Lung cancer Radiotherapy

Procedure

Radiation therapy can also be used if the lung cancer has already spread: in such cases, radiation therapy can prevent or alleviate symptoms caused by metastases, for example, in the brain or bones (palliative radiation therapy).

Radiation therapy is performed as an outpatient treatment, is non-invasive (i.e. does not require anesthesia) and can thus be easily integrated into everyday private and professional life. Depending on the extent of the tumor, radiotherapy can be carried out in one or a few treatment sessions as radiosurgery for small tumor foci, or as fractionated treatment over several weeks for larger tumors. Radiation therapy is often combined with chemotherapy or immunotherapy to improve efficacy. Close and personal support is a matter of course for us.

The Department of Radiation Oncology at the USZ uses only the most advanced techniques to provide precise radiation therapy for lung cancer with minimal side effects. You will be cared for by internationally recognized experts in lung cancer research and treatment.

For many patients, we are already offering the treatment of tomorrow: in clinical trials, we are continuously working on improving the treatment of lung cancer to make it even more effective and tolerable. To the overview of currently open studies.

In the following, we will describe radiation therapy for the various types and stages of lung cancer.

Early-stage non-small cell lung cancer

For early-stage non-small-cell lung cancer (NSCLC), surgical removal of the tumor is the treatment of choice for patients who are in good enough health to undergo the procedure. For older patients, those with poor lung function, or those with underlying conditions—such as heart disease—that make anesthesia risky, a treatment alternative equivalent to surgery is what is known as body stereotactic radiation therapy (SBRT). Highly focused radiation therapy can destroy the lung tumor and achieve a cure in the vast majority of patients.

Stereotactic body radiation therapy (SBRT) destroys the tumor in just a few radiation sessions: typically five outpatient sessions lasting 30 minutes each. This is achieved by highly focused irradiation with an accuracy in the millimeter range.

Stereotactic body radiation therapy (SBRT) is a key clinical and scientific focus at our clinic: Prof. M. Guckenberger and Prof. N. Andratschke played a pivotal role in developing this technique, and we share our expertise through a wide range of international courses and conferences. We are active as international experts in guideline commissions. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety.

In clinical trials, we are continuously trying to improve the treatment of lung cancer in order to make it even more effective and tolerable. To the overview of currently open studies.

Non-small cell lung cancer in the locally advanced stage

In cases of locally advanced non-small cell lung cancer (NSCLC), when the tumor has already spread to the lymph nodes, surgical removal or radiation therapy is required. In addition, chemotherapy is necessary in each case to eliminate any cancer cells that may have spread. Depending on the extent of the tumor, surgery, radiation therapy, and chemotherapy may also be necessary (trimodal therapy).

One important innovation is immunotherapy, which is used following radiation therapy and has significantly improved survival rates for patients with lung cancer. Because the tumor is often extensive, radiation therapy is divided into many small “doses”: treatment is administered in fractions over approximately 30 weekday sessions spread out over a period of about 6 weeks. Spreading the radiation treatment over several weeks makes the treatment more tolerable; it is primarily performed on an outpatient basis and can be integrated into patients’ personal and professional lives.

Radiation therapy for lung cancer is a clinical and scientific focus of our clinic and of Prof. M. Guckenberger and Prof. N. Andratschke. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in surgery and medical oncology to ensure a seamless treatment plan.

In clinical trials, we are continuously trying to improve the treatment of lung cancer in order to make it even more effective and tolerable. To the overview of currently open studies.

Oligometastatic non-small cell lung cancer

In the past, when non-small-cell lung cancer (NSCLC) had spread—that is, metastasized—it was believed that a cure was no longer possible; consequently, patients were treated “only” with chemotherapy. Today we know that this needs to be viewed in a more nuanced way: if the lung cancer has formed only a few metastases (a maximum of 3–5), then we supplement chemotherapy (or immunotherapy and targeted therapy) with radiation therapy (or surgery) to treat all cancer sites: The goal is not only to shrink the cancer but to eliminate it completely. In a relevant proportion of patients, a cure or at least long-term tumor control can be achieved.

Stereotactic body radiation therapy (SBRT), a highly focused radiation treatment administered in just a few outpatient sessions, is the most thoroughly studied local treatment method for this situation of oligometastasis. Body stereotactic radiation can combat metastases in almost all regions of the body highly effectively and with few side effects: metastases in lymph nodes, the lungs, the liver, the adrenal glands, in the brain and in bones. Tumor foci in distant regions can be treated in a single treatment session; unlike surgery, two separate procedures are not required. It is also important to find the optimal combination of local radiation therapy and systemic therapy.

For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.

Oligometastatic lung cancer is a clinical and scientific focus of our clinic and of Prof. M. Guckenberger and Prof. N. Andratschke. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in Medical Oncology and Surgery to ensure a seamless treatment experience.

In clinical trials, we are continuously trying to improve the treatment of lung cancer in order to make it even more effective and tolerable. To the overview of currently open studies.

Metastases of non-small cell lung cancer, e.g. in the brain or bones

Lung cancer is an aggressive form of cancer that often forms secondary tumors as the disease progresses; this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones, liver or brain. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.

For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.

Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery. Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions. Metastatic lung cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions.

State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in Medical Oncology to ensure a seamless treatment experience. We also consult with our colleagues in palliative medicine at an early stage.

In clinical trials, we are continuously trying to improve the treatment of lung cancer in order to make it even more effective and tolerable. To the overview of currently open studies.

Small cell lung carcinoma

Small-cell lung cancer is an aggressive form of cancer, but it responds very well to chemotherapy and radiation therapy.

In the early stages, referred to as “limited disease,” we treat our patients in collaboration with our colleagues in Medical Oncology. After the first round of chemotherapy, radiation therapy and concurrent chemotherapy are administered. The goal is to destroy the entire tumor. Following treatment for the lung tumor, the brain is treated with low-dose radiation. This is necessary because, in small-cell lung cancer, individual cells very often metastasize to the brain: Radiation therapy kills these few cells before they can continue to grow and cause symptoms.

In advanced stages involving metastases—referred to as “extensive disease”—chemotherapy combined with immunotherapy is the first line of treatment. If the tumor responds well to this treatment, it is followed by a short course of radiation therapy lasting two to three weeks to treat the tumor in the lung even more effectively.

Metastatic lung cancer is a clinical and scientific focus of our clinic and of Prof. M. Guckenberger and Prof. N. Andratschke. State-of-the-art equipment and experienced medical physicists and medical technologists contribute to treatment of the highest quality and safety. At the same time, we work closely with our colleagues in medical oncology to guarantee “one-stop” treatment. We also consult with our colleagues in palliative medicine at an early stage.

In clinical trials, we are continuously trying to improve the treatment of lung cancer in order to make it even more effective and tolerable. To the overview of currently open studies.