en Radiation Biology Radiation Biology مقاله مروری Review article <div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:newspaper"><span style="text-kashida-space:50%"><span style="line-height:119%"><span style="font-family:Calibri"><span style="color:black"><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Background:</span></span></span></span></span></span> <span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">Digestive tract cancers, including esophageal, gastric, colorectal, liver, pancreatic, gastrointestinal stromal tumors (GISTs), and digestive blastomas, accounted for 26% of cancer cases and 38% of cancer-related deaths worldwide in 2020. Managing these malignancies is challenging due to frequent advanced-stage diagnosis, complicating treatment and resulting in poor prognoses. Radiotherapy has evolved from a palliative approach to a curative treatment for several digestive tract cancers, with advances in techniques like three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and stereotactic body radiotherapy (SBRT) improving precision and efficacy. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Materials and Methods</span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-weight:bold"><span style="language:en-US">:</span></span></span></span></span> <span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">PubMed was searched from inception to September 2024 using various keywords with Boolean modifiers and operators. The abstracts were screened, and any relevant articles were imported into a reference manager. Additionally, the references of the selected articles were further screened for any further relevant articles. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Results: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">This literature review examines the integration of radiotherapy into multimodal treatments, such as neoadjuvant chemoradiation for esophageal and gastric cancers, as demonstrated by the CROSS study. Challenges include resistance to therapy, often mediated by molecular mechanisms involving non-coding RNAs, and significant side effects like gastrointestinal toxicity and fatigue. The emerging role of the gut microbiome in influencing radiotherapy efficacy and side effects is also highlighted. </span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Conclusion: </span></span></span></span></span></span><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="language:en-US">Despite successes, overcoming resistance and reducing side effects remain significant challenges. Advances in radiotherapy techniques, combined with a deeper understanding of molecular biology and the gut microbiome offer promising avenues for enhancing efficacy and tolerability.</span></span></span></span></span></span></span></span></span></div> Digestive tract, cancer, radiotherapy, neoadjuvant therapy, radiotherapy, side effects. 757 769 http://ijrr.com/browse.php?a_code=A-10-1-1395&slc_lang=en&sid=1 G. Chen 7900319475328460031945 7900319475328460031945 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China S. Jiang 7900319475328460031946 7900319475328460031946 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China L. Kong 7900319475328460031947 7900319475328460031947 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China T. Yang 7900319475328460031948 7900319475328460031948 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China X. Sun 7900319475328460031949 7900319475328460031949 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China T. Xu 7900319475328460031950 7900319475328460031950 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China L. Fan 7900319475328460031951 7900319475328460031951 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China Q. Xie xieqingrjh@163.com 7900319475328460031952 7900319475328460031952 Yes Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025 Shanghai, China H. Zhao zhaohong1968qd@163.com 7900319475328460031953 7900319475328460031953 No Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 266042 Qingdao, Shandong, China