Radiotherapy is one of the most common treatments for oral cancer. However, in the clinic, recurrence and metastasis of oral cancer occur after radiotherapy, and the underlying mechanism remains unclear. Cancer stem cells (CSCs), considered the “seeds” of cancer, have been confirmed to be in a quiescent state in most established tumours, with their innate radioresistance helping them survive more easily when exposed to radiation than differentiated cancer cells. There is increasing evidence that CSCs play an important role in recurrence and metastasis post-radiotherapy in many cancers. However, little is known about how oral CSCs cause tumour recurrence and metastasis post-radiotherapy. In this review article, we will first summarise methods for the identification of oral CSCs and then focus on the characteristics of a CSC subpopulation induced by radiation, hereafter referred to as “awakened” CSCs, to highlight their response to radiotherapy and potential role in tumour recurrence and metastasis post-radiotherapy as well as potential therapeutics targeting CSCs. In addition, we explore potential therapeutic strategies targeting these “awakened” CSCs to solve the serious clinical challenges of recurrence and metastasis in oral cancer after radiotherapy.

放射疗法是口腔癌最常见的治疗方法之一。然而，在临床上，放疗后发生口腔癌的复发和转移，其潜在机制尚不清楚。癌症干细胞（CSC）被认为是癌症的“种子”，已被证实在大多数成熟的肿瘤中处于静止状态，其固有的抗辐射性使它们在暴露于辐射时比分化的癌细胞更容易存活。越来越多的证据表明，CSC在许多癌症的放射治疗后的复发和转移中起着重要作用。然而，关于口服CSCs如何引起放疗后肿瘤复发和转移的了解甚少。在这篇评论文章中，我们将首先概述鉴定口腔CSC的方法，然后重点介绍由放射诱发的CSC亚群的特征（以下称为“唤醒的” CSC），以突出其对放疗的反应以及在放疗后肿瘤复发和转移中的潜在作用。放射疗法以及针对CSC的潜在疗法。此外，我们探索了针对这些“唤醒的” CSC的潜在治疗策略，以解决放疗后口腔癌复发和转移的严重临床挑战。