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Radiation therapy continues to play a pivotal role in cancer treatment, with heightened effectiveness achieved through precise delivery and the synergistic integration of immunotherapy. The intricate interplay among gut microbiota, bacteria, fungi, and their impact on the response to radiation therapy highlights the complex relationship between cancer biology and the immune system. Recent experiments indicate that an abundance of fungi, rather than a decrease in bacteria, hinders the efficacy of radiation therapy. Profiling a patient's microbiome, encompassing both bacterial and fungal elements, holds promise in predicting their prognosis and response to various cancer treatments, including radiation therapy, chemotherapy, or immunotherapy.