Radiotherapy Response Patterns in Thoracic NUT Carcinoma: A Case Report.

NUT carcinoma is a rare and highly aggressive malignancy, particularly when arising in the thorax. Radiotherapy is commonly used for symptom palliation; however, radiotherapeutic response patterns in thoracic NUT carcinoma remain poorly characterised. We report a 22-year-old woman with thoracic NUT carcinoma who demonstrated markedly heterogeneous responses to palliative radiotherapy across metastatic sites. A thoracic lesion causing superior vena cava (SVC) syndrome showed sustained radiographic improvement after irradiation, whereas a pelvic bone metastasis progressed shortly after single-fraction radiotherapy despite transient symptom relief. Although differences in delivered radiation dose likely contributed to these outcomes, this case illustrates practical considerations in palliative radiotherapy for thoracic NUT carcinoma, including effective symptom control for SVC syndrome and the limited durability of single-fraction radiotherapy for bone metastases. This case highlights practical considerations in palliative radiotherapy for thoracic NUT carcinoma and provides an educational perspective for respiratory physicians involved in multidisciplinary cancer care.