The Role of Stereotactic Body Radiotherapy in Oligometastatic Non-Small Cell Lung Cancer

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This is an interesting review of the trials done and on-going on the issue of local treatments for patients with an oligometastatic status. the paper is ,well written and is on a clear interest to provide information on this issue.

Reading the paper, the authors are not given information on the possible role of radiosurgery or SBRT to stimulate the inflammatory status of the tumor and more sensitive to immunotherapy; There is a lot of discussion on the timing but this is another issue.

 

The paper should be published as It provide information on the data available and on somr hot questions.

Author Response

Comment 1: 

This is an interesting review of the trials done and on-going on the issue of local treatments for patients with an oligometastatic status. the paper is ,well written and is on a clear interest to provide information on this issue.

Reading the paper, the authors are not given information on the possible role of radiosurgery or SBRT to stimulate the inflammatory status of the tumor and more sensitive to immunotherapy; There is a lot of discussion on the timing but this is another issue.

 

The paper should be published as It provide information on the data available and on somr hot questions.

Response 1: 

Thank you very much for your comments. We initially discussed possibly discussing the Abscopal effect, and how radiation therapy and immunotherapy may have a synergistic effect. However, this remains a controversial topic; especially with the data from NRG LU-002 which may appear to refute this theory, we decided to omit this topic from our article in its entirety. If you think this is essential for our work, please let us know.  

Reviewer 2 Report

Comments and Suggestions for Authors

This paper presents a review of the role of SBRT in the treatment of oligometastatic NSCLC. SBRT has several advantages in this setting. It is non-invasive, applicable to diverse patient populations, and effective for lesions in various anatomical locations, even in patients who cannot undergo surgery. The text highlights that SBRT can improve progression-free and overall survival, delay the need for systemic therapies, and mitigate the financial and quality-of-life burdens of disease progression, while ongoing trials, such as NRG-LU002, aim to refine its role, particularly in combination with emerging immunotherapies.

The paper is well written and structured. Introduction clearly address the review’s topic. The studies are well described and documented with tables. Discussion well focalized the main aspects of this matter.

I have not fundamental criticism for this manuscript and I suggest the publication in the present form.

Author Response

Reply 1: 

This paper presents a review of the role of SBRT in the treatment of oligometastatic NSCLC. SBRT has several advantages in this setting. It is non-invasive, applicable to diverse patient populations, and effective for lesions in various anatomical locations, even in patients who cannot undergo surgery. The text highlights that SBRT can improve progression-free and overall survival, delay the need for systemic therapies, and mitigate the financial and quality-of-life burdens of disease progression, while ongoing trials, such as NRG-LU002, aim to refine its role, particularly in combination with emerging immunotherapies.

The paper is well written and structured. Introduction clearly address the review’s topic. The studies are well described and documented with tables. Discussion well focalized the main aspects of this matter.

I have not fundamental criticism for this manuscript and I suggest the publication in the present form.

Response 1: 

Thank you for your comments and for the feedback to our article.