This review article explores the key targets and mechanisms of radiotherapy (RT)-induced gastrointestinal mucositis (RIGIM) development and progression. RIGIM is a frequent and potentially disabling side effect of radiation therapy, impacting the mucosal lining of the gastrointestinal tract. The pathophysiology of RIGIM is complex, involving oxidative stress, inflammatory pathways, DNA damage, changes in the gut microbiota, and disruption of the mucosal barrier’s integrity. The clinical presentation of RIGIM varies, ranging from mild inflammation to severe ulceration, significantly impacting patients’ quality of life, nutrition, and treatment adherence. This article discusses the risk factors, symptoms, and clinical manifestations of RIGIM, as well as current and potential therapeutic strategies. These strategies include pharmacological interventions, microbiome modulation, and supportive care, aimed at preventing, mitigating, or treating RIGIM and ultimately improving the lives of cancer patients undergoing RT.
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