Radiation therapy occupies one of the key places in the arsenal of cancer treatment methods. This non-invasive method has been actively used for many decades and has demonstrated high effectiveness in combating various types of malignant neoplasms. Despite significant progress in ionizing radiation delivery technologies and the introduction of targeted radiosensitizers and immunotherapy, classical radiation therapy faces limitations related to radioresistance of tumor cells. This is due to a variety of factors, such as genetic mutations, metabolic features of cancer cells, their ability to repair DNA, the presence of a tumor microenvironment, and many others. Radioresistance of tumors reduces the success of treatment, which makes it necessary to search for new approaches to improve the effectiveness of radiation therapy. This review discusses the basic principles of radiation therapy and the properties of cancer cells that affect their radiosensitivity. Both the existing methods of overcoming cancer cell radioresistance and the prospects for their further development are being considered, which can significantly improve the effectiveness of cancer treatment.
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