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RP was diagnosed by chest computed tomography (CT), clinical symptoms, and irradiated field concordance, while infectious pneumonia and tumor progression were excluded by laboratory tests and serial imaging. Grade \u2265\u20092 RP occurred in 43.54% of patients (22.01% grade 2, 21.53% grade 3; no grade 4\/5 RP), with osimertinib showing the highest rates of grade \u2265\u20092 and grade 3 RP, followed by aumolertinib and furmonertinib. For grade \u2265\u20092 RP, patients receiving aumolertinib or furmonertinib had a lower observed risk than those receiving osimertinib, while ipsilateral lung V5 \u2265\u200935.93% and gross tumor volume (GTV) \u2265\u200912.62 mL were independent risk factors. For grade 3 RP, an inverse association between smoking history and RP risk was observed, whereas ipsilateral lung V30 \u2265\u200924.61% and GTV \u2265\u200914.56 mL were associated with increased risk. Median progression\u2010free survival (PFS) was 26.70 months, with no significant difference among the three TKIs. In this cohort, first\u2010line third\u2010generation EGFR\u2010TKI plus TRT was associated with frequent but generally manageable RP. TKI type, ipsilateral lung V5\/V30, and GTV were key predictors of RP, although the dosimetric thresholds and drug\u2010specific differences identified in this cohort require external validation.<\/jats:p>","DOI":"10.1002\/ijc.70630","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T09:51:53Z","timestamp":1782553913000},"page":"2791-2803","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reassessing the Incidence and Risk Factors of Radiation Pneumonitis in Treatment\u2010Naive\n                    <scp>EGFR<\/scp>\n                    \u2010Mutant\n                    <scp>NSCLC<\/scp>\n                    With Concurrent Third\u2010Generation\n                    <scp>EGFR<\/scp>\n                    \u2010\n                    <scp>TKI<\/scp>\n                    and Thoracic Radiotherapy"],"prefix":"10.1002","volume":"159","author":[{"given":"Shuyue","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxiao","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuquan","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaru","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feihu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan Shandong China"},{"name":"Department of Oncology Affiliated Hospital of Southwest Medical 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