Tumor vessels-radiotherapy interaction and nanomedicines interventiona review

Radiotherapy is one of the key modalities for the clinical management of malignant tumors. It not only directly kills cancer cells but also exerts significant effects on the tumor microenvironment (TME). Conversely, the TME also has a substantial impact on the outcomes of radiotherapy and other regiments, and is closely associated with patient prognosis. As a critical component of the TME, tumor blood vessels participate in various stages of tumorigenesis and progression, and markedly modulate the efficacy of radiotherapy. The advent of nanomedicines has greatly facilitated radiotherapy sensitization and enabled precise remodeling of the tumor vasculature. Accordingly, this review first outlines vascular features within solid tumors, discusses the effects of different radiation doses on tumor vasculature, and further dissects vascular modulation strategies combining nanomedicines with radiotherapy. We further highlight the key barriers to clinical translation and outline prospective research directions, aiming to offer theoretical support for refined radiotherapy regimens and the development of vasculature-targeted nanomedicines.