Thoracic Radiotherapy in the Immunotherapy Era: Current Challenges and Future Directions

Dear Colleagues,

The treatment landscape of lung cancer has changed substantially with the introduction of immune checkpoint inhibitors, molecularly targeted agents, and other emerging systemic therapies. These advances have prolonged survival and expanded treatment options, while also raising new questions regarding the optimal role, timing, and safety of thoracic radiotherapy.

This Special Issue, entitled “Thoracic Radiotherapy in the Immunotherapy Era: Current Challenges and Future Directions”, aims to explore how radiotherapy should evolve in an era of increasingly diverse systemic treatments. Topics of interest include the integration of thoracic radiotherapy with immune checkpoint inhibitors and novel anticancer agents; prevention and prediction of pulmonary toxicity; management of patients with interstitial lung disease or other high-risk conditions; and strategies to improve the therapeutic ratio through advanced radiation techniques, adaptive radiotherapy, and particle therapy.

Moreover, improvements in systemic therapy are changing not only how radiotherapy is delivered, but also when and for whom it should be used. As more patients achieve prolonged disease control, local treatment may play an increasingly important role in selected patients with oligometastatic or oligoprogressive disease, as well as in consolidation and durable disease control. These evolving indications require careful consideration of treatment sequencing, combination strategies, patient selection, and late toxicity.

We welcome original research, real-world studies, exploratory and feasibility analyses, early clinical experiences, dosimetric investigations, and comprehensive reviews. Emerging data that may help shape the future of thoracic radiotherapy are encouraged.

Topics of interest include, but are not limited to, the following:

• Integration of thoracic radiotherapy with immunotherapy and novel systemic treatments;
• Treatment sequencing and multidisciplinary decision-making;
• Radiation-induced lung injury and immune-related pneumonitis;
• Thoracic radiotherapy in patients with interstitial lung disease or other high-risk conditions;
• Patient selection and prediction of treatment-related toxicity;
• Advanced radiation techniques, including IMRT, adaptive radiotherapy, proton therapy, and carbon-ion radiotherapy;
• Radiotherapy for oligometastatic and oligoprogressive lung cancer;
• Consolidative and salvage local therapy in the era of prolonged systemic disease control;
• Real-world implementation, feasibility studies, and early clinical experiences;
• Biomarkers, radiomics, and dosimetry relevant to thoracic radiotherapy.

Dr. Shuri Aoki
Dr. Chai Hong Rim
Dr. Katsuyuki Shirai
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.