When is Radiation Therapy Used to Treat Lung Cancer?
By Hak Choy, MD
As medical treatments for lung cancer become more advanced, increasingly personalized regimens for patients can be given that may often include radiation therapy.
Radiation therapy may be given as part of a treatment plan in the following ways:
- Prior to surgery or chemotherapy to help reduce the burden of tumor.
- At the same time or immediately after chemotherapy to increase cure rate for localized tumors.
- After surgery to help prevent recurrence of cancer.
- Palliatively, or to improve quality of life, if a tumor is causing pain or discomfort (such as shortness of breath from tumors compressing airways, or for bone pain from metastatic tumor in the bones). It is also used for treatment of metastatic tumors in the brain.
In addition, radiation oncology specialists at UT Southwestern have pioneered the use of a particular type of radiation treatment that may in the future provide an alternative to surgery for some groups of lung cancer patients. Called stereotactic body radiation therapy (SBRT), this treatment uses highly advanced imaging and tracking technology to deliver a powerful dose of radiation in just a few sessions in the outpatient setting. The result is a surgery-like ablation of the tumor using completely noninvasive technology.
Right now, this type of radiation therapy is being used for patients with early stage, non-small cell lung cancer that has not spread outside the lung. Candidates for this treatment are those who are unable to have surgery due to other illness, age, or other complicating factors.
Although diagnosing cancer in its early stages is preferred, the majority of lung cancer cases treated each year (75 percent) are advanced stage and many of these are metastatic (the cancer has spread to other sites). Both the lung tumor and its metastases may be treated with a variety of radiation techniques, including SBRT, IGRT (image-guided radiation therapy) and IMRT (intensity-modulated radiation therapy).
Radiation is particularly key in patients with brain metastases because chemotherapy is often unable to reach tumors in the brain due to poor penetration of such agents through the protective blood-brain barrier. Radiation has no such issues and can effectively treat metastatic tumors in the brain. The most precise, state-of-the-art radiosurgical treatment for brain metastases is the Gamma Knife Perfexion. (UT Southwestern has the only one in North Texas.)
With many tools and treatment methods available, radiation therapy is a powerful component in the treatment of lung cancer, offering increased survival and improved quality of life to patients at any stage.