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World J Gastroenterol. Nov 7, 2026; 32(41): 120954
Published online Nov 7, 2026. doi: 10.3748/wjg.120954
Cancer therapy-induced intestinal injury: Mechanisms, clinical manifestations, and management strategies
Yang-Long Nan, Tuan-He Sun, Kai-Jie Ren, Tian-Hao Min, Yu-Yi Ma, Xin Xie, Xiao-Yuan Deng, Yuan-Chang Peng, Yuan-Yuan Liu, Shi-Yao Tong, Wei Wang, Cheng-Xue Dang, Hao Zhang
Yang-Long Nan, Tuan-He Sun, Kai-Jie Ren, Tian-Hao Min, Yu-Yi Ma, Xiao-Yuan Deng, Yuan-Chang Peng, Yuan-Yuan Liu, Shi-Yao Tong, Cheng-Xue Dang, Hao Zhang, Department of Surgical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Tuan-He Sun, State Key Laboratory of Electrical Insulation and Power Equipment, School of Electrical Engineering, Xi’an Jiaotong University, Xi’an 710049, Shaanxi Province, China
Xin Xie, Department of Nuclear Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, Shaanxi Province, China
Wei Wang, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Co-corresponding authors: Cheng-Xue Dang and Hao Zhang.
Author contributions: Nan YL wrote the original draft and contributed to visualization; Sun TH contributed to the discussion and design of the manuscript; Ren KJ, Min TH, Ma YY, Xie X, Deng XY, Peng YC, Liu YY, Tong SY, Wang W, Dang CX, and Zhang H reviewed and edited the manuscript; Ren KJ and Ma YY contributed to the visualization; Dang CX and Zhang H jointly conceptualized the study, supervised the work, and acquired funding, contributing equally as co-corresponding authors. All authors have read and approved the final manuscript.
AI contribution statement: AI tools (ChatGPT) were used during the revision process solely for language polishing and translation. No portion of the main text (including Abstract, Introduction, Main body, Discussion, and Conclusion) was generated by AI. We assure that the study design, selection of the review topic, and structure of the manuscript were entirely conducted by the authors. We confirm that all figures were created by the authors using BioRender, without any AI generation. All AI-generated outputs were critically reviewed and revised by the authors.
Supported by National Social Science Fund of China, No. 23BRK014.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Hao Zhang, MD, Department of Surgical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, No. 227 Yanta West Road, Xi’an 710061, Shaanxi Province, China.
hao.zhang@mail.xjtu.edu.cn
Received: March 18, 2026
Revised: May 3, 2026
Accepted: June 29, 2026
Published online: November 7, 2026
Processing time: 187 Days and 1 Hours
As cancer treatment advances in recent years, people with cancer are living longer, but the side effects of these treatments on normal tissues remain a major challenge, particularly the intestines. Intestinal injury induced by chemotherapy, radiotherapy, targeted therapy, immunotherapy, and surgical intervention represents an important factor that limits the effectiveness of cancer treatment. The common symptoms are diarrhea, abdominal pain and malabsorption, which can substantially impair the patients’ quality of life and may lead to severe complications. At present, the clinical strategies for the prevention and treatment of therapy-induced intestinal injury are still relatively scarce. In this minireview, we focus on the mechanisms underlying cancer therapy-induced intestinal injury, including oxidative stress, inflammation, apoptosis, and gut microbiota imbalance, and discuss targeted therapeutic strategies aimed at reducing morbidity, improving patient outcomes, and fostering a better quality of life.
Core Tip: Cancer therapy-induced intestinal injury is a relatively common, multifaceted side effect of chemotherapy, radiotherapy, targeted therapy, immunotherapy and surgical interventions. The underlying mechanisms include oxidative stress, inflammation, apoptosis and dysbiosis of the gut microbiota; all of them contribute to the disruption of epithelial integrity and intestinal function. This minireview synthesizes current mechanistic insights and therapeutic strategies, with a particular emphasis on microbiota modulation, targeted interventions, and emerging regenerative approaches. A comprehensive understanding of these processes is crucial for developing personalized treatments to prevent or mitigate intestinal injury, improve patient quality of life, and optimize cancer therapy outcomes.
