Radiotherapy for non-small cell lung cancer

External beam radiotherapy is a treatment that uses high-energy rays to destroy cancer cells. Using a large machine, a radiographer directs the beams at the affected area.

This type of radiotherapy may be used to:

  • Treat and cure the cancer (radical radiotherapy)
  • Control symptoms caused by the cancer (palliative radiotherapy).

Before you have radiotherapy, you may be asked to wear a hospital gown. Then the radiographers will help you into the correct position.

Once everything is ready, the radiographers will leave the room. The treatment itself takes a few minutes and is not painful.

You may have treatment every weekday with a rest at the weekend. The treatment will be given for 3–7 weeks. In some situations radical radiotherapy can be given using more than one treatment each day. This is called hyperfractionation.

Stereotactic radiotherapy is a newer external radiotherapy treatment. It uses specialist scans and machinery to target small cancers.

Internal radiotherapy may be used to open a blocked airway. A small piece of radioactive material is placed inside the lung next to the tumour for a few minutes and then removed.

Radiotherapy

Radiotherapy treats cancer by using high-energy x-rays to destroy cancer cells, while doing as little harm as possible to normal cells. The treatment is given in the hospital radiotherapy department. The number of treatments you have, and the length of time they take, will depend on the stage of the cancer and the aim of treatment.

Radiotherapy is usually given by aiming high-energy x-rays at the lung from a radiotherapy machine. This is known as external beam radiotherapy. Sometimes a type of internal radiotherapy called endobronchial radiotherapy or brachytherapy is used.

When radiotherapy is used

Radiotherapy can be given with the aim of curing the cancer (radical radiotherapy). This may be used instead of surgery. There are different ways of having radical radiotherapy.

You may have treatment every weekday with a rest at the weekend. The treatment will be given for 3–7 weeks.

Alternatively, radical radiotherapy can be given using more than one treatment – or fraction – each day. This is called hyperfractionation. As more than one treatment is given each day, the length of the course of treatment will usually be shorter than once-daily treatments. One type of hyperfractionated radiotherapy that gives three treatments a day is called Continuous Hyperfractionated Accelerated Radiotherapy (CHART).

This type of treatment is not widely available, and you may have to travel to a different hospital if your doctor thinks this treatment is suitable for you.

Palliative radiotherapy may be used to control symptoms. Fewer treatments are given and they usually have fewer side effects.


How external radiotherapy is given

To make sure that the radiotherapy works as well as possible, it has to be carefully planned. Before you start your treatment, you’ll have pictures taken with a CT scanner and measurements taken by the radiographers. This information will be used to work out the details of your radiotherapy. Treatment planning is a very important part of radiotherapy, and it may take a couple of visits. The doctor who plans and supervises your treatment is known as a clinical oncologist.

Marks may be drawn on your skin to help the radiographer position you accurately and set where the treatment will be delivered. It’s important not to wash or rub them off until the treatment is finished. Sometimes tiny, permanent marks (tattoos) are made on the skin. At the beginning of your radiotherapy, you’ll be given instructions on how to look after your skin in the area to be treated.

Before each session of radiotherapy, the radiographer will position you carefully on the couch, either sitting or lying, and make sure you’re comfortable. During your treatment you will be left alone in the room, but you’ll be able to talk to the radiographer who will be watching you. Radiotherapy is not painful and only takes a few minutes, but you do have to stay still while the treatment is being given.


Stereotactic radiotherapy

Stereotactic radiotherapy (SRT) is also known as stereotactic body radiation therapy (SBRT). It’s a new treatment that uses scans and specialist machinery to precisely target radiotherapy to treat small cancers. SBRT can be used to treat small primary and secondary lung cancers. SRT/SBRT may be an alternative to surgery for people who can’t have surgery, or where the tumour is in a difficult area to operate on. It’s only suitable for some people. SRT is usually given over a shorter period of time than standard external radiotherapy.

Currently, this treatment is not widely available in the UK and you may be referred to a specialist hospital if your doctor thinks it is a suitable treatment for you.


How internal radiotherapy is given

This type of radiotherapy may be given when the tumour is blocking one of the airways and has made the lung collapse. It’s a simple way of opening up the airway. If you have this type of radiotherapy, you’ll usually have only one session of treatment.

A thin tube (catheter) will be temporarily put inside your lung using a bronchoscope. A small piece of solid radioactive material (the source) will then be placed inside this tube, next to the tumour.

The radiotherapy is delivered directly to the tumour and healthy tissue will only be slightly affected. The source is left in place for a few minutes to give the treatment. The source and catheter are then removed. The treatment can be repeated two or three times, depending on the dose of radiotherapy you need.


Back to Radiotherapy explained

Possible long-term effects

Side effects of radiotherapy for lung cancer can happen many months or years after treatment. These are known as long-term effects.

Planning your treatment

Radiographers will work with you to plan your radiotherapy treatment.

Where will you have radiotherapy?

Radiotherapy treatment is given in a hospital’s radiotherapy department

Who might I meet?

You will meet many different specialists before, during and after radiotherapy treatment.

Possible side effects