Mass General Brigham investigators used artificial intelligence to link incidental radiation exposure to the thymus with poorer outcomes in patients treated for locally advanced non-small cell lung cancer. In a study published in Annals of Oncology, the analysis of more than 1,100 patients found that higher thymic exposure correlated with worse disease progression, suggesting immune-organ preservation may influence durability of treatment response. The findings position the thymus as more than a passive structure in adult oncology, and they align with growing interest in how radiation planning and immune system preservation can alter immunotherapy effectiveness. For radiation oncology teams, the immediate implication is that planning and constraint strategies may warrant renewed attention as AI tools help identify risk relationships that conventional quality metrics may miss.