Effect of curcumin intervention on radiation-induced injury: a GRADE-based systematic review and meta-analysis

Radiation-induced injury (RII) is a common condition among patients receiving radiation therapy which affects the quality of life and clinical outcomes in cancer patients. Curcumin has shown promising therapeutic potential in the ameliorating RII through its radioprotective, anti-inflammatory and antioxidant properties. However, the findings across studies remain inconsistent. A comprehensive systematic search of PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, and VIP was conducted from inception to 2 July 2025. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated using GRADE approach. Based on finding, curcumin significantly reduced the incidence of severe RII (RR: 0.58, 95% CI: 0.46, 0.74; P < 0.001), the score of radiation injury severity (SMD: -0.90, 95% CI: -1.25, -0.55; P < 0.001), score of pain using NRS (SMD: -7.56, 95% CI: -9.47, -5.65; P < 0.001) and VAS (SMD: -1.53, 95% CI: -2.52, -0.54; P = 0.002) and weight (SMD: -0.69, 95% CI: -1.25, -0.13; P = 0.015). However, curcumin was not associated with the incidence of overall RII (RR: 0.98, 95% CI: 0.95, 1.01; P = 0.259). The present systematic review and meta-analysis indicated that curcumin may exert promising effects in mitigating RII. It has been shown that patients with RII may benefit from curcumin treatment through reduced incidence of severe RII and score of severity and adverse events. Nevertheless, well-designed studies across multiple populations with rigorous methodologies and optimized dose regimens are warranted to establish firm conclusions.