电离辐射广泛应用于放射治疗，治疗超过50%的癌症患者。电离辐射还被广泛用于医学影像诊断。此外，最近的地缘政治事件重新点燃了核武器使用的真正威胁。医疗辐射应对措施是有效的辐射防护策略之一。本综述的目的是总结开发辐射应对措施中最常用的策略和程序，并评估它们的研究现状，重点关注处于临床试验阶段的措施。本综述的临床试验是根据系统综述和meta分析的首选报告项目(PRISMA)声明选择的。搜索在2022年5月进行，在clinicaltrials.gov数据库中进行。我们的搜索结果返回了263项研究，筛选后有25项被纳入综述。其中10项研究已经完成，其中3项有着良好的结果：KMRC011可以增加G-CSF、IL-6和中性粒细胞计数，表明具有治疗造血急性辐射综合征（H-ARS）的潜力；GC4419可以减少患有严重口腔黏膜炎的患者数量和持续时间；氧化佐剂、甘草苷和乌苏双酰胺的联合使用可以降低局部放射性肝损伤的发生率。迄今为止发现的药物副作用显著或疗效较低，因此大多数经过测试的药物都在开发的早期阶段终止。此外，这种类型药物的低盈利性刺激私营部门不再投资此类研究。为了解决这个问题，需要增加公共资源的投入。在技术上，更深入地采用in silico方法似乎更有前途。

Ionizing radiation (IR) is widely applied in radiotherapy for the treatment of over 50% of cancer patients. IR is also intensively used in medical diagnostics on a daily basis in imaging. Moreover, recent geopolitical events have re-ignited the real threat of the use of nuclear weapons. Medical radiation countermeasures represent one of the effective protection strategies against the effects of IR. The aim of this review was to summarize the most commonly used strategies and procedures in the development of radiation countermeasures and to evaluate the current state of their research, with a focus on those in the clinical trial phase.Clinical trials for this review were selected in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The search was performed in the clinicaltrials.gov database as of May 2022.Our search returned 263 studies, which were screened and of which 25 were included in the review. 10 of these studies had been completed, 3 with promising results: KMRC011 increased G-CSF, IL-6, and neutrophil counts suggesting potential for the treatment of hematopoietic acute radiation syndrome (H-ARS); GC4419 reduced the number of patients with severe oral mucositis and its duration; the combination of enoxaparin, pentoxifylline, and ursodeoxycholic acid reduced the incidence of focal radiation-induced liver injury.The agents discovered so far show significant side effects or low efficacy, and hence most of the tested agents terminate in the early stages of development. In addition, the low profitability of this type of drug demotivates the private sector to invest in such research. To overcome this problem, there is a need to involve more public resources in funding. Among the technological opportunities, a deeper use of in silico approaches seems to be prospective.