Radiation therapy uses high-energy X-rays or other types of radiation beams to kill cancer cells or stop them from growing. While the radiation damages both cancer cells and normal cells, normal cells can recover more quickly. Cancer cells, however, usually cannot recover at all.
In order to save the surrounding normal tissue, modern radiation therapy specifically targets the cancer as precisely as possible. Radiation oncologists at Fox Chase Cancer Center helped to develop these highly precise forms of radiation therapy. These techniques can be used instead of surgery, in many cases, to treat certain lung cancers.
Radiation also might be:
- Combined with chemotherapy
- Used before surgery (sometimes with chemotherapy) to shrink tumors in the lungs before the surgeon operates
- Used in place of surgery if you are unable to tolerate an operation
Internal Vs. External Radiation Methods
External radiation uses a machine to beam high-energy rays from outside the body to the tumor. It’s the most common type of radiation therapy used for cancer. It’s usually performed on an outpatient basis, and most patients get a series of treatments, called fractions.
Internal radiation involves placing small, radioactive implants inside the body, in or near a cancerous growth. It can allow specialists to treat a tumor with higher doses of radiation in a smaller area than external radiation allows. Internal radiation can offer fewer side effects than external-beam radiation treatments, depending on the type of treatment used, your health, the stage of your cancer, and other variables.
Whether your physician recommends external or internal radiation will depend on a number of factors, such as:
- Your type and stage of cancer
- The tumor’s size and location
- The tumor’s distance from normal tissues that could be vulnerable to radiation
- Your health and medical history
- Whether you’re receiving other types of cancer treatment, such as chemotherapy
Radiation might sound unsettling, but both types of treatments are usually painless. Before you have either type of treatment, your doctor will consider what’s best for your health, make a recommendation to you, and explain his or her reasoning. Our treatment plans are designed to be tolerable to your body, but produce effective results.
Radiation Therapies for Non-Small Cell Lung Cancer
External Beam Radiation Therapies include:
Intensity-Modulated Radiation Therapy (IMRT) combined with Volumetric Modulated Arc Therapy (VMAT)
This technique allows radiologists to “shape” the aim of several small radiation beams to precisely target the lung tumor in all three dimensions and spare more normal tissues. It allows for higher doses of radiation and reduced treatment delivery time, compared to standard IMRT treatments. Fox Chase Cancer Center was the first in the region to use VMAT and IMRT and our physicians have the most experience with these technologies in the United States. Data from CT and MRI scans is used to determine the shape and location of the lung tumor(s).
3-Dimension Conformal Radiation Therapy (3D-CRT)
This method is similar to IMRT, but may offer a better outcome for some types or locations of cancer. Radiation oncologists develop individually tailored treatment plans using three-dimensional imaging to precisely shape the radiation beams to the tumor. Depending on the cancer, 3D-CRT is often preferred over IMRT because there are fewer radiation beams, allowing doctors to completely avoid healthy tissue when appropriate.
Stereotactic Body Radiotherapy (SBRT)
This radiation technique uses the CyberKnife® robotic radiosurgery system or a linear accelerator to deliver large doses of radiation to very small areas. It aims multiple small X-ray beams at a target region or tumor. This allows for preserving more healthy tissue than conventional external beam therapy. We achieve additional precision by keeping the patient very still during the procedure.
Image-Guided Radiation Therapy (IGRT)
Uses imaging devices, such as X-rays, ultrasound, and CT scans, to localize and guide daily radiation treatment for some lung cancers. On-board imaging improves the precision and effectiveness of treatments by allowing physicians to target and track tumors more accurately. The On-Board Imager provides IGRT by obtaining high-resolution X-ray images to pinpoint tumor sites, adjust patient positioning if necessary, and complete a treatment, all within the time it would take to deliver standard treatment.
Internal radiation treatments include:
Brachytherapy or Implant Radiation Therapy
These types of therapy use either:
- Radioactive seeds (small pellets) placed inside or near a tumor, or
- A temporary implant, such as a wire or catheter
These materials deliver high-dose rate (HDR) or low-dose rate (LDR) radiation directly to the cancer site. This reduces radiation exposure to the surrounding healthy tissues.
Doctors can do real-time brachytherapy treatment planning in the operating room and implant either permanent or temporary seeds to treat lung cancers.
Radiation Therapies for Small Cell Lung Cancer
You might receive either internal or external radiation therapy, depending on the type and stage of your cancer.
External radiation therapy for small cell lung cancer can include:
Intensity-Modulated Radiation Therapy (IMRT) combined with Volumetric Modulated Arc Therapy (VMAT)
3-Dimension Conformal Radiation Therapy (3D-CRT)
Stereotactic Body Radiotherapy (SBRT)
Image-Guided Radiation Therapy
Other small cell lung cancer treatments include:
Internal radiation therapy for small cell lung cancer
This involves inserting either radioactive seeds (small pellets) or radioactive implants in the body, within or near the tumor site. A physician can order either high-dose or low-dose radiation, depending on which is appropriate. Internal radiation therapy lowers radiation exposure to surrounding healthy tissues.
Cranial irradiation therapy
This type of therapy may also be given to reduce the risk that the small cell lung cancer will spread to the brain.
Treatment Innovations
Fox Chase is known for its advanced treatments, highly experienced teams, and reputation for bold discoveries in cancer care. We are continuously involved in developing state-of-the-art treatments for lung cancer. One of our most recent innovations was hypofractionated radiation therapy.
Hypofractionated radiation therapy is a technique that delivers more doses of radiation per treatment. Patients can complete their course of radiation therapy much faster than conventional treatment and have fewer short-term side effects and better quality of life. Radiation oncologists at Fox Chase pioneered this new approach, which is fast becoming the standard of treatment for lung cancer.
Many clinical trials have proven hypofractionation to be just as safe and effective as conventional radiation therapy. Although the length of treatment using hypofractionation depends on the type of cancer being treated, lung cancer patients can complete their treatment course in as little as 1½ weeks when appropriate—a significant reduction from conventional treatment, which typically takes 6 to 6 ½ weeks.
In addition to delivering radiation therapies, Fox Chase also has the latest 4D technologies, such as the LightSpeed RT 16-slice 4D CT Simulator and the Calypso 4D Localization System [MC1] for real-time tracking and targeting of radiation treatments.