Radiotherapy for lung cancer

Radiotherapy for lung cancer uses x-rays to kill or damage cancer cells. It can be used to treat all types of lung cancer. It may be offered on its own or in combination with surgery or chemotherapy.

Radiotherapy can be used:

  • to treat an early stage lung cancer if you are unable to have surgery
  • to treat locally advanced (stage III) NSCLC or stages I–III SCLC
  • after surgery if the mediastinal lymph nodes contained cancer, to reduce the risk of the cancer coming back in the mediastinum
  • as palliative treatment to treat cancer that has spread to other organs, such as the brain or bones, and is causing symptoms
  • as palliative treatment to relieve pain and improve quality of life or extend your life (see Palliative treatment).

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Planning radiotherapy treatment

Before treatment starts, the radiation oncology team will plan your treatment, and will explain the treatment schedule and the possible side effects.

Having radiotherapy treatment

During treatment, you will lie on an examination table, and a radiotherapy machine will be aimed at the chest area. The radiation therapist will place you and the machine in the correct position and then leave the room.

You will not feel anything during the treatment, but may hear a buzzing sound from the machine. The treatment itself takes only a few minutes, but the full session may last for about 10–20 minutes.

Types of external radiotherapy

Radiotherapy may be delivered in different ways depending on the type of lung cancer. It is usually given as daily treatment over a number of weeks.

Palliative radiotherapy usually involves 1–10 treatments. A course of curative radiotherapy usually involves between 20–33 treatments over 4–6 weeks. Treatment is generally given during the weekdays with a rest over the weekend.

Stereotactic ablative body radiotherapy (SABR)

This is a way of giving highly focused radiotherapy to small NSCLC tumours while the surrounding tissue receives a low dose.

SABR is delivered from multiple beams that meet at the tumour. You may have 1–5 treatment sessions, 1–2 days apart for a couple of weeks. SABR is only suitable for tumours not close to major airways, blood vessels or the spinal cord.

Hyperfractionated radiotherapy

This means having more than one treatment of radiotherapy a day. Each treatment will be at least six hours apart to allow time for the healthy cells to repair themselves.

The whole dose of radiation is about the same as you would have for standard radiotherapy. This form of treatment is usually considered for SCLC.

Side effects of radiotherapy

The side effects of radiotherapy vary depending on the dose of radiation and the number of treatments.

Difficulty swallowing and heartburn – This may occur during treatment and continue for up to 3–4 weeks after treatment ends. You may need to change to a soft food diet and avoid hot drinks, such as tea and coffee, until these side effects improve.

Skin changes – The skin on your chest and back may become red or dry, like sunburn. Moisturising cream, such as sorbolene, should be applied to the skin when treatment starts – talk to your medical team about other products they recommend.

Fatigue – Feeling tired is common after radiotherapy. Plan your daily activities so you can rest regularly. It may also help to talk to your family, friends or employer about how they can help you.

Shortness of breath and cough – Radiotherapy may cause inflammation of the lungs, known as radiation pneumonitis. This may cause shortness of breath or a cough, sometimes during treatment but more likely one to six months after treatment ends. Radiation pneumonitis is usually temporary and can be treated with steroid (cortisone) tablets.

Side effects can change from one period of radiotherapy to the next and may build up over time. Let the radiation oncologist, radiation therapist or nurse know of any side effects you experience, as they can usually be managed.

Video: What is radiotherapy?

Watch this short video to learn more about radiotherapy.

This information was last reviewed in November 2016.
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