The Evolving Role of Local Radiotherapy in the Management of Oligometastatic Non-Small Cell Lung Cancer

Abstract: Oligometastasis represents an intermediate stage between locally advanced disease and widespread metastasis, typically referring to stage IV disease with a limited number of metastatic lesions (generally no more than five) and controlled primary disease. Traditionally, advanced non-small cell lung cancer (NSCLC) has been considered incurable, relying primarily on systemic therapies. However, the “oligometastasis hypothesis” proposes that radical local radiotherapy targeting metastatic lesions in such patients may eliminate all tumor burden, potentially achieving long-term survival or even cure. This review aims to elucidate the pivotal role of localized radiotherapy in oligometastatic NSCLC by examining its clinical landscape and therapeutic challenges. Furthermore, This review uniquely integrates biological stratification, technological innovation, and systemic treatment synergy to provide a comprehensive framework for patient selection and clinical decision-making in oligometastatic NSCLC. Keywords: oligometastasis, non-small cell lung cancer, local radiotherapy, SBRT