From:  Practical non-pharmacological interventions to improve quality of life for cancer patients and caregivers

 Summary of non-pharmacological interventions by strength of evidence, outcomes, and research gaps (Oxford Levels of Evidence 2022).

InterventionStrength of evidence (Oxford Level)Primary outcomes supportedKey research gaps
AromatherapyLevel 2–3Anxiety, sleep, mild nauseaStandardization of dosages; long-term effects
Massage therapyLevel 1–2Pain, anxiety, and sleep qualityCost-effectiveness; access in outpatient/rural settings
Mindfulness & guided imageryLevel 1–2Emotional distress, sleep, and caregiver burdenPediatric/Geriatric data; implementation studies
Music therapyLevel 2–3Mood, anxiety, and copingLarger RCTs; outcome heterogeneity
Art therapyLevel 3–4Emotional processing, caregiver supportStandardized outcome metrics; comparative trials
Sleep hygiene educationLevel 1–2Insomnia, fatigue, anxietyPersonalization by cancer stage: digital intervention trials
Topical essential oilsLevel 4Pain, skin careSafety trials in oncology; dermatologic outcomes
Digital CBT-ILevel 1–2Insomnia, fatigueLong-term adherence, low-literacy adaptation
Energy therapies (e.g., Reiki)Level 4–5Subjective well-beingHigh-quality trials; mechanistic research

RCT: randomized controlled trial; CBT-I: cognitive behavioral therapy for insomnia. Level 1: Systematic reviews of RCTs; Level 2: individual RCTs or observational studies with dramatic effects; Level 3: non-randomized cohort or case-control studies; Level 4: case series or poor-quality cohort/case-control; Level 5: mechanism-based reasoning or expert opinion.