[Current status and prospects in the diagnosis and treatment of radiation-induced intestinal injury].

The widespread adoption of radiotherapy for pelvic malignancies has substantially improved tumor control, yet the resulting radiation-induced intestinal injury (RII) poses a growing threat to patients' quality of life and long-term functional outcomes. To provide a comprehensive understanding of this field, this review summarizes recent advances in the pathological mechanisms, diagnostic classification, multidisciplinary treatment strategies, and preventive approaches for RII. Current evidence identifies a complex interplay among intestinal stem cell damage, vascular endothelial dysfunction, oxidative stress, and gut microbiota dysbiosis as the core driver of chronic RII progression; nonetheless, inconsistent diagnostic criteria, the absence of individualized risk stratification, and insufficient high-quality evidence for emerging therapies remain critical bottlenecks limiting clinical translation. We therefore argue that accelerating the translational integration of mechanistic insights with targeted interventions, alongside the establishment of a standardized full-course management framework encompassing pre-radiotherapy risk assessment, intratreatment organ protection, and long-term surveillance, represents the fundamental pathway to improving outcomes for patients with RII.