Radiogenomics: the utility in patient selection

The goal of radiation therapy (RT) is to deliver the therapeutic dose to target tissues minimizing the risks of normal tissue complication. Nowadays, technological advances in radiation delivery and the introduction of particle therapies have strongly limited the amount of dose distributed to normal tissues and enhanced the tumor killing capacity. Here, we discuss about the state of art in RT treatment modalities, tumor sensitivity and radiation toxicity. A special insight is dedicated to the role of tumor heterogeneity, cancer stem cells (CSCs) and hypoxia. In addition, in this review we provide an overview of the most recently studies evaluating the potential role of "omic" biomarkers for a personalized biological-driven treatment planning, useful to maximize the radiotherapy success without normal tissues complications.