While significant progress has been made in understanding the mechanisms of interaction between ionizing radiation and biological matter [ 1,2], the specific details of how mammalian cells die after radiation exposure remain unclear. At the molecular level, heterologous DNA double-strand breaks (dsb), closely apposed on the two deoxyribose backbones of the DNA, are regarded as the most common types of lethal radiation lesions in mammalian cells [ 1-41. However, at the cellular level, the consequence of dsb to the DNA is not necessarily cell death, because mammalian cells are proficient in the capacity to recombine and repair these lesions [5-91. Nonetheless, some structurally complex types of DNA dsb are apparently irreparable [3,4,. Quantitative evaluations of the kinetics of DNA dsb repair have demonstrated that, in general, the rate at which mammalian cells repair DNA dsb correlates with the level of their radiation sensitivity [7][8][9]. Hence, the prevailing hypothesis on the lethal effects of radiation identifies both the initial overall number of DNA dsb and the incidence of structurally complex variants of dsb, as well as the proficiency and rate of DNA dsb repair, as the factors that affect the ultimate survival of the cell after radiation exposure [7-91. The current knowledge of the molecular, biochemical, and genetic mechanisms of DNA repair after radiation exposure indicates that there may be evolutionary conservation of this function from bacteria to human cells. However, while genes and biochemical pathways associated with radiation damage repair have been identified in bacteria [ 19-221 and in lower eukaryotic systems [22-251, progress has been much slower in mammalian cells because of methodological difficulties in studying mammalian gene function and the scarcity of mutant cells that facilitate genetic analysis. Recent studies on patterns of response of mammalian cells to radiation exposure indicate that recovery from radiation damage involves not only DNA repair via excision, recombination, and replication, but that other cellular events, including a variety of cytosolic and membrane stress signals, are also involved. This review summarizes some of the recent data on the cellular network of responses to radiation injury in normal and tumor cells. An understanding of the patterns of DNA effects in the context of the overall network of cellular responses to radiation injury may lead to new approaches in the design of biological response modifiers to improve the therapeutic ratio of radiation treatments in human cancer.