Non-Small Cell Lung Cancer - Radiation Treatments

Standard Radiation Procedures

The goal of radiation treatment is to administer doses as high as possible to kill as many cancer cells as possible, without destroying surrounding healthy tissues or causing excessive toxicity. Different procedures may be tried. The exact radiation procedure depends on the site of the cancer or its extent:

External-Beam Radiation. External-beam radiation therapy focuses a beam of radiation directly on the tumor. It is generally used for metastasized cancer.
Brachytherapy. Brachytherapy involved the implantation of radioactive seeds through thin tubes directly into the cancer sites. Brachytherapy may be used for lung cancers that have spread to the throat and cause obstruction. High-dose-rate brachytherapy may also have some value for patients who have inoperable tumors in the central region of the lung.

text continues below

Hyperfractionated Radiotherapy

Hyperfractionated radiotherapy administers smaller than standard doses a number of times a day (usually two or three). This allows a higher cumulative dose over the whole course of treatment. It is not as useful as sole therapy, but needs to be combined with chemotherapy to have any survival benefits.

Hyperfractionated Accelerated Radiotherapy. Continuous hyperfractionated accelerated radiotherapy (CHART) administers multiple doses per day but uses standard doses. This allows the total dose of radiation to be administered over a shorter time period than the standard six weeks. CHART is proving to extend survival rates of patients with localized cancer over that of standard radiotherapy or non-accelerated hyperfractionated radiation. It can cause severe swallowing problems. A modification in which treatment is suspended for two days out of seven may help reduce this effect.

Three-Dimensional Conformal Radiotherapy

Three-dimensional (3-D) conformal radiotherapy involves external-beam radiation that is designed to conform closely to the specific targeted organs or tissues. This allows significantly higher doses to attack the cancer while reducing the risk to healthy cells. In a 2003 report, three-year survival rates in stage IIIA patients were nearly 60%, and nearly half the patients experienced no side effects.

Stereotactic body radiotherapy, an advance on conformal radiation, uses a body frame and an abdominal press to immobilize the patient's body and limit breath movement. This allows a more precise delivery of high-energy photons, which are delivered to the tumor using a linear accelerator. The technique is still investigational.