Modulating Redox Biology to Improve Radiation Responses

Redox biology plays an important role in cancer progression and therapy resistance. Tumor cells maintain elevated levels of reactive oxygen species to support proliferation while upregulating antioxidant defences to avoid oxidative cell death. Radiotherapy, a standard treatment for over half of all cancer patients, relies on the generation of reactive oxygen species and adequate oxygen availability for efficacy. However, hypoxic tumor microenvironments and enhanced antioxidant systems contribute significantly to radioresistance. This redox imbalance, which is characteristic of tumor cells, presents a therapeutic opportunity where modifying redox biology may sensitise tumors to radiation and promote cell death. In this review, we examine how redox signalling supports tumor survival and highlight emerging clinical strategies that target redox pathways to overcome resistance and improve radiotherapy outcomes.