When is Radiation Used for Lung Cancer?

The type of radiation treatment for lung cancer depends on many of your personal factors, including:

• The type of lung cancer
• The size and location the tumor
• How close the tumor is to normal tissues that are sensitive to radiation
• Whether you will have other types of cancer treatment
• Your general health and medical history
• Your age and other medical conditions

The standard treatment for small cell lung cancer (SCLC) is radiation to the chest given at the same time as chemotherapy (called concurrent chemoradiation). Radiation therapy can also be used to prevent SCLC from spreading to the brain. In the case of extensive-stage SCLC, it may be used to palliate tumors elsewhere in the body, such as in the brain or bone, before chemotherapy.

People with early-stage non-small cell lung cancer (NSCLC) who are not candidates for surgery are typically treated with stereotactic body radiation therapy. This treatment offers excellent long-term chances to eliminate small lung lesions.

What are the effects of radiation treatment?

Every person reacts differently to radiation treatment. Side effects experienced depend on the type and location of the lung cancer, the dose of radiation being given, and the patient’s general health.

Common side effects patients may deal with are: fatigue, skin problems, hair loss, nausea and vomiting, weight loss and lack of appetite.

What are the types of radiation used for treating lung cancer?

Radiation therapy slows or stops tumor growth by damaging the DNA and stops cancer cells from dividing and growing. In many cases, radiation therapy kills all of the cancer cells, thus shrinking or eliminating tumors.

Three-dimensional conformal radiation therapy (3D-CRT)
Three-dimensional conformal radiation therapy (3D-CRT) is used to treat tumors that in the past might have been considered too close to vital organs and structures for radiation therapy. Using this specialized equipment and software allows the radiation oncologist to develop a radiation therapy treatment plan with more precision.

Intensity modulated radiation therapy (IMRT)
This treatment is carefully planned by using 3-D computed tomography (CT) or magnetic resonance (MRI) images of the patient along with computerized calculations to the best dose intensity pattern specifically for the tumor.

To achieve this precision therapy, IMRT does require slightly longer daily treatment times. Most facilities rely on a specially trained team for IMRT delivery. This team includes the radiation oncologist, medical physicist, dosimetrist, radiation therapist and radiation therapy nurse. It requires additional planning and safety checks prior to starting the treatment when compared with conventional radiotherapy.

Stereotactic body radiation therapy (SBRT)
Stereotactic radiation is a type of external radiation therapy that uses special equipment to position the patient and precisely deliver radiation to a tumor. SBRT is also known as stereotactic ablative radiotherapy (SABR). This therapy is given in fewer (usually 1 to 5) treatments. Several beams are aimed at the tumor from different angles.

Because doctors are able to treat lung cancers more accurately, this procedure lessens the radiation exposure to nearby healthy tissues.

These advanced stereotactic radiation techniques allow for effective treatment of brain metastases. Stereotactic radiosurgery only targets areas of the brain that are suspected to be affected by the disease. Stereotactic radiosurgery may help patients avoid nervous system side effects caused by whole brain radiation therapy.

How is Radiation used as part of Combination Therapy?

For some people, radiation may be the only treatment you need. But, most often, you will have radiation therapy with other cancer treatments, such as surgery, chemotherapy, and immunotherapy. Radiation therapy may be given before, during, or after these other treatments to improve the chances that treatment will work.

Radiation therapy may be used in conjunction with surgery. In this scenario, radiation targets potential microscopic disease after surgery.

Learn more about Combination Therapy

Are There Radiation Clinical Trials?

There are clinical trials aimed to further improve the precision of imaging and radiation delivery techniques. Doctors continue to search for radiation treatments that minimize damage to the patient’s surrounding normal tissues and maximize the effectiveness of the radiation treatment to the tumor.

If radiation is suggested for lung cancer treatment, the best strategy may be to enroll in a clinical trial that evaluates new radiation techniques or combinations of surgery, chemotherapy, and radiation therapy. Doctors are also studying several targeted drugs in combination with radiation therapy to understand how radiation therapy and the immune system interact to fight cancer.

Your understanding of radiation treatment for lung cancer is important. Discuss any questions or concerns with your healthcare team.