Our radiation oncologists pioneered the use of intensity-modulated radiation therapy (IMRT) to treat lung cancer. Following a CT scan that maps the tumor in 3-D, IMRT uses sophisticated computer programs to calculate and deliver variable doses of radiation directly to the tumor from different angles. This technology targets the tumor while sparing the healthy tissue that surrounds it, enhancing your radiation oncologist’s ability to administer a lethal dose of radiation to a lung tumor and increasing your chance for cure.

Some people with lung cancer may be treated with a specialized form of IMRT called image-guided radiation therapy (IGRT). IGRT involves the use of sophisticated imaging tests to verify the position of the patient and the location of the tumor prior to and during the delivery of the treatment. Imaging tests play a crucial role in helping doctors to accurately plan and effectively deliver radiation therapy.

Because the traditional method of using a CT scan to target the tumor can sometimes damage normal tissue containing no cancer cells, we have incorporated PET imaging into the treatment planning process. PET technology allows our doctors to more precisely — and safely — target the tissue containing cancer cells and avoid harming healthy tissue.

IGRT requires no anesthesia and side effects are less likely than with traditional methods.

We treat approximately 400 patients with non-small cell lung cancer each year using IGRT to the chest as well for lung cancer that has spread to other areas of the body.

Many people with non-small cell lung cancer whose tumors are small and confined to the lung can benefit from a treatment called MSK Precise^TM. It is also known as hypofractionated radiation therapy. The dose of radiation that is given with each treatment is larger than in standard radiation therapy, but it is given in fewer treatments over a shorter period of time.

MSK Precise uses innovative imaging combined with a sophisticated computer system to deliver high doses of radiation to lung tumors. It is accurate within a few millimeters. MSK Precise even takes into account how a tumor moves when people breathe. This treatment can be effective for people who are not able to have surgery or when used in combination with chemotherapy, targeted therapies, or immunotherapy. For safety while using the higher radiation doses, our radiation oncologists do 3-D modeling of the tumor. This provides the tumor’s location at all times to ensure that the radiation is precisely targeted.

For some cases of lung cancer, our radiation oncologists can use proton therapy, an advanced form of radiation therapy, to deliver high doses of radiation to tumors that may be resistant to conventional forms while minimizing exposure to the surrounding healthy tissues. Proton therapy directs its cancer-fighting energy to precise locations within the body, allowing our doctors to deliver the necessary dose to the tumor — maximizing the chance of destroying it — while simultaneously lowering the dose to normal tissues and thereby reducing the risk of treatment-related side effects.

Currently, this cutting-edge technology is available at only 14 locations in the United States.  

Some people with lung cancer may be candidates for intraoperative radiation therapy, a brachytherapy procedure in which we deliver radiation therapy during surgery in order to help decrease the risk of cancer returning after treatment (recurring). We are also able to deliver high doses of radiation to the airways using a specialized approach called endobronchial brachytherapy. This localized form of radiation therapy may be useful in selected patients whose cancer has returned in the larger airways.

While radiation therapy is generally not used to treat cancer that has metastasized (spread) to the second lung or to other parts of the body, many patients receive radiation to treat symptoms that are caused by metastases. The goal of these treatments is to improve the quality of life for patients who are not candidates for surgery or radiation therapy.

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For some patients, the best strategy may be to enroll in a clinical trial that evaluates new radiation techniques or combinations of surgery, chemotherapy, and radiation therapy.

Many of our clinical trials aim to further improve the precision of our imaging and radiation delivery techniques. Our goal is to minimize damage to surrounding normal tissues and maximize the effectiveness of the radiation treatment to the tumor.

We are also studying several targeted drugs in combination with radiation therapy to understand how radiation therapy and the immune system interact to fight cancer.