Abstract
Introduction: In the palliative care (PC) setting, levels of nutritional knowledge, emotional support, and the impact and severity of the disease can influence important immunological and metabolic responses in patients. Furthermore, the spiritual and religious (S/R) impact associated with an adequate diet for energy homeostasis is evident. Objective: To describe, through a systematic review, the immunological and metabolic importance of palliative medicine in nutritional therapy. Methods: The systematic review guidelines of the PRISMA Platform were followed. The search was conducted from June to August 2025 in the Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. Study quality was based on the GRADE instrument, and risk of bias was analyzed according to the Cochrane tool. Results and Conclusion: A total of 91 articles were found. A total of 24 articles were fully evaluated, and 14 were included and developed in this systematic review study. Using the Cochrane risk-of-bias tool, the overall assessment revealed six studies with a high risk of bias and 29 studies that did not meet the GRADE and AMSTAR-2 criteria. Most studies presented homogeneous results, with X2=73.7%>50%. The conclusion is that there is still a shortage of clinical trials on home-based PC for geriatric cancer patients, resulting in poor information and a lack of evidence. Home-based interventions appear feasible and have a positive effect on pain control and functional status, but more high-quality studies are needed. Spiritual care may be particularly important during times of illness, suffering, or near the end of life, when patients seek comfort. Patients in PC are complex, with multiple clinical, psychological, social, and spiritual problems. Using a multidisciplinary approach, especially appropriate nutritional therapy, can improve the quality of life of patients and their families. It is essential to train, expand, and integrate PC teams, allowing patients a better quality of life until their death.