Introduction Treatment of thoracic symptoms related to lung cancer with palliative radiotherapy is routinely performed in conjunction with radiation oncology practice. Various clinical trials, meta-analyses, practice guidelines, consensus statements, and Cochrane reviews have been conducted on different questions related to palliative thoracic radiotherapy considerations including: patient selection, external-beam radiotherapy dose fractionation, endobronchial brachytherapy, and chemotherapy. Discussion Novel radiotherapy technologies such as stereotactic ablative radiotherapy may allow new populations to benefit from radiotherapy. These new populations include: early stage lung cancer patients not fit for surgery that previously would be treated with best supportive care or palliative approaches and the treatment of oligometastatic lung metastases.
ConclusionThe goal of this narrative review is: (1) to review the foundations of what has already been established in palliative thoracic radiotherapy, with a focus on published clinical trials, (2) to review and discuss emerging data and trends in radiotherapeutic options for patients with advanced thoracic malignancies, with a focus on both clinical trials and other forms comparative-effectiveness research, and (3) to discuss active areas of research and future directions for research in this challenging patient population.