Advances in palliative radiotherapy of metastatic non-small cell lung cancer

Radiotherapy has important role in the palliation of metastatic non-small cell lung cancer (NSCLC). Randomized trials tend to suggest that, in general, short regimens give similar palliation though with more long term toxicity compared to longer regimens. Hypofractionated radiotherapy has been the standard of care for the palliative management of lung cancer since decades. Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) are forms of extreme hypofractionation being used more frequently in the treatment of single or oligometastases. In general, they offer good tumor control with little toxicity (at a more expensive cost) compared to the traditionally fractionated radiotherapy regimens. The combination of targeted therapy with radiotherapy is an evolving concept in the management of metastatic lung cancer.