Radiotherapy is an effective local treatment modality of NSCLC. Its capabilities of eliminating tumor cells by inducing double strand DNA (dsDNA) damage and modulating anti-tumor immune response in irradiated and nonirradiated sites have been elucidated. The novel ICIs therapy has brought hope to patients resistant to traditional treatment methods, including radiotherapy. The integration of radiotherapy with immunotherapy has shown improved efficacy to control tumor progression and prolong survival in NSCLC. In this context, biomarkers that help choose the most effective treatment modality for individuals and avoid unnecessary toxicities caused by ineffective treatment are urgently needed. This article summarized the effects of radiation in the tumor immune microenvironment and the mechanisms involved. Outcomes of multiple clinical trials investigating immuno-radiotherapy were also discussed here. Furthermore, we outlined the emerging biomarkers for the efficacy of PD-1/PD-L1 blockades and radiation therapy and discussed their predictive value in NSCLC.

放疗是非小细胞肺癌有效的局部治疗方式。其通过诱导双链 DNA (dsDNA) 损伤和调节受照射和未受照射部位的抗肿瘤免疫反应来消除肿瘤细胞的能力已得到阐明。新型 ICIs 疗法为对包括放疗在内的传统治疗方法有抵抗力的患者带来了希望。放疗与免疫治疗的整合已显示出在控制肿瘤进展和延长非小细胞肺癌生存期方面的疗效。在这种情况下，迫切需要生物标志物来帮助为个人选择最有效的治疗方式并避免因治疗无效而引起的不必要的毒性。本文综述了辐射对肿瘤免疫微环境的影响及其相关机制。此处还讨论了多项研究免疫放射治疗的临床试验的结果。此外，我们概述了 PD-1/PD-L1 阻断剂和放射治疗功效的新兴生物标志物，并讨论了它们在 NSCLC 中的预测价值。