Lung Cancer Radiation Therapy
Radiation therapy is one of three main treatments for asbestos-related lung cancer. The therapy, which exposes tumors to high doses of radiation, can be used alone or as part of a multimodal treatment approach. The radiation begins killing cancer cells within days or weeks of the first session and can continue to attack the cells for up to several months afterward.
Radiation therapy can be used in a number of clinical settings for lung cancer:
- Before surgery to reduce the volume of the tumor
- After surgery to kill any cancerous cells the surgeon may have left behind.
- Or in place of surgery to shrink inoperable lung cancer tumors or to treat cancer that has spread to other parts of the body.
Radiation therapy can also be given alongside chemotherapy to improve the patient's response to the chemotherapeutic drugs.
A radiation oncologist will decide which whether internal radiation therapy or external-beam radiation therapy (EBRT) would be more effective for your cancer, prescribe a dose of radiation and help you manage your side effects. To learn more about the radiation therapy treatment process – as well as the other treatment options for lung cancer and other asbestos-related lung conditions such as mesothelioma, please request a copy of our free informational packet.
Types of Radiation Therapy for Lung Cancer
Although radiation therapy can shrink lung cancer tumors caused by asbestos exposure, it can also damage the non-cancerous cells around the tumors. Often, skin irritation occurs where the radioactive rays enter the chest, while internal tissue damage can lead to other side effects such as a raspy cough.
To reduce the number of healthy tissues that are compromised during treatment, a radiation oncologist may prescribe specialized radiation delivery techniques.
Broadly speaking, radiation therapy for lung cancer can be delivered in two ways, from either:
- a source inside the body (brachytherapy)
- an external delivery machine (external beam radiation therapy)
Brachytherapy involves implanting sealed radioactive "seeds" into the lung cancer tumor, while external beam radiation therapy delivers radiation from a machine called a linear accelerator.
However, the cause of the cancer is not a consideration in selecting a type of radiation therapy. Patients with asbestos-related lung cancer can receive the same types of radiation therapy as patients with lung cancer caused by any other carcinogen, such as smoking.
External Beam Radiation Therapy (EBRT)
The linear accelerator is the preferred device used to administer EBT for cancer patients. It kills tumors with high-energy rays while sparing the surrounding healthy tissues and cells.The most common delivery method for radiation therapy is external beam radiation therapy, in which a linear accelerator aims radioactive beams at tumors. EBRT is typically given once a day, Monday through Friday, in courses that last between two and 10 weeks, depending on the method of delivery.
There are several specific types of radiation therapy that can be classified as external beam radiation therapy, including image-modulated radiation therapy and stereotactic body radiation therapy. These types of EBRT are all different in the way that the beams are directed to the tumors.
Fast Fact: Radiation doses can be hyperfractionated (broken down into several weaker doses given more than once a day) or hypofractionated (increased to larger doses given less often than once a day.)
Treatment Process for External Beam Radiation Therapy for Lung Cancer:
click to view the processBecause lung cancer radiation therapy is a localized treatment, external beams are only directed at the patient's chest (unless the cancer has spread to another part of the body that is also being treated with radiation therapy). The way the beams are directed at the tumors and vary from type to type of EBRT.
Three-Dimensional Conformal Radiation Therapy (3DCRT)
Three-dimensional conformal radiation therapy is a basic form of radiation therapy that relies on a CT scan to create a digital image of the patient's internal organs and tumors. Radiation oncologists review the images and decide how many beams are needed and from which angles they can best deliver the radiation.
Computers then calculate how much radiation should be sent to the tumors. The patient is then positioned in a body mold while computer-controlled beam-shaping devices deliver the radiation.
Intensity-modulated radiation therapy (IMRT)
Much like 3DCRT, intensity-modulated radiation therapy (IMRT) uses CT scans to tell treatment-planning software where the tumor is. With IMRT, however, up to 120 movable "leaves" adjust the radioactive beams to fit the precise shape of the tumor during the delivery session.
Each beam can be programmed to send higher or lower amounts of radiation, allowing less radiation to pass through to the surrounding lung tissue. A full course of IMRT can take between four to eight weeks, depending on the size of the tumor and the therapeutic intent.
A 2011 series conducted by MD Anderson found that 46 and 30 percent of patients with inoperable non-small cell lung cancer achieved 2-year and 3-year survival rates, respectively after undergoing IMRT.
Image-Guided Radiation Therapy (IGRT)
Unlike other forms of radiation therapy, image-guided radiation therapy uses multiple images taken before and during each treatment session. Radiation oncologists can determine if the tumor has shrunk or spread since the last treatment and adjust the treatment field accordingly.
Lung cancer patients can benefit from IGRT's respiratory gating technology, which ensures that the tumors remain in the target area even with the constant motion that occurs during regular breathing.
In 2012, researchers at the University of Chicago found that 18 months after treatment with image-guided radiation therapy, 66.1 percent of patients had achieved local control of their metastatic non-small cell lung cancer. Of the 25 patients, 31.7 percent had also received distant control of metastases. Only two patients experienced radiation-induced toxicity.
Stereotactic Body Radiation Therapy
Patients who received localized control of their cancer after undergoing SBRT. The local recurrence rates were also lower than those treated with a wedge resection. Stereotactic body radiation therapy (SBRT) is an extremely high-dose treatment that has become a standard therapy for stage one non-small cell lung cancer. Multiple images are taken to identify the tumor's location and the coordinates are programmed into a computer. Gold markers are then placed into the body to indicate where the beams should be pointed, and radiation is administered for up to 45 minutes.
Although individual sessions are longer than sessions for other forms of external beam radiation therapy, fewer sessions are required, with most patients attending five or fewer. Patients with clearly defined lung cancer tumors fewer than 7 centimeters across are typically the best candidates for SBRT.
High-Dose Rate Brachytherapy
In a 1998 study of 190 lung cancer patients with bronchial tumors, median post-HRD brachytherapy survival rate was seven months, and up to 74 percent of patients obtained symptom relief.Internal radiation therapy, also known as brachytherapy, treats lung cancer through radioactive implants in the tumor itself. Although some forms of brachytherapy use permanent implants, lung cancer patients receive temporary implants through high-dose rate (HDR) brachytherapy.
In a procedure that takes only minutes, the patient receives conscious sedation, temporary catheters are inserted into the tumors and high-dose radioactive pellets are then placed inside of the catheters. After 30 – 90 minutes of implant activity, the catheters are removed. Unlike permanent brachytherapy implants, the temporary pellets used during HDR-brachytherapy do not cause patients to become radioactive after treatment sessions.
Patients with early stage non-small cell lung cancer are considered to be the best candidates for high dose-rate brachytherapy. However, lung cancer patients whose tumors are in the lung tissue rather than the bronchi are better candidates for external beam radiation therapy.
Side Effects of Radiation Therapy for Lung Cancer
Although radiation therapy is directed at the tumors, the radiation often affects surrounding healthy cells, causing unpleasant side effects. For lung cancer patients, these side effects are most commonly contained to the lungs and chest, where the radiation beams enter the body. Radiation to the lungs can reduce the amount of surfactants that allow the lungs to fully expand, leading to shortness of breath or a cough. Skin irritation at the radiation site is also common.
Many of these side effects are mild and can be managed through basic changes. Since the side effects of radiation therapy for lung cancer are similar to the side effects of radiation therapy for mesothelioma, the side effects of radiation therapy page can provide you with additional tips to help cope with your radiation-induced complications.
More serious injuries can occur after repeated radiation therapy sessions, with up to 20 percent of lung cancer patients developing radiation pneumonitis after treatment. Advanced lung injuries such as fibrosis (scarring of the lungs) may also occur. In one study, 7 percent of patients developed grade two or higher pulmonary fibrosis within 18 months of receiving image-modulated radiation therapy for inoperable non-small cell lung cancer.
Get A Patient Advocate
If you have questions about the types of radiation therapy used to treat asbestos-related lung cancer, call (800) 615-2270. You will be connected to a knowledgeable Patient Advocate who can provide you with comprehensive information about top doctors, treatment facilities and programs that offer financial assistance to help cover the costs of your medical bills.
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Last Modified Friday, May 18th, 2012 | Disclaimer | Privacy Policy |
The information provided by The Mesothelioma Center is not a substitute for professional medical advice, diagnosis or treatment.
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