Presently, more than half of cancer patients receive radiotherapy to cure localized cancer, palliate symptoms, or control the progression of cancer. However, radioresistance and radiation-induced bystander effects (RIBEs) are still challenging problems in cancer treatment. Exosomes, as a kind of extracellular vesicle, have a significant function in mediating and regulating intercellular signaling pathways. An increasing number of studies have shown that radiotherapy can increase exosome secretion and alter exosome cargo. Furthermore, radiation-induced exosomes are involved in the mechanism of radioresistance and RIBEs. Therefore, exosomes hold great promise for clinical application in radiotherapy. In this review, we not only focus on the influence of radiation on exosome biogenesis, secretion and cargoes but also on the mechanism of radiation-induced exosomes in radioresistance and RIBEs, which may expand our insight into the cooperative function of exosomes in radiotherapy.

中文翻译：

---

外泌体在放射治疗中的新兴作用

目前，超过一半的癌症患者接受放射治疗以治愈局部癌症、缓解症状或控制癌症的进展。然而，辐射抗性和辐射诱导的旁观者效应 (RIBE) 仍然是癌症治疗中具有挑战性的问题。外泌体作为一种细胞外囊泡，在介导和调节细胞间信号通路方面具有重要作用。越来越多的研究表明，放疗可以增加外泌体分泌并改变外泌体货物。此外，辐射诱导的外泌体参与了辐射抗性和 RIBE 的机制。因此，外泌体在放射治疗的临床应用中具有广阔的前景。在这篇综述中，我们不仅关注辐射对外泌体生物发生的影响，