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Abstract
The Warburg effect is a phenomenon in which cancer cells rely primarily on glycolysis rather than oxidative phosphorylation, even in the presence of oxygen. Although evidence of its involvement in cell proliferation has been discovered, the advantages of the Warburg effect in cancer cell survival under treatment have not been fully elucidated. In recent years, the metabolic characteristics of radioresistant cancer cells have been evaluated, enabling an extension of the original concept of the Warburg effect. In this review, we focused on the role of the Warburg effect in redox homeostasis and DNA damage repair, two critical factors contributing to radioresistance. In addition, we highlighted the metabolic involvement in the radioresistance of cancer stem cells, which is the root cause of tumor recurrence. Finally, we summarized radiosensitizing drugs that target the Warburg effect. Insights into the molecular mechanisms underlying the Warburg effect and radioresistance can provide valuable information for developing strategies to enhance the efficacy of radiotherapy and provide future directions for successful cancer therapy.

Affiliations

Hyunkoo Kang 1, Byeongsoo Kim 1, Junhyeong Park 1, HyeSook Youn 2, BuHyun Youn 3
1Department of Integrated Biological Science, Pusan National University, Busan 46241, Republic of Korea.
2Department of Integrative Bioscience and Biotechnology, Sejong University, Seoul 05006, Republic of Korea. Electronic address: hsyoun@sejong.ac.kr.
3Department of Integrated Biological Science, Pusan National University, Busan 46241, Republic of Korea; Department of Biological Sciences, Pusan National University, Busan 46241, Republic of Korea. Electronic address: bhyoun72@pusan.ac.kr.