The challenges of precision radiotherapy technology to the traditional theory of radiobiology

With the development of modern computing technology and medical physics, radiotherapy has made great progress. The theoretical basis of radiobiology seems to lag behind the clinical application of radiotherapy, which hampers the further improvement of treatment efficacy and the optimization of treatment modality. In this paper, some emerging challenges of precision radiotherapy technology to the traditional theory of radiobiology, such as radiosensitivity, dose-response curve and survival curve, linear-quadratic model, 4Rs theory, as well as the interaction between cancer and microenvironment, radiation-induced second primary cancers (RISPC), will be discussed. The interplay between precision radiotherapy and traditional radiobiology theories will be addressed with the aim to potentially solve some of the challenging problems.