 2020, 27(2): 48-52.

    YAO X Y, CHEN H Y, HU J E, et al. Summary of the best evidence on the assessment and management of chemotherapy-related constipation in cancer patients[J]. Journal of Nursing Science, 2020, 27(2): 48-52.
    [32]
    ZHANG H W, LIN Z X, CHEUNG F, et al. Moxibustion for alleviating side effects of chemotherapy or radiotherapy in people with cancer[J]. Cochrane Database Syst Rev, 2018, 11(11): CD10559. DOI: 10.1002/14651858.CD010559.pub2.
    [33]
    KISS N K, KRISHNASAMY M, ISENRING E A. Effect of nutrition intervention in lung cancer patients undergoing chemotherapy and/or radiotherapy: a systematic review[J]. Nutr cancer, 2014, 66(1): 47-56. doi: 10.1080/01635581.2014.847966
    [34]
    张贵霖, 李俊杰, 徐韬, 等. 针刺治疗癌症化疗后恶心呕吐疗效的meta分析[J]. 世界科学技术·中医药现代化, 2022, 24(7): 2867-2876.

    ZHANG G L, LI J J, XU T, et al. Meta-analysis of the efficacy of acupuncture in the treatment of nausea and vomiting after cancer chemotherapy[J]. World Science and Technology/Modernization of Traditional Chinese Medicine and Materia Medica, 2022, 24(7): 2867-2876.
    [35]
    陈凤, 杨雪, 刘丽, 等. 内关穴按压改善癌症病人化疗相关性恶心、呕吐效果的meta分析[J]. 护理研究, 2020, 34(9): 1535-1541.

    CHEN F, YANG X, LIU L, et al. Effect of Neiguan acupoint pressure on improving chemotherapy-induced nausea and vomiting in cancer patients: a Meta analysis[J]. Chinese Nursing Research, 2020, 34(9): 1535-1541.
    [36]
    李锐, 李月, 袁建梅, 等. 益生菌辅助防治化疗相关性腹泻的meta分析[J]. 中国药房, 2017, 28(9): 1220-1224.

    LI R, LI Y, YUAN J M, et al. Meta-analysis of probiotics as adjuvant therapy for the prevention and treatment of chemotherapy-related diarrhea[J]. China Pharmacy, 2017, 28(9): 1220-1224.
    [37]
    董良, 李海金, 赵建刚, 等. 帕洛诺司琼预防成人化疗所致恶心呕吐随机对照试验meta分析[J]. 中华肿瘤防治杂志, 2014, 21(18): 1461-1467.

    DONG L, LI H J, ZHAO J G, et al. Meta-analysis of randomized controlled trials of palonosetron for the prevention of chemotherapy-induced nausea and vomiting in adults[J]. Chinese Journal of Oncology Prevention and Treatment, 2014, 21(18): 1461-1467.
    [38]
    马德健, 曹珍, 王贲士, 等. 奥曲肽治疗放化疗相关性腹泻meta分析[J]. 中华肿瘤防治杂志, 2020, 27(2): 146-151.

    MA D J, CAO Z, WANG B S, et al. Meta——analysis of octreotide treatment of cancer chemoradiotherapy-induced diarrhoea[J]. Chinese Journal of Cancer Prevention and Treatment, 2020, 27(2): 146-151.
    [39]
    中华医学会放射肿瘤治疗学分会. 放射性口腔黏膜炎防治策略专家共识(2019)[J]. 中华放射肿瘤学杂志, 2019, 28(9): 641-647.

    Chinese Society of Radiation Oncology. Expert consensus on prevention and control strategy of radiotherapy-induced oral mucositis (2019)[J]. Chinese Journal of Radiation Oncology, 2019, 28(9): 641-647.
    [40]
    中国临床肿瘤学会抗肿瘤药物安全管理专家委员会, 中国临床肿瘤学会肿瘤支持与康复治疗专家委员会. 抗肿瘤治疗引起急性口腔黏膜炎的诊断和防治专家共识[J]. 临床肿瘤学杂志, 2021, 26(5): 449-459.

    Expert consensus on diagnosis, prevention and treatment of acute oral mucositis induced by anti-tumor therapy[J]. Clinical Oncology, 2021, 26(5): 449-459.
    [41]
    PETERSON D E, BOERS-DOETS C B, BENSADOUN R J, et al. Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up[J]. Ann Oncol, 2015, 26: v139-v151. DOI: 10.1093/annonc/mdv202.
    [42]
    ELAD S, CHENG K K F, LALLA R V, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy[J]. Cancer, 2020, 126(19): 4423-4431. doi: 10.1002/cncr.33100
    [43]
    马婷婷, 吴琼, 欧阳静, 等. 中国癌症症状管理实践指南: 口腔黏膜炎[J]. 护士进修杂志, 2020, 35(20): 1871-1878.

    MA T T, WU Q, OUYANG J, et al. Construction of Chinese management practice guideline for oral mucositis for cancer patients[J]. Journal of Nurses Training, 2020, 35(20): 1871-1878.
    [44]
    李薇, 张苗, 严艳, 等. 系统护理对头颈癌患者放疗所致口腔黏膜炎预防效果的meta分析[J]. 西部医学, 2019, 31(7): 1134-1139.

    LI W, ZHANG M, YAN Y, et al. Meta-analysis of preventive effect of systematic nursing on oral mucositis caused by radiotherapy in head and neck cancer patients[J]. Medical Journal of West China, 2019, 31(7): 1134-1139.
    [45]
    侯睿, 岳延涛, 王彬, 等. 循证护理在预防放化疗病人口腔黏膜炎中应用效果的meta分析[J]. 全科护理, 2021, 19(17): 2314-2320, 2361.

    HOU R, YUE Y T, WANG B, et al. Meta-analysis of application effect of evidence-based nursing on preventing oral mucositis in patients with chemoradiotherapy[J]. Chinese General Practice Nursing, 2021, 19(17): 2314-2320, 2361.
    [46]
    PAQUETTE I M, VARMA M, TERNENT C, et al. The American Society of Colon and Rectal Surgeons' clinical practice guideline for the evaluation and management of constipation[J]. Diseases of the colon & rectum, 2016, 59(6): 479-492.
    [47]
    石汉平, 许红霞, 李苏宜, 等. 营养不良的五阶梯治疗[J]. 肿瘤代谢与营养电子杂志, 2015, 2(1): 29-33.

    SHI H P, XU H X, LI S Y, et al. The five-step treatment for malnutrition[J]. Electronic Journal of Metabolism and Nutrition of Cancer, 2015, 2(1): 29-33.
    [48]
    谢忠海, 李鸿伟, 臧金, 等. 非小细胞肺癌根治术患者术后临床特征调查及预后影响因素分析[J]. 中华全科医学, 2022, 20(11): 1860-1862.

    XIE Z H, LI H W, ZANG J, et al. Investigation of clinical characteristics and prognostic factors in patients with non-small cell lung cancer after radical resection[J]. Chinese Journal of General Practice, 2022, 20(11): 1860-1862.
    [49]
    CHEN G, HAN Y, ZHANG H, et al. Radiotherapy-induced digestive injury: diagnosis, treatment and mechanisms[J]. Front oncol, 2021, 11: 757973. DOI: 10.3389/fonc.2021.757973.
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