Radiation Therapy for Non-Small Cell Lung Cancer

Sometimes our doctors recommend radiation therapy to shrink a lung tumor before surgery. Radiation therapy may be given by itself or in combination with chemotherapy. These treatments may also be used after surgery to destroy any remaining cancer cells.

Doctors may also prescribe chemotherapy and radiation for people who cannot have surgery because their tumors are difficult to remove surgically or have spread to areas outside of the lung.

Radiation therapy may be administered through a machine, an approach called external beam radiation therapy. Brachytherapy is another kind of radiation therapy that doesn’t use energy beams; instead, radioactive material is placed directly in the airways to shrink a tumor.

Our radiation oncologists use CT scans of the non-small cell lung cancer and surrounding tissue, in conjunction with treatment planning software, to design a radiation therapy plan for you. The software creates a three-dimensional image of the tumor and nearby organs, such as the heart and esophagus, enabling our doctors to determine how to best target the lung cancer, while sparing healthy tissue. Our radiation oncologists frequently blend or fuse the results from PET/CT scans with planning CT scans to provide a more complete understanding of the tumor’s location.

Doctors may also use CT scans during external beam radiation therapy sessions to ensure that the radiation targets the tumor and avoids healthy tissue. This approach, called image-guided radiation therapy, helps compensate for the movement of the lungs caused by breathing during treatment. The technique also enables doctors to track the size and shape of the tumor over several weeks, as radiation therapy shrinks it.

Our doctors may use one of several types of highly targeted external beam radiation therapy, which is delivered using a machine called a linear accelerator. This machine rotates around you during therapy, helping target the tumor from all directions. Your doctor can discuss what form of external beam radiation therapy is best for you.

Three-Dimensional Conformal Radiation Therapy

Three-dimensional conformal radiation therapy allows doctors to deliver radiation beams tailored to the size, shape, and location of the non-small cell lung tumor. The radiation oncologist aims radiation beams from several directions at the cancer, helping target the treatment area. This approach minimizes the radiation dose to healthy tissue.

The total treatment dose is broken into smaller ones, called fractions, delivered once a day, five days a week, for several weeks. Breaking the dose into fractions allows doctors to deliver enough radiation to be effective, while reducing the risk of side effects.

Intensity-Modulated Radiation Therapy

Our doctors may use intensity-modulated radiation therapy, which may further spare healthy tissue and reduce the risk of treatment-related complications.

Intensity-modulated radiation therapy allows doctors to divide treatment into many small beams and adjust the strength of each. These beams closely conform to the size, shape, and location of the cancer. Doctors can adjust the radiation within millimeters to spare surrounding healthy tissue. Treatment is delivered once daily, five days a week, for several weeks.

Stereotactic Body Radiation Therapy

Stereotactic body radiation therapy delivers a few high doses of carefully targeted radiation to the non-small cell lung tumor over several days. Your doctor may recommend this approach if you have a small tumor. People who cannot have surgery because of poor health may also be candidates for this procedure.

As with other forms of radiation therapy at Perlmutter Cancer Center, this approach uses computer and image guidance to precisely target the tumor, while avoiding healthy tissue. We use a specialized linear accelerator to deliver stereotactic body radiation therapy.

Brachytherapy

Brachytherapy, or radiation therapy placed directly into the airway, may be used to shrink tumors. This may be done if the non-small cell lung cancer is blocking an airway.

Doctors insert a bronchoscope, a long, flexible tube with a camera on the end, through the nose or mouth and into the airways. A thin tube called a catheter is placed through the bronchoscope at the site of the cancer, and the bronchoscope is withdrawn. Doctors then deliver radioactive material through the catheter to the tumor. The radiation is left in place for a few minutes, then removed.

This procedure may need to be repeated. The dose and number of treatments depends on how close the tumor is to healthy tissue.

Our doctors are often able to avoid serious side effects of radiation therapy, such as damage to nearby organs, including the heart and esophagus, by using highly targeted treatments. Other common side effects, such as fatigue, nausea, and vomiting, can often be managed with medication or with the help of NYU Langone support services and integrative health therapies.