NCCN Guidelines for Patients® | Lung Cancer - Non-Small Cell Lung Cancer

45 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 The images will be transferred to a treatment planning computer. Your lung and other organs will be seen on the scan. This information will show your radiation oncologist where to direct the radiation. After the treatment sites are set, your skin will be marked for treatment sessions. Your skin will be marked with a felt pen. Sometimes, set-up marks are made with tiny permanent tattoos. Photos of your set up will be taken. The marks and photos will be used to position you for daily treatments. After simulation, your radiation team will further plan your treatment. Plans will be made by viewing your scans on the treatment planning computer. Your radiation oncologist will work closely with a dosimetrist. They will plan the best dose, number and shape of radiation beams, and number of treatments. Your plan will be designed to treat the cancer while sparing normal tissue. Set-up session Once your treatment plan is made, a set-up session will be needed. This session is sometimes called “port film” day or dress rehearsal. The set-up session occurs in the treatment room. The radiation therapists will help place you in position on the treatment table. The set-up marks will be used for positioning. X-rays of the treatment fields will be taken and viewed by your doctor. These x-rays (or port films) are not for treatment. Your doctor will approve treatment when your set-up is correct. Treatment sessions Before treatment, your hospital gown will be lowered off your chest. You will then be placed into position. If a body mold was made, you will lie on it on top of the treatment table. You must be in the same position that was approved at the set-up session. X-rays of your chest will be taken to assure this. Conformal techniques are used for treating lung cancer. These techniques shape the radiation dose to the cancer site to spare healthy tissue. Which technique you receive depends on multiple factors. These factors include where the cancer is in your body. Another factor is what techniques your cancer center has to offer. The types of conformal radiation include: † † 3D-CRT ( three - d imensional c onformal r adiation t herapy) delivers a photon beam that matches the shape of the target. The machine will move around you to target the tumor. Treatment is completed in about 6 weeks. † † IMRT ( i ntensity- m odulated r adiation t herapy) is a form of 3D-CRT. It further modifies the beam’s intensity during treatment. † † SABR ( s tereotactic ab lative r adiotherapy) treats cancer with very precise, high-dose photon beams. Receiving SABR is much like other conformal techniques except treatment is finished in about 1 to 2 weeks. † † SRS ( s tereotactic r adio s urgery) treats cancer in the brain with precise, high-dose photon beams. This treatment is known by CyberKnife and Gamma Knife. Treatment is completed in 1 to 2 weeks. † † WBRT ( w hole b rain r adiation t herapy) uses small amounts of radiation to treat the entire brain. Treatment is completed in 2 weeks. † † Proton therapy treats cancer with proton beams that deliver radiation mostly within the tumor. Treatment is completed in about 6 weeks. A lung tumor is harder to target than some other tumors in the body. This is because breathing causes the tumor to move. IGRT ( i mage- g uided 5 Overview of cancer treatments Radiation therapy