Radiation therapy for lung cancer

Radiation therapy, a common treatment for lung cancer, uses high-energy forms of X-rays to kill cancer cells or damage them so they stop growing. Lung cancer patients may be treated with one or a combination of radiation therapy technologies.

For lung cancer, radiation therapy may be given in combination with other treatments, including chemotherapy. It may be used to shrink tumors before surgery or to kill remaining cancer cells after surgery. Radiation therapy may also be used instead of surgery for early-stage lung cancer or for patients who aren’t healthy enough to have surgery.

Radiation therapy may also be used as a palliative treatment to ease lung cancer symptoms, such as difficulty breathing. It may also be used to treat metastatic lung cancer that has spread to the brain, bones or other organs.

The length of radiation therapy treatment depends on a variety of factors, including the type of therapy used, the lung cancer stage and the patient’s overall health.

Types of radiation therapy for lung cancer

A variety of radiation therapy options may be available depending on the patient's diagnosis, so the radiation oncology team will work with the patient to develop a customized treatment plan based on the type of lung cancer and the tumor's location.

External beam radiation therapy (EBRT)

Advanced EBRT helps to lower the risk of side effects typically associated with radiation treatment for lung cancer, such as difficulty breathing or heart damage. Some additional advantages of EBRT may include:

• The procedure itself is painless.
• EBRT poses no risk of radioactivity to patients or to others who are in contact with them, allowing lung cancer patients to continue normal activities with family and friends.

Types of EBRT to treat lung cancer include:

Intensity modulated radiation therapy (IMRT)

Three-dimensional planning with IMRT allows the radiation oncologist to simultaneously treat lung cancer tumors with different doses of radiation, while sparing healthy tissue in the lungs and elsewhere. A computer-controlled device called a linear accelerator delivers radiation in doses that match the 3-D geometrical shape of the target, including concave and complex shapes.

RapidArc^®

The care team may use RapidArc technology to deliver IMRT with greater speed and precision. RapidArc radiation therapy is designed to shorten treatment times. In a single 360-degree rotation, a linear accelerator revolves around the patient, delivering a sculpted, tightly focused beam of radiation directly to a tumor in less than two minutes. This results in better tumor targeting and less damage to surrounding healthy tissue. It also helps reduce the amount of time a patient spends in radiation treatment.

Respiratory gating

Tumors, such as those near the lungs, often move as a result of breathing and other involuntary movements in the body. Respiratory gating enables the radiation therapy team to “paint” concentrated doses of radiation onto tumors with greater accuracy. The system tracks tumor motion as a result of breathing, helping the care team to target the tumor and protect healthy tissue from receiving unnecessary radiation during radiation therapy.

Stereotactic body radiation therapy (SBRT)

Preserving healthy tissue is important for many lung cancer patients, who may be struggling with other conditions, such as emphysema. With SBRT, the procedure:

• May be used instead of surgery in early-stage lung cancer or for patients for whom surgery is not an option
• Delivers higher radiation doses to tumors, which would not be possible with other radiation therapies
• Causes less damage to healthy lung tissue
• Requires fewer treatments than conventional radiation therapy

SBRT, a sub-type of external beam radiation, uses advanced technologies such as:

TrueBeam™ and CyberKnife^®: The software and respiratory tracking systems in these advanced technologies are designed to confirm the location of a lung tumor and continually track its movement in real time, which allows for the delivery of a more precise dose of radiation without damaging surrounding healthy tissue.

TomoTherapy^®: This technology is designed to deliver precise radiation doses to match complex lung tumor shapes while avoiding sensitive structures. This may help limit side effects, such as shortness of breath or heart damage.

High-dose rate brachytherapy (HDR)

Because the lungs support breathing and are located near the heart and other essential structures, it's important for radiation treatment to be tightly focused on tumors to help avoid serious side effects. That is why HDR brachytherapy may be a benefit for some lung cancer patients. Other potential benefits of HDR brachytherapy include:

• Radiation beams are precisely targeted inside the tumors, controlling the location and intensity, and offering more precision and concentrated dosing.
• Radiation exposure to healthy lung tissue and nearby organs is limited or eliminated, reducing side effects like difficulty breathing.

Lung cancer radiation side effects

Radiation therapy may cause side effects that require additional care. These side effects may include:

• Skin irritation, redness or blistering
• Pain
• Fatigue
• Hair loss where the radiation was delivered

Side effects may be more intense if radiation therapy is delivered with other treatments, such as chemotherapy.

Radiation therapy experts work with supportive care providers who are experienced treating the side effects of radiation therapy. They’ll work with patients to provide personalized care designed to keep them strong so they can continue with their lung cancer treatment without health-related delays or interruptions.