Current status of radiation-induced injury models and future perspectives

Radiation injury (RI) has been extensively investigated since the advent of atomic energy, with particular emphasis following nuclear incidents. In clinical oncology, skin and mucosal RI are among the most common complications, affecting over 95% of patients undergoing radiotherapy. Moreover, with advancements in cancer detection and treatment, the proportion of cancer patients dying from non-cancer causes-particularly treatment-related side effects–has risen significantly. In the case of cancer therapy-induced cardiovascular dysfunction, the mortality rate exceeds 50%; therefore, there is an urgent requirement for accurate assessment and effective treatment and prevention. Traditional RI models, such as in vitro cell cultures and animal studies, face limitations regarding their translational relevance. Bans on animal testing have accelerated the advancement and adoption of alternative models in biomedical and toxicological research. Recent advancements in bioengineering, such as 3D-bioprinted tissues, organ-on-a-chip methods, and patient-derived organoids, offer innovative and effective platforms for recapitulating human pathophysiology. This review discusses emerging reconstructed RI models, with a focus on organoids, 3D-bioprinted constructs, and organ-on-a-chip systems. Future perspectives in the field are also examined.