Abstract
Malignant tumors comprise cancer cells and their surrounding tumor microenvironment (TME). This environment includes cellular and non-cellular components that collectively form a sophisticated network contributing to cancer cell survival, progression, immune evasion, and resistance to treatment. Recent findings have shown that TME components act as a protective "fortress," effectively shielding cancer cells from the impact of radiation. This review provides a comprehensive overview of our current knowledge of how TME reinforces the resistance of cancer cells to radiotherapy. Furthermore, it outlines the growing body of evidence from preclinical and clinical studies regarding the influence of TME in fostering radioresistance. Additionally, it explores the potential of targeting various TME components to amplify responses to radiation in clinical settings, and delves into the associated challenges and future perspectives in this rapidly evolving field.
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