Radiation Therapy for Small Cell Lung Cancer

Doctors at NYU Langone’s Perlmutter Cancer Center may recommend radiation therapy, which uses high energy X-rays or photons to destroy cancer cells, as a treatment option for small cell lung cancer. It is often used in combination with chemotherapy, or shortly after chemotherapy, in people who have early cancers confined to the lungs and area lymph nodes.

The lymph nodes are small immune system glands located throughout the body that trap foreign invaders such as viruses and bacteria. Many cancers tend to spread to lymph nodes first.

VIDEO: Using radiation therapy to treat lung cancer.

Although doctors often prescribe chemotherapy alone to manage advanced small cell lung cancer, they sometimes recommend radiation therapy afterward to help shrink tumors. This can help relieve symptoms, such as trouble swallowing or breathing.

Treatment Planning and Guidance

Our radiation oncologists use CT scans of the cancer and surrounding tissue, in conjunction with computer software, to create a customized treatment plan. This software, which creates a three-dimensional image of the tumor and the surrounding organs, helps doctors determine how to best target the lung cancer while sparing healthy tissue. Doctors frequently blend or fuse the results of PET/CT scans with CT scans used for treatment planning to get a better understanding of the tumor’s location.

Doctors may also take frequent CT scans during radiation therapy sessions to ensure that treatment is targeting the cancer and avoiding healthy tissue. This approach, which is called image-guided radiation therapy, helps compensate for the lungs moving during treatment. The technique also enables doctors to track the size and shape of the tumor as radiation therapy shrinks it.

Types of External Beam Radiation Therapy

External beam radiation therapy is delivered using a machine called a linear accelerator. This machine can be moved around you during treatment sessions, helping oncologists target the entire tumor. There are several types of external beam radiation therapy. Each type has different degrees of targeting, and our doctors can talk to you about the best treatment option for you.

Three-Dimensional Conformal Radiation Therapy

Three-dimensional conformal radiation therapy delivers radiation beams tailored to the size, shape, and location of the cancer. Using a linear accelerator, the oncologist aims radiation beams at the cancer from different directions. Treatment is typically done twice a day, five days a week, over the course of three weeks. Breaking the total dose of radiation into smaller doses, called fractions, provides enough therapy to manage the tumor, while reducing the risk of side effects.

Intensity-Modulated Radiation Therapy

Intensity-modulated radiation therapy further spares healthy tissues, reducing the risk of treatment-related complications.

This approach divides each radiation dose into many small, computer-controlled beams of different, adjustable strengths. Together, the beams “sculpt” the area in three dimensions, closely matching the size, shape, and location of the tumor. Doctors can adjust the radiation within millimeters to spare surrounding healthy tissue. Treatment is usually done twice a day, five days a week, for three weeks in doses called fractions.

Prophylactic Cranial Irradiation

Prophylactic cranial irradiation, or whole brain radiation therapy, may be given to help prevent small cell lung cancer from spreading to the brain. Doctors may recommend this additional treatment for people with cancer that responds to radiation therapy and chemotherapy. Three-dimensional conformal radiation therapy or intensity-modulated radiation therapy can be used to destroy cancer cells in the brain that cannot be seen with imaging. The treatments are usually given daily for two weeks.

Managing Side Effects

Cognitive Rehabilitation

After radiation therapy to prevent small cell lung cancer from spreading to the brain, experts at NYU Langone’s Rusk Rehabilitation can provide cognitive rehabilitation. 

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Our doctors are often able to avoid damage to nearby organs, including the heart and esophagus, by using highly targeted radiation therapy. Side effects, including fatigue, nausea, and vomiting, can be managed with medication or through Perlmutter Cancer Center’s integrative health services.

Doctors at NYU Langone’s Rusk Rehabilitation can provide evaluations and prescribe cognitive rehabilitation to address any problems with thinking or information processing, which can occur as a result of radiation to the brain.