Functionalized Nanocarriers for Tumor-Selective Radiosensitization and Drug Delivery in Cancer Radiotherapy: A Systematic Review
-
Fatemeh Zare
,
Zahra Masoumi Verki
,
Mina Nouri
,
Amirhossein Rashnoodi
,
Emad Khoshdel
,
Başak Göksel
,
Fatemeh Ghamkhar-Nakhjiri
,
Reza Malekzadeh
Abstract
Purpose: 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 prospects of this technology.
Materials and 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, and 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), graphene-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).
Conclusion: Bismuth-based NPs represent the most promising radiosensitizers due to their high efficacy, safety, and clinical relevance, supporting their advancement toward clinical translation.
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16- Reza Malekzadeh, Behnaz Babaye Abdollahi, Marjan Ghorbani, Jalil Pirayesh Islamian, and Tohid Mortezazadeh, "Trastuzumab conjugated PEG–Fe3O4@ Au nanoparticle as an MRI biocompatible nano-contrast agent." International Journal of Polymeric Materials and Polymeric Biomaterials, Vol. 72 (No. 10), pp. 759-70, (2023).
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18- Navid Kheradmand et al., "Targeted Gold Nanoparticles for Molecular CT Imaging of Breast Cancer: An In-Vitro Study." Frontiers in Biomedical Technologies, Vol. 12 (No. 3), pp. 468-78, (2025).
19- H Liu AG Denkova, Y Men, "Enhanced cancer therapy by combining radiation and chemical effects mediated by nanocarriers." Advanced Therapeutics, Vol. 3 (No. 3), p. 1900177, (2020).
20- Chao Y Maiti D, Dong Z, Yi X, He J, Liu Z, Yang K, "Development of a thermosensitive protein conjugated nanogel for enhanced radio-chemotherapy of cancer." Nanoscale, Vol. 10 (No. 29), pp. 13976-85, (2018).
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27- Mohamed Mahmoud Fathy, "Biosynthesis of silver nanoparticles using thymoquinone and evaluation of their radio-sensitizing activity." BioNanoScience, Vol. 10 (No. 1), pp. 260-66, (2020).
28- Shokrieh Hatami Zharabad, Mahshid Mohammadian, Reza Zohdi Aghdam, Mohsen Hassanzadeh Dizaj, and Zhaleh Behrouzkia, "Increasing the radiation-induced cytotoxicity by silver nanoparticles and docetaxel in prostate cancer cells." Molecular Biology Reports, Vol. 51 (No. 1), p. 633, (2024).
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| Files | ||
| Issue | Vol 13 No 2 (2026) | |
| Section | Systematic Review(s) | |
| DOI | https://doi.org/10.18502/fbt.v13i2.21950 | |
| Keywords | ||
| Nanocarrier Targeted Drug Delivery Radiosensitization Cancer Nanoparticle | ||
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How to Cite
1.
Zare F, Masoumi Verki Z, Nouri M, Rashnoodi A, Khoshdel E, Göksel B, Ghamkhar-Nakhjiri F, Malekzadeh R. Functionalized Nanocarriers for Tumor-Selective Radiosensitization and Drug Delivery in Cancer Radiotherapy: A Systematic Review. Frontiers Biomed Technol. 2026;13(2):550-572.
