All Cancers Lung Cancer Treatment & Recovery

When is Radiation Therapy Used?

Medically Reviewed by Martin J. Edelman, MD

Written by J. GuanJan 2, 20242 min read

Source: Shutterstock

Dealing with cancer treatment can feel overwhelming and unpredictable. Throughout your journey, you will encounter various tests and treatments, including radiation therapy, a common option for lung cancer patients.

As definitive therapy

Radiation may be used with the goal of cure for small lung cancers, using techniques that have been called “stereotactic radiosurgery”, “stereotactic body radiotherapy” or “stereotactic ablative radiotherapy”.

As adjuvant therapy (after surgery)

Radiation therapy may also be used to kill any remaining cells from initial treatment, such as surgical resection. Any remnant cancer cells from initial treatment, undetected by scans, can be eliminated by radiation therapy.

As neoadjuvant therapy (before surgery)

To further improve the survival of early-stage non-small cell lung cancer (NSCLC) patients, researchers have explored if radiation therapy can be used as neoadjuvant therapy. Neoadjuvant therapies, such as chemotherapy or immunotherapy, have traditionally been used to shrink operable tumors before surgical resection. This will benefit NSCLC patients, especially those who do not tolerate chemo- or immunotherapy well.

In combination with other therapy

Chemoradiation is the combination of chemotherapy and radiation therapy. It is usually used in two ways:

As induction or neoadjuvant therapy before surgical resection
As definitive therapy for stage 2B and stage 3 lung cancers to ensure complete cancer removal.

Chemotherapy can also make cancer cells more sensitive to radiation, and the two therapies kill cancer cells more effectively when combined.

To delay cancer relapse for as long as possible

While most healthcare providers hesitate to use the word “curing cancer,” they continue to explore the best treatment options for patients with “curative” intent. Radiation therapy provides a long-term survival rate comparable to surgery for a specific group of patients with early-stage lung cancer who are not eligible for surgical intervention.

To treat limited-stage small cell lung cancer (SCLC)

The limited stage of SCLC is defined by tumor(s) and affected lymph nodes confined to one radiation “port”. Adjuvant radiation therapy is given if nodal involvement is found during surgery.

To manage oligometastatic non-small cell lung cancer (NSCLC)

It is common for stage 4 NSCLC patients to have metastasis to one or more sites (oligometastases). In addition to systemic treatment like chemotherapy, radiation therapy is offered to shrink or eradicate the metastatic tumor (tumor spread from lung cancer). Compared to surgery, radiation therapy is non-invasive, so it is preferred for organ preservation. This is vital for delicate organs like the brain.

In palliative care

When radiation therapy is used to treat lung cancer palliatively, the objective is to shrink tumors obstructing the airways and relieve the obstruction symptoms. One such example is brachytherapy. It involves the placement of radioactive sources in close proximity to the tumor. High doses of radiation target the tumor precisely and shrink the tumor to relieve airway symptoms.

Your doctor may implement radiation therapy during different times of your cancer treatment. It depends on the type and stage of your lung cancer. Stay resilient, and know that your healthcare providers are always there to support you and provide resources to help you face this challenge more easily and confidently.