[Research progress on the mechanisms and clinical interventions of gut microbiota in radiation-induced intestinal injury].

Radiotherapy is a critical treatment modality for abdominal and pelvic malignancies; however, it is associated with a high incidence of radiation-induced intestinal injury, which severely limits therapeutic efficacy and impairs patients' quality of life. In recent years, the bidirectional regulatory role of the gut microbiota in the development and progression of radiation-induced intestinal injury has garnered significant attention. Radiotherapy can induce a reduction in gut microbial diversity, disrupt the metabolism of short-chain fatty acids and tryptophan, and promote the expansion of opportunistic pathogens. Conversely, specific probiotics and their metabolites can alleviate intestinal injury through multiple targets. Based on these findings, gut microbiota-based interventions-such as probiotics and fecal microbiota transplantation-have demonstrated clear radioprotective and tissue-repairing effects. Perioperative modulation of the gut microbiota can also accelerate postoperative recovery of gastrointestinal function and improve nutritional status. Nonetheless, individual variability, standardization of donor screening, and long-term safety remain major challenges. Future efforts should leverage multi-omics and artificial intelligence technologies to advance precision intervention strategies tailored to individual microbiota profiles.