Localized cranial radiotherapy is a dominant treatment for brain cancers. After being subjected to radiation, the central nervous system (CNS) exhibits targeted effects as well as non-targeted radiation bystander effects (RIBE) and abscopal effects (RIAE). Radiation-induced targeted effects in the CNS include autophagy and various changes in tumor cells due to radiation sensitivity, which can be regulated by microRNAs. Non-targeted radiation effects are mainly induced by gap junctional communication between cells, exosomes containing microRNAs can be transduced by intracellular endocytosis to regulate RIBE and RIAE. In this review, we discuss the involvement of microRNAs in radiation-induced targeted effects, as well as exosomes and/or exosomal microRNAs in non-targeted radiation effects in the CNS. As a target pathway, we also discuss the Akt pathway which is regulated by microRNAs, exosomes, and/or exosomal microRNAs in radiation-induced targeted effects and RIBE in CNS tumor cells. As the CNS-derived exosomes can cross the blood-brain-barrier (BBB) into the bloodstream and be isolated from peripheral blood, exosomes and exosomal microRNAs can emerge as promising minimally invasive biomarkers and therapeutic targets for radiation-induced targeted and non-targeted effects in the CNS.

局部颅脑放疗是脑癌的主要治疗方法。受到辐射后，中枢神经系统（CNS）表现出靶向效应以及非靶向辐射旁观者效应（RIBE）和抽象效应（RIAE）。中枢神经系统中辐射诱导的靶向作用包括自噬和由于辐射敏感性引起的肿瘤细胞的各种变化，这些变化可由microRNA调节。非靶向放射作用主要是由细胞之间的间隙连接通讯引起的，含有微RNA的外泌体可以通过细胞内吞作用转导以调节RIBE和RIAE。在这篇综述中，我们讨论了microRNA在辐射诱导的靶向效应中的参与，以及外泌体和/或外泌体microRNA在CNS中的非靶向辐射效应中的参与。作为目标途径 我们还讨论了Akt途径，该途径在辐射诱导的靶向效应和RIBE在中枢神经系统肿瘤细胞中受microRNA，外泌体和/或外泌体microRNA调控。由于源自CNS的外泌体可以穿过血脑屏障（BBB）进入血液并从外周血中分离出来，因此外泌体和外泌体microRNA可能会成为有希望的微创生物标志物和辐射诱导的靶向和非靶向的治疗靶标中枢神经系统的影响。