Radiation Therapy for Early-Stage Lung Cancer
Surgery has long been the gold standard for treating early-stage lung cancer, but it’s not the right treatment option for everyone. Now, a form of highly targeted radiation therapy (stereotactic body radiotherapy, or SBRT) is proving to be an equally successful alternative treatment for certain patients.
How SBRT Works
SBRT delivers very high doses of radiation in a few sessions using precise image guidance. It uses advanced imaging technology to track the movement of lung tumors in real time, keeping the radiation tightly concentrated around a patient’s tumor while steering clear of healthy tissue.
Traditional radiation was given in the past for inoperable lung cancers, but it wasn’t very effective, causing a lot of side effects and taking weeks to deliver.
“Lung tumors move when a patient breathes,” explained Shelly Hayes, MD, a radiation oncologist and Director of Fox Chase Cancer Center Buckingham. “In the past, without some sort of ability to accurately target the tumor, radiation had to be applied to a large field so we could make sure we weren’t missing the tumor.”
Treating large fields meant that the radiation doses had to be decreased to protect the normal surrounding lung tissue. These doses were largely ineffective at killing the cancerous cells.
“Previously, daily radiation for seven weeks was the norm for lung cancer. And, it was largely ineffective—the tumor would often recur,” Hayes said.
SBRT is much more targeted, and it allows very high doses of radiation to be given in as few as a single session or up to five sessions in total. This requires less of a time commitment and minimizes breaks in systemic therapy (if that is part of the patient’s care).
Even better, mounting evidence shows that SBRT can be just as effective as surgery for treating some early-stage lung cancers. A randomized trial of patients with stage I lung cancer that compared surgery to SBRT found that SBRT provided equivalent tumor control rates as surgery with minimal side effects. These results provided evidence to support SBRT as a viable alternative to surgery for some patients.
“Patients who were treated with SBRT did just as well as the patients who had surgery, and in some instances, they did better and had fewer side effects,” Hayes said.
Identifying Eligible Candidates
A multidisciplinary care team can help determine whether SBRT is the right choice for you.
SBRT can be an especially good choice for early-stage lung cancer patients who may be at high risk for surgical complications. This includes elderly patients and those with cardiac or pulmonary disease.
SBRT is already improving survival outcomes for patients with early-stage lung cancer, and Hayes is optimistic for what’s to come.
“SBRT is now being offered as a frontline treatment for early-stage lung cancer,” she said. “Even if a patient is a candidate for surgery, we offer SBRT as an option in select patients. We counsel them on the pros and cons of each option and let them decide which treatment they prefer.”