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Radiation therapy of lung cancer

Most lung cancer patients will  benefit from radiation therapy during the course of the disease. It is assumed that 65% of patients will need this treatment modality. In Norway, there is still too few who are offered radiation treatment.

Radiation treatment is suitable for both non-small cell and small cell lung cancer, as part of curative treatment and in palliative situations. For thoracic tumors, metastases to the brain and most other localizations, high-energy photon radiation is used. For superficial skin metastasis, electron rays which abruptly decelerate within the tissue are used.

Curative radiation therapy

For limited stage small cell lung cancer, radiation therapy of the thorax is included as part of the curative schedule in practically all lung cancer patients, combined with chemotherapy before and after radiation. In addition, radiation therapy to the brain is offered to prevent metastasis in patients who achieve partial or complete response on initial therapy.

For non-small cell lung cancer, radiation treatment is offered after surgery in special situations, as curative-directed treatment instead of surgery or as part of combined chemoradiotherapy for locally advanced cancer.

Palliative treatment

For extensive lung cancer or in cases of reduced general health, radiation treatment of tumor masses in the central thorax may relieve symptoms in the majority of patients.

For metastases, radiation could be the first choice for both cancer types. However, chemotherapy may be more appropriate for metastases to internal organs.

For brain metastases of small-cell lung cancer, chemotherapy is often a better option than radiation therapy. This in contrast to non-small cell lung cancer, where radiation is usually the treatment of choice for brain metastases.

Fractionation patterns

A series of treatment schedules are appropriate depending on treatment goal, tissue type, localization of the radiation field, and the patient's general health condition.

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