Landscape and evolutionary trends of nanotechnology in cancer radiosensitization

Radiotherapy is one of the most basic clinical tumor treatment methods, yet its efficacy is often limited by radioresistance and off-target toxicity. Nanoradiosensitizers have emerged as a promising strategy for enhancing local dose deposition and regulating tumor microenvironment (TME). Despite the rapid development of the nanoradiosensitizer field, a comprehensive roadmap describing its evolution remains lacking. We analyzed 1,866 publications on nanoradiosensitizers in the Web of Science Core Collection (WoSCC) database up to 2024. The global landscape is drawn using advanced visualization tools, including Bibliometrix, VOSviewer, CiteSpace, and Scimago Graphica. Our analysis reveals that the field has undergone exponential growth and a distinct paradigm shift, with research focus evolving from initial material synthesis (e.g., high-Z metals for physical dose enhancement) to complex biological regulation (e.g., hypoxia relief, TME regulation). Notably, keywords and trend analysis have identified that the integration of nanoradiosensitizers with immunotherapy has become the frontier of the current research field, such as enhanced immunogenic cell death (ICD) and immune checkpoint blockade (ICB). Overall, this study highlights the shift of nanoradiosensitizers from material-driven exploration toward mechanism-based biological and translational studies. Future research must prioritize overcoming translational barriers, including biosafety, large-scale manufacturing, and clinical evaluation, to enable the clinical application of radioimmunotherapy strategies.