The combination of programmed cell death 1/programmed cell death ligand 1 blockade and thoracic radiotherapy has become the new standard of care in the treatment of locally advanced non-small-cell lung cancer. The information regarding the pulmonary safety of such therapy remains limited to mostly retrospective studies and case reports with a small portion of data from prospective clinical trials. By analyzing the underlying mechanisms of interactions between radiation and immunotherapy from preclinical data and summarizing safety data from relevant clinical studies with pulmonary toxicity, we believe that longer and rigorous follow-up is warranted, to determine if the combination of such modalities is appropriate for patients without risking undue toxicity.

Cutaneous T-cell lymphoma is a rare group of malignancies characterized by the proliferation of CD4+ T-cells, of which mycosis fungoides (MF) is the predominant subtype. The neoplastic lymphocytes of MF are extremely radiosensitive and even low doses of radiation can produce excellent responses. As such, radiotherapy (RT) is considered to be the most efficacious single agent treatment option for MF. Total skin electron beam therapy (TSEBT) is a special RT technique that allows for homogenous irradiation of the entire skin. The effectiveness of conventional-dose (cd) TSEBT (30–36 Gy), particularly at inducing complete cutaneous responses, has been well documented over the years. Nonetheless, most patients eventually relapse. In these cases, cd-TSEBT is limited as RT toxicity is dose-dependent. Consequently, clinicians are moving towards low-dose (ld) TSEBT (10–12 Gy). Institutional studies and prospective trials have shown similar response rates, overall survival and symptomatic relief with this regimen, albeit at the cost of complete response. Advantages of ld-TSEBT include decreased treatment length, improved side effect profile, and the opportunity for multiple applications following disease recurrence. This comprehensive review evaluates TSEBT techniques, clinical outcomes, impact of different dose regimens, and toxicities in the treatment of MF. Future applications of TSEBT with newer systemic agents are also discussed.