radiation therapy
radiation therapy
Overview
Radiation therapy is a major cancer treatment modality that uses ionizing radiation to damage cellular DNA and other critical biomolecules, thereby inhibiting tumor growth and inducing cell death. Its antitumor effects are mediated both by direct DNA damage and by indirect injury through reactive oxygen species generated during radiolysis. In modern oncology, radiation therapy is used as a definitive, adjuvant, neoadjuvant, or metastasis-directed treatment, often in combination with chemotherapy, surgery, targeted therapy, or immunotherapy.
Clinically, radiation therapy is central to the management of many solid tumors and selected hematologic malignancies, but its effectiveness is limited by normal-tissue toxicity and by intrinsic or acquired radioresistance. Recent research has emphasized adaptive radiotherapy, biomarker-guided treatment selection, immune modulation, and strategies to reduce complications such as radiation dermatitis, oral mucositis, pneumonitis, and ototoxicity. The field also increasingly integrates computational tools, imaging, and multi-omics approaches to optimize dose delivery and predict response.
Focus of Latest Publications
Recent publications show radiation therapy being studied both as a standalone local treatment and as part of multimodal regimens. In locally advanced non-small cell lung cancer, a prospective study evaluated an adaptive radiotherapy protocol using a “traffic light” adaptation approach focused on target coverage, protocol performance, and patient outcomes. A separate carbon-ion radiotherapy study developed a delta-based multi-omics decision-support model to estimate adaptive radiotherapy benefit before treatment, reflecting growing interest in individualized adaptation during treatment.
Several studies addressed disease-specific timing and sequencing. In grade 2 meningiomas, a national retrospective analysis compared early versus late radiotherapy and examined progression-free survival, overall survival, and tumor-related mortality. In high-risk localized prostate cancer, radiotherapy remained part of standard-of-care androgen-deprivation therapy combinations. Another prostate cancer study examined rectal spacer use among Medicare beneficiaries receiving radiation therapy, highlighting how technique and access vary by modality, region, race, income, and year. In metastatic breast cancer, metastasis-directed therapy trials incorporated radiotherapy as a local treatment for oligometastases.
A major theme across the recent literature is radiosensitization and radioresistance. In lung cancer, C1QBP-STAT1 signaling was reported to promote activation of the c-MYC-CHK1/CHK2 axis and contribute to radioresistance, while another study identified HDAC6 inhibition as a way to enhance radiosensitivity in melanoma. In basal-like breast cancer, MUC1 was described as a survival effector of radiotherapy-induced epithelial hybrid states, suggesting a mechanism by which tumor cells may persist after irradiation. In polyploid giant cancer cells, radiation therapy was linked to DNA damage mediated primarily through reactive oxygen species, with mechanical dormancy implicated in resistance. Additional work on neutrophil extracellular traps, HMGB3, and other tumor microenvironment factors also framed radiotherapy resistance as a broader biological problem.
Radiation therapy was also investigated as an immune-modulating treatment. Multiple studies emphasized that radiotherapy can prime antitumor immunity but may also induce immunosuppressive factors that limit systemic benefit. One study reported synergy between radiotherapy and an inducible AAV-based immunotherapy platform using AAV-iIL12, aiming to program local and systemic antitumor immunity. Another examined electrostatic assembly of ginseng polysaccharides and chito-oligosaccharides to enhance dendritic cell-mediated antigen priming for synergistic radio-immunotherapy. Related work described x-ray-responsive Mn2+ release via scintillating nanoparticles to activate the cGAS-STING pathway, and another study highlighted radiotherapy-induced remodeling of the T cell landscape in head and neck cancer. These findings align with broader interest in checkpoint inhibitor combinations, PD-1/PD-L1-based strategies, and abscopal effects.
Clinical toxicity and supportive care were also prominent. Acute radiation dermatitis was studied in head and neck cancer patients receiving radiotherapy, with a phase II randomized trial evaluating fullerene for prevention or mitigation. Oral mucositis onset and severity were analyzed in relation to clinicopathological, biobehavioral, and demographic factors. Radiation pneumonitis was modeled in lung cancer patients with interstitial lung disease using machine learning. Other work addressed cancer therapy-induced ototoxicity and the burden of side effects associated with radiotherapy in multimodal cancer care.
Beyond oncology, radiation therapy was mentioned in expert guidance for hematologic malignancies during pregnancy and in the management of persistent or recurrent Cushing’s disease, where it was listed among treatment options alongside repeat transsphenoidal surgery, medical therapy, and bilateral adrenalectomy. A cost comparison study also evaluated radiotherapy as an alternative to surgery for lentigo maligna. Regional planning studies assessed radiotherapy capacity and diagnostic capacity in relation to changing cancer burden, underscoring the importance of infrastructure and access.