Purpose: Marking the one hundredth anniversary of quantum mechanics in 2025, quantum science has become foundational for the development of contemporary technologies, enabling advances in sensing, imaging, computing, and materials engineering. Cancer radiotherapy, although traditionally developed within the scope of classical dosimetric models
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Purpose: Marking the one hundredth anniversary of quantum mechanics in 2025, quantum science has become foundational for the development of contemporary technologies, enabling advances in sensing, imaging, computing, and materials engineering. Cancer radiotherapy, although traditionally developed within the scope of classical dosimetric models and phenomenological biological frameworks, is fundamentally initiated by quantum-mechanical radiation-matter interactions. Radiation-induced DNA damage, which ultimately determines therapeutic effectiveness, originates from primary quantum-mechanical processes involving particle transport, electronic excitation and ionisation, followed by successive physicochemical and chemical stages including water radiolysis and radical formation. As scientific disciplines undergo a rapid “quantum transition,” radiation cancer treatment is increasingly positioned to benefit from deeper integration of quantum principles and emerging quantum technologies.
Methods: This review examines how quantum mechanics governs the primary radiation-matter interactions that initiate the physical, physicochemical, chemical, and ultimately biological stages of radiation action at the (sub)cellular level, with particular emphasis on track structure, water radiolysis, DNA damage induction, and multiscale biological response. Contemporary approaches to DNA damage modeling are discussed, including track-structure Monte Carlo methods, nanodosimetric frameworks, and multi-scale simulation approaches that connect microscopic interaction events with biological outcomes. Key quantum concepts relevant to radiation therapy are outlined, together with emerging quantum technologies such as nanoscale quantum sensing, quantum lasers, quantum dots, and quantum computing, which are evaluated for their potential roles in dosimetry, imaging, treatment planning, and radiation transport simulations. In this context, artificial intelligence (AI) is considered a complementary tool to accelerate computation and integrate quantum-informed data across multiple scales.
Results: The review highlights that quantum-informed modeling enables a more consistent description of radiation-induced processes across spatial and temporal scales, linking microscopic interaction mechanisms to DNA damage formation and macroscopic biological outcomes. Recent advances in track-structure and radiobiological modeling provide new opportunities for improving predictions of radiation effects and treatment response. Emerging quantum technologies show potential to enhance measurement sensitivity, improve simulation efficiency, and enable more precise control of radiation delivery. Furthermore, AI-assisted approaches facilitate the extraction of predictive patterns from complex datasets, supporting faster and more accurate estimation of biological endpoints such as DNA damage and cell survival.
Conclusions: The quantum aspects of advanced treatment modalities, including proton and heavy-ion therapy, ultrafast radiation delivery, and the FLASH effect, as well as future concepts such as laser-plasma-driven and coherence-informed radiotherapy systems, indicate a promising direction for next-generation cancer treatment. By critically assessing both opportunities and limitations, this work provides a coherent framework for integrating DNA damage modeling, quantum principles, quantum-inspired techniques, emerging quantum technologies, and advanced computational tools to guide future developments in radiation oncology.
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