Strategies and Mechanisms of Radiosensitization in Cancer Therapy

More than 50% of patients with malignant tumors require radiotherapy (RT). However, its efficacy is often hindered by inherent or acquired radioresistance and damage to surrounding normal tissues. Radiosensitizers offer the potential to enhance the therapeutic efficacy of radiotherapy while minimizing toxicity to normal tissues. This review provides a comprehensive overview of the current understanding of the multi-dimensional mechanisms underlying radiosensitization. Additionally, we discuss the synergistic role of physicochemical interventions and advanced delivery systems in improving radiosensitization. Advances in clinical translation are summarized, highlighting several radiosensitizers that have entered clinical trials. Despite considerable progress, challenges such as delivery efficiency and tumor heterogeneity remain. Future research should focus on multi-targeted strategies, biomarker-guided patient selection, and integration with immunotherapy to achieve precise and effective radiosensitization.