Radiation therapy for lung cancer is carried out as an independent method of treatment, in combination with surgery or with anticancer drugs, as well as as part of a complex effect on the tumor, including surgery, radiation and chemotherapy, undertaken in one patient.
The effectiveness of radiation therapy depends on many factors, among which, in addition to the morphological structure of the tumor, which determines its sensitivity to radiation exposure, essential are: optimal determination of the volume of tissues to be irradiated; single and cumulative doses; radiation tolerance and the development of complications.
Depending on the goal, when irradiating patients with lung cancer, as in the treatment of tumors of other sites, radical, palliative and symptomatic therapy is distinguished.
Radical radiation therapy is carried out to cure a patient, and palliative treatment is aimed at prolonging life and improving its quality due to a decrease in tumor volume. Symptomatic radiation therapy is used to relieve such severe manifestations of the disease caused by the growth of the tumor and its metastases, such as pain, compression of the adjacent organs and anatomical structures, and others.
In cases of obtaining a pronounced clinical and objective, confirmed by X-ray examination, the effect of radiation, which was originally undertaken with a palliative purpose, the treatment can be continued, increasing the total dose to those used in radical radiation therapy.
Differences in the sensitivity of different morphological types of lung cancer to conservative treatment determine the characteristics of radiotherapy in patients with high and poorly differentiated, especially small cell tumors.
Radiotherapy in patients with advanced stages of development
non-small cell lung cancer is carried out as a component of the combined treatment in combination with surgery or as a separate type of treatment and in combination with chemotherapy.
When combined with surgical treatment, radiation therapy is carried out before or after surgery, often using both options. The goal of preoperative radiotherapy is to cause radiation damage to the tumor while maximizing the adjacent healthy tissue. It should be noted that despite the use of radiosensitizers and radioprotectors, as well as the selection of non-traditional, individual fractionation modes in order to optimize the spatial-temporal distribution of the dose, an adverse reaction in healthy tissues may occur during irradiation of the lung root and mediastinum. This has an impact on the healing process after surgery, causing severe complications, especially in the bronchial stump.The risk of an increase in the frequency and severity of postoperative complications associated with this limits the use of high doses during preoperative irradiation and reduces its effectiveness.