NCCN Guidelines for Patients® | Lung Cancer - Non-Small Cell Lung Cancer
44 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 A board-certified radiation oncologist who treats lung cancer often should oversee treatment. A radiation oncologist is a doctor who’s an expert in treating cancer with radiation. He or she will design the treatment to meet your needs. External radiation For lung cancer, the most common radiation method is EBRT ( e xternal b eam r adiation t herapy). A large machine makes high-energy x-rays used for treatment. This machine is called a LINAC (linear accelerator). See Figure 15 . The radiation beams will move through your body very quickly. There is no ongoing radiation inside of you after the treatment session. You will not have to avoid people. It takes a team of people to perform the radiation therapy. The radiation team consists of doctors, medical physicists, dosimetrists, nurses, and radiation therapists. Your team will work together to design your treatment plan and provide treatment. Planning session A planning session is needed to map out your treatment. The planning process is called simulation. It involves getting an imaging scan. During the scan, your body will be in the position that is needed for treatment. The scan is only used for treatment planning. At minimum, a CT scan should be used for simulation. 4D-CT ( four - d imensional c omputed t omography) is ideal to account for tumor movement from breathing. Contrast may be used to improve scans of certain tumors. These tumors are in the inner two-thirds of the lung or are in lymph nodes. A PET/CT scan can be useful. It can help to aim radiation beams when the lung has collapsed or contrast can’t be used. PET/CT scans within 4 weeks of treatment are advised. You will not have to do much to prepare. Think about wearing easy-to-remove clothes since you’ll wear a hospital gown. The planning session takes about 1 hour. During simulation, you will lie face up on a table. Your arms will be raised above your head. A body mold may be made. Colored laser lights will be used to help position you. If your breathing causes large movements, motion control methods may be used. Next, the scan will be done. The medical physicist or dosimetrist may take more measurements for treatment planning. 5 Overview of cancer treatments Radiation therapy Figure 15 External radiation Radiation therapy is often delivered from a large machine. The x-rays pass through skin and travel to the tumor. Healthy tissue is protected using modern types of treatment.