Role and potential therapeutic strategies of matrix mechanics for optimizing tumor radiotherapy

Radiation therapy is one of the most effective therapeutic modalities for tumors. The changes in matrix stiffness of tumors and associated tissues are important consequences of side effects after radiotherapy. They are documented to induce the radio-resistance of cancer cells and promote the recurrence and metastasis of tumors, resulting in poor patient prognosis. Identifying the relationship between radiation and matrix stiffness is beneficial to optimize clinical treatment schemes and ultimately improve the patient prognosis. Herein, this review includes knowledge regarding the specific cellular, molecular processes and relevant clinical factors of the changes in matrix stiffness of tumors or associated tissues induced by radiation. The effects of altered matrix stiffness on the behaviors of cancer cells and associated normal cells are further detailed. It also reviews literatures to elucidate the mechanical signal transduction mechanism in radiotherapy and proposes some strategies to enhance the efficacy of radiotherapy based on matrix mechanics.