Radiation Treatments

Radiation is the other primary treatment for early-stage lung cancer. It is also being investigated in advanced lung cancers.

Radical Radiation in Early-Stage Cancer. Radical radiation is used as the sole procedure in stage I and some stage II patients who have adequate lung function but, for medical or other reasons, cannot be treated surgically. In these cases, the five-year survival rate is about 20%, and the cancer is likely to recur. Survival rates may be higher or lower depending on the tumor size. In general, with radiation therapy alone, the larger the tumor, the lower a patient's chance of survival. (A 2002 analysis suggested that the use of radiotherapy after surgery in patients whose tumors had been completely removed might be associated with reduced survival rates.)

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Combined Treatments for Improving Survival in Advanced Cancer. Radiation is also being investigated in various combinations with chemotherapy, surgery, or both. At this time, concurrent radiation treatment plus platinum-based chemotherapy may extend survival times in advanced lung cancer. Other combinations are showing promise.

Palliative Radiation. Palliative radiation is used to shrink cancers and reduce pain and symptoms in stage III patients with poor lung function and those with metastasized cancer. In up to 85% of patients with advanced disease, palliative radiation therapy helps relieve pain, shortness of breath, the superior vena cava syndrome, coughed-up blood, and symptoms caused by brain metastases. Radiation, in these cases, is not generally used with the intention of reducing mortality rates, although it may increase survival in some patients, such as those with excellent lung function and whose tumors are small enough that thoracoscopy is needed to detect them. Of note: delaying radiation therapy until symptoms develop does not appear to reduce survival times or impair quality of life compared to starting it right away in patients with minimal or no symptoms.