Radiation therapy uses high energy x-rays to destroy cancer cells. Special tools and dosing will help to kill as much of the cancer as possible while minimizing the effect on nearby healthy tissue. A radiation oncologist will customize the treatment dose for individual needs.
For lung cancer, radiation therapy may be used in combination with chemotherapy (called chemoradiation). The combination of chemotherapy and radiation is often more effective in shrinking lung tumors and extending life than either treatment alone.
Radiation therapy may also be given: Before surgery to shrink the tumor and minimize the amount of tissue that has to be removedAfter surgery to kill any remaining cancerous tissueFor metastatic cancer to relieve symptoms and extend survival time
There are many different radiation machines used for external radiation therapy based on the size of the tumor, surrounding tissue, and type of cancer. The radiation oncologist will discuss options, doses, and frequency of radiation so that the highest amount of radiation can be delivered to the cancer with as little impact on healthy tissue as possible.
External beam radiation is often given daily over the course of several weeks.
Radiation of a Tumor
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Delivery methods help to deliver the maximum amount of radiation possible to the tumor while minimizing exposure to healthy surrounding tissue. Methods to improve delivery include:
3D conformal radiation therapy (3D-CRT)—Imaging tests are used to map the lungs. Once the tumor is located, radiation beams are directed at it from different angles.Intensity modulated radiation therapy (IMRT)—A computerized machine rotates around the patient to deliver radiation to the tumor site. Dosage can be weakened or strengthened depending on the target tissue. Another type of IMRT that can be used is called volumetric modulated arc therapy (VMAT).Stereotactic body radiation therapy (SBRT)—Mainly used for early stage lung cancer. It may be used when surgery cannot be done or the patient chooses not to have it.Stereotactic radiosurgery (SRS)—Stereotactic radiosurgery is a type of external radiation therapy that can deliver radiation in a very precise location. This allows delivery of higher doses of radiation because it can precisely deliver it to the tumor and not healthy tissue. The precise delivery may also require fewer doses than traditional radiation therapy.
It is used in patients who have one tumor that has spread to the brain. In some cases, it may be used at the same time as surgery.
This is also called internal radiation therapy. Radioactive material in a specialized container is placed near the tumor. This allows a higher dose of radiation to be delivered directly to the tumor. It is generally used to treat tumors that are obstructing the airway. The material is placed during a bronchoscopy, a procedure that threads a lighted tube into the nose or mouth and down the trachea to the tumor site.
Complications of radiation therapy to the chest and abdominal areas may include:
Sore throatShortness of breath or other breathing problemsPain or difficulty during swallowing, which may make it hard to eatCough
A variety of treatments are available to help manage side effects of radiation therapy, such as dry, irritated skin, nausea, vomiting, and fatigue due to anemia. Sometimes adjustments to treatment doses may also be possible. The earlier side effects are addressed, the more likely they will be controlled with a minimum of discomfort.
Lung cancer (non-small cell). American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003115-pdf.pdf. Accessed July 28, 2016.
Lung cancer (small cell). American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003116-pdf.pdf. Accessed July 28, 2016.
Radiation therapy. American Lung Association website. Available at: http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/diagnosing-and-treating/radiation-therapy.html. Accessed July 28, 2016.
Treatment option overview. National Cancer Institute website. Available at: http://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq#section/_164. Updated July 8, 2016. Accessed July 28, 2016.
Treatment option overview. National Cancer Institute website. Available at:
http://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq#section/_92. Updated July 7, 2016. Accessed July 28, 2016.
Last reviewed September 2016 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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