A scoping review of non-pharmacological symptom management in head and neck cancer patients during the peri-chemoradiotherapy period

Head and neck cancer (HNC) is a globally prevalent malignancy. However, HNC therapies often induce distressing symptoms that impair patients quality of life and treatment adherence. While non-pharmacological interventions are guideline-recommended for symptom management, a comprehensive overview of their current landscape is lacking. Guided by the UK Medical Research Council (MRC) complex intervention framework, this scoping review aims to: (1) catalogue non-pharmacological interventions for HNC patients during the peri-chemoradiotherapy; (2) detail the outcome measures assessing their effectiveness; (3) examine intervention development methodologies and frameworks; (4) assess pilot testing and efficacy evaluations; (5) categorize and analyze facilitators and barriers of implementation. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, PubMed, Scopus, Embase, and other databases were searched from inception to May 2025. A total of 68 eligible studies were included in the present study. Nurses were the primary deliverers of these interventions, which were most frequently conducted in home settings. Interventions were categorized into 9 distinct categories, and main outcome measures could be classified into 6 categories. The results revealed the multifaceted complexities of implementing interventions across patient, healthcare provider, program design, and systemic levels. Given this scoping review only maps published literature without quality assessment or effect synthesis, the research demands summarized from included studies point to an urgent need for standardized, theory-driven, patient-centered non-pharmacological interventions integrated into HNC care pathways. Future trials are recommended to boost intervention adaptability, strengthen methodological standards, and improve the scalability and sustainability of non-pharmacological symptom management.