2025年度非小细胞肺癌放射治疗研究进展OA

In 2025,the role of radiotherapy in the overall management of non-small cell lung cancer(NSCLC)is being substantially redefined.In early-stage NSCLC,10-year follow-up data reported at American Society for Radiation Oncology strongly support stereotactic body radiotherapy(SBRT)as offering curative potential comparable to surgery in operable patients,although risk stratification for special subgroups-such as patients with ultracentral tumors or interstitial lung disease-remains a central challenge.For locally advanced disease,the PACIFIC paradigm is firmly established,and simply adding concurrent immunotherapy has not translated into additional benefit.At the same time,deeper exploration of radiation techniques,including SBRT-based dose escalation to the primary tumor and functional imaging-guided planning,is opening new avenues for improving efficacy while better controlling toxicity.In addition,immunotherapy rechallenge strategies have shown encouraging survival signals in relapsed patients,expanding the salvage treatment landscape in the beyond-PACIFIC era.In advanced NSCLC,treatment strategies are also being reshaped by the integration of radiotherapy:studies such as NorthStar have demonstrated the clear advantage of combining local consolidative radiotherapy with targeted agents;proton craniospinal irradiation has yielded substantial survival gains over conventional photon involved-field radiotherapy in leptomeningeal metastases;and the combination of SBRT with immunotherapy has not only shown efficacy in oligometastatic and oligo-residual disease,but has also reshaped the tumor microenvironment through abscopal effects.This review summarizes the advances in NSCLC radiotherapy research in 2025.