Research Information System
Frontiers in Biomedical Technologies, vol.13, no.4, pp.1, 2026 (Scopus)
Background: This study aims to provide a comprehensive review of recent advances in the application of nanocarriers
for targeted drug delivery and radiosensitization in cancer radiotherapy (RT), as well as to examine the challenges,
solutions, and future prospects of this technology.
Methods: This systematic review was conducted in accordance with PRISMA guidelines and protocol registered in
PROSPERO (CRD420251154905). A comprehensive literature search was conducted in PubMed, Scopus, Web of
Science, identifying 373 records. Following PRISMA guidelines, 40 studies met the inclusion criteria focusing on
functionalized nanocarriers in cancer RT. Data extraction covered nanoparticle types, functionalization, therapeutic
payloads, cancer models, radiation modalities, and outcomes.
Results: Forty studies were analyzed, categorized into iron oxide-based (10), silver (10), bismuth-based (7), graphene42 based (4), gadolinium-based (4), and titanium-based (2) nanoparticles (NPs). Bismuth-based NPs demonstrated
superior radiosensitization with sensitizer enhancement ratios (SERs) of 1.25–1.48 and up to 450% increase in reactive
oxygen species (ROS) in-vivo, achieving ~70% tumor volume reduction without systemic toxicity. Silver NPs
demonstrated dose enhancement factors (DEF) rising from 1.4 to 1.9 and synergistic effects with docetaxel plus 2 Gy
radiation. Iron oxide NPs functionalized with HER2 and RGD ligands reduced cell viability by 1.95-fold and achieved
DEF of 89.1 in targeted systems. Gadolinium NPs reached SERs up to 2.44 at 65 keV, while graphene-based systems
enhanced ROS production by 75.2%. Titanium-based NPs increased ROS levels 2.5-fold. Combination therapies
integrating chemotherapeutics including cisplatin and curcumin with nanocarriers yielded SERs up to 4.29. The
radiation modalities included megavoltage X-rays (4–10 MV, n=24), synchrotron keV X-rays (n=2), gamma rays
(0.38–1.25 MeV, n=3), and electron beams (6–12 MeV, n=3).
Conclusions: Bismuth-based NPs represent the most promising radiosensitizers due to their high efficacy, safety, and
clinical relevance, supporting their advancement toward clinical translation.