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Lung Cancer: Radiation Oncology

Radiation therapy, also called radiotherapy, is another common treatment option for some types of lung cancer. With radiation therapy, high-energy X-rays are used to shrink tumors, relieve pain and pressure, decrease symptoms, and improve quality of life. Cancer specialists called radiation oncologists provide this specialized treatment. Radiation can be used for symptom improvement alone or for the surgical alternative in locally, advanced lung cancer (usually in combination with chemotherapy.) Radiation may also be used after surgery if patients are thought to be at high risk of recurrence.

Radiation treatments are given to a specific area of the body (called a radiation field) during a series of outpatient hospital visits. The amount of radiation used to treat lung cancer varies, based on treatment intent, type of lung cancer, the size and location of the tumor, and the sensitivity of the normal tissue that surrounds it. Side effects of radiation depend on where the radiation field is located. Usual side effects of chest/ lung irradiation include fatigue, dry cough, mild shortness of breath, irritation of the esophagus, as well as redness of the skin over the treatment field.

Radiation Techniques

  • Three-dimensional conformal radiation therapy - uses CT images and computers to shape radiation beams to match the tumor’s size and shape, so the radiation dose can be sculpted to the tumor while minimizing collateral damage to surrounding normal tissues.
  • Respiratory gating – patients are treated during a certain phase of the breathing cycle in order to minimize the radiation field size, which allows for an increased dose to the tumor while decreasing the dose to normal tissue.
  • Stereotactic radiotherapy – May be an alternative to surgery for certain types of lung cancers, which are very early stage. It involves precise localization of the tumor using CT-based images while being treated. Because of the precise localization and small treatment areas, high daily radiation doses are possible. Treatment can be completed in one to two weeks.
  • Accelerated hyper-fractionation – Involves treating patients with twice daily radiation. As a result the overall treatment time is shorter. The technique has been shown to be useful in early stage small cell lung cancer.
  • Radiation sensitizers – drugs that make cells more sensitive to the effects of radiation (usually chemotherapy.)