Nurse-Led Oral Health Education for Head and Neck Cancer Patients on Radiotherapy: A Systematic Review and Meta-Analysis

Background Patients with head and neck cancer (HNC) undergoing radiotherapy frequently experience varying degrees of oral tissue damage, but the traditional care model often lacks continuous and personalized health education. While nurse-led interventions show potential in symptom management, existing evidence remains fragmented. This meta-analysis aimed to evaluate the effectiveness of nurse-led oral health education on oral health outcomes and exercise compliance in HNC patients undergoing radiotherapy. Methods PubMed, Web of Science, Embase, CINAHL, Cochrane Library, CNKI, and WanFang Data were exhaustive searched from inception to November 2024 and updated in April 2025. The Cochrane Risk of Bias tool 2 (RoB 2) was used to evaluate the methodological quality and risk of bias. Pooled effect sizes (Relative Risk or Standardized Mean Difference) and 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using the I ² statistic. Results Eight studies containing 596 participants were analyzed. Nurse-led oral health education, characterized by personalized guidance and multi-modal materials, effectively reduced the incidence of moderate to severe oral mucositis (RR = 0.68; 95% CI [0.47, 0.98], P  = 0.04; I ²  = 26%). Furthermore, it significantly improved the accuracy of oral functional exercise (RR = 6.59; 95% CI [2.45, 17.72], P  < 0.01) and enhanced the long-term dental health status (SMD = -0.58; 95% CI [-0.97, -0.18], P <0.01). Sensitivity analyses confirmed the robustness of these findings. Conclusions Nurse-led oral health education provides sustained benefits for HNC patients undergoing radiotherapy, particularly in reducing mucositis severity and promoting self-care behaviors. These findings support the integration of systematic and standardized nursing-led educational protocols into oncology clinical pathways. Future research should explore the optimal timing and duration of interventions. Trial Registration: This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number: CRD42024615226; registration date: 2025/4/29.