Abstract
Background/Objectives: Radiotherapy, radiobiology, and oncology have evolved rapidly over the past six decades. This progress has generated vast but fragmented bodies of scientific evidence. The present study aimed to systematically map and interpret their conceptual and temporal development using artificial intelligence (AI)-based methods. It highlights the integration between molecular mechanisms, clinical applications, and technological innovation within a precision radiotherapy framework. Methods: A corpus of 3343 unique articles (1964-2025) was retrieved from Scopus, PubMed, and Web of Science. Records were harmonized through deduplication, lemmatization, and metadata normalization. Topic modeling using Latent Dirichlet Allocation (LDA) and co-occurrence network analysis were applied to identify dominant research axes. Semantic and temporal analyses were conducted to reveal patterns, emerging trends, and translational connections across decades. Results: Three historical phases were identified. The first was a period of limited production (1964-1990). The second showed moderate growth (1991-2010). The third, from 2011 to 2024, represented exponential expansion, with publication peaks in 2020 and 2023. LDA revealed two principal axes. The first, a clinical-anatomical axis, focused on cancer sites, treatment modalities, and prognosis. The second, a mechanistic-molecular axis, centered on DNA repair, radiosensitivity, and biomarkers. Case synthesis from 2014-2025 defined five operational classes: DNA repair and molecular response; precision oncology and genomic modeling; individual radiosensitivity; mechanisms of radioresistance; and advanced technologies such as FLASH radiotherapy and optimized brachytherapy. Conclusions: AI-driven semantic and temporal analyses showed that radiotherapy has matured into an interconnected and interdisciplinary domain. The derived Precision Radiotherapy Implementation Plan translates molecular and computational insights into clinically actionable strategies. These approaches can enhance survival, reduce toxicity, and inform equitable health policies for advanced cancer care.