Advances in the research on radiotherapy for lung cancer: a 2025 review

This study reviewed radiotherapy-related studies on lung cancer presented at the 2025 major international conferences [American Society of Clinical Oncology (ASCO), World Conference on Lung Cancer (WCLC), European Society for Medical Oncology (ESMO), and American Society for Radiation Oncology (ASTRO)] or published in high-impact journals. The studies were classified by pathological type [non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)] and analyzed according to different tumor stages. Research showed that the combination of immunotherapy and stereotactic body radiotherapy (SBRT) failed to improve overall survival (OS) and progression-free survival (PFS) in early-stage NSCLC, so its combined application requires caution. In locally advanced NSCLC, EA5181 and SKYSCRAPER-03 trials identified that durvalumab administered concurrently with definitive chemoradiotherapy (dCRT) or atezolizumab + tiragolumab combination following concurrent chemoradiation therapy (cCRT) failed to improve PFS. The PACIFIC regimen remains the current standard treatment. R-ALPS trial indicated that, as consolidation therapy after dCRT, immunotherapy combined with anti-angiogenic agents achieved a prolongation of PFS with manageable treatment-related adverse events (TRAEs). In advanced NSCLC, NROG-002 and NorthStar trials demonstrated that epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) plus thoracic radiotherapy (TRT) or local consolidation therapy (LCT) can significantly improve patients' PFS. The results expanded the traditional "oligometastasis" definition from "oligo-sites" to "oligo-organs". For SCLC treatment, hypofractionated radiotherapy (HyPORT) has comparable efficacy to conventional radiotherapy, with a lower incidence of adverse reactions. NRG-CC003 trial indicated that hippocampal avoidance prophylactic cranial irradiation (HA-PCI) reduced neurocognitive function (NCF) failure in comparison with PCI. This review provides references for clinical decision-making in lung cancer radiotherapy and future research directions.