Radiotherapy for lung metastases

Pulmonary metastases are a common site of spread for many cancers, regardless of the primary tumour. While systemic treatments remain the standard of care, local therapies, particularly stereotactic body radiotherapy, have shown promising results in terms of local control and survival in selected patients with oligometastatic disease. This document presents the updated recommendations from the Société française de radiothérapie oncologique (SFRO, French society for radiation oncology) regarding the indications and technical aspects of radiotherapy for intrapulmonary metastases. The focus is on stereotactic body radiotherapy, including patient selection criteria, prescription protocols, treatment planning, respiratory motion management, and organ-at-risk constraints. Alternative approaches, such as moderately hypofractionated palliative radiotherapy, are also discussed for cases where stereotactic body radiotherapy is not feasible. These recommendations aim to guide clinical practice and promote the safe and effective use of high-precision radiotherapy for pulmonary metastases.