| Sumario: | Acceptance and commitment therapy (ACT) is widely used for cancer patients, yet its effects are not well understood with respect to psychosomatic outcomes and quality of life (QoL). This review aims to explore the effects of ACT on the psychosomatic outcomes and QoL of cancer patients. Eleven electronic databases were searched from inception to December 2025. Two authors independently extracted the data. RevMan 5.4 was used for data analysis and RoB 2.0 and GRADE were used for quality assessment. Forty studies were included, 30 of which were eligible for meta-analysis. The meta-analysis revealed that compared with the control, ACT used alone had significant effects on hope [SMD = 3.01, 95% CI (0.69, 5.34)], psychological flexibility [SMD = −1.42, 95% CI (−1.96, −0.87)], psychological distress [SMD = −0.79, 95% CI (−1.45, −0.13)], anxiety [SMD = −0.92, 95% CI (−1.70, −0.14)], depressive symptoms [SMD = −0.95, 95% CI (−1.50, −0.39)], fatigue [SMD = −0.81, 95% CI (−1.55, −0.06)] and QoL [SMD = 1.07, 95% CI (0.14, 2.00)] in cancer patients. ACT used in combination can relieve depressive symptoms [SMD = −2.04, 95% CI (−2.44, −1.65)], anxiety [SMD = −2.10, 95% CI (−2.78, −1.41)] and fatigue [SMD = −2.49, 95% CI (−2.90, −2.08)]. ACT can improve hope, psychological flexibility, psychological distress, anxiety, depressive symptoms and the QoL of cancer patients. Future studies should expand sample sizes and optimize designs to advance research with cancer patients. • ACT improves hope and fatigue in cancer patients. • ACT reduces depression and anxiety and improves quality of life in cancer care. • Sessions of 30–45 min are linked to more effective ACT outcomes. • ACTs should be tailored to different cancer types and cultural backgrounds. • Future studies with better designs and larger samples are needed to confirm the effects of ACT.
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